By India Gardener / Broadcast version by Nadia Ramlagan reporting for the Kent State-Ohio News Connection Collaboration.
Rising housing costs are creating significant challenges for Ohioans seeking affordable homes - especially those with the lowest incomes.
According to the National Low Income Housing Coalition (NLIHC), to afford a two-bedroom home in Ohio without spending more than 30% of your income on rent, you will need an annual household income of $39,702.
Ohio's median household income was $67,520 in 2022, according to U.S. Census data. But even in a relatively affordable state, households whose incomes are at or below the poverty guideline-$15,225 for a single person under 65 or $29,678 for a family of four-face significant challenges in finding housing they can afford.
In Ohio, 67% of extremely low-income residents - those making just 30% of the area median income - are spending more than half of their income on rent, according to NLIHC.
"Over 700,000 renters are spending over half their income on rent, and, when you're spending that much of your income on rent, there's very little left over for the other necessities of life - food, transportation, education, healthcare, childcare - all of those things suffer," said Marcus Roth, communications/development director with the Coalition of Homelessness and Housing. This statewide coalition advocates for affordable housing.
The 2021 Ohio Housing Needs Assessment states there was a shortage of over 256,875 affordable rental units for extremely low-income (ELI) households across the state in 2018. This translated to a meager 44 available units for every 100 of these households.
Considering inflation, the median gross rent in Ohio increased by 9% from $733 to $797 per month from 2012 to 2018. The highest earners' incomes have outpaced this rise in rent since 2006, but those in the lowest 20 percent of income earners since 2008 have not. They are at heightened risk for housing cost burdens and instability.
"The main thing we need to do is increase the supply of affordable housing," Roth said. "We have a huge shortage of affordable housing. It's just grown worse and worse over the last 10 to 15 years."
The Ohio Housing Finance Agency's research highlights a significant decline in authorized new housing units - all housing units, not just affordable ones - for construction since 2000. In 2022, only 30,936 housing units were authorized, down from 49,745 in 2000.
"We have not had enough affordable housing for a very, very long time. But one of the novel things about what we're seeing is that that instability is creeping up the economic ladder," said Carlie Boos, executive director of the Affordable Housing Alliance of Central Ohio. "And it's not just minimum wage earners who are feeling the pinch. It's not just retirees who are feeling the pinch, but now it's folks who are working 40 hours a week in a very respectable profession."
Limited housing availability, combined with rising construction costs, has created a shortage of affordable housing options.
According to the Ohio Finance Housing Agency Fiscal Year
"We're in an atypical moment in history where we are just not building enough homes for all of the people who live here," said Boos. "We're getting more and more and more people, especially in Central Ohio, where we're going to grow by another million people in the coming years."
Boos discussed the housing crisis in Ohio and how it requires a multifaceted approach that includes increasing the supply of affordable housing, providing financial assistance to low-income renters, and regulating the rental market.
"There's a lot of different tools that we can start making work for us. One of the things that I think Central Ohio has really been aggressive on... well, it's housing bonds," Boos said. Housing bonds are issued by governments at the state and local levels to help raise money for new affordable housing projects.
"Last November, the city of Columbus put a ballot measure up for a vote that passed super-majority-style," Boos said. "With $200 million and new resources to support affordable housing and start to bring those rents and those home ownership costs down... We had a $50 million pilot before that was overwhelmingly successful. So we know that this is going to have a huge impact."
Exploring financing methods, such as public-private partnerships and social impact bonds, can further tap into private-sector investments for affordable housing development. These include the Low-Income Housing Tax Credit (LIHTC) and the HOME Investment Partnerships Program (HOME).
Roth said the most recent Ohio state budget created a state version of the federal Low-Income Housing Tax Credit program.
"It is about $100 million of additional state resources that will go toward the development and rehabilitation of affordable housing. So that is a great first step," Roth said. "It'll create 4,000 additional units of affordable housing."
This collaboration is produced in association with Media in the Public Interest and funded in part by the George Gund Foundation.
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This spring marks the 50th anniversary of the Vietnam War ending. In North Dakota, veterans from the war, along with others who have served, are in line for extra state support if they have issues with housing stability.
During this legislative session, the state approved $1 million over the next two years, with half of it going to the Post War Trust Fund, which helps veterans cover expenses like dental care. The other half will help fund existing efforts that focus on finding stable housing for military veterans struggling to keep a roof over their head.
Rick Olek, a Vietnam combat veteran from Fargo, was a big voice in getting the funds across the finish line.
"It's very rewarding that we accomplish something here but part of the reward is just making our community and our Legislature aware that it's an ongoing problem," Olek explained.
Nationally, the number of veterans experiencing homelessness declined last year but there was a 7% increase the previous year, marking the first such spike in a while. Support organizations said like many other populations, veterans are feeling the squeeze of rising rents.
Olek said the action is meaningful to those who served in Vietnam, with historians often noting the general lack of public support they received when first returning home.
"Vietnam vets have had to fight and basically really get activated to get these benefits or whatever else that they've been able to get," Olek pointed out.
Another component of the initiative allows veteran charitable groups, such as local VFWs, to donate gaming proceeds for these services. A key partner organization, Community Action Partnership of North Dakota, said the resources will help make veteran homelessness in North Dakota rare, brief and nonrecurring.
Disclosure: The Community Action Partnership of North Dakota contributes to our fund for reporting on Budget Policy and Priorities, Health Issues, Housing/Homelessness, and Hunger/Food/Nutrition. If you would like to help support news in the public interest,
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By Angela Hart for KFF Health News.
Broadcast version by Suzanne Potter for California News Service reporting for the KFF Health News-Public News Service Collaboration
President Donald Trump is vowing a new approach to getting homeless people off the streets by forcibly moving those living outside into large camps while mandating mental health and addiction treatment — an aggressive departure from the nation’s leading homelessness policy, which for decades has prioritized housing as the most effective way to combat the crisis.
“Our once-great cities have become unlivable, unsanitary nightmares,” Trump said in a presidential campaign video. “For those who are severely mentally ill and deeply disturbed, we will bring them to mental institutions, where they belong, with the goal of reintegrating them back into society once they are well enough to manage.”
Now that he’s in office, the assault on “Housing First” has begun.
White House officials haven’t announced a formal policy but are opening the door to a treatment-first agenda, while engineering a major overhaul of the housing and social service programs that form the backbone of the homelessness response system that cities and counties across the nation depend on. Nearly $4 billion was earmarked last year alone. But now, Scott Turner, who heads Trump’s Department of Housing and Urban Development — the agency responsible for administering housing and homelessness funding — has outlined massive funding cuts and called for a review of taxpayer spending.
“Thanks to President Trump’s leadership, we are no longer in a business-as-usual posture and the DOGE task force will play a critical role in helping to identify and eliminate waste, fraud and abuse and ultimately better serve the American people,” Turner said in a statement.
Staffing cuts already proposed would hit the part of the agency overseeing homelessness spending and Housing First initiatives particularly hard. Trump outlined his vision during his campaign, calling for new treatment facilities to be opened on large parcels of government land — “tent cities where the homeless can be relocated and their problems identified.” They could receive treatment and rehabilitation or face arrest. Now in office, he has begun to turn his attention to street homelessness, in March ordering Washington, D.C., to sweep encampments, potentially separating homeless people from their case managers and social service providers, derailing their path to housing.
The administration is discouraging local governments from following the federal policy, telling them it will not enforce homelessness contracts “to the extent that they require the project to use a housing first program model.” And, in a recent order “reducing the scope of the federal bureaucracy,” Trump slashed the U.S. Interagency Council on Homelessness, shrinking the agency responsible for coordinating funding and initiatives between the federal government, states, and local agencies, known as Continuums of Care.
“Make no mistake that Trump’s reckless attacks across the federal government will supercharge the housing and homelessness crisis in communities across the country,” Democratic U.S. Rep. Maxine Waters of Los Angeles said in response to the order.
Support Without Forced Treatment
Housing First was implemented nationally in 2004 under the George W. Bush administration to combat chronic homelessness, defined as having lived on the streets with a disabling condition for a long period of time. It was expanded under President Barack Obama as America’s plan of attack on homelessness and broadened by President Joe Biden, who argued that housing was a basic need, critical to health.
The policy aims to stabilize homeless people in permanent housing and provide them with case management support and social services without forcing treatment, imposing job requirements, or demanding sobriety. Once housed, the theory goes, homeless people escape the chaos of the streets and can then work on finding a job, taking care of chronic health conditions, or getting sober.
“When you’re on the streets, all you’re doing every day is figuring out how to survive,” said Ann Oliva, CEO of the National Alliance to End Homelessness. “Housing is the most important intervention that brings a sense of safety and stability, where you’re not just constantly trying to find food or a safe place to sleep.”
But Trump wants to gut taxpayer-subsidized housing initiatives. He is pushing for a punitive approach that would impose fines and potentially jail time on homeless people. And he wants to mandate sobriety and mental health treatment as the primary homelessness intervention — a stark reversal from Housing First.
The shift has ignited fear and panic among homelessness experts and front-line service providers, who argue that forcing treatment and criminalizing homeless people through fines and jail time simply doesn’t work.
“It’s only going to make things much worse,” said Donald Whitehead Jr., executive director of the National Coalition for the Homeless. “Throwing everybody into treatment programs just isn’t an effective strategy. The real problem is we just don’t have enough affordable housing.”
Trump got close to ending Housing First during his first term when he tapped Robert Marbut to lead the U.S. Interagency Council on Homelessness in 2019. Marbut pushed for mandating treatment and reducing reliance on social services, while curtailing taxpayer-subsidized housing. He argued that forcing homeless people to get sober and enter treatment would help them achieve self-sufficiency and end their homelessness. But covid-19 stalled those plans.
Now, Marbut said, he believes the president will finish the job.
“Trump knows that what we need to do is get funding back to treatment and recovery,” Marbut said. “The Trump administration is laser-focused on ending Housing First. They realized it was wrong the first time and that’s why I was selected to change it. They still realize it’s wrong.”
Trump and administration officials did not respond to questions from KFF Health News. A request to interview Turner was not granted. Project 2025’s “Mandate for Leadership,” a conservative policy blueprint from some of Trump’s closest advisers, explicitly calls for an end to Housing First.
Under Attack
Housing First is under attack not only from Republicans who have long criticized taxpayer-subsidized housing for homeless people, but also from Democrats responding to public frustration over homeless encampments multiplying around the nation. Last year, the federal government estimated that more than 770,000 people in the U.S. were homeless, a record high. That was up 18% from 2023. And while housing grows increasingly unaffordable, homeless camps have exploded, spilling into city parks, crowding sidewalks, and polluting sensitive waterways, despite unprecedented public spending.
Already, cities and states, liberal and conservative, are cracking down on street homelessness and targeting the mental health and addiction crisis. This is true even in deep-blue states like California, where Gov. Gavin Newsom has created a “CARE Court” initiative that can mandate treatment even though housing isn’t always available and threatened to withhold funding from cities and counties that don’t aggressively clear encampments.
San Francisco Mayor Daniel Lurie has proposed ending harm reduction for drug users. Los Angeles Mayor Karen Bass is prioritizing encampment sweeps even though the promise of housing or shelter is elusive. And San Jose Mayor Matt Mahan won initial City Council support for plans to arrest people who refuse shelter three times in 18 months and to divert permanent housing funding to pay for an expansion of homeless shelters.
Mahan believes liberals and advocates have been too “purist” because housing isn’t being built fast enough, while investments in shelter and treatment have been inadequate. “It can’t only be about Housing First,” he said.
Homelessness crackdowns have exploded since the U.S. Supreme Court made it easier for elected officials and law enforcement agencies to fine and arrest people for living outside. Since June, roughly 150 laws imposing fines or jail time have been passed, with about 45 in California alone, said Jesse Rabinowitz, campaign and communications director for the National Homelessness Law Center.
Rabinowitz and other experts say both Republicans and Democrats are undermining Housing First by criminalizing homelessness and conducting encampment sweeps that hinder the ability of front-line workers to get people into housing and services.
However, there’s disagreement on whether to entirely dismantle the policy. Liberal leaders want to maintain existing streams of housing and homelessness funding while expanding shelters and moving people off the streets. Conservatives blame Housing First for the rise in homelessness and are instead pushing for mandatory treatment and cutting housing subsidies.
“I used to think it was just a waste of taxpayer money because it wasn’t treatment-based, but now I think it actually enables people to remain homeless and addicted,” Marbut said of the Housing First approach. He favors requiring behavioral health treatment as a prerequisite to housing.
Evidence shows Housing First has been successful in moving vulnerable, chronically homeless people into permanent housing. For instance, a systematic review of 26 studies indicated that, compared with treatment-first, “Housing First programs decreased homelessness by 88%.”And the approach has shown remarkable improvements in health, reducing costly hospital and emergency room care.
Experts say Housing First has been severely underfunded and implemented unevenly, with some homelessness agencies taking federal money but not providing appropriate services or housing placements.
“Making it the broad policy to all homelessness leaves it vulnerable to being attacked the way it’s currently being attacked,” said Philip Mangano, a Republican who spearheaded the development of Housing First as the lead homelessness adviser to George W. Bush. “The truth is it’s a mixed bag. For some people like those who are using substances, the evidence just isn’t there yet.”
Others say it has been ineffective in some places because of rampant misspending, abuse, and a lack of accountability.
“This works when it’s done right,” said Marc Dones, a policy director for homelessness initiatives at the University of California-San Francisco, arguing that housing can save lives and lower spending on costly health care. “But I think we have been too polite and too nice for too long about some real incompetence.”
Jeff Olivet, who succeeded Marbut at the U.S. Interagency Council on Homelessness under Biden, said Marbut and Trump’s positions are misguided. He argues that Housing First has worked for those who have gotten indoors, yet the number of people falling into homelessness outpaces those getting housing. And he says there was never enough money to provide housing and supportive services for everyone in need.
“Housing First is not just about sticking somebody in an apartment and hoping for the best,” Olivet said. “It’s really about providing stable housing and access to health care, mental health and substance use treatment, and to support people, but not forcing it on people.”
Angela Hart wrote this story for KFF Health News.
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