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

As flames engulfed a nearby canyon, dozens of residents in a sober-living home fled to an unoccupied building about 30 miles south. The evacuees, many of whom were previously homeless, watched helplessly as their home burned on live TV.

When they awoke on air mattresses the next morning, loss set in. Some feared uncertainty. Others were jolted back to lives they thought they’d left behind.

“I had nothing but the clothes on my back. It just brought back all of those feelings of being homeless and a drug addict,” said one resident, Sean Brown. “Kind of like I was back at square one.”

The large two-story Altadena house, known to staff and residents as Art House, was surrounded by fruit trees and rugged mountains. For many, it was a safe space that enabled them to achieve and maintain sobriety, rebuild relationships, and hold down jobs.

Brown, 35, was among nearly 50 people displaced in January after the massive Eaton Fire destroyed one property and damaged another operated by the nonprofit Los Angeles Centers for Alcohol and Drug Abuse. Supported by public dollars, the organization provides housing and behavioral health treatment to people struggling with addiction, many who had been living on the streets. Operators say both properties are uninhabitable and that they are searching for permanent housing for those displaced.

“Our residents are still in temporary lodging. Right now we’re looking for something on an interim basis, but we still need to identify long-term housing for them,” said Juan Navarro, CEO of the nonprofit. “And we need even more beds. We’re seeing even bigger demand for treatment and services after the fires.”

In the weeks since one of the nation’s costliest natural disasters, it’s become evident that the Los Angeles wildfires have not only displaced people who had dug themselves out of homelessness and gotten into housing, but also dealt a blow to the region’s homelessness response. That far-reaching system of care formed by government agencies and local nonprofits has been buoyed by billions of dollars from the city, county, and state in recent years to combat California’s homelessness epidemic.

Now, wildfires are adding pressure to a system already under tremendous strain in getting chronically homeless people indoors. Homeless service operators and street medicine providers have been putting pressure on state and local leaders to allocate more funding to house people on the streets, but they are running up against competing demands for wildfire recovery — and tighter budgets.

“Many of the people we work with have already lost everything and they’re trying to rebuild their lives, and now there’s a whole other group of people doing the same thing and competing for the same resources,” said Jennifer Hark Dietz a licensed clinical social worker and the CEO of PATH, which provides services and housing for homeless people.

In recent years, state and local leaders have leveraged unprecedented investments to open thousands of shelters and temporary and permanent units. That’s helped Los Angeles County and the state notch meaningful gains, even as more than 187,000 people remain homeless in California, including 75,000 people across Los Angeles County.

The 2024 homelessness tally showed a 45% increase in the number of people who in the past year moved off the streets into permanent housing, and the number who moved from tents into temporary housing rose 32%, according to Va Lecia Adams Kellum, CEO of the Los Angeles Homeless Services Authority, which leads the countywide homelessness response system. That’s nearly 30,000 permanent housing placements across Los Angeles County.

And while homelessness rose 18% nationwide from 2023 to 2024, according to the most recent federal estimate, it increased only 3% in California. More strikingly, Los Angeles County reduced overall homelessness, albeit slightly.

The number of people living outside fell 5.1% in Los Angeles County, and in the city of Los Angeles, the number of unsheltered people dropped 10.4%.

That hard-fought progress is now in peril as the wildfires displaced tens of thousands of Los Angeles residents and destroyed more than 16,000 structures. Affordable housing, already in short supply, is being further strained.

Formerly homeless people who have experienced addiction, domestic violence, or mental illness now worry they won’t be prioritized for placements, despite losing their homes and qualifying for state and local homelessness initiatives to get people indoors. Many homeless people who have long waited for housing will be forced to wait even longer, as more displaced people face homelessness and compete for costly housing.

Homeless Again

It’s unclear how many formerly homeless people are homeless again. Street medicine providers and other front-line workers say some are temporarily living in hotels, while others moved in with friends or family members.

There’s evidence that some have fallen back into homelessness.

“We’re already seeing some people have moved into their vehicles because they don’t have the money to pay for even temporary housing,” Adams Kellum said. “Before the fires, we were already seeing very vulnerable people unable to manage their rents, so this competition for housing puts people at even greater risk for homelessness.”

Adams Kellum said coordinating resources and services across a vast region has led to major progress but that more money is needed to help move people from short-term to permanent housing.

For now, residents of the burned-down Art House will be allowed to reside in an empty building in Santa Fe Springs that the nonprofit had planned to redevelop for residential treatment, Navarro said. He said the nonprofit is looking for more stable housing for those displaced but that rehousing them at Art House remains out of reach for now.

Residents grieve the loss of the Art House’s transformative setting, which they call an “empowerment campus.” Brown said that he has embraced that ethos, even as he has been displaced and remains traumatized by the wildfires. He is currently working two jobs and taking classes toward a bachelor’s degree.

Paul Rosales, a 24-year-old in recovery from meth, said Art House was a place of healing. “That’s where I found myself; it’s where I built my recovery. There was a beautiful orange tree, and the mountains were just a short walk away where you could meditate and watch the sunset.

“It was away from Skid Row. I knew I was safe,” Rosales said. “That’s all gone now.”

Residents say they’re grateful they aren’t on the streets, but anxiety grows by the day, especially for queer and transgender people who had formed a community there.

“It’s constant stress of not knowing if I’m going to be in a stable housing situation,” said Alexandria Castaneda, 29, who was addicted to meth but got sober after getting indoors.

Battle for Resources

Sarah Hoppmeyer, chief program officer for Union Station Homeless Services, which provides housing for people on the streets, said she worries about dwindling resources. She and other providers stressed the importance of not overlooking people currently stuck in homelessness, many of whom have been waiting years for housing.

“We don’t want the wildfires to de-prioritize people who were already experiencing homelessness,” she said.

Elected leaders have pledged to preserve the gains Los Angeles County has made in reducing homelessness by allocating existing resources and demanding more. Several voter-approved initiatives in Los Angeles are critical, they say, but so too is lobbying for state support.

“Without continued and expanded support and resources, we risk losing ground” in reducing the number of people living on the streets, said Los Angeles County Supervisor Kathryn Barger, chair of the county board.

Previous massive fires have led to increases in homelessness, including in 2018 in Sonoma County and in 2024 on Maui, whose homelessness rate soared the year after fires.

State Sen. Sasha Renée Pérez, a Democrat whose district includes parts of Los Angeles County that burned in the wildfires, said she will continue pressing for additional homelessness funding as a member of the Senate budget committee. While Gov. Gavin Newsom’s administration says the state has plowed an unprecedented $27 billion into local homelessness response and prevention initiatives, he didn’t include any new money for battling the homelessness crisis in his proposal this year.

“Unfortunately, this year we didn’t see additional money being placed into that fund,” Pérez said. “But we have to keep making these investments.”

Newsom said Monday the state should not continue to “fund failure.” He said he is open to negotiations with cities, counties, and state lawmakers so long as any new homelessness funding comes with greater accountability, meaning that local governments use the money to clear encampments, dismantle tents, and reduce unsheltered homelessness.

Newsom officials stressed that the state budget is tight — it’s narrowly balanced and under greater strain than in previous years, with threats from the Trump administration and the potential loss of critical federal funding for programs such as Medicaid. The governor said he is “hopeful that we can land on an agreement,” but he warned the state could claw back funding if local governments aren’t adequately addressing street homelessness.

“We have been too permissive as it relates to encampments and tents. We need them cleaned up,” Newsom said. “We’re providing unprecedented support. Now we need to see unprecedented results.”

Assembly member John Harabedian, another Los Angeles-area Democrat, said additional homelessness spending is critical for wildfire victims and to continue combating the crisis statewide.

“Those folks who were already homeless, who just got into some sort of housing stability but then lost it again — they’re going to need immediate attention,” he said. “Our system is failing people.”


Angela Hart wrote this story for KFF Health News.


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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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Nebraska is among the states with the sharpest increases in housing prices between 2021 and 2024, according to a new report.

The hike has been accompanied by dramatically higher homeowners' insurance premiums.

Only four states saw home prices spike more dramatically than in Nebraska in the three-year period - three of them in the West. More expensive homes bring higher insurance costs.

The Consumer Federation of America's Director of Housing Sharon Cornelissen said it's often not the cost of the house, but the cost of insuring it that keeps some potential home buyers out of the market.

"Our insurance crisis is increasingly also a housing crisis, right?" said Cornelissen. "These are not separate. We know for example that first-time homebuyers already struggle to afford a mortgage today, and with spiking insurance costs, many may feel that they can never own a home."

The housing price hike and increase in insurance costs come despite Nebraska having among the lowest costs of living in the nation.

The CFA report shows Nebraskans have seen a 35% increase in homeowners' insurance prices in the three-year period.

While many people are trying to qualify for a mortgage, the Federation's Director of Insurance Doug Heller said insurance companies are making it increasingly difficult for buyers by hiking premiums - and denying coverage based on "perceived risk."

"The crisis is also a reflection of some brazen bullying we have seen from insurance companies around the country," said Heller, "as they put customers that have paid premiums for decades on the chopping block, and turn their back on communities that have relied on them for generations."

The report says insurance companies claim they're still trying to recover from $11 billion in losses caused by damaging derecho winds that leveled parts of Nebraska and other Midwest states in 2020.




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It is estimated more than 2,600 people live on the streets across Arkansas.

Since taking office, President Donald Trump has proposed a "treatment first" plan, which includes moving unhoused people into camps.

Neil Sealy, senior organizer for Arkansas Community Organizations, said the proposal does not address the root cause of homelessness.

"There are a lot of homeless people who have addiction problems and they need help, but they also need to have a safe place to live," Sealy pointed out. "Putting them in an internment camp is outrageous and it's punitive and it needs to be stopped."

Sealy noted Arkansas has been in a housing crisis since the 1980s and additional cuts to the Department of Housing and Urban Development will make things worse. The number of unhoused people increased 6% between 2022 and 2023.

The president has not made a formal announcement about his homelessness plans but cuts have been made to programs supporting efforts to help unsheltered people across the country. During his campaign, Trump said unhoused people would be moved into tent cities and required to undergo mental health or drug treatment. Sealy emphasized not everyone who lives on the streets needs such services.

"That is not the only cause of homelessness," Sealy underscored. "There are all kinds of situations in life that -- when your money is gone -- and when you're now going to cut subsidized housing and you're not going to build more housing, but if they find you on the streets you're going to stay in a tent."

The president said the administration will work with people who are down on their luck to reintegrate them into a normal life. He added those refusing treatment would be jailed.

Sealy contended with fewer federal dollars, the Arkansas economy will worsen and lawmakers need to hear from their constituents.

"Call their House of Representatives, their Congressman or woman, or their Senator and keep calling," Sealy urged. "Then seek out organizations like ours who are building a resistance. We just have to push back hard."


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