Housing & policy

Housing First in Honolulu: what it is and what a decade of evaluations found

Housing & policy · Published 2026-10-23

Housing First is a simple idea that runs against intuition: give people who have been homeless for a long time a place of their own first, without requiring them to get sober, complete treatment or "earn" housing in a shelter, and then offer the support they need to stay. Honolulu adopted the approach in late 2014. More than a decade of local evaluations make it one of the better-documented homelessness programs in the islands.

The principles

Housing First programs share a few core features:

• No housing readiness test. Sobriety, treatment compliance or a period in shelter are not conditions of getting housing.
• Voluntary services. Case management, health care and addiction or mental health treatment are offered, often intensively, but accepting them is not a condition of keeping the home.
• Normal tenancy. Participants hold a lease or occupancy agreement with ordinary rights and obligations, usually with rent capped at a share of their income.
• Priority for the most vulnerable. Programs typically serve people experiencing chronic homelessness, often with serious health conditions.

Hawaiʻi has written the approach into state law. Section 346-378 of the Hawaiʻi Revised Statutes establishes a State Housing First program within the Department of Human Services, alongside the City's own programs.

Honolulu's program

The City and County of Honolulu's first Housing First increment was run by the Institute for Human Services (IHS), a Honolulu shelter and service provider, under contract with the City, and began housing participants in December 2014. Later phases followed, with different providers and funding sources. The most recent evaluated phase, known as Housing First IV, is funded through the State's ʻOhana Zones program and listed in the State's January 2026 report as providing 60 individual or family units and vouchers.

What the evaluations found

Year one (December 2014 to December 2015)

Researchers in the University of Hawaiʻi at Mānoa Department of Psychology, led by Jack Barile, evaluated the first year under contract with the City. They reported a housing retention rate of 97%, a 23% fall in physically unhealthy days and a 25% fall in mentally unhealthy days, and gains in energy, social support and community participation. A photovoice project gave 20 participants cameras to document their lives in housing.

Year two

The second-year evaluation, published in 2017, found an overall retention rate of 89%. After two years the program had served 214 people in 135 households, including 48 children; all households had been chronically homeless before placement, and most clients were single men with an average age of 45 at intake. Eighteen participants were no longer stably housed, five of them because they were incarcerated.

The same report described large changes in other outcomes: participants were 64% less likely to visit an emergency room and 74% less likely to be admitted to hospital, and 61% less likely to be arrested after two years. After one year, 92% reported never or rarely using drugs and 80% the same for alcohol.

Housing First IV (2020 to 2022)

A city-commissioned evaluation of Housing First IV reported a retention rate of 97%, which the report set against a national average of about 85%.

Reading the results carefully

These are strong numbers, and they are consistent with national research on Housing First. They also come with limits worth stating:

• Retention is not the same as recovery. Staying housed is the primary goal, and on that the program performs well. Changes in health and substance use were largely self-reported.
• Before-and-after design. The local evaluations track the same people over time rather than setting them against a randomly assigned group, so some change might have happened anyway.
• Small, selected groups. A few hundred people over several phases is a meaningful sample, but not the whole population of people experiencing chronic homelessness on Oʻahu.
• Retention versus returns. System-wide data measure something different: how many people who leave any program for permanent housing come back within two years. On Oʻahu that figure was 13.8% in the 2024 reporting year; see what happens after shelter.

The constraint: finding units

Housing First depends on a supply of rentals that participants can move into. The State's January 2026 report notes that the City was working on a contract change to allow ʻOhana Zones subsidies to be used in privately owned rentals, rather than only City-owned units, to increase use of the Housing First IV program. That detail sums up the challenge in a tight market: money for rent and services is only useful if there are landlords and units to take it. Hawaiʻi's 2023 law against refusing tenants because of a voucher or permanent supportive housing program, described in our Section 8 guide, was meant partly to help.

The policy debate

Housing First has been the federal government's preferred approach for many years, and much of Hawaiʻi's permanent housing inventory was built around it. That consensus is now contested. In late 2025 HUD signalled that it would move away from prioritizing permanent housing and proposed a 30% cap on permanent housing projects in its Continuum of Care grants, while encouraging transitional housing; the State reported in January 2026 that the change was enjoined pending litigation.

Within Hawaiʻi, the State has added options that sit between the street and Housing First, notably kauhale villages, and the City has expanded outreach and involuntary mental health evaluation under the MH-3 process. Supporters of Housing First argue these complement rather than replace it; critics of the federal shift warn that capping permanent housing would leave people stuck in temporary programs, where Oʻahu stays already average close to a year.

Services make the difference

The "first" in Housing First refers to order, not to housing alone. Programs pair the apartment with case management and access to health care. In Hawaiʻi, part of that support can now be paid for by Medicaid through the Community Integration Services benefit, explained in our guide to Medicaid housing supports.

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