Director of the Health Integration Project
As the House and Senate negotiate a final package to help communities respond to the opioid epidemic, they should adopt a provision in the Senate package that provides new funding for housing assistance for people in recovery from a substance use disorder. The House version provides for recovery housing, but only by diverting needed funds away from low-income households that are using Housing Choice Vouchers.
People with substance use disorders leaving inpatient or residential treatment often need affordable housing assistance to re-enter their communities, particularly those who can’t live with family or friends because their living environments would threaten their sobriety. Also, people with substance use disorders disproportionately face homelessness: about 16 percent of those experiencing homelessness have a substance use disorder, compared to about 7 percent of the general population.
People with substance use disorders often face barriers to accessing housing assistance. Federal law bars people who are evicted for certain drug-related activities from receiving federal housing assistance. Federal policies also let housing agencies deny assistance to people with histories of alcohol or drug misuse or those whom agencies determine are at risk of engaging in illegal drug use. The recovery housing program called for in the Senate’s package wouldn’t have to adhere to these policies.
Housing barriers can inhibit people’s recovery process and lead to worse outcomes. An inability to pay rent and the threat of losing housing can lead to stress that triggers substance misuse and relapse. People experiencing homelessness who also have a substance use disorder typically find it hard to get well without a safe place to live, because they often use alcohol or drugs to cope with the dangers of life on the streets. We can’t substantially reduce the incidence of substance misuse or reverse the opioid epidemic without addressing people’s housing needs.
The Senate housing provision authorizes Congress to appropriate funds within the Community Development Block Grant to let states with drug overdose death rates above the national average provide housing assistance for people in recovery from a substance use disorder. The legislation directs the Department of Housing and Urban Development (HUD) to distribute funds using a formula that prioritizes states with high drug death rates, and to a lesser extent, high unemployment and low work participation. People would get housing assistance for up to two years or until permanent housing assistance is available. States could use these funds to help communities provide a continuum of housing supports so that people can choose the housing option that meets their needs.
Policymakers could improve the proposal by letting HUD and states extend assistance beyond two years, adding an evaluation component to study program effectiveness, and requiring HUD to partner with the Department of Health and Human Services to ensure that states direct funding to high-quality recovery housing programs. Nevertheless, the proposal is a significant improvement over the House provision passed in the THRIVE Act (H.R. 5735), which, in order to fund recovery housing, would take 10,000 Housing Choice Vouchers away from low-income families. Recovery housing is a key service, but it’s counterproductive to divert already scarce rental assistance to pay for it, as 3 in 4 households that are eligible for federal rental assistance don’t receive it due to lack of funding.
Moreover, the voucher program is a bad fit for this purpose. There are statutory and regulatory rules that would be difficult for recovery housing providers to adhere to, such as the rules regarding tenants with substance use disorder histories mentioned above. And the House provision could set harmful precedents, such as time-limiting vouchers, requiring participation in services to receive assistance, and possible restrictions on where people re-entering the community can live.