Creator of Housing First tells council fidelity, ACT access drive success

Dr. Sam Sembarras, an architect of Housing First approaches, told the joint Committee on Human Services and Committee on Health that the model succeeds when programs follow an evidence‑based fidelity checklist and match services to individuals’ needs. "It houses people that other organizations or other models cannot successfully house, keeps them housed 80% of the time," he said.

Sembarras emphasized that fidelity requires choice, separation of housing and services, and intentional community integration. He argued that some PSH sites are operating at low fidelity and that administrative barriers (for example, narrow diagnostic thresholds for ACT referrals) limit access to intensive teams that can provide the around‑the‑clock help some residents need. "The fit between the service support and the client is essential to the success to reach that 80% housing stability," he said. The expert urged earlier ACT enrollment during outreach or coordinated entry so a treatment team can build rapport before a resident moves into housing.

Sembarras described single‑site versus scattered‑site tradeoffs: many people prefer scattered‑site community apartments to avoid institutional labeling, but some high‑needs tenants may benefit from more supervised, program‑style settings. He recommended local efforts to ensure landlords feel supported and to avoid oversaturation of high‑needs placements in any single building.