Opinion: Permanent supportive housing works. Let’s not undo it.

Permanent Supportive Housing, or PSH, is not a theory. It is not a pilot. It is one of the most evidence-backed strategies we have to end chronic homelessness. And in New York state, it is a bedrock of our housing and human services infrastructure.

PSH combines long-term rental assistance with flexible, person-centered supportive services for individuals living with serious mental illness, substance use disorders, chronic health conditions, and histories of trauma. Rent is typically capped at 30% of income, and services are voluntary but accessible. Most importantly, housing is permanent and not time limited.

At a time when housing instability is rising across New York, weakening this model would be a costly mistake. At a time when the state is working to strengthen behavioral health systems, expand Health-Related Social Needs services, and integrate care across sectors, destabilizing PSH would undermine those very goals.

This issue is especially urgent as the Trump administration signals a shift away from Permanent Supportive Housing, proposing funding and policy shifts that might reduce its role in the homelessness response system. With the next Continuum of Care notice of funding opportunity expected in June 2026, New York confronts a critical inflection point that will shape whether we protect or destabilize the very programs proven to end chronic homelessness.

Chronic homelessness is not simply about lack of access to housing; it has a host of other causes, including poverty, substance use, mental health challenges, domestic violence, and more. Unhoused individuals often cycle through shelters, emergency rooms, inpatient psychiatric care, detox programs, and jails.

These are not solutions; they are symptoms of system failure.

When individuals have stable housing, studies show that they are more likely to engage in behavioral health care, adhere to medication, reduce emergency service utilization and rebuild social and economic well-being. Decades of national research and implementation show that PSH significantly improves housing retention and reduces the risk of returning to homelessness.

Absent stable housing, people rely heavily on high-cost systems: emergency departments, inpatient care, shelters, and incarceration. Studies consistently show that supportive housing can offset these costs by lessening reliance on crisis services.

In a state like New York, where Medicaid, hospital systems, and shelter networks are already under strain, PSH is not just a humane policy. It is a fiscally responsible policy.

New York state faces a severe affordable housing shortage – particularly for extremely low-income individuals. At the same time, homelessness continues to escalate in both urban and suburban communities statewide.

PSH plays a critical role in stabilizing the most opportunity-deprived populations within this system. Thousands of individuals across the state are currently housed through supportive housing programs. These are not theoretical beneficiaries; these are New Yorkers who are already stabilized, already engaged in care and already rebuilding their lives.

Even modest reductions in PSH capacity would increase pressure on already overwhelmed shelter systems, drive higher healthcare utilization and strain local governments. More importantly, it would displace individuals who have achieved stability after years of system involvement.

New York should absolutely continue to evaluate and improve its systems. Accountability, performance measures, and innovation are essential. But reform must be based on evidence, and the evidence is clear: individuals experiencing chronic homelessness achieve the best outcomes in permanent housing models with supportive services.

Short-term or transitional approaches may have value for some populations, but they are not substitutes for PSH for those with the highest needs. We should rely on what works –  integrating PSH with healthcare systems, strengthening service delivery and improving coordination – not replacing it with less effective alternatives.

If we are serious about ending chronic homelessness, not shifting it between systems, PSH must remain at the center of our approach.

It stabilizes lives. It reduces public cost. And New York cannot afford to undo what works.