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Sorry for the late reply, sleep and all. Just woke up so I may ramble a bit.

tl;dr: Housing first is hard because not everyone is ready or wants housing and it's more people than everyone thinks. Also, having a roof over head doesn't always help if supportive services aren't available. So you're right about the access to services.

To clarify, housing first does work in L.A. Just not to the extent that could be considered successful overall. Successful housing first depends a lot on the client. Those motivated to improve their situation tend to do well. Other successful clients are usually able to obtain some kind of steady income, such as disability or retirement. Almost all have some kind of support system outside of our services. We've housed tons of those clients, especially during and just after the pandemic.

Also, the one area where I do highly push for housing first and more housing units is with unhoused families. Those families cannot be split up, shouldn't be split up, and rightfully refuse to be split up. Unfortunately, the vast majority of new homeless housing projects are geared towards single individuals, and families will not work in those units. There are some new developments geared toward families but unfortunately there are too many unhoused families for them to make a big difference.

To the difficulties with housing first. The bulk of the remaining unhoused populations are those that are considered difficult and/or impossible to house independently. It's a larger number than people realize. The reasons vary, but the main ones are severe mental health issues and/or substance use issues.

Severe mental health issues prevent a lot of our clients from performing basic life skills so they need more supervision and assistance than is available. There is a severe lack of mental/physical health treatment options to assist these persons. Obviously we can't force people to get help, so we have to try and deal with them in whatever state they happen to be in. But they can't be permanently housed until they have some kind of stability or permanent support.

One common problem is a mental health issue mixed with violence and anger management issues.There are many who tear apart units like twisters in the Midwest due to whatever ails them. Theres been violent threats, physical violence, and other similar activities. There are some that have no desire to care for anything so once they're housed, the unit becomes a biohazard. I'm not joking. We use a biohazard cleaning company quite often. These clients tend to keep being shuffled around until they can find assistance to help with stability. Unfortunately, being shuffled around doesn't help with stability, so it's hard to get stuff done and they destroy units along the way. Due to anger, violence, and/or destruction, these clients tend to burn bridges we've built with landlords. So that keeps others from using those units. We also spend a lot more money than necessary in damage mitigation than we can really afford.

To move on to the substance use issues, many of that population refuse housing assistance for a variety of reasons related to drug use. These clients we literally can't house. Again, we are unable to force people in to housing or treatment. Unfortunately, the numbers of that population keep growing and growing thanks to excessive drug use of all kinds. We assist them, but not with housing until they ask.

There's a growing population that won't be rented to due to past evictions, credit history, criminal history (including sex offenders), etc. Until laws change, those clients won't be housed in their own unit.

There is another growing population that refuses to be housed for whatever reason. They range from what some would call lazy (there's usually deeper issues to a person than "they're just lazy") to people with deeply held beliefs against participating in modern society, such as "sovcits". We still assist them, just not with housing until they ask.

There are others that have their own reasons, but in the end, most fall into the mental health and/or substance use issues.

(I kind of cut a few things short due to length. Feel free to ask for clarification.)

Also. landlords will only take so much from our clients. If one of our clients causes so many problems that we have to relocate them to avoid eviction, it tends to burn connections to those units.

Not all landlords we work with are scum, but those that are scum are super scummy. Almost every housing program has caps on rental assistance per month and every housing voucher we can connect a client to also has a cap. Landlords that do not want our clients will price units just above the caps so they're inaccessible. Yes, a small part of the reason there are high rents in L.A. is to keep extremely low income/low income individuals out of units. (Example: generally, housing vouchers pay up to $2400/mo for a single individuals. Landlords are aware of this and will market their units at $2500. The housing authority typically will not pay over the cap, so those units are inaccessible. We have watched this happen over and over again over the last 4 years since vouchers became widespread.) Landlords that suck, really really suck.

For some transparency: We pay security deposit up to 2months rent, monthly rent (depending on the client's situation) and up to $1500 as a landlord incentive. The landlord also has access to 24 hour assistance, a direct line to case managers and supervisors, damage mitigation funds, and a few other "perks". We still have a really hard time finding landlords that will work with us. This is usually due to the general stigma against unhoused populations.

There's more I can say about housing first, but this is a long rambling comment already sorry.