John McDermott comments on how much more comfortable his apartment bed is than sleeping on the streets. McDermott got his apartment through a “housing first” program. (Michael S. Williamson/The Washington Post)

A District program that proponents say was on track to end chronic homelessness by 2015 among those with mental and physical disabilities in the city has stagnated since Mayor Vincent C. Gray (D) took office two years ago, advocates for the homeless say.

The permanent supportive housing program, known as “housing first,” has been implemented by cities across the country since the 1990s, and by the District since 2008, to help the segment of the homeless population that the public is perhaps most apt to encounter on the streets. It seeks to house the chronically homeless — defined as those with mental or physical disabilities who are homeless for at least a year or four times within three years — before providing them services such as substance abuse or psychiatric treatment or employment help.

The housing first approach has been nearly twice as successful at keeping the chronically homeless in housing than models that require that they first comply with treatment or other conditions, said Kurt Runge, who is director of advocacy at the homeless services organization Miriam’s Kitchen and on the city’s Interagency Council on Homelessness.

“In the past you had to be six months sober, you had to have an income, you had to have this, you had to have that,” Runge said. “The theory is, put people in housing and then you’ll be able to address these things.”

But the mayor’s office says that while the city has been pouring more money than ever into ending chronic homelessness, it cannot make up for federal funding that has dried up in the past two years.

“It’s a dual whammy — the federal one-time money runs out and we’re hit by sequestration,” said Pedro Ribiero, a spokesman for the mayor’s office. “The federal government is not handing out money anymore. . . . The advocates should consider themselves lucky that the District has continued to put local money into it.”

In the program’s first three years in the District, more than 1,200 new housing units were added, with the number peaking in 2010 at 583. But since then, the number of new units has dropped off sharply, to 210 in 2011 and 121 last year.

The District contributed $18 million to the program this year, and expects to contribute $21million in 2014, up from $12 million in 2009, Ribiero said. There is still some federal funding coming in, but the one-time federal grants that boosted the program in its first years were part of the Recovery Act, he said, adding that it is not possible to expect the same level of growth now that the federal government is in dire financial straits.

But some advocates say the city’s failure to make up the shortfall indicates a lack of commitment to the chronically homeless.

“Under the [Adrian] Fenty administration, we were really leading the country on how we were going to end homelessness, and what you are hearing is that fire has begun to ebb,” said Christy Respress, executive director of Pathways to Housing DC, which helps provide housing for homeless people with serious mental illness, substance abuse and other problems.

The chronically homeless are particularly costly to society, because they account for a disproportionate number of emergency room visits, inpatient hospitalizations and other expensive services, according to the U.S. Interagency Council on Homelessness. The council estimates the mortality rate for chronically homeless people to be four to nine times higher than for the general population.

Of the estimated 10,000 homeless people in the District in a given year, around 1,700 are chronically homeless. The city has said it aims to provide at least 2,500 units of permanent supportive housing by 2015 to meet projected need.

Funding for permanent supportive housing is just part of the city’s budget for housing the homeless; other programs, which are less costly to implement, include a local rent supplement program that does not include other social services and Rapid Rehousing, which provides housing for up to two years.

“The ratio has changed in the last couple of years,” said D.C. Council Budget Director Jennifer Budoff. “The people who have come to the council and come to me have expressed more of a need for the local rent supplement.” But she added, “That’s not to say that the permanent supportive housing isn’t still needed.”

David Berns, director of the D.C. Department of Human Services, said the city’s strategic plan for eliminating chronic homelessness requires a multilateral approach. “For the chronically homeless individual who has been on the street for years, almost always the permanent supportive housing program is the most effective.” But, he said, in recent years the city has seen a massive influx of homeless families who may be better served by other models.

Exacerbating the problem is the fact that the number of affordable housing units in the city has fallen from 70,000 to 35,000 as housing values have risen in the past decade, Berns said.

In John McDermott’s one-
bedroom apartment in Northeast, all of his medications, syringes and breathing aids are neatly organized. That was not the case during the year and a half that McDermott, 62, was sleeping in a covered spot near the front entrance of the International Monetary Fund. There, he wasn’t able to treat his diabetes, cirrhosis, asthma and other disabilities.

“If you’re walking around on the streets with needles and stuff you’ll be a victim for drug addicts and stuff who know you take it,” said McDermott, who said he worked as a White House cook but became homeless in 2007 after being unable to find work. “And some of my medications have to be refrigerated.”

Without the apartment he got through Housing First four years ago, “I’d be in a coffin in the ground six feet under,” said McDermott, who now advocates for the homeless.

Showing visitors his bedroom, he said, “I had my own bedroom when I was on the streets, but it wasn’t as soft as this one.” On his living room wall hangs a print of a homeless man sitting on a sidewalk, wrapped in a blanket. “It reminds me of where I was and where I could be,” he said.

Clifton Wilson’s eyes shine when he talks about his new efficiency apartment in Edgewood. He moved in last month, after 26 years of sleeping in prison, in shelters or on the streets.

“It’s a little weird, but I’m getting used to it,” said Wilson, 55, a former Arlington County Public Works employee who takes medications to control his bipolar disorder and other chronic health conditions. “The bed is so comfortable it will spoil you; I don’t want to get out of it sometimes.”