The Door at the End of the Hallway: What Rhode Island’s Data Says About Ending Homelessness

On the night of January 27, volunteers fanned out across Rhode Island to count people sleeping in shelters, cars, and tents. According to Rhode Island Current’s reporting on data from the Rhode Island Coalition to End Homelessness, the count found 416 unsheltered people and 1,820 in shelters, compared with 618 unsheltered the year before (Weisman, 2026). The overall total, 2,236, is down 6 percent (Weisman, 2026). That looks like progress. But the coalition’s executive director called the count an imperfect measure (Weisman, 2026), and a May 2026 University of Rhode Island report notes that the count leaves out people who are doubled up, staying with family or friends because they have nowhere else to go (University of Rhode Island, 2026).

So we have a number that moved. The harder question is why, and what actually works.

What the best evidence says

Here is the surprise: I could not find a published study that compares every intervention head to head in Rhode Island. The coalition’s own data page notes that requests for homeless management data can take up to four weeks and that most of it is self-reported (Rhode Island Coalition to End Homelessness, n.d.). The strongest comparison comes instead from the federal government, and it studied families rather than single adults. According to the U.S. Department of Housing and Urban Development (HUD), 2,282 families in 12 communities, including Boston and New Haven but not Rhode Island, were randomly assigned to different interventions after spending at least seven days in shelter (HUD, 2016). Random assignment is rare in this field, and it is what makes the findings credible.

The results were not what many expected. According to HUD, priority access to a long-term housing subsidy cut by more than half the share of families who were homeless or doubled up in the prior six months, at both follow-up points (HUD, 2016). Rapid rehousing showed almost no evidence of improving outcomes compared with usual care, though it did so at about 9 percent lower cost, and transitional housing had few advantages (HUD, 2016). The monthly price tags tell a second story. HUD reported average costs per family of $4,819 for emergency shelter, $2,706 for transitional housing, $1,172 for a subsidy, and $880 for rapid rehousing (HUD, 2016). The subsidy cost about 9 percent more than usual care over three years, but the benefits were substantial (HUD, 2016). The option we lean on most when someone is in crisis was the most expensive one measured.

Housing First, and its limits

For single adults, the benchmark is Housing First, which offers housing without requiring sobriety or treatment first. A 2019 systematic review of randomized trials found that participants were about two and a half times as likely to be housed at 18 to 24 months, had roughly 37 percent fewer emergency department visits, and showed no clear difference in substance use (Baxter et al., 2019). The review included only four trials, all rated at high risk of bias (Baxter et al., 2019).

Critics deserve a fair hearing. The same review found imprecise and inconsistent effects on most short-term health outcomes and noted that long-term effects need further study (Baxter et al., 2019). A 2026 Health Affairs policy brief reaches a similar verdict: a strong evidence base for housing stability, but mixed findings on health outcomes and costs (Health Affairs, 2026). HUD’s 2023 review of the evidence is more optimistic, concluding that Housing First promotes housing stability, improves some health outcomes, and may reduce the use of high-cost services (HUD, 2023). The model reliably does one thing very well: it keeps people housed. The evidence does not show that it is a cure for addiction or mental illness.

Rhode Island’s own evidence

Our local evidence is older and smaller. According to a profile by the U.S. Interagency Council on Homelessness (USICH), an evaluation of Housing First Rhode Island by Eric Hirsch and Irene Glasser found that participants had been homeless an average of 335 days a year before entering the program, and 80 percent were still housed after 12 months (USICH, n.d.). Public service use per person fell from $31,617 in the year before entry to $8,364 in the year after, leaving a net offset of $8,110 per person after housing and service costs (USICH, n.d.). That is a before and after comparison of a small program, so treat it as a promising signal rather than a verdict.

More recent system data points the same direction. According to the Providence Business News, which reported on the coalition’s State of Homelessness report, Rhode Island’s permanent housing programs have kept 96 to 98 percent of residents housed since 2020 (McNulty, 2025). I could not access the report itself, and retention is not the same as a comparison against alternatives, so treat this figure with care.

The real bottleneck

Here is where the story turns. The same report found that only 14.2 percent of shelter exits in 2025 led to permanent housing, while nearly 60 percent went to unsheltered or unknown destinations (McNulty, 2025). More than 1,100 households sat on the prioritization list for permanent supportive housing or rapid rehousing, but just 19 units opened each month, with average waits of 77 days for supportive housing and 56 days for rapid rehousing (McNulty, 2025). The report’s own conclusion was that the challenge is not retention, it is access.

The national debate is also shifting under Rhode Island’s feet. Executive Order 14321, signed July 24, 2025, directs federal agencies to end support for Housing First policies to the extent the law allows (Exec. Order No. 14321, 2025), which makes the local evidence matter even more.

What the data leaves us with

Put the pieces together and a pattern emerges. Long-term subsidies and supportive housing show the most durable results. Emergency shelter costs the most and resolves the least. Rhode Island’s housing programs appear to work for the people who reach them, but the exits from shelter are narrow. The honest takeaway is less about which program wins and more about whether each one has a door at the end of the hallway.

The gap in the evidence is just as important. I could not find a published Rhode Island comparison of these approaches using the state’s homeless management data. That may be the most useful story still waiting to be written.

References

Baxter, A. J., Tweed, E. J., Katikireddi, S. V., & Thomson, H. (2019). Effects of Housing First approaches on health and well-being of adults who are homeless or at risk of homelessness: Systematic review and meta-analysis of randomised controlled trials. Journal of Epidemiology and Community Health, 73(5), 379-387. https://doi.org/10.1136/jech-2018-210981

Exec. Order No. 14321, 90 Fed. Reg. 35817 (July 29, 2025). https://www.govinfo.gov/content/pkg/FR-2025-07-29/html/2025-14391.htm

Health Affairs. (2026). Housing First and health evidence [Health policy brief]. https://www.healthaffairs.org/content/briefs/housing-first-and-health-evidence

McNulty, M. (2025). Study: Surge in unsheltered homeless highlights housing challenges in R.I. Providence Business News. https://pbn.com/study-surge-in-unsheltered-homeless-highlights-housing-challenges-in-r-i/

Rhode Island Coalition to End Homelessness. (n.d.). Homeless Management Information System. https://rihomeless.org/hmis

University of Rhode Island. (2026, May 18). Hidden homelessness: How many Rhode Islanders live doubled up? https://web.uri.edu/public-health/wp-content/uploads/sites/1261/Doubling-Up-RI-Report-5-18-26.pdf

U.S. Department of Housing and Urban Development. (2016). Family Options Study: 3-year impacts of housing and services interventions for homeless families (Summary report). Office of Policy Development and Research. https://www.huduser.gov/portal/sites/default/files/pdf/FamilyOptionsStudySummaryReport.pdf

U.S. Department of Housing and Urban Development. (2023). Evidence Matters: Spring/Summer 2023. Office of Policy Development and Research. https://www.huduser.gov/PORTAL/node/10469

U.S. Interagency Council on Homelessness. (n.d.). Housing First Rhode Island: Crisis response and systems change community profile [Archived web document]. https://webarchive.library.unt.edu/web/20120928043748/http://www.usich.gov/resources/uploads/asset_library/HousingFirst_RhodeIsland_Profile.pdf

Weisman, J. L. (2026, May 15). 2026 Point-in-Time Count results show fewer Rhode Islanders were unsheltered. Rhode Island Current. Republished by Eastern Progress. https://www.easternprogress.com/2026-point-in-time-count-results-show-fewer-rhode-islanders-were-unsheltered/article_36161699-a51c-5e7a-9646-6727dd0f80f7.html

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