Health Secretary Robert F. Kennedy Jr. announced on Monday that the federal government would expand funding for faith-based addiction treatment as a response to mounting public drug use and homelessness in American cities.
Mr. Kennedy, who credits 12-step programs with helping him end a 14-year heroin addiction as a young man, said a fragmented health care system had encouraged people with mental illness and addiction to “cycle endlessly between sidewalks, emergency room visits, jails and mental hospitals and shelters.”
Asserting that “substance abuse drives homelessness,” Mr. Kennedy called for intensive treatment programs that would teach homeless people “the lessons of how to live in a community” and assist them in finding employment. He said he had seen many people turn their lives around in “sober homes and recovery houses.”
As part of that push, he said, the federal government will open funding opportunities, including state opioid response grants, to faith-based organizations.
“We are bringing faith-based providers fully into this work,” he said. “This is a chronic disease. It’s a physical disease, it’s a mental disease, it’s emotional disease, but above all, it’s spiritual disease. And we need to recognize that and faith-based organizations play a critical role.”
But he also announced a significant new funding stream to increase access to medications to treat opioid use disorder, allowing states or tribes to tap into federal child protection funds to pay for addicted parents to receive those medications, such as buprenorphine, methadone and naltrexone.
The effort aims to keep children at home with their families rather than placing them in foster care. Yngvild Olsen, until recently the director of substance use treatment at the federal Substance Abuse and Mental Health Services Administration, or SAMHSA, said the change “has the potential to save lives” by expanding access to the medications.
At an event marking “Prevention Day,” Mr. Kennedy introduced a $100 million pilot program called STREETS, or Safety Through Recovery, Engagement and Evidence-Based Treatment and Supports, for people who are both homeless and mentally ill or addicted.
“We’ll engage people continuously, from first contact on the street through recovery, through employment and through self-sufficiency,” he said. “Law enforcement, courts, housing providers and health care systems will work as one team, so people will no longer fall through the cracks.”
Mr. Kennedy announced a $10 million grant to expand assisted outpatient treatment, which uses court orders to compel people with mental illness to receive treatment in the community.
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Tom De Vries, the president of Citygate Network, a Colorado-based association of 330 Christian rescue missions and ministries, said his members had relied for many years on philanthropic money and were adjusting to the possibility of a major change.
“The government has reached out to us and invited us into the process more than we had been previously,” he said. Meanwhile, he said, federally funded secular homeless service providers have been reaching out to Christian missions and ministries hoping to establish partnerships.
“New ministries look at this and say, this may be able to open the door for us to serve in ways we have not been able to,” he said. Some are weighing the promise of funding against restrictions on religious practices, like hiring only Christian employees, that might require “a compromise of conviction,” he added.
The Trump administration has departed from the “Housing First” approach that guided federal homeless services for a generation, which provides chronically homeless people with long-term housing and offers — but does not require — treatment for mental illness and addiction.
The Rev. Andy Bales, who served as C.E.O. of the Union Rescue Mission in Los Angeles for 18 years, said proponents of Housing First had sidelined many faith-based providers, excluding them from funding streams and shutting down transitional housing.
“They wrote us off,” he said. “It was brutal.”
Mr. Bales said he had been hopeful that recovery would regain its former status with Mr. Trump’s return to the presidency. But those hopes dimmed, he said, as the administration’s abrupt policy pivot threatened to return as many as 170,000 formerly homeless people to the streets.
“It not only scared stakeholders, but it caused Republican senators to intervene and say, ‘This is too aggressive,’” he said. “I don’t think it’s going to be rolled out successfully unless the tone changes, and there is some compromise and diplomacy carried out.”
Ellen Barry is a reporter covering mental health for The Times.
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