Our History
A Movement for Health Justice
The National Health Care for the Homeless Council (NHCHC) was founded in response to a growing crisis and a simple belief: health care should reach people where they are.
In the early 1980s, homelessness in the United States became highly visible. Health systems were unprepared, and traditional models of care failed to reach those most in need.
A new approach emerged.
The Beginning (1983–1988)
In 1983, a national demonstration program, Health Care for the Homeless (HCH), launched in 19 cities.
Its core idea was straightforward:
Bring care directly to people in shelters, soup kitchens, and on the streets.
It worked.
By the end of the program:
- Nearly 100,000 people were served
- Approximately 300,000 visits were delivered
This model proved that compassionate, community-based care could reach people long excluded from traditional systems.
Federal Recognition (1987)
In 1987, Congress established dedicated federal funding for HCH programs through the McKinney Act.
For the first time, health care for people experiencing homelessness became a national responsibility.
The Council Takes Shape (1985–1991)
As local programs began learning from one another, they formed what became NHCHC.
From the start, the Council served as more than a technical assistance provider. It became a national movement hub, bringing together:
- Clinicians
- Administrators
- Advocates
- Researchers
- People with lived experience
Core commitments included:
- Clinical care
- Policy advocacy
- Consumer leadership
- The principle that housing is health care
Building a Model of Care
HCH programs pioneered approaches that are now standard across health care:
- Team-based, multidisciplinary care
- Addressing social determinants of health to deliver whole-person care
- Street outreach and shelter-based services
- Integrated behavioral health
- Medical respite or recuperative care
- Trauma-informed practices
- Patient-centered care models
A National Community
The first national conference was held in 1989.
Today, the Annual Conference & Policy Symposium is the largest gathering of the HCH community. It remains a central space for:
- Sharing innovation
- Building partnerships
- Elevating lived experience
- Advancing policy solutions
Growth and Integration (1996–2004)
HCH became part of the broader Health Center Program in 1996, expanding its reach nationwide.
During this time, the Council:
- Launched the HCH Clinicians’ Network
- Published key field resources
- Expanded medical respite programs
- Established the National Consumer Advisory Board
The Council became a unifying force across the field.
Advocacy at the Core
The HCH movement has always emphasized that homelessness is a result of public policy, not an individual failing. Expanding insurance coverage alone is not enough to end homelessness.
NHCHC continues to advocate for:
- Health equity
- Medicaid expansion
- Integrated care
- Affordable housing
- A rights-based approach to health care
Centering Lived Experience
People with lived experience of homelessness are essential leaders in this work.
Through governance, policy, and advisory structures, their role has evolved from consultation to true leadership.
Advancing Medical Respite Care
NHCHC established the National Institute for Medical Respite Care (NIMRC) as a special program to strengthen standards and expand access to care.
The NIMRC Certification program was launched in 2025 and sets national benchmarks for safe, high-quality, person-centered medical respite services.
Today
The need for this work continues.
Almost 300 HCH health centers and over 240 medical respite programs now serve approximately 1 million people each year. Yet homelessness persists, driven by:
- Shortage of affordable housing
- Economic inequality
- Systemic racism
NHCHC works at the intersection of health and housing to:
- Support providers
- Advance research and policy
- Elevate lived experience
- Strengthen systems of care
Our Mission
We were founded to:
- Deliver high-quality, compassionate care
- Change systems that exclude
- Advocate for justice
- Build community
- Affirm that housing and health care are human rights
That mission continues.
And so does the work.
