Purpose -The purpose of this paper is to analyze the nation's first hospital to housing for homeless individuals. The Chicago Housing for Health Partnership (CHHP), a Housing First and Harm Reduction model, creates a new comprehensive system of health care, housing and supportive services. Design/methodology/approach -The researchers conducted a year long process evaluation of the housing program using a multi-method approach, which involved qualitative interviews, focus groups, document analysis and observations. The paper examined the CHHP system at three different levels (the administrative, service provision and the client levels). Findings -The study allowed the organizational participants the ability to better understand their program by visually modeling the system for the first time and documenting its effectiveness. It also furthered the understanding of how and why the housing first model is best accompanied by a harm reduction approach. Finally, the paper was able to show how and why organizational system design is important in creating the most effective environment in which programs have a real impact. Originality/value -The authors were able to help CHHP program leaders conduct strategic planning and to present their program as an effective model future funding agencies and to policy makers. CHHP has incorporated the recommendations into their permanent model. In addition, the CHHP leadership, in a network with other Housing First advocates, has disseminated the findings at national conferences and networking meetings. The authors' relationship with CHHP will continue with the design of a second stage research strategy in order to continue research on Harm Reduction Housing and policy advocacy.

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