President-elect Donald Trump Donald John TrumpOmar fires back at Trump over rally remarks: 'This is my country' Pelosi: Trump hurrying to fill SCOTUS seat so he can repeal ObamaCare Trump mocks Biden appearance, mask use ahead of first debate MORE announced this morning that he has selected Dr. Ben Carson to lead the Department of Housing and Urban Development (HUD).

This continues Trump’s pattern of appointing dutiful sycophants that do not have tangible expertise for their given cabinet positions. Appointing Carson reminds me of the movie Gravity, where Sandra Bullock’s medical doctor character is appointed with fixing the Hubble Space Telescope.

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Can anything truly be considered unreasonable in fiction? Yet, in these post-fact times concerns should be continuously raised in regards to the evidence of the rationale for decisions affecting millions will be made.

I would never endeavor to question Carson’s concern for those who utilize HUD programs. I think across the political spectrum that an overwhelming number of people care about eliminating the scourge of poverty, yet disagree about the mechanisms for tackling this seemingly insurmountable task.

As a former shelter based social worker, I had to routinely work with clients in certifying their homeless or chronically homeless status for HUD paperwork, so I do have some suggestions for Carson.

Given my area of expertise I would never attempt to do neurosurgery without a few tips. Well actually given the persistent tremor in my right hand I would never attempt any kind of surgery.

Yet, working in shelters did require me to become First Aid and CPR certified. In the case of medical emergencies arising in shelter I would be the front line defense for that person’s health outcomes. Although I am not preferable by the medical establishment to address a medical emergency I had some medical skill. In my tenure, I called 911 many times and fortunately the true professionals were able to address the emergencies.

I would like to provide Carson a little primer from my experience working in shelters and transitioning people to permanent housing.

So the truth: not everyone can even successfully complete current shelter programs; much less have the ability to transition to permanent housing. Shelter programs are setup to be temporary and most shelters do carefully monitor the lengths of stay in shelter. Shelters really do work as temporary safe havens for people to launch from and into lives that are independent of more government programs.

Yet, if a client has overwhelming needs that can’t be solved in a few months then shelters aren’t the solution. These are clients who may have extensive trauma histories; active addictions, uncontrolled mental illness and these challenges overwhelm their ability to stabilize their lives.

In the housing field there will always be people who descend into the definition of HUD’s definition of chronic homelessness because there are not enough programs that scientifically address their unique needs. We must rethink short-term solutions to problems that may need multiple types of housing solutions. Most psychiatric facilities are extremely short term and most substance abuse programs are at most a few months.

For those that need long term housing programs, I implore you to look into Housing First programs because they have proven that if someone has stable permanent housing then they reduce the cost burden on taxpayers. This is because this population tends to also over utilize public services: shelters, jails, emergency rooms, and first responders.

There is the issue of bleeding hearts in housing services, yet the fiscal argument can be made to have robust programs that are effective and drive down costs of overall government expenditure. My most challenging housing clients were always some of the ones who have aged out of foster care.

They were so acclimated to being bounced around that they never learned what is a real home. The average cost of a child in foster care is thousands of dollars and still those clients often grew up to maintain relationships with their birth families. This whole population is at a greater risk of lifelong housing instability. Doesn’t it make sense to address the root problems of housing related issues rather than having frequent fliers who never get effective help, which just costs the government more.

One final thought: please truly think about the philosophy you have regarding the meaning of home. What would gentrification mean to you if you can’t afford to live in the community you’ve lived in your whole life? What does grandma’s house mean if she can’t afford to pay her property taxes or home maintenance costs long after the mortgage was paid? What is the home of the brave, but a place where Americans belong and have an anchor to sail from?

Carson I congratulate you on your new position, yet I implore you to continue to use the fine instrument of the scalpel as you modify HUD. For anesthesia can only be administered on an individual level. So scrub in, but remember that in housing there can never be a sterile environment

Melanie Carlson has her Masters in Social Work and spent five years working in domestic violence and homeless shelter based programs. Currently, she is in a social work PhD program studying the intersection of domestic violence, housing and immigration.

The views expressed by contributors are their own and not the views of The Hill.