The Patterns and Costs of Services Use among Homeless Families

Dennis Culhane, Jung Min Park, Stephen Metraux

October 2011

This study examines families’ use of behavioral health hospitalization and foster care placement prior to, during and following shelter use, comparing families based on shelter pattern and type of housing exit. Results show that inpatient and foster care services use drops in the homelessness period, but rebounds following exit, regardless of pattern of shelter use, and type of housing exit. Results suggest that shelters supplant use of services, but not on a sustained basis. Despite declines in concurrent services use, the homelessness period is overall more costly for episodically and long-term shelter users, primarily owing to the high costs of shelter. High rates of inpatient and foster care services use following the homeless spell suggest that providers of homeless assistance should systematically screen and refer homeless families to on-going community-based service supports. Service use patterns indicate that homeless spells may disrupt continuity of care with community-based health and social services.

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