ASPPH logo


Member Research & Reports

Member Research & Reports

BU: After Massachusetts Policy Change, Homeless Children Seek Shelter at ER

In 2012, Massachusetts implemented new restrictions in its emergency assistance program, which provides shelter and other services to homeless families with children and pregnant women. One of the restrictions requires most families to have stayed in “a place not meant for human habitation” to be eligible for shelter.

Now, a new study co-authored by a Boston University School of Public Health (BUSPH) researcher finds hundreds of homeless children visited a pediatric emergency department in Boston to fulfill that requirement, with their stays costing more than if they had simply been sheltered.

The study, published in the American Journal of Public Health, found a nearly nine-fold increase in the number of visits for homelessness at the emergency department of Boston Medical Center. The visits averaged almost $200 each, 97 percent paid by Medicaid, compared to the $130 the state’s emergency assistance program spends to shelter a family for a night.

“This change in state policy appears to have had an unintended consequence of more families coming to our emergency departments,” says senior author Dr. Megan Sandel, associate professor of environmental health at BUSPH and associate professor of pediatrics at Boston University School of Medicine.“This study highlights the need to develop better homeless diversion services, and the need to invest in new affordable housing.”

Read more