Shelter-based services in Massachusetts for homeless adult individuals.

A statewide survey (response rate = 79.5%), conducted in Massachusetts of the emergency shelters for homeless individuals, found that most of the shelters provided a range of services in addition to a bed. The most common of these were food, clothing, and referral for more permanent housing and information on employment opportunities. The majority of shelters also offered mental health services and medical care. Most mental health services were provided in-house but less than half of the shelters provided medical care in-house. Other shelters referred residents to health care sites in the community. Shelters that relied on staff from other community agencies, the most common arrangement, to provide medical care in-house allocated the least amount of overall time to health services. Shelters with medical personnel on staff averaged the most. Smaller shelters tended to provide little if any in-house medical care. The need to advocate for greater in-house medical services in small shelters and hiring staff, who are trained certified nursing assistants, are discussed.