Massachusetts shelter eligibility change raises pediatric ED visits for homeless children, study finds

Instances of homeless children visiting emergency departments increased by more than fourfold in Massachusetts after the state updated eligibility standards for its emergency shelter policy, according to a study published in Pediatrics.

Here are three things to know:

1. In 2012, Massachusetts altered the eligibility requirements for its emergency shelter policy. The policy states homeless families must reside in an area "not meant for human habitation," which includes the ED, to be eligible for emergency shelter.

2. For the study, researchers analyzed data on both the frequency and costs associated with pediatric ED visits within homeless populations from March 2010 to February 2016 to assess how the eligibility policy affected ED trends.

3. Researchers identified 312 ED visits during the study period, 95 percent of which occurred after the policy was changed. Children who visited the ED after the policy change were more likely to share no medical complaints. The number of homeless children in Massachusetts only increased by 1.4 times during the study period. However, ED visits linked to homelessness saw a thirteenfold increase, with about 89 percent of payments covered by state-based insurance plans.

"It is important to understand the magnitude of the problem of child homelessness, the characteristics of children being seen for homelessness, the reasons for families' homelessness, and the unintended healthcare costs to enable legislators and policymakers to create more effective policies for these families in Massachusetts and throughout the United States," the study authors concluded.

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