The 130th Annual Meeting of APHA

Abstract #43762

Martha R. Burt, PhD, Labor and Social Policy Center, The Urban Institute, 2100 M Street, NW, Washington, DC 20037, (202) 261-5551, mburt@ui.urban.org and Patrick Sharkey, BA, Labor and Social Policy Center, Urban Institute, 2100 M Street, N.W., Washington, DC 20037.

A recent article in JAMA has shown a strong association among homeless people of having insurance and receiving physical health care. The questions this paper addresses are: (1) does the same association hold for mental health and substance abuse treatment, for those who need it? (2) which way does the association run (have Medicaid and thus get treatment, or go for treatment and get signed up for Medicaid),(3) or, is a third factor, being in a program that is likely to supply case management, responsible for both having insurance and getting care? To answer these questions we use data from the 2,738 homeless adults in the 1996 National Survey of Homeless Assistance Providers and Clients. We already know that insurance coverage is more likely among homeless people who have mental health or substance abuse problems, and among those who are SSI/SSDI recipients. Further, we know the answer to our first question is affirmative—insurance coverage and receipt of mental health and/or substance abuse treatment are associated. Analyses will probe the associations to understand the timing of insurance coverage (before or after homelessness), the timing of care in relation to coverage, and program participation. If, as we suspect, some significant part of the association of insurance and care is explained by program participation, the implications will be clear for helping homeless people with mental health (and other) problems get the care they need.

Learning Objectives: This presentation will allow the attendee to

• Examine and evaluate whether local programs are structured to assist homeless people to get appropriate care
• Examine and evaluate whether local programs are structured to assist homeless people to get insurance and other benefit coverage that will improve their treatment options
• Assess the value of research results that control for important variables such as mental health status when examining the association of insurance and care, rather than examining the dynamics of how people get both insurance and care.

Keywords: Homeless Health Care, Mental Health

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.