Service Level and Program Size
Of considerable interest to many people are estimates of the number of clients being served by homeless assistance programs. NSHAPC results offer an important overview of service utilization in the United States, but they must be interpreted correctly. Since people may use more than one type of service during an average day, the estimates of service levels made by NSHAPC programs necessarily contain an unknown and unknowable amount of duplication. Their answers cannot be added up to determine the total number of clients who use services on an average day. For that reason they are referred to as "program contacts," not as "clients served." Further, many of the clients using the programs included in NSHAPC are not homeless, so care must be taken to interpret the following figures appropriately, as simple estimates of program use by clients who may need a wide variety of different services and may get them at a variety of programs. A final caveat is that these figures do not represent all of each type of service available to homeless clients, for two reasons. First, shelters serve meals to their residents, and may also offer some types of health and other services. Therefore, NSHAPC food and health programs do not represent all of the food and/or health services available to homeless clients within a community. Second, some homeless clients get services from mainstream housing, health, and social service programs that were not included in NSHAPC program universe because they do not meet the study's definition of a homeless assistance program. Total Number of Expected Service Contacts For each type of NSHAPC program, figure 4.2 shows how many contacts the programs expected to have on an average day in February 1996. Food pantries as a group clearly expected to have the most program contacts (over 1 million) on an average day, followed by about 520,000 contacts at soup kitchens. Programs offering financial and/or housing assistance, outreach programs, and emergency shelters each expected to have between 240,000 and 250,000 program contacts a day. In contrast, the estimate of program contacts for all four types of health programs with a focus on serving homeless clients, taken together, is only about 140,000, and this estimate is accurate only if each person uses one and only one type of health service on an average day. These figures probably are high estimates for average daily service use, since February is a peak month for many homeless assistance services, and program representatives tend to recall their peak periods rather than their average days. 
Variability in Program Size Homeless assistance programs vary greatly in size, where size is defined as the number of service contacts expected on an average day in February 1996. Figure 4.3 shows how programs of different types are distributed by size. The figure makes clear that food programs are most likely to be quite large (26 percent expected 101 to 299 service contacts daily and 11 percent expected more than 300 service contacts daily), and only about 1 in 11 expected as few as 1 to 10 service contacts in a day. Shelter and housing programs are likely to be small (28 percent expected 1 to 10 and another 31 percent expected 11 to 25 service contacts a day), with only 2 percent expecting more than 300 service contacts daily. Health and other homeless assistance programs are the most evenly distributed across a range of sizes, with about 40 percent of each expecting 25 or fewer and between 44 and 45 percent of each expecting between 26 and 100 service contacts daily. The biggest programs, though few in number, account for very large proportions of the clients being served on an average day (figure 4.4). This is true regardless of which type of program one examines, but is most true for shelter/housing programs. The 80 percent of shelter/housing programs serving 50 or fewer clients daily serve only 32 percent of all the clients who use these programs on an average day (in February 1996). On the other hand, the 8 percent of shelter/housing programs serving more than 100 clients daily serve 51 percent of the clients using shelter/housing programs. Indeed, the 2 percent of these programs serving more than 300 clients daily serve 28 percent of all shelter/housing users on an average day. The story is the same with food and other homeless assistance programs. Only 11 percent of food programs and 5 percent of other programs serve more than 300 clients daily, but these programs accommodate, respectively, 55 percent of everyone getting food from food programs and 55 percent of everyone getting help from other programs on an average day. Service delivery in health programs for homeless clients is less skewed toward the very large programs (over 300 daily) and away from the very small programs (25 or fewer daily), but even here the 42 percent of programs that are very small serve only 7 percent of those who use health programs on an average day, while the very large programs serve 30 percent of health program users. 
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