Research has shown that homeless people suffer from high rates of physical and mental illness, substance use and addictions. Yet, even with universal health insurance, homeless people face barriers to accessing health care and social services to meet their needs. While there has been increasing interest in meeting the health needs of shelter users, there have been very few studies over the last ten years that describe the types of care needed or costs of programs that service these needs. The data currently gathered by shelters to determine their budgets does not include the direct and indirect health care related costs. This has left many homeless shelters in a financial deficit. Additionally, because homeless shelters are municipally funded and health care is provincially funded, there is confusion about which level of government should be responsible for paying for these services.