Abstract There is a dearth of evaluation research regarding shelter health care. Health needs outweigh health services which are rarities within shelter settings (Gross & Rosenberg, 1987). The purposes of this article are to review the need for shelter health care, describe how shelter-based advanced practice nurses (APNs) addressed health care needs and program goals in one shelter setting, and report findings from an impact evaluation study where APN services were rated by shelter clients (n= 69) for themselves and their children (n= 95). APNs have the ability to manage health care in shelter settings, but need to seek creative funding by documenting their worth. A 21-item evaluation survey was designed to measure components of health assessment and education provided to clients by APNs. Content and construct validity were addressed by a statistician and nursing experts, and the internal consistency reliability coefficient (Cronbach's alpha) was measured at .91. Results showed that clients (96.1%) identified strongly positive responses to health services provided with some weak areas detected. Implications include the need to continue programs that serve vulnerable populations in times of cutbacks. Measuring program effects via impact evaluation is recommended for services in process to monitor quality and to give impetus to funding opportunities.