The study focused on differences in personal characteristics and service use among homeless mothers separated from their children, mothers accompanied by children, and women who were not mothers. The analysis also focused changes in health status, community adjustment, and service use associated with reunification of homeless mothers and their children at 1-year follow-up. The participants were homeless women enrolled in the Federal Center for Mental Health Services’ Access to Community Care and Effective Services and Support (ACCESS) Program in 18 communities across the country. The ACCESS demonstration established specialized outreach teams and assertive case management teams. Results of the analysis revealed that separated mothers demonstrated greater vulnerabilities than accompanied mothers did, but more resources than women who were not mothers. Seventeen percent of the 698 separated mothers were reunited with children at 12 months. Factors predicting family reunification included changes in housing, psychosis, drug use, and therapeutic relationships. Findings suggest that programs for homeless mothers with severe mental illness can produce changes that promote family reunification. Tables and 21 references