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Right‐sizing the population, actively managing LOS and providing high‐quality housing will go a long way toward maintaining a shelter population within the organization's capacity to provide care. However, there may still be times when the incoming population exceeds the organization's ability to provide appropriate outcomes. While even the most successful shelter health program may not be sufficient to fully remedy such an imbalance – especially when substantial funding or policy barriers to life‐saving programs exist – interventions other than euthanasia are more likely to be effective and accepted, as well as being an end in themselves.

Fortunately, it is increasingly recognized that methods to regulate intake and increase live outcomes are appropriate for shelters of all types, whether publicly funded/municipal or private/non‐profit and regardless of the terminology by which they are described (e.g. “Open admission,” “Adoption guarantee” or “No‐kill”). For instance, at the time of publication of the first edition of this text, scheduling intake, in coordination with available space, was a relatively uncommon practice at municipal shelters. However, it is now more widely recognized that this represents a responsible policy and indeed a best practice to better serve both animals and the public.

This does not mean that intake is limited, only that it is coordinated with available space in order to maintain safe and humane conditions in the shelter. For instance, the intake of an animal presented on a Friday might be deferred until after an adoption event over the weekend in order to make space without resorting to euthanasia. In fact, just as public health is often best served by preventive programs designed to keep people out of hospitals, more shelters and communities are investing in safety net programs that serve many animals without requiring shelter entry at all (HSUS 2012).

On the other side of the equation, more strategies have been developed to increase live outcomes for those animals that do enter the shelter's care. For instance, high fees and restrictive policies were once widely considered imperative to protect animals from ill‐prepared or uncaring adopters. However, it is now known that animals adopted through a conversational rather than a strict, policy‐based adoption process, acquired without a fee and even received as gifts receive equal levels of care and enjoy equal levels of owner attachment (Weiss and Gramman 2009; Weiss et al. 2014). The negative consequences of high adoption fees should never be underestimated: the resultant increases in LOS, crowding and subsequent illness and even euthanasia far outweigh any adoption revenue that would have been gained. Fee‐waived events, adoption promotions and a welcoming adoption process are as integral to maintaining animal health in shelters as any medical treatment or vaccine.

Finally, as described earlier in this chapter in the case of RTF, shelter animal health as well as outcomes can be dramatically improved when adoption is not the only live pathway out. Transport programs provide an interim solution to move animals from higher to lower risk shelters, and detailed guidelines and regulations have been developed to minimize the risk associated with this practice by various states, the ASV and National Federation of Humane Societies, among others (National Federation 2019; Newbury et al. 2010). Ideally, in the longer term, shelters and communities will continue to explore and expand other avenues for increasing live outcomes. In addition to RTF, this includes increasing the number of animals reunited with their owners through non‐punitive approaches mirroring the “adopters welcome” approach that has enjoyed such success by not only encouraging members of the community to adopt shelter animals, but by also offering ongoing support (http://www.animalsheltering.org/topics/adoptions).