The research literature addressing rural homeless service models is very limited. Little research has evaluated rural programs, compared them to urban programs, or evaluated homeless service strategies unique to rural areas. Moreover, the available program evaluation and research tends to focus narrowly on one type of program, one particular program, or one location. Although valuable information concerning promising practices can be gleaned from providers and advocates, these service models have not been subjected to rigorous testing and have not been widely disseminated. An examination of state, regional, and city plans to end homelessness, completed in late 2006, indicates that only 1 percent of the 90 plans examined focuses on strategies to end homelessness in rural areas (National Alliance to End Homelessness, 2006). However, some states updated their plans since the NAEH study with the result that specific goals and strategies related to rural homelessness are beginning to emerge. The Montana plan, for example, calls for partnerships with tribes to learn more about homelessness in rural or reservation settings. South Dakota plans include capacity expansion in rural areas, including reservations, with a goal of developing housing and service models for rural areas. In response to a biannual study of homelessness in 2005, Iowa has revised its plan to end homelessness to include strategies for providing equitable access to health services to rural residents (Ditsler et al., 2007; Montana Council on Homelessness, 2007). In addition, 17 rural and Appalachian counties in southeastern Ohio have joined together to develop and implement plans to end homelessness. In 2007, the project, Rural Homeless Initiatives in Southeast and Central Ohio, will produce the first regional, county-driven plan to end homelessness in a rural area.
Two studies currently testing service models for homeless populations in both urban and rural areas include extensive evaluations. The Supportive Housing and Managed Care Pilot in Minnesota is a permanent supportive housing project operating since 2001 in Ramsey County (an urban county including St. Paul and its suburbs) and Blue Earth County (a rural county including Mankato and the surrounding area). Blue Earth County has a population of approximately 58,000 residing in an area of 764 square miles, including the small town of Mankato (population 32,427). Early findings show that the families and single adults in Blue Earth County tend to enter the pilot with a higher level of functioning than their urban counterparts but have the same trajectory of progress (Jennifer Ho, personal communication, 2007). Trusting relationships with staff appear to hold promise for the development of long-term stability in the community (National Center on Family Homelessness, 2006). Stakeholder interviews indicate that individuals and families with long histories of homelessness, mental illness, substance use disorders, and HIV/AIDS are achieving housing stability. A cost study and an adult outcome study are scheduled for release in 2007.
The Sound Families Initiative, established by the Bill and Melinda Gates Foundation, has as its goal to create 1,500 service-enriched transitional housing units for homeless families in three counties in Washington, two urban (King CountySeattle and Pierce CountyTacoma) and one rural (Snohomish County), and to serve as a catalyst for a new level of cooperation on homelessness-related issues within the three counties. The mixed-method evaluation examines the impact of Sound Families on the families served, on transitional housing programs, as well as on the challenges the programs and their clients continue to face. The evaluation has nearly 200 families enrolled in a longitudinal interview process at 10 case study sites. Although the first reports do not compare the families living in the rural county with those in the two urban counties, families reported improvement in their overall quality of life, with 88 percent securing permanent housing at exit and 74 percent increasing their household income. In addition, the number of families with children who attended only one school during a school year increased from 49 percent at intake to 80 percent at exit and 86 percent one year after exit. Attendance improved for the children in stable housing, and parents reported their children were doing better in their schoolwork (Bodonyi et al., 2005).