Through the  CoC system HUD allocates homeless assistance grants to organizations  that participate in homeless assistance program planning networks. In a prior GAO  report, we discussed the three most common federal definitions of rural— from the Bureau of the Census, the Department of Agriculture’s (USDA)  Economic Research Service, and the Office of Management and Budget— which have differing criteria, such as population threshold or proximity to  urban areas. However, even within one measure such as population  threshold, different agencies can use different parameters and therefore  identify different areas as rural. The range of living  situations of persons experiencing homelessness in rural areas may  overlap with the living situations of those experiencing homelessness in  nonrural areas. However with a limited number of shelters or other outreach, they may  not be accessing services. Challenges in Collecting Comprehensive Data Make Understanding the Extent of Homelessness in Rural and Nonrural Areas Difficult

Due to limited comprehensive data and challenges in combining data from  different federal sources, understanding the extent of homelessness in  rural and nonrural areas is difficult. Each agency focuses on the segments of the homeless  population that the agency serves, resulting in incompatible data for  comparison and analysis. In total, these  programs fund permanent and short term housing and a variety of  supportive services such as mental health services, substance abuse  treatment, case management, and job training. This funding may be used to expand water  and sewer services and to provide housing assistance. Limited Data Are Available on the Amount of Targeted and Nontargeted Assistance to Rural Versus Nonrural Areas

The amount of federal funding for targeted homeless assistance programs  in rural areas is uncertain. For instance, HUD’s CoC  programs maintain data on the amount of assistance for rural areas;  however, grant applicants could designate (self-identify)—based on a HUD  provided definition of rural area—whether they were in rural areas or not. Similarly, funding information on the mainstream and other nontargeted  programs that can provide support to individuals or families experiencing  homelessness is limited. Barriers to the Rural Homeless Population Seeking Assistance Include Limited Availability of Services, Lack of Transportation, and Lack of Affordable Housing

According to state and local officials, as well as individuals experiencing  homelessness we interviewed in the states we visited, limited availability  of services, lack of transportation, and lack of affordable housing have  been some common barriers that the rural homeless population  encounters when seeking assistance. Because shelters are one of the visible points of  entry to a network of services such as health care, alcohol and drug  treatment, job training, and case managers, those experiencing  homelessness in rural areas who are without shelters may be more likely  to be disconnected from caseworkers who can provide referrals to these  supportive services. Limited Effective Collaboration among Federal Homelessness Programs Has Hindered Opportunities to Integrate Services

While a few examples of federal collaboration regarding homelessness  have demonstrated aspects of effective collaboration, effective  collaboration has been limited between HUD and HHS, two of the key  federal agencies funding housing and supportive services that include  programs for more than one subpopulation. Particularly, VA identified a number of Veterans Affairs Medical  Centers to participate in the program and provide case management  resources. Data  limitations and the array of federal programs, some of which are not  specifically targeted toward homelessness and some of which do not track  if their services or dollars have been expended in rural areas or on persons  experiencing homelessness, have resulted in multiple data sets that do not  allow for an overall assessment of the characteristics and extent of rural  homelessness or a comparison with nonrural homelessness. By more formally  linking housing and supportive services, HUD and HHS could increase  their ability and opportunities to address gaps in efforts to effectively  address homelessness and decrease challenges to service providers and  persons experiencing homelessness. Recommendation for Executive Action

To strengthen formal collaboration efforts, we recommend that the  Secretary of Housing and Urban Development and the Secretary of Health  and Human Services direct the appropriate program offices to further  explore opportunities to more formally link housing and supportive  services—in the most appropriate forms and combinations of mainstream  and targeted programs identified by both agencies—with specific  consideration for how such collaboration could minimize barriers to  service provision in rural areas. Both  HHS and HUD generally agreed with our recommendation and provided  technical comments which we incorporated, as appropriate. We selected the  site visit locations based on several factors, including (1) discussions with  advocates and researchers in the field of homelessness—including the  Housing Assistance Council, the National Alliance to End Homelessness,  the National Law Center on Homelessness and Poverty, and the Urban  Institute—to learn about rural homelessness issues and the outcomes  across different states; (2) a review of studies and reports on local and  state efforts to serve the homeless in rural areas, including papers  prepared for the 2007 National Symposium on Homelessness Research  that highlighted issues related to rural homelessness; (3) the presence of  tribal lands and colonias; and (4) geographical diversity.
Why GAO Did This Study

The Homeless Emergency Assistance and Rapid Transition to Housing (HEARTH) Act of 2009 directed GAO to conduct a broad study of homelessness in rural areas. In this report, we provide information about rural homelessness issues, based in significant part on our work in rural areas within six selected states. Specifically, the report addresses the following questions: (1) What are the characteristics of homelessness in rural areas? (2) What assistance is available to individuals or families experiencing homelessness and what amount of funding have the federal departments and agencies awarded to organizations that assist persons experiencing homelessness in rural areas? (3) What barriers do persons experiencing homelessness and homeless service providers encounter when seeking assistance or funding to provide assistance? To address these issues, GAO reviewed relevant literature, conducted site visits, and interviewed agency officials.

What GAO Found

Rural homelessness involves a range of living situations but comparing the extent of homelessness in rural and nonrural areas is difficult primarily due to data limitations. Based on GAO visits to six states, persons experiencing homelessness in rural areas could be living in one of a limited number of shelters, in extremely overcrowded situations, in severely substandard housing, or outdoors. While HUD and other agencies collect some data on homeless populations, several challenges exist in using these data to compare the extent of homelessness in rural and nonrural areas. They include difficulties in counting transient populations, limited reporting by service providers in federal data systems, inconsistent reporting across programs, and focusing on the segments of the homeless population that the agency serves. Definitional differences also make comparisons difficult. For instance, the three most common federal definitions of rural use differing criteria such as population or proximity to urban areas. Even within one measure such as population, different agencies can use different parameters and therefore identify different areas as rural. A number of federal programs exist to support those experiencing homelessness in rural areas. Targeted and nontargeted programs fund permanent and emergency housing and supportive services such as mental health services, case management, and job training. However, federal agencies maintain limited data on the amount of homeless assistance awarded to rural areas, making comparisons with assistance awarded to nonrural areas difficult. For instance, HUD maintains some data on the amount of homeless assistance awarded to rural areas through its targeted programs, but the data are based on providers' identification of locations as rural or not. Nontargeted programs can serve persons experiencing homelessness but do not track how much funding is used for homeless assistance. As a result of data limitations such as these, comparisons of funding levels offer limited insight into the relationship between the size of the homeless population in an area and the amount of funding received. Barriers to accessing and providing homeless services in rural areas include limited access to services, large service areas, dispersed populations, and a lack of transportation and affordable housing according to state and local officials and persons experiencing homelessness in the states we visited. For instance, many rural areas have few shelters or shelters with few beds serving very large areas. A program in which HUD provides housing vouchers to homeless veterans and the Department of Veterans Affairs provides clinical and case management services to these same veterans is one of a limited number of examples of formal collaboration and leveraging of federal resources that link housing and supportive services. The effects of limited collaboration may be particularly acute in rural areas because of the barriers cited above. Without a more formal linking of housing and supportive services by HUD and HHS, two of the key agencies for funding these activities, the effectiveness of federal efforts to address homelessness may be diminished.

What GAO Recommends

GAO recommends that the Departments of Housing and Urban Development (HUD) and Health and Human Services (HHS) explore further opportunities to strengthen formal collaboration on linking housing and supportive services to address homelessness, with specific consideration for how such collaboration can minimize barriers to service provision in rural areas. HHS and HUD generally agreed with the recommendation.