Human Services to Support Rural Health – Models and Innovations

These stories feature model programs and successful rural projects that can serve as a source of ideas and provide lessons others have learned. Some of the projects or programs may no longer be active. Read about the criteria and evidence-base for programs included.

Effective Examples

Parent Partners

Updated/reviewed March 2024

• Need: To support parents whose children have been removed from the home so that the parents can make the changes needed for the children to return safely home.
• Intervention: A statewide program in Iowa pairs these parents with mentors who have successfully navigated their own child welfare cases.
• Results: Participants' children were more likely to return home than non-participants' children and participants were less likely to have another child removal within a year of the child coming home.

Medical Legal Partnership of Southern Illinois

Updated/reviewed August 2023

• Need: Legal barriers often prevent economically disadvantaged people in Southern Illinois from obtaining positive health outcomes despite receiving medical care.
• Intervention: The Medical Legal Partnership of Southern Illinois (MLPSI) was formed to create a system where medical providers can refer patients in need of legal assistance to local attorneys.
• Results: Over 5,400 patients have utilized MLPSI since its founding in 2002. The program has relieved over $8.1 million in medical debt for both hospitals and patients.

Other Project Examples

First Day Forward

Added March 2024

• Need: Enhanced support for people with substance use disorders leaving jail and reentering communities in rural northeastern Kentucky.
• Intervention: A reentry program that uses peer support specialists to teach cognitive life skills, obtain essential identification documents, and help people create and follow personalized case plans before and after their release.
• Results: More than 420 people have been served by First Day Forward, with recidivism rates significantly lower among people who successfully completed the program.

The Possibility Shop

Updated/reviewed January 2024

• Need: To connect vulnerable populations in Allegany County, Maryland, to health and human services and to items like hygiene products, food, and clothing.
• Intervention: The Possibility Shop partners with health organizations, insurance navigators, food banks, and other agencies.
• Results: In 2023, 8,684 service encounters occurred and 501 intakes to services were performed.

One Health Recovery Doulas

Added October 2023

• Need: To support pregnant and parenting women with a history of substance use, mental health, or co-occurring disorders in rural areas of Montana.
• Intervention: One Health, a consortium of Federally Qualified Health Centers (FQHCs), developed a team of "recovery doulas" – individuals who are dual-certified as doulas and peer-support specialists. The One Health recovery doula program offers group and individual services to women and their partners from pregnancy through the first years of parenthood.
• Results: A team of nine recovery doulas (or doulas-in-training) employed by One Health offer services in ten rural Montana counties. Recovery doulas have provided essential support to women with substance use disorder, survivors of sexual abuse, unhoused individuals, and individuals facing other complex challenges.

SJRC Texas Belong Community-Based Care (CBC)

Added June 2023

• Need: To develop a child welfare system that provides rural Texas communities with flexibility, authority, and adaptability to improve services for children and families.
• Intervention: SJRC Texas's division Belong is the lead provider for Community-Based Care, which oversees foster and kinship care, case management, reunification services, and prevention services in the South Central and Hill Country regions of Texas.
• Results: Since October 2021, SJRC Texas Belong CBC has served over 1,100 children and young adults and provided over 700 home and virtual visits.

The Rural Outreach Center

Added June 2023

• Need: To expand services for individuals and families living in poverty in rural Western New York.
• Intervention: The Rural Outreach Center (ROC) offers care coordination, therapy, budgeting assistance, and multiple other services and opportunities to help address immediate needs as well as empower individuals to work toward long-term freedom from generational poverty.
• Results: The Rural Outreach Center serves approximately 250 adults and children each year through counseling, care coordination, and empowerment opportunities. The ROC reports that many participants have achieved and sustained goals related to housing, savings, employment, and other social determinants of health – which are also measures of poverty.

HCC Network of Rural Missouri's Project Connect Event

Updated/reviewed April 2023

• Need: To expand public health and human services to adults living in rural West Central Missouri.
• Intervention: Health Care Collaborative Network of Rural Missouri organizes Project Connect events, daylong resource fairs that offer free public health and human services to underserved adults.
• Results: In 2022, Project Connect events welcomed 179 guests and facilitated 2,673 total service encounters.

Together for Beaufort County

Updated/reviewed October 2022

• Need: A community-wide collaborative process to identify and address specific quality-of-life challenges confronting the citizens of Beaufort County, South Carolina.
• Intervention: Together for Beaufort County facilitates the coordination of local and regional coalitions that address economic, social, health, educational, and environmental factors through shared collective impact process.
• Results: Out of 46 counties in South Carolina, Beaufort County has reached the top ranking in health outcomes.

NEON Pathways Community Hub

Updated/reviewed July 2020

• Need: Connect individuals to services that address health barriers.
• Intervention: A pay-for-outcomes model utilizing Community Health Workers who help provide community members with tools to address needs associated with improving health.
• Results: Trained Community Health Workers help patients navigate the healthcare and social service systems and provide education about community healthcare resources.