This monograph discusses runaway and homeless youth and the programs that serve them in seven large and medium-sized cities throughout the United States. The monograph focuses on the characteristics and service needs of these youths and the demands they pose for service providers. It examines how the population and the service environment have changed since passage of the Runaway and Homeless Youth Act of 1974 and whether public policies and practices have kept pace with these changes. It looks at social and practice issues confronting providers and policymakers and highlights viable strategies that have been developed by programs to serve this population of youth effectively. This monograph is based on in-depth examinations of programs in Albuquerque, New Mexico; Boston, Massachusetts; Chicago, Illinois; Des Moines, Iowa; Iowa City, Iowa; San Diego, California; and Seattle, Washington. During site visits extensive interviews were conducted with staff and funders. The following issues were discussed: (1) essential services, including substance abuse prevention, mental health, Acquired Immune Deficiency Syndrome (AIDS) prevention and education, medical and dental care, housing, emergency shelter, education, and employment and training; (2) organizational issues and strategies including policies and values, boards of directors, staff recruitment, management information, research and evaluation, volunteers, and youth and family involvement; (3) funding; and (4) interagency collaboration. References are included. Nine appendices include a list of the programs studied, excerpts from AIDS education manuals and policy and procedures manuals, and various documents specifically pertaining to individual programs. (ABL)