Study 1: National Survey of Systems of Care Implementation

This study was noteworthy both for taking an in-depth look at systems of care and the context in which they operate, and for taking a comprehensive, holistic look at every factor that the Center believes are related to the implementation of effective systems of care (see below). This study provided the first national data on system of care implementation in a disproportionate stratified probability sample of 300 counties across the United States.

The theoretical framework that guided each study included the following 13 implementation factors believed to contribute to effective systems of care:

  • Transformational leadership
  • Strong foundation in the values/principles of systems of care
  • A clear description of the local population of concern
  • A clear and widely held theory of change
  • Implementation plan
  • A plan for interagency and cross-sector collaboration
  • A comprehensive financing plan
  • Clear outreach mechanisms and pathways to care
  • Families provided with choice and voice
  • Individualized, culturally competent and comprehensive treatment approaches
  • A skilled provider network
  • Performance measurement system
  • Accountability system at the provider level

    At the national level, the study assessed the extent to which the above implementation factors were being followed, and the relationships among them. The new knowledge generated by this study can help guide efforts to improve systems of care implementation.

    At the local community level, the study provided a self-diagnostic tool for administrators and policymakers to assess the level of implementation of factors for their systems of care, and make possible meaningful local comparisons with national and similar peer community data.

    The functional outcomes for children that were assessed and measured include:

  • the proportion of children in out-of-home placements;
  • the proportion of enrolled children who are arrested and subsequently involved with the juvenile justice system; and
  • the proportion of children with mental health needs who are receiving services.

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