Study 3: Financing Structures and Strategies to Support Effective Systems of Care

This study was the first to thoroughly investigate cross-agency financing structures and strategies, and provides important information about finance policies that can assist communities across the country. The study's two primary research objectives were to test the validity of the theory that financing structures and strategies support effective systems of care and investigate how these financing components operate separately and collectively within a community and systemic context, to create effective financing policy. The study also investigated whether each financing component contributes to positive system-level outcomes.

This study hypothesized that effective financing mechanisms would:

  • redirect spending from "deep-end" restrictive placements to home and community-based services and supports, consistent with systems-of-care values;
  • support and provide incentives for evidence-based and promising practices;
  • support a wide-ranging, diverse network of providers;
  • support voice and choice for families when planning services; and
  • Support a strong family and youth voice in policy development and system management.

The financing study used a participatory action research approach and a multiple-case embedded design, and collected data from 10 case study sites: (a) five communities identified as having effective financing structures and strategies, and (b) five communities having potential effective financing structures and strategies but being at a relatively low level of implementation. Three additional high implementing sites were nominated by a panel of experts.

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