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The System-of-Care Model

Implementation in Twenty-seven Communities

Community Health Resource Services, MAHEC, 118 W. T. Weaver Blvd., Asheville, NC 28804

Ana Maria Brannan

ORC Macro

Lela N. Baughman

ORC Macro

Maureen Wilce

Centers for Disease Control and Prevention

Timothy Gawron

Metropolitan Child and Adolescent Comprehensive Community Services Network in the Illinois Department of Human Services' Office of Mental Health

The purpose of this study was to document system-of-care development following the receipt of federal funds to establish and support a system of care, and to assess the extent to which system-of-care principles were realized.To assess fidelity of implementation of the system-of-care model, 27 sites were visited on an annual basis for 4 years. A variety of qualitative data was collected to assess the presence of 16 key attributes comprising an ideal system of care (e.g., cultural competence, family involvement). Despite many changes in each local service system, no site (including sites with prior system-building experience and/or significant preexisting resources) was able to fully implement all aspects of the system-of-care model, as ideally conceptualized in the system-of-care program theory model. Exploratory efforts to develop a tool to assess implementation quantitatively failed to meet reliability thresholds, but information is provided on how measurement quality was improved for a new tool. With a reliable tool, findings can be considered in the context of other information, such as service delivery practices, service experiences, client-level outcomes, and effectiveness of individual treatments and services delivered.The authors suggest that a close assessment of these multilevel factors will enable a valid test of the effectiveness of the system-of-care model.

Journal of Emotional and Behavioral Disorders, Vol. 9, No. 1, 30-42 (2001)
DOI: 10.1177/106342660100900104


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