ABSTRACT
In this article we describe a system-level assessment that examined the extent to which 8 system-of-care principles (e.g., family-focused care, coordination of services, use of least restrictive service options) were operationalized across 8 system components (e.g., system governance, quality monitoring, case monitoring and review). Data were collected in 3 federally funded systems of care and 3 matched comparison sites. Comparisons of system scores across paired sites suggested that the federal program that funded the systems of care helped those sites come closer than the comparison sites to the ideals articulated in the principles. There was also less variability in scores across the funded systems of care, with greater variability found across the comparison sites’ scores. Some movement toward the system-of-care approach was demonstrated in the comparison sites, however, despite their lack of special funding. The systems of care performed especially well in the principles of interagency involvement and community-based service delivery. Although they generally performed better than the comparison sites, the systems of care continued to struggle in their system-level quality improvement efforts and in culturally competent service delivery.
