The 130th Annual Meeting of APHA

Abstract #45998

Mary Evans, PhD, Research and Training Center for Children's Mental Health, University of South Florida, 13301 Bruce B. Downs Blvd, Tampa, FL 33567, (813) 974-9112, evans@fmhi.usf.edu

Children with multiple special needs have not been served well by the traditional fragmented approach to care. For 15 years collaboration among child-serving organizations has been encouraged to increase the efficiency and improve the outcomes associated with care. This presentation reports a study of policy instruments used by states in creating systems of care for children with emotional and behavioral problems requiring services from multiple child-serving agencies. A national survey of state directors of children's mental health was conducted requesting information on the policy instruments that were used to establish systems of care. Responses were received from 39 states (78%); 34 (68%) had developed systems of care. Allowing for multiple approaches, 82% used legislation, 15% used inducements, 41% used capacity building, and 44% used other methods of system change. Data on policy instruments used by states, collaborating agencies involved, and principles underlying the effort to create a system of care were analyzed using Jaccard's method of cluster analysis. The optimal solution produced five clusters. Clusters differed on type of policy instrument used, inclusion of juvenile justice and education agencies in the effort, and number and variety of guiding principles, such as a family focus or community-based services. Jaccard's method identified an exemplar state for each cluster. These states were site visited to obtain information directly from providers and parents to examine the relationship between the policy instrument used and the system's outcomes, including level of collaboration among child-serving agencies at state and local levels.

Learning Objectives:

Attendees will
• Learn the methods used in conducting a two phase study of collaboration in systems of care
• Learn the relationship between the policy instrument used to establish systems of care and the resulting level of collaboration among the partners.
• Learn about the usefulness of backward mapping in examining the relationship between collaboration among child-serving agencies at the local and state levels.

Keywords: Children With Special Needs, Mental Health

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.