System Development and Sustainability Strategies

CFS staff are conducting studies of SOC sites to better understand how system implementation factors contribute to a local community's ability to develop systems of care for children with serious emotional disturbance and their families, and integrate these factors into system development efforts. Findings will advance efforts to serve this priority population and will provide a better understanding of effective theories of change for systems of care. Questions being addressed are:

• How do local communities use the systems of care implementation factors to achieve outcomes for a local population of children with serious emotional disturbance?
• Are system implementation factors used in specific or unique combinations to develop local systems of care? * How does local context influence systems of care development?
• Why and under what conditions are specific system implementation factors critical to successful systems-of-care development?
• What conditions support or impede the development of systems of care?
• Are there system implementation factors not identified in the Center's model that communities use to develop their systems of care?

A series of issues briefs, based on findings from completed SOC Case Studies of System Implementation, will provide readers with a summary of lessons learned from established system of care communities. The briefs offer concrete examples of how these communities have successfully developed their systems of care. The series begins with lessons learned during Phases I and II of the study and includes a description of methods of data collection and analysis. These issue briefs are intended to not only provide information for the reader but also to create dialogue around the topics discussed and the system of care concept as a whole.

Implementation Issue Briefs

System of Care Definition: System Implementation Issue Brief #1

This issue brief describes the use of the system of care (SOC) definition by the team to identify established SOC communities for the study, and the evolution of this process into the development of an expanded definition of the system of care concept. This issue brief offers the expanded definition and is intended to raise awareness regarding the need for a shared understanding of the system of care concept and facilitate discussion about the proposed definition, system implementation, and evaluation of impact. [174kb pdf]

Critical Factors in System of Care Implementation: System Implementation Issue Brief #2

This issue brief presents cross-site patterns of system implementation based on lessons learned from data collected in Phases I and II of Case Studies of System Implementation. The issue brief offers a suggested model in which established system of care (SOC) communities leverage change. A description of the model, lessons learned from established SOC communities and broad guidelines for the use of implementation factors are provided. [187kb pdf]

Strategies for System of Care Development: Locally Identified Factors for System Implementation: Supplement to Issue Brief #2:

This document provides locally identified and defined system implementation factors from data collected in Phases I and II of the study. This document is not intended to stand alone, but rather to provide additional information for readers of Issue Brief #2. [300kb pdf]

Leadership Qualities in Successful Systems of Care: System Implementation Issue Brief #3

This issue brief describes system of care leadership as described by SOC stakeholders within Phase I and II sites for the study, Case Studies of System Implementation. It describes the challenge of leadership within a complex system, lessons learned from established systems of care, and strategies for successful leadership within system of care communities based on research findings to date. [185kb pdf]

Evidence-based Practices and Systems of Care: Implementation Matters: System Implementation Issue Brief #4

This issue brief provides key findings on the relationship between evidence-based practices (EBPs) and system of care based on data collected for Case Studies of System Implementation. A description of the integration of evidence-based practices into established system of care communities, lessons learned, and strategies for successful integration are offered. [167kb pdf]

Technical Reports

Strategies for System of Care Development: Making Change in Complex Systems

This paper introduces a framework for analysis of system implementation. The framework has been utilized by the research team to examine points of leverage in established systems of care in which stakeholders took strategic action to move their systems forward. These concepts related to leveraging system change were informed by Meadows (1999). [300kb pdf]

Leveraging Change in the Hawaii System of Care: Site Report for Case Studies of System Implementation

This report describes system specific efforts to leverage change in the State of Hawaii's System of Care and provides insight into how factors affecting system implementation contributed to the development of a system of care for children with serious emotional disturbance and their families. The report provides insight into particular successes as well as areas for further development. [792kb pdf]

Leveraging Change in the Placer County California Children's System of Care: Site Report for Case Studies of System Implementation

This report describes system specific efforts to leverage change in the Placer County California Children's System of Care and provides insight into how factors affecting system implementation contributed to the development of a system of care for children with serious emotional disturbance and their families. The report provides insight into particular successes as well as areas for further development. [1000kb pdf]

Leveraging Change in the Santa Cruz County California Children's System of Care: Site Report for Case Studies of System Implementation

This report describes system specific efforts to leverage change in the Santa Cruz County California Children's System of Care and provides insight into how factors affecting system implementation contributed to the development of a system of care for children with serious emotional disturbance and their families. The report provides insight into particular successes as well as areas for further development. [768kb pdf]