Annual Report to Congress on the Evaluation of the Comprehensive Community Mental Health Services Program for Children and Their Families

Examples From the Sites and National Program

An essential goal of the Comprehensive Community Mental Health Services for Children and Their Families Program is for evaluation to be useful at multiple levels (e.g., individual child, family, service program, site, and overall national program). The usefulness of evaluation information directly impacts on the ways that evaluation data inform the development of systems of care both during and after their Federal funding period.

There are many examples of evaluation data being utilized at the individual site level to enhance the provision of services to families and to monitor as well as inform the development of site-specific activities for serving children. Examples include individual case review, care review teams, quality assurance activities, review of evaluation data by governing bodies, and local dissemination of evaluation information through publications such as newsletters. In fact, one of the key indicators of a mature system of care is its ability to utilize evaluative information to identify and capitalize on strengths as well as to address challenges as it moves into the future.

The extensive efforts necessary to develop and maintain a system of care for children with serious emotional disturbance and their families, however, will have only temporary effects on communities unless programs are able to sustain themselves after their 5-year Federal grant funding cycle. The ability of systems of care to continue to develop and evolve beyond the supports available in a 5-year Federal demonstration project has direct bearing on the adoption of the system-of-care approach on a wide-scale basis across this country. Matching requirements of the CMHS grants are structured in such a way that the development of local sources of support and funding is a well-defined objective for each of the programs. Sustainability is clearly an important outcome of the CMHS system-of-care initiative.

Local and nationally based system-level assessments provide sources of evaluation information that can be used to track and inform the development of different aspects of systems of care. A fully developed system of care can expand the availability of and accessability to a wide range of flexible, community-based services, which can then produce positive, documented outcomes for children and families. Evaluation information regarding the development of the system of care and its effects can then be communicated to the public, in general, and to local, State, and Federal policymakers, more specifically. The goal of these communications would be to advocate for resources and policy-level changes that will sustain and perhaps even enhance systems of care once Federal funding is exhausted. These latter communication efforts can also be evaluated to determine their impact on key stakeholders who influence the economic and policy changes necessary to sustain community-based systems of care.

There are several examples at the individual program level where federally funded systems of care have been able to use evaluation data to leverage local- and State-level policy changes for serving children with serious emotional disturbance (Holden & Santiago, 1998):

In Southeast Kansas, for example, informational presentations that included evaluation data were made to local- and State-level policymakers. These presentations and other advocacy efforts resulted in local and State funding increases of over $5 million per year in system-of-care services for children with serious emotional disturbance and their families.
Evaluation data from a statewide CMHS-funded system of care in Rhode Island was presented to administrators and legislators as part of advocacy efforts. This resulted in the passing of legislation that (1) provided a broad definition of serious emotional disturbance that will help to identify children and adolescents who are eligible for services, and (2) mandated a pilot program for local coordinating councils to collaborate with the State Department of Education to reduce costly out-of-home and out-of-district placements.
In Maine, evaluation data from the Wings program was instrumental to the development of a structured plan for children’s mental health services that was initially passed in 1997 and fully appropriated in spring 1998. Information on costs of services and clinical outcomes was used to support advocacy efforts. The Wings system of care served as a model for designing and implementing this statewide initiative, which will focus on case management and crisis services.

The communication of evaluation information at local, State, and Federal levels thus becomes a critical component in the sustainability process. Communication of information about the progress that systems of care are making takes many diverse forms. These can range from national-level efforts such as yearly congressional reports and Hill briefings, to local efforts ranging from mass mailings of newsletters detailing systems development and positive change to more direct advocacy efforts with local- and State-level governments. Congressional briefings are another example of the use of evaluation data to support the further development of systems of care. A briefing was conducted on May 15, 1998, that included multiple stakeholders and presented evaluation information from individual sites as well as the national perspective. Regardless of the final communication venue, the evaluation of our efforts to implement effective community-based systems that produce positive outcomes for children and families is an instrumental component that influences future sustainability.

Table of Contents | Previous | Next