Abstract
The California AB377 Evaluation Project was established to study the replication of an innovative system of care in three California counties for youth suffering from severe emotional disturbance. Development of the innovative system of care was pioneered in Ventura County, California, and the replications were legislatively enabled through Assembly Bill 377 (AB377). This paper reports evaluative findings about a central goal of the innovative care system: the reduction of use of highly restrictive out-of-home placements though creation and maintenance of coordinated and effective community-based services. Group home facilities are the focus of the evaluation work because these facilities consume the largest proportion of all public expenditures for youth in residential placements in California. More than 10 years of aggregate county and state level monthly expenditure and utilization data are presented. The results indicate that the demonstration counties have generated lower per capita inflation adjusted rates of expenditures and per capita group home placements than California as a whole. The evaluation results provide evidence that an integrated system of care can reduce group home placements. However, the nature, quality and effectiveness of any and/or all alternative services provided remains a topic for further investigation.
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References
Attkisson, C., Dresser, K., & Rosenblatt, A. (In Press). Service systems for youth with severe emotional disorders: System of care research in California. In L. Bickman & D. Rog, (Eds.),Children's mental health services: Research, policy, & innovation. Newbury Park, CA: Sage Publications.
Attkisson, C., Dresser, K., & Rosenblatt, A. (1991). Service systems for youth with severe emotional disorder: Systems of care research in California. InClose to home: “Community-based mental health services for children.” Hearing before the Select Committee on Children, Youth and Families, U.S. House of Representatives, April 29, 1991. Washington, DC: U.S. Government Printing Office.
Beachler, M. (1990). The mental health services program for youth.The Journal of Mental Health Administration, 17 115–121.
Bickman, L., Heflinger, L. A., & Pion, G. (1990). The evaluation of an innovative mental health system for children: Initial plans. In A. Algarin & R. Friedman (Eds.),A system of care for children's mental health: Building a research base (pp. 51–64). Tampa, FL: Florida Mental Health Institute.
Burns, B. J., & Friedman, R. M. (1990). Examining the research base for child mental health services and policy.The Journal of Mental Health Administration, 17 87–98.
Children's Mental Health Services Act, California Welfare and Institutions Code §5565.10–5565.40 (1987).
Cook, T. D., & Campbell, D. T. (1979).Quasi-experimentation: Design and analysis issues for field settings. Boston, MA: Houghton Mifflin Company.
Day, C., & Roberts, M. C. (1991). Activities of the child and adolescent service system program for improving mental health services for children and families.Journal of Clinical Child Psychology, 20 340–350.
Feltman, R., & Essex, D. (1989). The Ventura Model: Presentation package. (Available from: Randall Feltman, Director, Ventura County Mental Health Services, 300 Hillmont Avenue, Ventura, California 93003.)
Institute of Medicine. (1989).Research on children and adolescents with mental, behavioral, and developmental disorders. Washington DC: National Academy Press.
Joint Commission on the Mental Health of Children. (1970).Crisis in child mental health: Challenge for the 1970's. New York: Harper and Row.
Jordan, D. D., & Hernandez, M. (1990). The Ventura Planning Model: A proposal for mental health reform.The Journal of Mental Health Administration, 17 26–47.
Kiesler, C. A., & Sibulkin, A. E. (1984). Episodic rate of mental hospitalization: Stable or increasing?American Journal of Psychiatry, 141 44–48.
Kiesler, C. A., & Sibulkin, A. E. (1987).Mental hospitalization: Myths and facts about a national crisis. Beverly Hills, CA: Sage.
Kiesler, C. A., & Simpkins, C. (1991a). The de facto national system of psychiatric inpatient care: Piecing together the national puzzle.American Psychologist, 40 579–584.
Kiesler, C. A., & Simpkins, C. G. (1991b). Changes in psychiatric inpatient treatment of children and youth in general hospitals, 1980–1985.Hospital and Community Psychiatry, 42 601–604.
Kiesler, C. A., Simpkins, C. G., & Morton, T. L. (1989). The psychiatric inpatient treatment of children and youth in general hospitals.American Journal of Community Psychology, 17 821–830.
Lave, J. R. (1989). Commentary. In C. A. Taube, D. Mechanic, & A. Hohmann (Eds.).The future of mental health services research (pp. 155–158) (DHHS Pub. No. ADM 89-160). Washington, DC: U.S. Government Printing Office.
McCleary, R., & Hay, R. A., Jr. (1980).Applied time series analysis for the social sciences. Beverly Hills, CA: Sage Publications.
Mechanic, D. (1989). The evolution of mental health services and mental health services research. In C. A. Taube, D. Mechanic, & A. Hohmann (Eds.),The future of mental health services research (pp. 1–8) (DHHS Pub. No. ADM 89-160). Washington, DC: U.S. Government Printing Office.
National Advisory Mental Health Council. (1991).National plan for research on child and adolescent mental disorders. Rockville, MD: National Institute of Mental Health.
National Institute of Mental Health. (1983).Program announcement: Child and Adolescent Service System Program. Rockville, MD: National Institute of Mental Health.
National Mental Health Association. (1989).Final report and recommendations of the invisible children Project. (Available from the national Mental Health Association, 1021 Prince Street, Alexandria, VA 22314-2971).
President's Commission on Mental Health. (1978).Report of the President's Commission on Mental Health. Washington, DC: Government Printing Office.
Rosenblatt, A., & Attkisson, C. (1992). Integrating systems of care in California for youth with severe emotional disturbance I. A descriptive overview of the California AB377 evaluation project.Journal of Child and Family Studies, 1 93–113.
Rosenblatt, A., & Attkisson, C. (in Press). Integrating systems of care in California for youth with severe emotional disturbance III: Answers that lead to questions about out-of-home placements and the California AB377 evaluation project.Journal of Child and Family Studies.
Saxe, L. (1991, August).Reforming mental health services for seriously emotionally disturbed youth. Rhetoric, practice and research. Paper presented at the annual convention of the American Psychological Association, San Francisco, CA.
Stroul, B. A., & Friedman, R. M. (1986).A system of care for seriously emotionally disturbed children and youth. Washington DC: CASSP Technical Assistance Center.
Ten reasons to invest in the families of California: Reasons to invest in services which prevent out-of-home placement and preserve families. (1990). Prepared and published by the County Welfare Directors Association of California, Chief Probation Officers Association of California, and the California Mental Health Directors Association through a grant from the Edna McConnell Clark Foundation, Spring 1990.
Ware, J. E. Jr. (1989). Measuring health and functional status in mental health services research. In C. A. Taube, D. Mechanic, & A. Hohmann (Eds.),The future of mental health services research (pp. 289–302) (DHHS Pub. No. ADM 89-160). Washington, DC: U.S. Government Printing Office.
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Rosenblatt, A., Attkisson, C.C. & Fernandez, A.J. Integrating systems of care in california for youth with severe emotional disturbance II: Initial group home expenditure and utilization findings from the California AB377 Evaluation Project. J Child Fam Stud 1, 263–286 (1992). https://doi.org/10.1007/BF01322070
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DOI: https://doi.org/10.1007/BF01322070