Defining the scope of systems of care: an ecological perspective

The definition of a system of care (SOC) can guide those intending to develop and sustain SOCs. Hodges, Ferreira, Israel, and Mazza [Hodges, S., Ferreira, K., Israel, N., & Mazza, J. (in press). Systems of care, featherless bipeds, and the measure of all things. Evaluation and Program Planning] have emphasized contexts in which services are provided to families, plus the adaptive, dynamic, complex nature of systems and multiple components that comprise SOCs. However, two areas need additional clarification: (1) the nature of the "system" of concern in a "system of care," and how it should differ from a "service delivery system"; and (2) the degree to which intended, or desired, outcomes of a SOC extend beyond increased access to "necessary" services and supports. These prime issues in the conceptualization of SOCs are addressed, drawing on ecological theory to underscore the need for broader systems--including factors in the proximal and distal contexts of children and families--to be engaged in the process of promoting well-being and helping children and families function and participate fully in their communities. A revised definition is proposed, with implications for the implementation of SOCs.