A business model for managing system change through strategic financing and performance indicators: a case study

Area of Science:

• Child Welfare
• Public Health Systems
• Healthcare Management

Background:

• County government agencies often face fiscal challenges impacting children's services.
• Existing children's systems may lack integrated approaches and rely on costly interventions.

Purpose of the Study:

• To describe the reform of a children's system of care using a fiscal crisis as an impetus.
• To outline a cross-system response integrating a system of care framework and business principles.

Main Methods:

• Implementation of a system of care framework with inter-departmental collaboration and strategic reinvestment.
• Focus on cross-system entry points, financing reallocation from residential to community-based services.
• Utilizing a quality improvement system with performance indicators for management oversight.

Main Results:

• Successful diversion of youth from deep-end system penetration.
• Significant reduction in residential treatment bed days, enabling fund reallocation.
• Positive outcomes for children served in community-based settings post-diversion.

Conclusions:

• A fiscal crisis can be leveraged to reform children's systems of care effectively.
• Cross-system collaboration and strategic reinvestment are key to successful system change.
• Shifting resources to community-based services improves outcomes for children.