Care Coordination Services: A Description of an Alternative Service Model for At-Risk Families

The objective of this article is to describe a care coordination model that includes promising practices which are supported by both practice-based and research-based evidence. This model was developed to address the gaps of other models, namely an emphasis on skill teaching with parents, the flexibility to adapt to the needs of youth with a wide variety of presenting problems, and model fidelity assessment tools to help scale up the program across multiple locations with fidelity.

We discuss preliminary administrative and outcome data from 898 youth served across eight locations.

Data suggest positive outcomes at departure from service, as well as 6 months and 12 months post case closure.

Preliminary data indicate that youth with educational and behavioral health challenges can benefit from coordination of services that are both youth guided and family driven. As this program has been scaled up and has an established vehicle of dissemination, it is in a unique position to be tested via more highly controlled and rigorous efficacy trials.