Implementation and Development of Federally-Funded Systems of Care Over Time

This study describes development in federally funded systems of care. Data for this study were collected using the System
of Care Assessment that rated grantees’ enactment of system of care principles in the infrastructure and service delivery
domains. Data were collected by trained raters who conducted several site visits over the funding period. This study described
system development over time across 61 sites and tested whether gains were statistically significant. Latent profile analysis
was used to explore whether sites could be meaningfully grouped based on their baseline service delivery domain scores. Differences
across groups were tested in terms of community, system, and client characteristics. Differential growth across groups was
also examined. Overall, systems of care developed over time in both the infrastructure and service delivery domains. Although
infrastructure scores were generally lower than service delivery scores, greater gains were seen for the infrastructure domain.
Three groups of sites were identified that could be distinguished in terms of degree of development overall, and for specific
system of care principles. The groups of sites differed in terms of community factors, system features, and client characteristics.
In addition, repeated measures analyses found differential growth in system development over time across groups.