interagency collaboration

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Interagency CollaborationVirginia Smith Harvey aa University of Massachusetts Boston ,Published online: 15 Oct 2008.

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Interagency Collaboration: Providing a System of Care for Students

Virginia Smith Harvey

University of Massachusetts Boston

ABSTRACT. Child welfare, education, health, juvenile justice, and mental health systems have simultaneously initiated movements to reform services to troubled children during the past ten years. Recent- ly, these agencies have shown increased interest in bringing their change efforts together for a more unif~ed system of care. This paper describes essential components of systems of care and interagency collaboration. A case illustration describes a setting in which special service providers in schools, particularly special education administrators and school psychologists, played major roles in the collceptualiza- tion and implementation interagency collaboration for a system of care. [Single or multiple copies of this article are available from The Haworth Document Delivery Service: 1-800-342-9678. 9:00 a.m. - 5:OO p.m. (EST).]

INTRODUCTION

Movements to reform services to troubled children have been evident during the past ten years. Many of these initiatives focus on

Address correspondence to: Dr. Vuginia Smith Harvey, Department of Coun- seling and School Psychology, Graduate College of Education, Wheatley Hall, University of Massachusetts Boston, 100 Monissey Boulevard, Boston, MA 02125-3393.

The Department of Education, Oflice of Special Education and Rehabilitative Services provided funds for portions of this project. [Single or multiple copies of this arficle are available from The Haworth Document Delivery Service: 1dW-342-9678,9:00 a.m. - 5:OOp.m. (ESTJ.1

Special Services in the Schools, Vol. 10(1) 1995 O 1995 by The Haworth Press, Inc. All rights reserved 165

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166 SPECIAL SERVICES IN THE SCHOOLS

one target population and represent only one major system. For example, the child welfare system has focused on family preserva- tion. Recent publications provide accounts of attempts to coordinate systems change through interagency collaboration. Child welfare or mental health agencies often spearhead these efforts, and school personnel typically participate minimally (Lourie, 1994).

To address the complex needs, complex funding eligibilities, multiagency involvement, and changing situations of children and their families, several states have instituted statewide plans for systems of care. These systems, sometimes called "wraparound services," involve interagency collaboration in program coordination, case management, and cooperative funding (Behar, MacBeth, & Holland, 1989; VanDenBerg, 1990). Other implementation sites have been re- gions or cities (Lourie, 1994; Nelson & Pearson, 1991; Schrnitz & Gilcrist, 1991; Suoul, Lourie, Goldman, & Katz-Leavy, 1992). Some program evaluations of these projects have demonstrated that such coordination of services results in decreased costs to the community relative to residential placements (Nelson & Pearson, 1991).

Lourie (1994) has suggested the following principles of providing services in a system of care (a) community based and farnily focused services, (b) competence to meet the needs of clients, (c) coordination of interagency programs, (d) inclusion of farnily members in the development and implementation of plans for children, and (e) accepting the family as the most powerful resource for the child. For success, fundamental changes in thinking are necessary. The team must view children from an ecological perspective, and consider all aspects of a child's functioning and environment. Members refrain from using a medical or psychodynamic approach, assume neither the farnily nor the child to be the source of the problem, and do not direct interventions toward correcting deficits (Leone, 1990). The strengths of the child and farnily are given prominence and weaknesses are minimized. The family's and child's needs determine which services are provided, rather than whether the services are available.

Target Population

Authors writing in educational and psychological journals usually cite interagency collaboration in reference to three populations of students: the early intervention and preschool population, the popu-

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Krginia Smith Harvey 167

lation identified as having severe emotional or behavioral disorders (EBD), and the post-secondary, transition-to-work population (Olympia Division of Special Services and Professional Programs, 1987). These populations are usually involved with multiple agencies, and effective programming is often impossible without collaboration. A number of sources encourage collaboration for these populations including federal laws (IDEA, Public Law 99-547), grants, model programs (Nelson & Pemon, 1991), and the National Institute of Mental Health's development of the Children and Ado- lescent Special Services Project (Stroul & Friedman, 1986). Addi- tional focus on the provision of a full array of public and private services to meet the complex needs of children with EBD, particularly those with emotional or behavioral disorders so severe that they interfere with their education or community living, began when Knitzer (1982) pointed out that children with EBD were not even being served by the public agencies designed to provide them services. Interagency collaboration often targets students who have been placed, or who are about to be placed, in residential facilities. Another primary target group is students who are at home or in foster care but whose parents are finding it increasingly difficult to keep them in the home (Stroul et al., 1992).

Senice Array

According to Stroul and Friedman (1986), for adequate functioning at home, in school, and within the community, children with EBD and their families require a wide range of accessible services including the following: (a) educational services (alternative schools, assessment, full time special education, part time special education, residential schools); (b) health services (acute care, long term care, screening and assessment); (c) mental health services (assessment, crisis intervention, day treatment, individual therapy, group therapy, home based services, hospitalization, parent support); (d) recreation services (after school programming, summer programming); (e) social services (fmancial assistance, foster care, home services, protective services, respite care); and (e) vocational services.

Many communities do not have the above services. Further, even when these services are available they are typically not coordinated, which results in inefficient and ineffectual provision of care (Knit-

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zer, 1984). Often more than one service agency is responsible for a child with EBD and adequate planning involves interagency collaboration and support. Case management and cooperative funding are vital to adequately address all factors (Stroul & Friedman, 1986). Comprehensive evaluations across residential, educational, familial, legal, medical, psychological, safety, social, and vocational life do- mains are also required (VanDenBerg, 1993). In a system of care, services are modular, circular, overlapping, and interactive rather -. -

than on a continuum from least to most restrictive (Multiagency Network for Severely Emotionally Disturbed Children, 1989).

Stroul et al. (1992) profile five systems of care in some detail. School based services vary by community but in different locations have provided some or all of the following: (a) anger management programs; (b) before and after-school care; (c) case management; (d) a continuum of educational programs; (e) consultation with staff, children, parents; (f) contracts with the local mental health center for staff, preventative groups, or evaluations; (g) home- school collaboration staff; (h) mentoring programs; (i) paraprofessional support in regular classes; (j) parent support groups; (k) recreation, cultural enrichment, and social competency programs; and (I) substance abuse programs.

However, Lourie (1994) investigated nine states and sixteen local sites providing integrated services for troubled children. According to his study, school personnel are only occasionally members of interagency teams. Community mental health or child welfare agencies most often provide the leadership.

Community Coordinafion

According to Stroul(1992). six factors indicate successful interagency collaboration and system development: leadership, shared responsibility and vision, meaningful interagency process, proactive attitudes, creative approaches to problem solving, and service implementation, Interagency collaboration can be initiated at state, region, community, or school levels.

Interagency collaboration begins when a group of community leaders share frustrations regarding the current system, develop a shared vision of an ideal system of care, and become committed to the concept of building a system of care. Following the develop-

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Mrginio Smith Horvey 169

ment of a shared vision, leaders initiate the systems change and begin facilitating problem solving. This most often occurs following a trigger mechanism (e.g., a grant or lawsuit). Effective irnple- mentation then requires support from state administrators and policy makers to enact necessary changes including flexible funding and changes in eligibility requirements.

Successful interagency programs have a community team with diverse membership (e.g., leaders from businesses, child welfare agencies, churches, civic groups, colleges, cultural facilities, housing authorities, medicine, mental health, police, the private sector, public assistance, recreation facilities, schools, and vocational services). Developing a community team poses significant organiza- ,

tional problems because service providers are in different locations and have different eligibility criteria, vocabularies, funding sources, and treatment philosophies. Team members must pay direct atten- tion to the process of team building, including developing a cooperative vision, fostering a supportive climate, sharing decision mak- ing, eliciting leadership, and outlining systematic procedures for conducting team business (Nelson & Pearson, 1991).

Lourie (1994) found the following procedures typical of successful implementation of a system of care:

Assessments are needs based. Members minimize categorical population defmitions. Members blur professional and agency boundaries, and ac- knowledge a common population and underlying premise of social service. Financing mechanisms are restructured to support integrated services (possibly through sources such as block funding, Medicaid, or grants from the Department of Education or Robert Wood Johnson Foundation Mental Health Services Program for Youth). Training is provided for professionals, across agencies, and with families; Time needed to develop the system of care is devoted: 10 to 15 years is often necessary, far beyond the three to five years typically allocated in demonstration projects. State-local communication and synergy occurs, so that local procedures and state policies do not become too discrepant.

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Client Level Coordination

When discussing a particular child at the client level, the team includes the four to eight persons that the family believes know the child. Often members of the standing community team are not present during client level meetings, although direct service providers from their agencies are present as appropriate. During successful client level meetings, the professionals listen to the needs of the families and the children, find ways to meet these needs, and persis- tently refuse to give up on a child. The team determines the strengths of the family and child and repeatedly returns to and uses these strengths in developing problem solving strategies. Often the most effective strategies are not traditional. For example, rather than individual therapy, the team may recommend an after-school recreation program, funding for housing, respite care, or transportation funds (Harvey, 1993).

Family Involvement

Family involvement is critical in developing a system of care. Many families have experienced years of frustration with agencies and prefer to disengage rather than expose themselves to further frustration. Disengagement further increases with language or cultural differences. The following steps can help engage families: (a) addressing issues of confidentiality, (b) fostering the alliance of the family with one team member, (c) including parent advocates on teams, (d) listening and responding to family needs, (e) presenting as a well functioning group of professionals, (f) providing parent and external system education, and (g) providing the family with transportation to the meetings.

At a number of training conferences (Partners for Change: Fami- lies as Allies, 1992; Wraparound: A Safety Network for Children, 1994), parents have enumerated ways in which professionals can be helpful. Helpful professionals were available daily, collaborated with other agencies, were creative in provision of recreational and after school programs, demystified mental illness, were instructive (gave concrete strategies for behavior management and information about mental illness), were respectful and supportive (said "I know it is hard," provided support groups), and were tenacious (called

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Virginia Smith Harvey 171

parents, initiated contact, didn't "let go"). Unhelpful professionals blamed the parent, did not listen to the parent, did not recognize or try to pinpoint problems. dismissed parental concerns, excluded foster parents, referred to parents impersonally ("mom"), segre- gated children from peers, undermined parental confidence, used excuses to avoid helping ("it doesn't affect academics"), violated or ignored individual plans, were too busy, were judgmental, and were unwilling to help unless the child came in to the office, when the parent was unable to even get the child into the car.

Major Challenges

A number of barriers make the provision of a system of care and inter-agency collaboration challenging. These usually include eligibility criteria, funding, time, and resources. In addition, teams fre- quently identify additional local barriers.

Eligibility criteria. Federal and state laws mandate public school systems to provide a free and appropriate education to all. Every student living within a given geographical area is "eligible" for an education and consideration for special services. In contrast, community mental health, child welfare, developmental disability, juvenile justice, mental health, recreational agencies, social service, and vocational rehabilitation agencies are not so mandated. Eligibility for these services is not automatic and is dependent on meeting specific requirements. Even when agencies are mandated to work with a given population, the agesof eligible clients are not identical. For example, child welfare agencies, juvenile justice, and child and adolescent mental health units are often not responsible for children beyond the age of 18, but vocational rehabilitation units are not involved until that age.

Eligibility criteria also vary from agency io agency. Individual states define criteria for identification of students as educationally handicapped and criteria are quite discrepant from state to state. Department of education eligibility requirements differ from the criteria used by mental health agencies, who generally use the American Psychiatric Association criteria, and from the eligibility criteria used by other agencies such as juvenile justice and agencies for developmental disabilities.

Eligibility criteria for purposes other than determining target

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1 72 SPECIAL SERVICES IN THE SCHOOLS

populations can also be discrepant. That is, the child welfare agency criteria for acceptable foster homes may be diierent from those used by the agency for developmental disabilities.

Funding. Funding mechanisms also create barriers. It is not un- common for agency heads to feel competitively protective about "their" funds and believe that other agencies have more sources of money. Some agencies are in direct competition with each other for non-public funds (e.g., those funded through United Way) while others are in direct competition for public funds. Cross-agency sharing of funds, or pooled flexible funds, expand programming options and greatly increase the potential for success (Jacobs, 1990).

If a child is in an expensive out-of-district placement, fscal constraints can be dealt with by obtaining state and agency permis- sion to spend the same monies flexibly. It is logical to take some of the $40,000 spent on a residential placement to train therapeutic foster parents and provide parent training, after school care, and individual and group therapy. Unfortunately, it is more difficult to find the monies to provide-the same services to prewnt placement in residential placements, and still more difficult to find monies for preventive or early intervention services. Interagency teams ,must communicate with funding sources about the existence, importance, and effectiveness of interagency collaboration. VanDenBerg (1990) recommends finding methods to "lock" funds previously used for residential placements to provide needed community based services. For example, a city or state can budget a constant amount of money for providing services for children with EBD after a number of children have been returned from residential placements, and apply those funds toward interagency programs. Time. Time is a bamer from a number of perspectives. Many

service providers do not have flexibility in their ~schedules. FO; example, community mental health agencies earn funds only through billable hours. Therefore, attending an interagency meeting about a child who is not a client of the mental health agency (e.g., because their family belongs to a managed care health plan) costs the agency time and money, and must be provided on a pro bono basis. School personnel, particularly teachers, often do not have time in their schedules for meetings.

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Finding a common meeting time can be surprisingly'challenging. School personnel find it difficult to meet during the school day, whereas mental health personnel fmd it difficult to meet after three o'clock. If an interagency team is composed primarily of administrators from each agency, a specific time can be set aside on a regular basis for interagency meetings (e.g., ten o'clock to noon, every other Friday). At the elementary level, meetings are most easily scheduled during planning time at the school building, or needed class coverage provided by a special education teacher or paraprofessional not involved in the case. At the secondary level, meetings are most easily scheduled after school at the agency with personnel with least mobility at that time of day.

Finally, effective management of interagency cases requires additional time allocations that must be recognized by administrators and built into practitioners' schedules. This role might be as- sumed by the teacher, counselor, or psychologist with the strongest relationship to the family.

Resources. Determining the composition of interagency teams can be challenging because agency catchment areas are not identical. Therefore, some individuals will be on more than one interagency team at all but the state level. At the community level, the director of special education represents children only within the school district yet the mental health representative represents children from outlying towns and the director of child welfare may represent the children from the entire county. The same is true at the client level: whereas school personnel are attached to one geograph- ic location, children who attend a given school are Likely to have a number of different child welfare and community mental health workers.

Determining which agency has primary responsibility for a case and designating the case managers can also be a barrier to interagency collaboration. The varied eligibility requirements can result in considerable confusion over which agencies should be funding and coordinating services for a child. For example, an 18 year old with a history of sexual perpetration and an IQ of 75 does not fit eligibility requirements for a number of agencies, but is clearly in need of coordinated services.

Some practitioners feel undemained to work with students with

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EBD. To minimize this barrier, staff in schools and recreational facilities need to develop specific skills in behavior management, consultation, and crisis de-escalation. Funher, training should be an ongoing process rather than a final product, as staff will need ongoing support as they attempt to meet the unique needs of each student.

If school or agency personnel are not aware of already available resources, effective interagency collaboration is impeded. One method to diminish this barrier includes face-to-face meetings, both for individual cases and interagency get-to-know-you lunches. Another method is to develop a community resource manual. According to the Indiana Division of Special Education (1987), successful collaborating agencies designate one person to maintain contacts with schools, accu- rately define needs, clearly express problems and requests, schedule face-to-face meetings, and avoid minimizing problems.

CASE ILLUSTRATION: SCHOOL INITIATED INTERAGENCY COLLABORATION

As previously mentioned, Lourie (1994) found that schools have been minimally involved on interagency teams and have not provided leadership in developing systems of care. TO demonstrate the pivotal role a school district can play in this process, a case illustration is provided.

Nashua, NH has a population of about 80,000 and a public school enrollment of 12,000 students. In 1985, the district began construct- ing necessary supports for students with EBD, and in 1988 the district began to adopt a general policy of inclusion; by 1990 "inclusion" was designated as one of the general education district goals. Beginning in 1990 the district became increasingly involved with many regular education reforms including the movement toward applied mathematics, experimental science curricula, hetero- geneous grouping, literature based reading, outcomes based mea- surement, and process writing.

By 1991 the Nashua Schools were responding to the needs of the students with EBD by providing a continuum of services including: aide support within the regular classroom, full-time special education, individual counseling with school psychologists, out-of-dis-

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Virginio Smirh Harvey 1 75

trict day programs, part-time special education, and special education teacher support within the regular classroom. With this range of services the schools were able to provide for many of the educational needs of these students. However, without additional support they were often unable to participate in after-school care, recreational, or summer programs. This resulted in increasing stress on the family unit, increased dficulties for the children at school, home, and in the community, and subsequent residential placement. Although Nashua had developed flexible, comprehensive, and in- clusive programs capable of educating all children within the schools, it soon became apparent that the needs of students during after school hours must be addressed through interagency collaboration in order to keep them in the district schools.

A conference (Where Children Shall Live, 1991) coordinated by Nancy Rollins of the New Hampshire Children and Adolescence Special Services Project (CASSP) served as Nashua's catalyst for interagency collaboration. Following this conference, Gail Baning- er, Special Education Director, contacted local agency leaders and initiated interagency meetings. This community interagency team included administrators from the schools and the local mental health, child welfare, and developmental disabilities' agencies.

The first step was to create a vision: "that every child should have, and live in, a family as much as possible." The team decided that short t e n placements, group homes, hospitals, institutions, and respite care exist to support. not supplant, the family. Following the development of this vision, ground rules were enumerated. The community team decided that the following facilitate productive meetings: brainstorming without criticism, bringing food, creating fun, developing personal connections, maintaining confidentiality, not blaming, not personalizing, recognizing gaps, sharing resources, showing respect for each other (not interrupting, not inviting guests without prior notification, and sticking to the agenda), showing up on time, staying organized, supporting each other's frustrations, and trusting and sharing important information. The team developed procedures for referring students, developing agen- das, inviting parents, ensuring confidentiality, and taking minutes. Each meeting ends with the development of action plans in which responsibilities and time lines are designated.

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Although the initial meetings were very challenging, once team members began working together comprehensive programming was accomplished and expensive out-of-district placements were avoided. During client level meetings, additional participants included parents, school personnel, psychologists, and caseworkers. One case manager is assigned to each client and may be from any one of the agencies, dependent on child and family needs.

In many settings outside sources, such as the U.S. Department of Education, fund interagency meetings. In Nashua, however, each of the cooperating agencies donates the time devoted to interagency meetings. Furthermore, each agency shares the cost and time expenditure of case management duties. Already existing agency and school district funds provide most of the flexible programming, but some grant and Medicaid funds have augmented services.

Target Population

Members of the community team agreed to take responsibility for contributing to planning programs even when the children are not their legislative mandate, the children do not meet their eligibility criteria, and funds are not in their budgets. If a client level meeting results in an action plan constrained by limitations beyond the team's control (resource availability, rules and regulations, etc.), the team forwards an ideal action plan to the state directors for each agency (Pelletier, 1992). The purpose of sending ideal action plans to the state directors has been to elicit cross-agency cooperation at the state level. In some instances this has resulted in changed policies, for example, the development of common criteria for foster home approval. In other instances this has resulted in state level cooperative funding for family or student programs.

Service Array

More than a year after the founding of this team, the U.S. Depart- ment of Education awarded the Nashua Schools an 18 month federal grant to facilitate interagency collaboration for students with EBD. These monies were not used to fund interagency meeting attendance or case coordination, because these services were already in place and funded by participating agencies. Instead, the funds provided interagency staff training, recreational program-

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ming, and parent support groups. Special service educators, particularly school psychologists, provided services for each aspect of the project. They (a) co-led parent support groups with staff from the community mental health agency, (b) took part in interagency planning committees, (c) participated in training school and recreational staff, and, (d) provided crisis intervention, group counseling, individual therapy, and staff consultation during the after-school and summer programs as well as during the normal school day.

A substantial portion of this grant was devoted to staff training, an area often neglected by systems of care with interagency collaboration (Lourie, 1994). In interagency workshops for direct service providers, the following were provided: (a) an overview of the .interagency system of care concept; (b) a demonstration of the support that the concept has at the state and local level,'including a summary of present and proposed legislation, by upper level state administrators from the divisions of child welfare, education, health and human services, and mental health; (c) a role play and discus- sion of the specifics of successful experiences from parents, students, and agency representatives; and (d) an opportunity to individually develop this model of service delivery in workshops both within and across agencies.

Participants brainstormed barriers and solutions, and practiced interagency collaboration using a case study. The same ideas were shared at meetings for state senators, state representatives, judges, city alderman, members of the Board of Education, and upper level administrators from agencies and area schools.

At these sessions, parents also acted as trainers. Parent participa- tion in developing and training interagency teams is impo~tant for two reasons. First, it reinforces the philosophy that one of the main purposes of interagency collaboration is to empower parents and develop family driven programs. Second, the perspectives given by parents are heartfelt and powerful, and immediately deflect tenden- cies to blame families.

RESEARCH OUTCOMES

Providing a system of care through interagency collaboration has an underlying philosophy that children should receive appropriate

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neatment in as normal an environment as possible. Expected outcomes are decreased expenditures and placements in residential settings. Interagency collaboration would also be expected to create closef relationshipsbetween agencies, develop community responsibility for serving children, increase family involvement, and de- crease disruption &I the lives of children and their families. Under- lying all outcomes, however, is the anticipation that system reform will result in im~roved student outcomes.

Systematic evaluation of interagency system of care programs has been neglected (Lourie, 1994; Stroul et al. 1992). Preliminary data (MacFarquhar, Dowick, & Risley, 1993) indicate that interagency collaboration leads to effective progams for children within the community, as long as service providers plan for each child individually. Allen, Golubock, and Olson (1987) determined that treatments designed to support the child's natural family are more effective than treatments in residential settings. Behar (1990) found that the implementation of interagency services saves funds, although services for students with EBD are nonetheless three to five times as costly as those for typically developing students. Inter- agency collaboration results in fewer students requiring hospitalization or residential treatment.

Clarke, Schaefer, Burchard, and Welkowitz (1992) investigated the effect of interagency services on 12 students with EBD (the original sample of 28 was reduced by relocation, discontinuing services or school, or other factors). They found that services coordinated over a two year period resulted in clinically and statistically significant improvements in home adjustment. There were not cor- responding improvements in school behavior, although all students were maintained in regular classrooms.

However, a number of questions merit further investigation. Mi-

ly which populations most benefit from the expenditure of the time and effort involved in interagency collaboration? In Alaska, the program was least successful with adjudicated youth of 18 because they were able to sign themselves out of the system (Nelson & Pearson, 1991), but more information is needed in this area Other areas in need of investigative research include factors that affect the integrity of implementation and the durability of community and local teams.

Much of the impetus for systems reform has stemmed from the

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Virginia Smifh Harvey 179

observation that despite enormous funds expended for out-of-state residential pl,acements, "graduates" often are unemployed and non- productive members of society. A critical question-whether graduates of a system of care with interagency collaboration become functioning adults-remains to be addressed.

SUMMARY Child welfm, education, health, juvenile justice, and mental

health systems have initiated movements to reform services to troubled children and recently, these agencies have shown increased interest in bringing their change efforts together for a more unif~ed system of c m . These systems, sometimes called "wraparound services." involve interagency collaboration in program coordination, case management, and cooperative funding. The interagency teams view children from an ecological perspective, and consider a l l as- peas of a child's functioning and environment. Members refrain from assuming neither the family nor the child to be the source of the problem, and do not direct interventions toward correcting deficits; the strengths.'of the child and family are given prominence and weaknesses are minimized. Essential components of systems of care and interagency collaboration include leadership, shared responsibility and vision, m e a n i @ . u l interagency process, proactive attitudes, creative approaches to problem solving, and service implementation.

Interagency collaboration can be initiated at state, region, community, or school levels. Often child welfare or mental health agencies spearhead these efforts, and school personnel participate minimally. However, in Nashua, NH interagency collaboration was successfully initiated by providers of special services in the schools. Although challenging to initiate, collaboration has the major benefit of encouraging special service providers to support one another and not attempt to "cure" complex problems in isolation.

REFERENCES

Allen, M., Golubock, C., & Olson, L. (1983). A guide to adoption assistance and child welfare act of 1980. In M. Hardin (Ed.). Foster children in fhe court (pp. 575-609). Boston: Butterworth Legal Publishers. . .

American Psychiatric Association (1994). Diagnostic and sfofistical manual of mental disorders. 4th edition. Washington, DC: author.

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1 80 SPECIAL SERVICES I N THE SCHOOLS

Behar, L. (1990). F i c i n g mental health services for children and adolescents. Bulletin of the Meninger Clinic, 54(1), 127-139.

Behar, L. B., MacBeth, G., & Holland, J. M. (1989). Distribution of mental health services and their costs within a system of care for seriously e m o t i o ~ l l y disturbed and at risk children and adolescents. Raleigh. NC: North Carolina Division of Mental Health, Mental Retardation, and Substance Abuse Ser- vices.

Clarke, R. T., Schaefer, M., Burchard, J. D., & Welkowitz, J. W. (1992). Wrapping community-based mental health services around children with a severe behavioral disorder: An evaluation of Project Wraparound. Journal of Child and Family Studies, 1 . 241-261.

Harvey, V. S. (1993, January). Partners for change: Families as allies. New H m p - shire Association of School Psychologists, The Protocol, pp. 1.4.

Indianapolis Division of Special Education (1987). Resource guide for community agencies and contractual service providers for emotionally handicapped students. Indianapolis, IN: Indiana Department of Education.

Jacobs, J. H. (1990). Child mental health: Service system and policy issues. Social Policy Report: Sociev for Research in Child Development, 4(2),1-19.

Knitzer, J. (1982). Unclaimed children: The failure of public responsibility to children and adolescents in need of mental healrh services. Washington, DC: Children's Defense Fund.

Knitzer, 1. (1984). Mental health services to children and youth: A national view of public policies. American Psychologist, 39,905-91 1.

Leone, P. F. (1990). Understanding troubled and troubling youth. Newbury Park, CT. Sage Publications.

Louie, I. S. (1994). Principles of local system development for children, adolescents, and their families. Chicago, IL: Kaleidoscope, Inc.

MacFarquhar, K. W., Dowick, F! W., Risley, T. R. (1993). Individualizing services for severely emotionally disturbed youth: A nationwide survey. Adrninis~ration andpolicy in menral health, 20 (3), 165-174.

Multi-agency Network for Severely Emotionally Dishubed Children (1989). Building and balancing the system of care rhrough early intervention case management. Tallahassee, FL: Depanment of Health and Rehabilitation.

Nelson, C. M. & Pearson, C. A. (1991). Integrating services for children and youth with emotional and behavioral disorders: Current Issues in Special Education #1. Reston, VA: Council for Exceptional Children.

Olympia Division of Special Services and Professional Rogrms (1987). Partner- ship for thefuture: Proceedings. Olympia, WA: Office of the State Superinten- dent of Public Insmction.

Pelletier, S. B. (November, 1992). Collaboration in Nashua, New Hampshire yields results. Common Ground. 19.

Partners for Change: Families as Allies (1992, November). Conference conducted by the New Hampshire Child and Adolescent Special Services Roject, Concord. NH.

Schmitz, C. L.. & Gilcrist. L. D. (1991). Developing a community-based care

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system for seriously emotionally disabled children and youth. Child and Ado- lescent Social Work. 8,417-430.

Stroul, B. A. & Friedman. R. M. (1986). A system of care for severely enytionally disturbed children and youth. Washington, DC: Georgetown University CASSP Technical Assistance Center.

Shuul. B. A., Lourie. I. S., Goldman, S. K., & Katz-Leavy. J. W. (1992). Profiles of local systems of core for children and adolescents with severe e m o t i o ~ l disturbances. (Revised edition). Washington, DC: Georgetown University Child Development Center, CASSP Technical Assistance Center.

VanDenBerg. J. (1990). State and n a t i o ~ l recognitions: The Alaska Youth Initia- tive Program. Juneau, AK: Department of Health and Social Services.

VanDenBerg, 1. (1993). Individualized child mental health services as part of a system of care. Administration and Policy in Mental Health, 20 (4).

Where Children Shall Live (December, 1991). Conference conducted by the New Hampshire Children and Adolescence Special Services Project.

Wraparound: A Safety Network for Children (1994, June). Conference conducted by the Greater Nashua Network for Preventing Child Abuse and the Nashua Public Schools, Nashua, NH.

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interagency collaboration

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