Introduction Federal Programs for Child Mental Health Services Principles for a Successful Funding Strategy Blending or Braiding Federal Funds Using Federal Funds Effectively Entitlements and Permanent Authorities How States Use Federal Entitlement and Block Grant Funds Discretionary Programs Plug the Gaps Matrix of Federal Entitlement and Block Grant Programs to Support Systems of Care for Children with Serious Mental and Emotional Disorders Collaborations for Interagency Systems of Care Who Collaborates? First Steps to Take Getting Down to Business Barriers to Overcome Keeping Collaborations Going Managing Change in Difficult Times Conclusion Notes Further Readings Tables 1. Purposes of and Constraints in Major Federal Programs 2. Discretionary Federal Programs Supporting Services and Activities of Interagency Systems of Care for Children with Mental Health Needs Principles for a System of Care for Child and Adolescent Services

Principles For A Successful Funding Strategy

A study of the Robert Wood Johnson project that led the way in demonstrating the effectiveness of interagency systems of care found that successful systems use resources from various sources, often in ways that less successful collaborations do not. Successful systems integrate resources behind a common plan for each child and family, to which all the collaborating agencies are committed. Rather than tightly controlling expenditures through overly restrictive regulations and burdensome cost-accounting at the provider level, these systems have set up an extensive provider network, which operates in a flexible manner, focuses on performance and outcomes, and makes continuous efforts to improve the quality of services. Flexibility is supported either by blending various funding streams and/or by braiding major program funding or by doing some of both (This box provides additional information on these mechanisms). Under this approach, each family has one care plan that is coordinated through a single accountable entity but funded with resources from various programs.³

To ensure a successful funding strategy, those interviewed suggested that state and local planners need to:

• have a clear vision of what they are trying to finance;
• engage in collaborative planning across agencies and with families;
• understand resource options. Planners must determine in what way federal funds can be used, under what timetable, how and by whom, and what are reporting requirements. In doing this, it is important to avoid a rigid and conservative interpretation of federal rules, particularly Medicaid;
• create a funding strategy that merges and takes maximum advantage of different funding sources—federal and other—so that child and family needs drive agency decisions on which services to provide;
• focus on outcomes but recognize the need for accountability – in particular, cost-accounting must be rigorous to demonstrate how program requirements are being met. It is necessary to track, document and account for funds as well as demonstrate outcomes;
• engage families in the service and provider monitoring process;
• possess a data infrastructure that can provide the essential information needed to ensure accountability; and
• provide training and cross-training of staff.

Next: Blending or Braiding Federal Funds