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

Federal Programs For Child Mental Health Services

Financing an interagency system of care requires that state and local officials make effective use of all relevant resources. Much of the funding for services to children with mental and emotional disorders comes from the federal government. Unfortunately, these monies come from numerous complex programs. These programs are hard to understand individually and even harder to understand as parts of a comprehensive revenue stream for state and local systems of care.

The rules for the various federal programs are designed to ensure accountability. These programs target resources to address specific needs of children and achieve specific federal policy objectives. However, participants stressed that both the number of federal programs that fund services for children and the fact that federal dollars flow through several separate federal agencies create significant difficulties for state and local officials who are designing comprehensive interagency systems of care to meet the range of needs that children with serious mental and emotional disorders have.²

Those interviewed were most frustrated by the fact that individual children may be eligible for some federal programs, but not others. This creates gaps in funding for the continuum of needed services. Families may have limited choices and experience delays in accessing appropriate services because their children fall between the cracks of federal programs. In the worst situations, children are provided the services that can be funded rather than the services that could best meet their needs. At a minimum, disjointed funding streams force families to go from place to place to seek care and undermine efforts to provide continuity in services. Inconsistent accounting standards, including different data-collection and reporting requirements, can further frustrate state and local efforts to provide a coordinated system of care.

While these are all significant obstacles, states contacted for this study have found ways to address many of them and to use federal funds effectively and in a coordinated manner. These states have achieved more success in this than many other state and local officials realize. Their combined experiences are reflected in the recommendations that follow.

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