Systems of care was originally developed to address the needs of children with serious emotional disturbances. It is now being applied to other populations whose needs require services from multiple agencies, including families in the child welfare system. This broader implementation will help more families benefit from the systems of care focus on improving access to and availability of services, reducing service and funding fragmentation, and improving the skills, knowledge, and attitudes of frontline service providers.

The Children's Bureau conducts the Child and Family Services Review (CFSR) process as a means to assess State child welfare agencies' performance on seven outcomes and seven systemic factors. Results from these reviews have documented the need for a more comprehensive strategy to support children, youth, and families in the areas of safety, permanency, and well-being. Systems of care shows promise as a means to improve performance in these areas, for example, by helping to prevent placement in out-of-home care, reduce the number of placements, and address the primary health, mental health, and educational needs of children and youth and their families.

Systems of care is now being used to address needs identified by States' CFSRs and improve outcomes for children and families involved with child welfare, including:

• Children, youth, and families at risk of child maltreatment
• Children and youth who have been substantiated for maltreatment but have not been removed from the home
• Children and youth in State custody (foster care)