In this article we explore the relationship between the degree to which local systems of care share responsibility for children and adolescents (measured by the Caseload Segregation/Integration Ratio) and four service delivery outcomes in one state over a 4-year period. Caseload segregation/integration is measured for community mental health agencies, child protection and juvenile justice programs, and special education programs for emotional and behavioral disorders. Service outcomes under examination include referral for intensive residential treatment and hospitalization for behavioral health care (for all children), incarceration (for boys), and maternity (for girls). Results indicate that greater caseload integration is associated with less referral for residential treatment and higher rates of incarceration.The interpretation of these findings is discussed, and further research is suggested.
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