A community-based system of services is an infrastructure that operates across service sectors. It facilitates the integration of services in several dimensions— including organization, delivery, and financing. The development of community-based systems of services is a response to the complexity and fragmentation of services for CSHCN and their families. Multiple service programs—each with its own funding streams, eligibility requirements, policies, procedures, and service sites—serve CSHCN. It is clear that communities and their resources affect the way families of children with special health needs find and use services. Therefore, the health of communities themselves can have a positive effect on the growth and development of CSHCN. There now exist a number of initiatives to develop communit- based systems of services and a number of related community development initiatives in communities throughout the nation. The public sector has furnished much of the impetus for such initiatives, but the private sector, especially through the efforts of several national foundations, has increasingly become active in instituting such initiatives.

To evaluate this outcome, the 2009-2010 survey used a series of questions about potential barriers to access to services for CSHCN, and whether or not parents were often frustrated in their efforts to obtain services for their children. It should be noted that the results for this outcome cannot be compared to either of the previous rounds of the survey, as the set of questions used to evaluate the outcome have changed completely.

In addition to the questions that are directly used to assess the achievement of the outcome goal, this section also presents the findings of the survey on the specific services that CSHCN and their families need, and whether or not they received all of the services they needed

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