Many of today’s "health problems" are in fact social challenges with health-related implications and outcomes. For example, the disparity in health status across members of different ethnic, racial, and tribal groups is caused by a wide array of factors and is not due solely to inadequate medical care. Similarly, the utilization of health and social services is influenced by a variety of psychological, financial, environmental, and geographic factors.

Improving health status requires the collaborative efforts of representatives of many agencies in the public and private sectors and an array of disciplines. For these reasons, it is essential to work toward the goal of improved health outcomes using a systems, rather than a categorical, approach. A system of care, as defined by Health Systems Research, Inc. (HSR), is one that contains all the service components needed to improve health status. Each component must be available, accessible, and responsive to the needs of individuals and families, regardless of where they live, their income, or their racial, ethnic, or tribal background. Equally important, each component of the system must communicate with the others to ensure coordination, collaboration, and integration of services.

Most communities, regions, and States find it difficult to shift from a categorical approach to a systems approach to care. They must confront and address categorical funding requirements, turf allegiances, tradition, and an overall resistance to change. HSR staff has helped numerous communities and States manage this shift. Using a strengths-based, results-oriented approach, HSR focuses on:

• Conducting cross-agency, interdisciplinary strategic planning
• Facilitating interagency collaborations
• Increasing providers’ competencies to integrate service delivery and effectively serve people of differing cultures, linguistic backgrounds, abilities, and sexual orientation
• Supporting consumer groups as full participants in all aspects of system planning, implementation, and evaluation
• Designing and conducting evaluations
• Blending funding across program and agency boundaries.

At HSR, we are able to distinguish the "trees"' from the "forest" of the health and human services world, understanding both program-specific details and the broader context in which program and policies interact. We have assisted in systems-building efforts in every State, the District of Columbia, and several Territories. As a result, we appreciate the unique needs and characteristics of each jurisdiction and tailor our assistance to local needs and customs.

In our work, we help stakeholders understand their interconnections and the individual and collective value of a collaborative approach to planning, implementing, and evaluating services. We use a range of techniques, including group facilitation, cross-training, interactive workshops, and policy academies.