Journal of Child and Family Studies, Vol. 2 No. 2, 1993, pp. 119-141 Integrating Systems of Care in California for Youth with Severe Emotional Disturbance III: Answers That Lead to Questions About Out-of-Home Placements and the AB377 Evaluation Project Abram Rosenblatt, Ph.D., 13 and C. Clifford Attkisson, Ph.D. 2 This paper is the third in a series of reports on preliminaty empirical findings from replications of an integrated system of care for youth suffering from serious emotional disturbance. The development of the innovative system of care was pioneered in Ventura County, California, and the replications in three other California counties were legislatively enabled through California legislation (Assembly Bill 377). This report presents results on the expenditure and utilization of foster homes, residential placements made through special education programs, and state hospitals. Evaluation results indicate that foster home and state hospital utilization and expenditures are lower for the counties replicating the innovative system of care than for the state of California as a whole. Expenditures for special education residential placements are either at the state rate or lower in one county. The cumulative evidence supports the conclusion that the replication counties are utilizing restrictive levels of care at lower rates than would be expecte4 given state-wide patterns. The results, in conjunction with prior findings, are discussed in the context of questions about the possible fates of youth who no longer live in publicly funded residential facilities. KEY WORDS: mental health; services research; foster care; children; psychiatric hospitalization. 1 Assistant Research Psychologist, Department of Psychiatry, The University of California, San Francisco. 2 Professor of Medical Psychology, Department of Psychiatry, The University of California, San Francisco. 3 Correspondence should be addressed to Abram Rosenblatt, Department of Psychiatry, 401 Parnassus Avenue, Box CPT, The University of California, San Francisco, San Francisco, CA, 94143. 119 1062-1024/9310600-0119$07.00/0 0 1993 Human Sciences Press, Inc.