| Ramsey County ACE is a comprehensive intervention for child delinquents under age 10 who have multiple serious risk factors for future serious and violent offending. A key feature of the program is an Integrated Services Delivery Team (ISDT) at the county level that promotes collaboration across jurisdictional lines, including Child Protection Services, Mental Health Services, Financial Services, and Corrections. The county also contracts with agencies in the communities where children live to provide direct services through a case management model. Case managers with low caseloads (12-13 families) put together a package of services that is aimed at reducing risk factors and promoting healthy development. This paper will review how the model is used to tailor services to children's needs while retaining accountability for outcomes at the program level. Modifications that improve effectiveness include monthly case reviews by the psychologist and social worker on the county ISDT, setting concrete short-term goals, and conducting quarterly assessments of progress using a standardized clinical measure. Educational workshops on delinquency also help equip case managers to be more effective. Preliminary evidence of the program's effectiveness will be reviewed along with a summary of how barriers to change increase with the child's assessed level of risk.
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