Alaska Youth Initiative: the dream, the reality.

Many states have been interested in revising their systems of care for young people. The Alaska Youth Initiative (AYI) attempted to improve the system of care by providing community-based, individualized services to youths who would otherwise be institutionalized outside the state. Major policy changes included emphasis on local service provision, individualized services, unconditional care, and coordination of services. The AYI's performance on its original goals is mixed. Complications in implementation arose from lack of provider training, conflict over coordination at the state level, and difficulty in individualizing programs. Although significant successes have occurred, administrators could improve the implementation of similar types of programs by making specific plans to address concerns of various stakeholders, providing fiscal incentives for cooperation for state workers, and providing ongoing training in both clinical and administrative areas.