Maintaining Systems of Care in the Midst of Shock

The COVID-19 pandemic created massive disruptions across society. These disruptions put into focus integrated social service referral networks’, hereafter systems of care, ability to be resilient in times of crisis. This research examines 11 systems of care across the United States. The researchers compare network performance before and immediately following the emergence of the COVID-19 pandemic using quantitative service episode data (N = 2,579). Resilience is measured by examining whether networks improved their time to service (i.e., efficiency) and case resolution rate (i.e., effectiveness). The authors explain systems of care resilience and fragility based on in-depth interviews with care system workers (N = 17). Through these interviews, they identify three strategies that support resilience (1) coordination change, (2) network reduction, and (3) network growth and connection. In addition, they identify three factors that explain system of care fragility: (1) lack of capacity, (2) technology barriers, and (3) over-reliance on familiar providers.