St. Luke's Health Initiatives and the Flinn Foundation strive to make Arizona a better place to live for all of its residents. Despite our state's assets, Arizona has many issues to address, with health and poverty among the most important. Our organizations have been pleased to sponsor the state capacity research that provided the background and impetus for "More Promises to Keep: Sustaining Arizona's Capacity for Welfare and Health Reform." St. Luke's Health Initiatives and the Flinn Foundation view the information and analysis provided in this report as a good way to stimulate discussion of health and welfare policy options and community actions. Research and dialogue are essential steps in the process of constructive change, as is communication with the public. We urge readers to consider the ideas presented in this paper and to continue to work together to improve the health and welfare of all Arizonans.

Despite all of the spending reductions, fund transfers, and other techniques used to balance the budget in the preceding few years, Arizona’s general fund faces a massive deficit. This issue of Policy Points poses an important question: Are you content with the historically low expenditures being made from the general fund and satisfied that the current low level of public services will be permanent?

In preparation for new federal legislation that promotes unprecedented levels of comprehensive planning and service integration at state and local levels, an analysis of state issues relevant to comprehensive service delivery is necessary. This paper examines such state issues, with a focus on Arizona's at-risk population, and presents a framework for comprehensive service delivery. It provides the rationale for such service delivery, summarizes the literature on research-based practices, illustrates district approaches to comprehensive service delivery, and sets forth guidelines for developing a comprehensive plan. System components of an effective plan are discussed in detail--student education, parent/family involvement, social/economic services, health services, and professional development. Five general principles underlie success: philosophy, people, processes, promising practices, and partners. Recommendations for developing comprehensive service delivery programs include the following: (1) build on existing information; (2) consolidate knowledge; and (3) think long-term. Contains 11 figures and over 250 references. Appendices contain information on Arizona practitioners' views and an illustration of a side-by-side program analysis.