As stated in the President's New Freedom Commission on Mental Health's final report, Consumer Operated Services are an """"""""emerging best practice"""""""". The current application will enhance and accelerate the ongoing research being conducted in Kansas to develop a best practices model for CROs in Kansas and help move these CROs from being considered an emerging best practice to an evidence based practice. Specifically, this research has two goals, the first of which is to establish a """"""""best practices"""""""" set of standards that result in the best outcomes for members and sustain the solvency of the organization. This includes 1) the development of a best practices model of organizational functioning, 2) determine fidelity to the model, adherence to best practices among Kansas CRO's, and the development / continuation of a quality improvement process that incorporates feedback from CRO members to improve the best practices model. In order to collect data to help move CROs from being considered an emerging best practice to an evidence-based practice, this research seeks to conduct a pilot impact evaluation of CRO members. The objectives of this evaluation are to 1) document the effectiveness of CROs and estimate the effect size of member outcomes using rigorous methodology, and 2) further refine the CRO """"""""best practices"""""""" model by examining the relationship between organizational characteristics and member outcomes. To accomplish these goals, site visits and surveys of all existing members of seven targets CROs across Kansas will be conducted. Assessments of CRO characteristics will be based on the Consumer Operated Services Fidelity Rating Instrument (COS-FRI) developed by Carol Mowbray, who is also consulting on this project. In order to assess the impact of participation all new members who join a target CRO during the project will be invited to participate in baseline and 12 month follow-up interviews (n=240). Surveys will collect information on client demographics, community integration outcomes, use of services, and psychosocial outcomes.
