In the lead agency model, the public child welfare agency contracts with a private nonprofit or for-profit agency to serve as a lead agency for a county, service area, or region. The lead agency then coordinates and provides all necessary services (either directly or by subcontracting with providers) and sometimes conducts utilization management and quality assurance. The goals in having a lead agency are to enable or encourage provider networks and provide accountability at the local level. In some cases, the lead agency assumed considerable financial risk (discussed later).
Every service district in Florida, for example, is required to contract with a lead agency (or, in the Miami area, more than one lead agency) that will take over all child welfare responsibilities beyond initial intake and investigative functions. In Kansas, the state child welfare agency maintained responsibility for administrative services (such as utilization management, monitoring services, and tracking performance and outcomes) and contracted with nonprofit lead agencies to coordinate and provide all child and family services. Maryland’s managed care initiative in Baltimore involves a vendor (a partnership of a nonprofit and a for-profit agency) that is responsible for all administrative functions, case management, and service delivery for children referred into the project.