The Use of Formal Partnership Agreements to Align Service Delivery Across Health and Social Service Systems

Formal partnership agreements (FPAs), such as contracts, Memorandums of Understanding, or service agreements, are tools for aligning human services across systems and sectors. Yet, specific elements of FPAs most critical for supporting service alignment remain unclear. This mixed methods study examines whether inclusion of FPA elements addressing shared purpose, data, and governance were associated with timely receipt of services. We conducted qualitative analysis on FPAs (n = 57) between public child welfare agencies and private behavioral health providers participating in a cross-sector systems intervention in 26 Ohio counties. These data were linked with quantitative analysis of county-level administrative data on a key process outcome: timeliness of substance use treatment receipt for families involved in the child welfare system. Findings suggest that treatment timeliness was higher in counties where FPAs emphasized shared purpose across partners. FPAs may support cross-sector and multi-system collaboration by clarifying service alignment goals.