In the late 1980s and the early 1990s the Department of Children and Family Services faced legal challenges, including a class action lawsuit, from federal investigators, advocates for children, and the American Civil Liberties Union alleging inadequate and poor quality mental health services for youth in its custody. These challenges were settled through a consent decree in which DCFS agreed to initiate major reforms in the state child welfare system. As part of the consent decree, the University of Illinois at Chicago’s Department of Psychiatry was identified by both DCFS and the plaintiffs as an “independent expert” to help implement the system change efforts, and an innovative collaboration was crafted between UIC and DCFS. Since 1993, DCFS officials and UIC faculty and staff have been working together to improve clinical outcomes for foster children with psychiatric and behavioral disorders resulting in the formation of the Behavioral Health and Welfare Program. The Behavioral Health and Welfare Program consists of four separate projects with distinct but inter-related deliverables.