This paper reflects on lessons learned from the implementation of KAN Focus, a demonstration project to develop a system of care for children with severe emotional disturbance in rural southeast Kansas. It notes trends toward providing more and younger children with community-based support services which provide family centered services, short-term, targeted approaches such as information and advocacy for parents, case management, attendant care, and home-based family therapy. Outcome data in Kansas are reported to show that children are progressing more rapidly, completing services sooner, and returning to services less often. A review of research found that when the primary risk factors are poverty, single family homes, and lack of medical care, health- and education-focused home visitation programs can have dramatic positive effects. However, when the same risk factors are accompanied by mental illness, substance abuse, or family violence, success rates of such programs are much lower. Three specific lessons from the Kansas effort are discussed: (1) systems of care for young children are very different than the ones for children and adolescents with severe emotional disturbance; (2) collaboration is worthwhile but hard work; and (3) good program evaluation improves collaboration, service effectiveness, cost efficiency, and sustainability. (DB)