Each year, increasing numbers of children and families seek care for psychiatric crises; unfortunately, most communities offer limited services to meet these needs. Youth in crisis often present to emergency departments, but may not need or benefit from that level of care. Instead, data reflect improved clinical and financial outcomes when communities offer a continuum of crisis services. In this article, the authors present care models from two communities - Ventura County, California, and the state of Connecticut – and review program development, implementation, and monitoring. The authors also highlight principles for leaders to consider in developing these services.