The analysis revealed that most programs used case management as a crucial strategy for meeting and coordinating information, services, and resources required to meet the complex needs of drug-using women and their families. Grantees noted that while case management offers flexibility and a personalized approach, it requires structure, expertise, and management. Case management had pejorative connotations for some women. All 12 projects began with available services such as prenatal care or drug treatment and used momentum from perceived crises to build systems and coalitions. Coalitions were crucial to establishing relationships, brining in local participants, changing attitudes, and reducing isolation. Many projects used grant funds to develop systems of care by sharing funds, staff, or space or by cosponsoring events with other related programs. Projects that survived beyond their grant periods used seven sustainability strategies, including building sustainability into their projects form the beginning, providing a unique service or training, and obtaining small grants from local foundations and other sources while awaiting more stable and substantial support. Chart, list of focus group participants, and 39 references