The Bexar County Juvenile Detention model began as a multiagency effort that involved three organizational entities: the University of Texas Health Science Center Department of Pediatrics, the Bexar County Juvenile Probation Department, and the Bexar County Medical/Psychiatric Services Department. The purpose of the model was to address the primary and secondary needs of high-risk youth for medical and substance abuse treatment services. Case management involves the coordination and delivery of psychosocial, drug abuse prevention and intervention, AIDS prevention/education, and primary medical care by a multidisciplinary team of social worker psychologists, nurses, and physicians. Service integration occurs in two phases. In phase one, assessment, substance abuse and HIV education as well as medical and substance abuse treatment services are provided at the detention facility. In phase two, follow-up services are arranged and coordinated by a case manager. The detained juveniles who participate in the program are primarily from an ethnic or racial minority. Some of the lessons learned in the 14 months of the program's operations are outlined. 38 references