This study aims to analyze the process of decentralization of health care to adolescents in under socio amid open in the city of Nova Iguaçu. The rationale of the study part of the rescue efforts of different models of public policy established throughout Brazilian history under the influence of changes capitalists. Thus, examines some of the historical periods that pervades Brazilian pubic administration by the various changes in the way public policy management, decentralization of social policies in Brazil March 80. And it also characterizes the attempt to reform the state, the configuration of social policies in the 90s and the way of conducting social work through social and educational activities. The analysis process was to references the categories governance, intersectoral, territorialization that have key role in the implementation of health care to adolescents in the county. This in turn requires a reordering of institutional decentralization policy in both the legal aspect as in aspects of infrastructure, human resources, budgetary allocation, community integration and inclusion in the political agenda of the municipality. Faced with this new reality requires that the municipality has a public management inteirada of real local demands, as integrated with the network, with the guarantee of rights and the achievement of the implementation of health care to adolescents in under socio-in an open environment.