Wraparound is a team planning process that creates an individualized plan to meet the needs of children and their families by utilizing a strengths-based approach. The Wraparound philosophy is that each child and family are unique and must have an individually designed set of services and supports that focuses on keeping the child in their home. The child and family will decide on team membership which may include clinicians, Child Welfare workers, Juvenile Court, schools, other community agencies, family and anyone else the family finds supportive. The Wraparound plan is then developed using a team approach. Wraparound is an established practice of coordinating services and supports for families and their children, who have a serious emotional disturbance, are involved with multiple systems and where other forms of intervention have not had successful outcomes. Wraparound is available to children/youth from birth-21 and their families involved in the Community Mental Health system and are available in every community in Michigan.
- Medicaid Provider Manual description of Wraparound Services
From the Behavioral Health and Intellectual and Developmental Disability Supports and Services heading and Behavioral Health and Intellectual and Developmental Disability Supports and Services sub-section (http://www.mdch.state.mi.us/dch-medicaid/manuals/MedicaidProviderManual.pdf).
3.29 WRAPAROUND SERVICES FOR CHILDREN AND ADOLESCENTS
“Wraparound services for children and adolescents is a highly individualized planning process facilitated by specialized supports coordinators. Wraparound utilizes a Child and Family Team, with team members determined by the family often representing multiple agencies and informal supports. The Child and Family Team creates a highly individualized Wraparound plan with the child/youth and family that consists of mental health specialty treatment, services and supports covered by the Medicaid mental health state plan, waiver, B3 services and other community services and supports. The Wraparound plan may also consist of other non-mental health services that are secured from, and funded by, other agencies in the community. The Wraparound plan is the result of a collaborative team planning process that focuses on the unique strengths, values and preferences of the child/youth and family, and is developed in partnership with other community agencies. This planning process tends to work most effectively with children/youth and their families who, due to safety and other risk factors, require services from multiple systems and informal supports. The Community Team, which consists of parents/guardians/legal representatives, agency representatives, and other relevant community members, oversees Wraparound. Children/youth and families served in Wraparound shall meet two or more of the following criteria:
- Children/youth who are involved in multiple child/youth serving systems.
- Children/youth who are at risk of out-of-home placements or are currently in out-of-home placement.
- Children/youth who have been served through other mental health services with minimal improvement in functioning.
- The risk factors exceed capacity for traditional community-based options.
- Numerous providers are serving multiple children/youth in a family and the identified outcomes are not being met.
Children/youth receiving Wraparound would not also receive, at the same time, the Supports Coordination coverage or the state plan coverage Targeted Case Management. In addition, PIHPs shall not pay for the case management function provided through home-based services and Wraparound at the same time.
PIHP/CMHSP for Medicaid providers delivering Wraparound services (provided either as a 1915(b) Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) service or an SEDW service) must request approval of the Wraparound Service Program from MDHHS through an enrollment process defined by MDHHS, and re-enrollment must occur every three years. Programs are to be re-enrolled to ensure policy and Wraparound model fidelity adherence.”
- Wraparound Evaluation
The Wraparound Evaluation Project is based on data collected and analyzed to assess how well Wraparound process is meeting its goals and to inform future efforts to improve and strengthen the Wraparound process in the state of Michigan.
The report provided analyzes outcomes for children and youth who received Wraparound services across the state of Michigan. The sample of Wraparound participants for this report includes youth who have initial and exit CAFAS/PECFAS data available (N = 1170). There are a total of 1076 children/youth who are 7-19 years of age and 94 children who are birth to 6 years of age included in this report.
This data report analyzes data collected between December 1, 2010 and July 1, 2016. Review the 3rd Quarter Wraparound Evaluation.
- Wraparound 180 days in CCI/Hawthorn
When a child or youth who is receiving Wraparound services is placed in a Child Caring Institution (CCI) or Hawthorn, Wraparound support will continue for the youth and family for a period of up to 180 days for the purpose of ongoing planning to transition the child/youth back into the community. The primary focus of Wraparound services will be the development of a plan to transition the child/youth from the CCI or Hawthorn back to the community as soon as possible.
Children/youth who are in a CCI or Hawthorn and who are not already receiving Wraparound may be provided Wraparound up to 180 days prior to discharge for purposes of transitioning back to their home and community. The referral to Wraparound services may be initiated by the child or youth’s parent/guardian, the CCI or Hawthorn, or other child serving systems. The goal of this referral must be to facilitate, and develop a plan for, the successful discharge of children/youth back to their community. If a referral is made to the Community Mental Health provider from another child serving system the referral process will be consistent with Wraparound referral mechanisms already in place.
A child or youth who is in a CCI or Hawthorn will continue to count toward the facilitator’s caseload size. Discharge planning should be initiated at the time of placement or first Wraparound meeting following admission.
- Wraparound teams will develop outcomes with the CCI or Hawthorn treatment providers to identify when discharge should occur. The development of outcomes should occur as soon as possible after the child or youth is placed and no later than 30 days from date of CCI or Hawthorn admission. These outcomes will state specifically the change that needs to occur in behavior or mental health functioning to support a successful transition to the community. These outcomes will identify a means for measurement of progress toward the desired change, and the outcomes will be measured and documented at every Wraparound team meeting.
- Wraparound team meetings will occur no less than twice monthly with CCI or Hawthorn staff, family and youth, and other team members.
- Wraparound meetings should be face to face when possible but may utilize conference calling or other means if distance prohibits face to face contact.
- Wraparound teams will continue to work with family members to assess needs related to the return of the child/youth to their home and community.
- Wraparound teams will work with treatment providers to share pertinent information and to assist in the development of treatment goals.
- Transition planning will focus on increasing functioning of the child/youth with the goal of returning the child/youth to their home and community as quickly as possible.
Included in the transition plan will be a strength based crisis and safety support plan that is individualized to the child/youth and family.
- 2019 TRAINING CALENDAR