Wraparound – A Team Based Approach

What is Wraparound? Evidence-based model for youth involved in multiple systems Facilitation of child and family teams to develop a single plan of care Reduce duplication, increase coordination, focus on outcomes Use of natural supports and flexible services Use of peer support for families and youth

10 Principles of Wraparound –Family Voice & Choice –Team Based –Natural Supports –Collaboration –Community Based –Culturally Competent –Individualized –Strengths-based –Persistence –Outcomes Based

Wraparound Facilitator –Follows client and family through various levels of care and across providers –Completes a comprehensive strengths and needs assessment of each child and family –Has authority to authorize and fund services and flexible supports –Facilitates at least monthly meetings of identified team to develop and monitor single plan of care –Utilize identified strengths to meet needs –Caseload of 15 or fewer

Needs vs. Services –Philosophical shift in approach to developing care plans –Services are not needs –Brainstorm strategies as a team –Blend of professional services and flexible/natural supports

Examples from Wraparound Plans Facilitate neighborhood meeting for a youth discharged from residential treatment to educate the community on the youth’s needs and how to effectively interact Assist parent to reconnect with estranged sibling to offer ongoing emotional support and occasional child care Purchase baby carrier to allow parent to take public transit with other kids to attend family therapy appointments Purchase cell phones/ phone cards for transition age youth to ensure ability to stay connected to treatment team Mobilize extended family members to provide supervision for a high needs child after school to allow parent to maintain employment Provide first month’s rent to get family out of moldy apartment for youth with serious mental illness and asthma

Fiscal Impact? Washington County experience –Reduced annual cost per client by 33% –Reduced cost of Psychiatric Residential by 43% per client served –Reduced cost of Psychiatric Day Treatment by 71% –Overall use of acute and subacute care declined by 58% (not just for youth in Wraparound)

Now What? Wraparound is expanding to another 8 sites across Oregon Opportunity to coordinate across systems (medical, dental, addictions) Adapt to medical homes and chronic disease? Thank You!