Wraparound in Washington State: Coordinating Care and Why it Matters Skagit Results: Dawn Scott and Terrance Ellison Pilot Site Results: Ericka Wiggins

Skagit Wraparound Program Status From: July 08 – June 10

Client Demographics Total of 20 youth and their families One (1) youth was a readmission, resulting in an actual unduplicated count of 19 Six (6) were non-Medicaid clients

Racial Demographics

Age Range at Intake Boys from 6 – 18  Mean: 12  Median: 12 Girls from 7 – 17  Mean: 12  Median: 11

Living Situation at Intake Two Parents:630% Biological Mother Only630% Biological Father Only210% Home Of Relative210% Foster Care15% Adopted315%

Referral Source N = 20Percentage Mental Health Agency 1575% School Based Mental Health 315% Psychiatric Hospital 15% Self Referral 15%

14 IEP and One (1) 504 Services Six (6) Months Prior to Wraparound Police Involved CPSARISResidential Treatment MH HospitalOutpatient MH Outpatient Substance Abuse Inpatient Substance Abuse Specialized Education Services Boys Girls Total %15%45%20%N/A35%90%10%5%75%

Two (2) IEP and One (1) 504 New Services After Entering Wraparound Police Involved CPSARISResidential Treatment MH HospitalOutpatient MH Outpatient Substance Abuse Inpatient Substance Abuse Specialized Education Services Boys22N/A Girls01N/A Total23N/A %10%15%N/A15%30%N/A10% 15%

School Status Intake Six Months 12 Months YesNo% Enrolled in School or Child Care 18290% School Changes or Disruptions 11955% Suspended (N/A= 3, 3) 61135% Expelled (N/A= 2, 3) 21611% YesNo% CHG 19195%+5% 51525%-30% 31715%-20% 1195%-6% YesNo% CHG 16480%-15% 41620%-10% 1166%-9% 0170%-5%

Youth Risk Factors Intake Six Months12 Months YESNO% Police Involvement 31715% Suicidal Gestures (missing=1) 91047% Strike Another Person 16480% Damage Property15575% Take Property (missing= % Run Away51525% Act Worried or Fearful 18290% Problems Due to Drugs 1195% Receive Outpatient MH Counseling 18290% Receive Inpatient MH Treatment 71335% YESNO% CHG 1195%NC 51525%NC 81240%-5% 51525%-5% 51525%-17% 21810%-5% 81240%-15% 1195%-5% 14670%-10% 21810%-10% YESNO% CHG 1195%-10% 51525%-22% 91145%-35% 61430%-45% 81142%-18% 31715%-10% 11955%-35% 21810%+5% 16480%-10% 41620%-15%

Caregiver Risk Factors Intake Six Months 12 Months YESNO% Under Supported Chronic Physical Illness 31715% Untreated Mental Illness41620% Untreated Substance Abuse (missing=1) 0190% Psychiatric Hospitalization0200% Incarceration1195% Domestic Violence1195% Victim of Sexual Abuse31715% Poverty (missing=2)71139% Exposure to Substance Abuse In The Home 21810% YESNO% CHG 31715%NC 21810%-10% 0200%NC 0200%NC 0200%-5% 21810%+5% 0200%-15% 71335%-5% 0200%-10% YESNO% CHG 1195%-10% 0200%-10% 0200%NC 1195%+5% 0200%NC 1195%-5% 0200%NC 71335%NC 0200%NC

Loss of Personal Time

Not at All

Loss of Personal Time A Little

Loss of Personal Time Somewhat

Loss of Personal Time Quite a Bit

Loss of Personal Time Very Much

Missing Work or Neglecting Other Duties

Not at all

Missing Work or Neglecting Other Duties A little

Missing Work or Neglecting Other Duties Somewhat

Missing Work or Neglecting Other Duties Quite a Bit

Missing Work or Neglecting Other Duties Very Much

Family Members Having To Do Without Things

Not at all

Family Members Having To Do Without Things A Little

Family Members Having To Do Without Things Somewhat

Family Members Having To Do Without Things Quite a Bit

Family Members Having To Do Without Things Very Much

$$ COSTS BENEFITS $$ Therapeutic Foster Care (CHAP): 4, (50% From NSMHA & 50% From CA) Juvenile Detention: 3, (Detainees do not receive Mental Health Services) Psychiatric Hospitalization: 41, CLIP Facility: 9, Wraparound: 1,500.00

Program Growth

Wraparound Washington Pilot Sites Skagit County, Grays Harbor, and Cowlitz County Combined Results

Client Demographics at Intake N% Age % % % Gender -Male2265% -Female1235% Race -White2782% - African American26% -Native American26% -Biracial26% -Other13% Hispanic (missing=7) -Yes27% -No2593%

Referral Source N = 34Percentage Mental Health Agency2471% DSHS26% Parent/Family13% Juvenile Justice13% School13% Other515%

School Status at Intake, 6 Months, and 12 Months (n=34) Baseline YesNo% Enrolled in School or Child Care 31391% School Changes or Disruptions (missing=1) % Suspended (missing=5) % Expelled (missing=8) 32312% 6 MonthsYesNo% Change Enrolled in School or Child Care (missing=1) 30391%No Change School Changes or Disruptions (missing=1) %-19% Suspended (missing=3) 42713%-25% Expelled (missing=3) 1303%-9% 12 MonthsYesNo% Change Enrolled in School or Child Care (missing=1) 26779%-12% School Changes or Disruptions (missing=3) 92229%-4% Suspended (missing=8) 2248%-5% Expelled (missing=8) 0260%-3%

Youth Risk Factors at Intake, 6 Months, and 12 Months Baseline6 Months12 Months YesNo%YesNo% ChangeYesNo%Change Police Involvement (missing=3) 62817%3319%-8%2297%-2% Suicidal Gestures (missing=1, 2, 3 ) %72525%-14%62519%-6% Strike Another Person (missing=1, 1, 2) %151846%-24%141843%-3% Damage Property (missing=2, 2) %112134%-34%92328%-6% Take Property (missing=2, 4, 2) %131743%-16%82425%-18% Run Away (missing=1, 2, 3) 72621%72522%+1%42713%-9% Act Worried or Fearful (missing=2, 2, 2) 27584%201263%-21%131941%-22% Problems Due to Drugs (missing=1, 2, 3) 1323%2306%+3%1303%-3% Receive Outpatient MH Counseling (missing= 1, 1) 31391%28585%-6%24973%-12% Receive Inpatient MH Treatment (missing=1, 2) 92527%52815%-12%3299%-6%

Caregiver Risk Factors at Baseline, 6 Months, and 12 Months Baseline6 Months12 Months YesNo%YesNo% ChangeYesNo%Change Under Supported Chronic Physical Illness (missing=5, 3, 2) 52417%62519%+2%3299%-10% Untreated Mental Illness (missing=4, 2, 2) 82227%3299%-18%2306%-3% Untreated Substance Abuse (missing=5, 2, 3) 0290%0320%No Change0310%No Change Psychiatric Hospitalization (missing=4, 2, 3) 32710%1313%-7%1303%No Change Incarceration (missing=4, 2, 3) 32710%2306%-4%0310%-6% Domestic Violence (missing=5, 3, 5) 62321%72423%+2%1283%-20% Victim of Sexual Abuse (missing=5, 3, 5) 52417%1303%-14%0290%-3% Poverty (missing=7, 1, 4)111641%141942%+1%121840%-2% Exposure to Substance Abuse In The Home (missing=4, 3, 4) 32710%0310%-10%0300%No Change

Community Supports for Wraparound Inventory (CSWI) Skagit County

Community Supports for Wraparound Inventory (CSWI) A tool that assesses the level of development of a particular community’s system-level support for wraparound. Data collected December-January items grouped into 6 themes 1. Community Partnership 2. Collaborative Action 3. Fiscal Policies and Sustainability 4. Access to Needed Supports & Services 5. Human Resource Development & Support 6. Accountability

Skagit County CSWI 39 invited to take the CSWI 30 of the 39 invitees responded = 76.9%

CSWI Overall and Theme Means- Skagit County

Theme Means: Pilot Sites and Comparison Total Score Cowlitz County66.3 Grays Harbor81.2 Skagit County79.2 National79.4

Wraparound Fidelity Index Wraparound Washington Total Fidelity Scores

Youth Information Number of Youth Assessed56 Interviews completed (total) -Caregiver31 -Facilitator55 -Youth14 Gender (missing=1) -Male34 -Female21 Race (missing=2) -White44 -American Indian/Alaskan Native3 -Mixed Race3 -Black or African American1 -Native Hawaiian/Other Pacific Islander1 -Other2

Overall Fidelity for All Sites WFCGYouth Pilot Sites National Mean837573

Fidelity Scores by Phase for All Sites Phase 1: Engagement Phase 2: Plan Development Phase 3: Implementation Phase 4: Transition Pilot Sites National Mean

Fidelity Scores by Principle for All Sites Family Voice and Choice (FVC)Team Based (TB)Natural Supports (NS)Collaboration (CO)Community Based (CB) Pilot Sites National Mean Culturally Competent (CC)Individualized (IN)Strengths Based (SB)Persistence (PE)Outcome Based (OB) Pilot Sites National Mean