About Wraparound, CCF and Community Partnerships, Inc.

What’s the history of Wraparound? The term Wraparound was probably first coined in the early 1980’s to describe a new movement in mental health care for children. The initial concepts of this way of delivering mental health care were simple. Treatment was based on individualized needs and service and probably most importantly was unconditional. In the late 1980’s the Robert Wood Johnson foundation funded some of the initial state wraparound programs, including one in Wisconsin. From these early programs, Children Come First (CCF) emerged in 1993 to serve children and families in Dane County. The Achieving Reunification Through Teamwork (ARTT) unit was created by Dane County Human Services in 1995 and coordinates care for one-third of the CCF youth. Community Partnerships began the management of the CCF contract in 1999. CCF started out serving 30 youth and families in April 1993 and has grown to 170 youth and families as of July 2005.

So now what does Wraparound mean? Essentially, it is defined as a way of providing mental health services to children and their families involving a collaborative team-based approach. The basic philosophical elements to this way of delivering mental health care include:

• Voice – The child and family are active partners in making treatment decisions.
• Team – The approach must involve a team consisting of members of those social systems (family, school, community, neighbors, church) who are most important to the child.
• Community Based – Mental health treatment success is best achieved in the community in which the child lives.
• Culturally Competent – The process must be built on each family’s unique values, preferences, and strengths.
• Individualized – Every child has different needs and abilities and treatment plans need to reflect this.
• Strengths Based – Mental health treatment success can be best achieved if we focus not only on the problems of a child and family but also what is going well and is healthy about the family.
• Natural Supports – The use of informal community supports such as neighbors, church or friends is important to the success of children.
• Continuity of care – Unconditional commitment to continue to help the families through whatever services are necessary to meet treatment goals.
• Collaboration – The child is best treated if all the important systems in her life are working together towards similar goals.
• Flexible Resources – It is important to be able to flex resources towards what the team believes is most important to the mental health needs of the child.
• Outcome based services – Goals and services must be measured and treatment adjusted to improve outcomes.

So what do we do at CP and CCF to provide these Wraparound Services? Certainly our largest service is to act as the lead agency to provide leadership and case management to each youth. We develop and implement the treatment plan, in collaboration with the treatment team based on wraparound philosophy. Our case coordinators act as the leader to implement these principles. They organize and work with the youth and families strengths. Our coordinators lead teams with representatives from schools, mental health, juvenile justice, and child welfare systems so that they can work cooperatively to more effectively address the needs of youth in need of mental health treatment. They get natural supports involved with the treatment of the child and help assure that the treatment team is working in a culturally sensitive way. And most of all, they provide unconditional commitment to family that allows the child to get well.

What are our outcomes? Children Come First has accomplished a great deal in the past 12 years. New revenue was brought into Dane County by accessing Medical Assistance dollars that were previously untapped. The network of service providers in the county has expanded in the kind and diversity of services. Program outcomes indicate improved school attendance, better daily functioning and a less restrictive living environment after program involvement.

Cost savings are also a significant outcome of the program. In May 1995 there were a total of 105 Dane County youth in residential treatment centers. As of May 2005, only 41 program youth were placed in a residential facility. At any given time, approximately 75% of program youth are placed in a community setting. With the average cost of a residential placement at $7,900 per month and the cost to participate in CCF at $3,400 per month, it is much more cost effective to involve youth in CCF. Providing early treatment helps save money and resources in the long run. Mental illness is difficult to manage in any family, but the wraparound philosophy helps lessen that burden and is better for the community and most importantly, for the young people who need the help.