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Overview
The Children’s Bureau in the Office of Mental Health and Substance Abuse Services (OMHSAS) works with the University of Pittsburgh and its community partners to manage the Pennsylvania Youth and Family Training Institute. The Institute has an Advisory Board composed of equal representation of youth, families, and professionals. Shannon Fagan, former Westmoreland County CASSP Coordinator, is the Executive Director. More information is available on the Institute’s new web site.
The High Fidelity Wraparound practice model can be described as a “process” for service delivery and acquisition for youth and families with multifaceted behavioral health needs. It is not a specific service or intervention. The model was formally defined by the U.S. National Wraparound Initiative. Members of this initiative have identified standards for conducting high fidelity wraparound and means for measuring successful outcomes. The process of High Fidelity Wraparound must involve family voice and choice, be a team-based approach, use natural supports, facilitate collaboration and integration, be community based, be carried out in a culturally competent manner, be individualized, strengths based and persistent, and be based on outcome measures and cost effectiveness.
High Fidelity Wraparound in Pennsylvania, PA CASSP Newsletter, December 2009
Resources on High Fidelity Wraparound for counties, agencies, providers, families and youth. This information is intended to clarify the process involved in carrying out High Fidelity Wraparound for all parties who would potentially be involved.
- General overview of the wraparound process, principles, and steps
- Description of how and why wraparound works, provided by the National Wraparound Initiative and excerpted from their resource guide. A link to the full guide is provided below.
- Ensuring fidelity to the wraparound process: methods and results of three states’ efforts to make wraparound all that it should be
- NWI’s overview of the four phases: Phases and Activities of the Wraparound Process: Building Agreement About a Practice Model, by Janet Walker and Eric Bruns, National Wraparound Initiative Advisory Group
- http://wrapinfo.org/: This is a central site with links to four valuable resources:
- National Wraparound Initiative (NWI): information related to how this advisory group came to be; how they have come to a standard definition for the process of wraparound; how it is implemented; and how successful outcomes are assessed
- Resource Guide to Wraparound: compilation of all of the work that has been accomplished by the NWI, including a definition of the process and principles; pilot studies that have been completed; success stories from youth and families. It serves as a working manual for implementation.
- Wraparound Evaluation and Research Team (WERT): a research team that has completed extensive investigations on the implementation and outcomes of the wraparound process. Members of this team are also part of the NWI. This group of researchers also collaborated to create the Wraparound Fidelity Assessment System, a multi-faceted evaluation tool for evaluating the process of and outcomes of wraparound. The WERT site includes research and presentations associated with the Wraparound Fidelity Index.
- Wraparound Online Data Entry System (requires registration and log-in)
- Vroon VandenBerg, LLP, a national consulting agency that provides information, training, consultation and coaching for the implementation of High Fidelity Wraparound.
- High Fidelity Wraparound and Systems of Care, December 2009 edition of the PA CASSP Newsletter, reporting on the early implementation of high fidelity wraparound in Pennsylvania through the Youth and Family Training Institute.
Key players in process implementation:
User guides for youth and families:
How High Fidelity Wraparound differs from Pennsylvania’s Behavioral Health Rehabilitation Services (often commonly called wraparound):
In Pennsylvania, Behavioral Specialist Consultant (BSC), Therapeutic Staff Support (TSS), and Mobile Therapy (MT) are commonly prescribed Behavioral Health Rehabilitation Services (BHRS) for children and adolescents under the age of 21 who have mental health diagnoses. These services are typically rendered necessary when the youth’s mental health needs exceed what is typically able to be accomplished in standard outpatient therapy. These services are coordinated by the aforementioned behavioral health staff and an Interagency Service Planning Team (ISPT). BSC, TSS, and MT services were added to the Medical Assistance fee schedule in 1994 and are intended to accomplish the following: provide one-to-one services in a youth’s home, school or other community setting; prevent the youth’s need for a more restrictive treatment setting; assist primary caregivers and school personnel in learning and providing direct behavioral support; be carried out in a culturally competent manner; and be individualized to meet the social, emotional and/or behavioral needs of the child. By definition, these services are intended to be carried out according the principles set forth by the Pennsylvania Child and Adolescent Service System Program (CASSP). CASSP stipulates that BHRS services provided to children and families be child-centered, family focused, community-based, multi-systemic, culturally competent, and least restrictive/least intrusive.
These services have been and continue to be commonly referred to as “wraparound” services in Pennsylvania. The state has moved away from this misnomer and now refers to TSS, MT, and BSC, programs as BHRS. This is in large part because of the statewide initiative to implement the “High Fidelity Wraparound” process in helping children and families with complex problems. This initiative and information pertaining to “High Fidelity wraparound” is provided above.
More information related to BHRS services in Pennsylvania, the ISPT process, and CASSP principles:
Youth and Family Training Institute 2011 Annual Report Summary
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