1.  Brief description of program or practice:

Wrap Around Milwaukee is a public managed care program (HMO) that targets services to families of children with severe emotional problems.  Children that would otherwise be institutionalized - kids from residential programs were getting poor services and poor outcomes.  60% are delinquent youth.

2.  Focus of program/practice. Which of the following are involved in implementing the program or practice? (Please list all that apply.)

All principal systems weaved into a seamless system providing the full range of services.

Agencies (e.g., schools, counselors, county mental health)

Child welfare, juvenile justice, schools, all 140 agencies - non-profits in service network
State level - Health care financing, Medicaid

Organizations (e.g., family organization)

Natural supports (e.g., extended family):

Individual providers (public or private, e.g., clinicians)

Psychologists - 11 lead case management agencies

Funding sources (e.g., IDEA, Medicaid):

$3300/month/child from Child Welfare
$8 million from Juvenile Justice
$1478/month/child from Medicaid
Federal grant
Total budget - $27 million/year

Wrap Around Milwaukee arranges and pays for everything - one single service care plan.   All kids are involved in justice system because they started out in residential care by court order.

3.  How long has the promising program or practice been in operation? 

5 years.  It started as a CMHS Federal grant site.  In May 1996, they first started targeting this population.

4.  Degree of implementation and degree of institutionalization. Please indicate below the extent to which the program or practice has been implemented (i.e., Pervasiveness/penetration of the program or practice) and institutionalized (i.e., internalized/routinized use of program or practice).

It is the alternative for these threshold youth.

5.  What are the salient values, philosophies, principles, beliefs, or assumptions underlying the program or practice?

Wrap Around philosophy - finding out needs, identifying services to meet needs - wrapping services around - very individualized.  Focuses on strengths.  Child and family teams - anyone involved - look at resources to meet needs - assign care manager. 

6.  What are the key features of the program or practice that make it promising?

• 24 hour crisis intervention (12 member team)
• Provider network with broad array of services - 140 agencies and individual providers - fee for service basis
• Flexible dollars
• Wrap Around Review and Intake Team
• Family and Child Team
• Partnership Council - sets policies, reviews progress in program
• Quality Assurance
• Utilization/Review Team

7.  What contextual factors (i.e., environment in which the program or practice operates) appear to be necessary for its successful operation?

• Very good relationships between leaders, directors, key stakeholders
• Training and education across systems (agencies), continual amount of training
• Information sharing
• Push values and philosophy with stakeholders

Which of the following principles underlying the National Agenda for Achieving Better Results for Children and Youth With Serious Emotional Disturbance, effective wraparound models, and systems of care, does the program or practice encompass? (Please check all that apply.)