Using the Wraparound Model in a Home and Community Based Services Waiver

According to the New Freedom Commission on Mental Health, created on April 29, 2002, there are significant barriers associated with providing community-based services for children and youth with serious emotional disturbances as an alternative to placing them in Psychiatric Residential Treatment Facilities (PRTFs). Children, youth, and families typically have little influence over decisions affecting service delivery, planning, and the use of financing to deliver care. In an effort to find an solution for this problem, the Centers for Medicare & Medicaid Services (CMS) is conducting a Medicaid waiver demonstration project, for youth up to 21 years of age, based on the Wraparound model. As adherence to the principles, protocol, and processes of the Wraparound model is assumed to improve outcomes for youth and families, States participating in the demonstration are required to measure fidelity to the model. The overall effectiveness of the Demonstration is measured by cost-neutrality and the functional status of the youth being served. Specifically, a) does treating an individual in a community setting cost the same or less then in a PRTF, and b) did the provision of community based services to youth under the demonstration results in the maintenance or improvement of the child's functional status. This presentation will describe the relationship between adherence to the wraparound model, as measured by the Wraparound Fidelity Index (WFI4) and the functional status, measured by the Child and Adolescent Needs and Strength (CANS), of youth participating in the demonstration.