1. High Fidelity Wraparound Pilot
Service Component of NC System of Care Implementation Grant

2. NC System of Care Grant Pilot of high fidelity wraparound
Support and strengthen System of Care Local Community Collaboratives
Increase access to family and youth voice and peer support
Increase timely access to an array of evidence and trauma-informed, community services

3. High Fidelity Wraparound Pilot in NC
Package of:
Structured family-driven team planning process
Intensive care coordination
Family and youth peer support
Supervision and coaching

4. What is High Fidelity Wraparound?
Structured, Family-Driven Team Planning
intensive, individualized care planning and management process”
“ structured, creative, and individualized team planning process….to address a range of life issues”
“emphasis on integrating the youth into the community and building the family’s social support system”
Source: National Wraparound Initiative

5. Who will be served in the pilot?
1st Year
Youth transitioning from Psychiatric Residential Treatment Facilities (PRTFs)
2nd-4th Years
Expand to include youth with high use of crisis services and other levels of residential care
Nationally, youth with the most complex needs are served (1-5%) with high fidelity wraparound.

6. What else is needed for High Fidelity Wraparound?
Wraparound staff
Accountability
Community Partnerships and Action
Fiscal Policies
Access to supports and services
Foundation of System of Care Values

7. Staffing: NC Wraparound Team
Intensive care coordination with low staff to family ratios of 1:10/1:12
Family and youth peer support offered to every family
Supervisor/coach

8. Accountability
High fidelity wraparound requires monitoring with fidelity tools that can include chart reviews, observation of team meetings, and interviews with families and youth served.
High fidelity wraparound requires high quality, consistent training and coaching from dedicated and certified coaches.

9. Community Partnerships and Action
Interagency collaboration and involvement of natural supports are necessary for high fidelity wraparound.
System of Care Community Collaboratives can develop protocols to increase collaboration across agencies.
System of Care Community Collaboratives will be critical in the pilot sites in monitoring the fidelity of their local projects.

10. Fiscal Policies
There needs to be a case rate or billable service for intensive care coordinators and/or family/youth peer support to use.
These rates need to be robust enough to support low ratios and the training/coaching that is critical in high fidelity wraparound.

11. Access to services and support
Youth transitioning home from PRTFs and their families need to access a range of community-based services and supports in a timely fashion.
Some of these supports and services are behavioral health services but some are other kinds of services and supports such as assistance with housing, connecting to pro-social activities related to the young person’s interests and strengths, and helping the young person with legal and school issues.
This requires support from the Community Collaboratives and it requires that services be individualized.

12. How is high fidelity wraparound different from NC's current CFTs?
While there have been successes with Child and Family Teams in some of the SAMHSA grant funded System of Care sites, that success has not been scaled up statewide due to lack of systemic support.
Families' experience of Child and Family Teams varies by:
Which CFT training the facilitator had (There are 4 DMH/DD/SAS endorsed versions plus trainings for DSS, DJJ, and school staff).
Whether the facilitator is trained and supported in family driven care.
Funding does not support critical cross agency collaboration and routine access to family and youth peer support.
Funding has not supported intensive care coordination for the youth with the most complex needs or coaching in providing this intensive service planning model.

13. High Fidelity Wraparound
Child and Family Teams in NC
Growing evidenced base
Serves the youth with the most intense , complex needs and their families.
Consistent training and coaching of facilitators
Facilitators are intensive care coordinator with low ratios of 1: 10 or 1:12
Have access to family and youth partners who are part of the package of high fidelity wraparound
Demonstrated cost savings
Available to youth in residential treatment and community based services of intensive in-home, Multisystemic Therapy, and day treatment
4 training options for MH providers including an online version
Highly variable access to family and youth peer support

14. What is the benefit of the high fidelity wraparound pilot for the rest of the state?
Track outcomes to learn if the young people and their families are doing better
Learn how to roll-out and sustain (development of multi-agency support at the state level and the community level, development of fiscal policy, learn how to develop informal supports for both individual youth and also communities)

15. What else will the SOC Grant do besides NC Wraparound?
Work to strengthen Community Collaboratives: setting priorities, tracking progress on priorities, identifying and filling service gaps, developing interagency protocols and memorandum of agreement, supporting family/youth voice and support
Access to family and youth support beyond the family peer support in high fidelity wraparound: LME/MCOs and other agencies can contract for family peer support services for youth and families at all levels of need
Timely access to an array of services and supports and flexibility providing services
Commitment to family and youth driven, community-based, and quality care
Strengthen the current Child and Family Teams

16. Strengthen Current CFTs
Review the multiple models of CFT training with DSS and other partners and consider options for improving the training/support in order to improve the families’ experiences of CFTs and their outcomes.
We will learn from NC Wraparound ideas to support the Child and Family Team planning process.