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Published byAustin Stokes Modified over 9 years ago
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WRAPAROUND MILWAUKEE “Never doubt that a small group of committed citizens can change the world: indeed, it’s the only thing that ever does.” Margaret Mead
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Bruce Kamradt Project Director Operated by Milwaukee County Mental Health Division Child & Adolescent Services Branch Presented by:
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What Has Been Achieved In Wraparound Milwaukee for Children with Severe Emotional Needs Better Clinical Outcomes Children & Families Function Better Reduced Recidivism of Delinquent Youth Served Improved School Attendance Reduction in the Use of Residential Treatment & Psychiatric Hospitalization Reduction in Cost of Care
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Wraparound Approach for Children with Serious & Complex Mental Health Needs Focus on Family and Children’s Strengths One Family - One Plan Across Systems Community-Based Care and Treatment Needs Driven vs Categorical Services Care for Children in Context of Families Parent Choice in Provision of Services Focus on Refinancing Strategies Unconditional Care
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What is Wraparound Milwaukee Public Care Management Organization Governance with Milwaukee County Behavioral Health Division Manages the Care of Children with Serious Emotional & Mental Health Needs at Immediate Risk of Residential Treatment, Correctional Placement or Psychiatric Hospitalization All referrals come through the Child Welfare or Juvenile Justice System Pools $30 Million in Funds from Child Welfare Medicaid Mental Health Juvenile Justice
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Key Components of Program Fiscal & Operational Management 24 Hour Mobile Crisis Team Care Coordination Provider Network 80 Services 230 Agency and Individual Providers Family Advocacy / Support Organization Quality assurance / Program Evaluation Clinical Support and Resource Teams Extensive Use of Informal Supports ie. Boys & Girls Clubs, Churches, Civic Organizations, etc.
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Demographics of Children & Families We Serve 70% Male 30 % Female Average Ave - 13.5 years Ethnicity 64% African American 27% Caucasian 7% Hispanic 2% Other 52% Delinquent - 48% Child Welfare 50% with Annual Family Income Under $15,000 40% Regular Education - No IEP Continued
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Demographics of Children & Families We Serve Diagnosis 65% Conduct Disorder 50% Depression / Oppositional Defiant 46% Attention Deficit 25% Substance Abuse 15% Adjustment Disorders 12% Cognitive / Developmental Disorders
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What are Pooled Funds? CHILD WELFARE Funds thru Case Rate (Budget for Institutional Care for Chips Children) JUVENILE JUSTICE (Funds Budgeted for Residential Treatment for Delinquent Youth) MEDICAID CAPITATION (1557 per Month per Enrollee) MENTAL HEALTH CRISIS BILLING BLOCK GRANT HMO COMMERCIAL INSUR WRAPAROUND MILWAUKEE MANAGEMENT SERVICE ORGANIZATION (MSO) 30 M CHILD AND FAMILY TEAM PLAN OF CARE 9.5 M8.5 M10 M2.0 M CARE COORDINATION PROVIDER NETWORK 240 Providers 85 Services
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Provider Network 80 Services No Formal Contracting -- services purchased on a fee- for-service basis -- rates established by Wraparound Milwaukee Extensive Quality Assurance/Quality Monitoring Residential Treatment Vendors were asked to re- engineer institutional services to community-based services Consumer Choice of Providers All Providers & Care Managers linked through internet- based IT system for authorizations, plan submission, invoicing, etc.
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Outcomes - Program Average daily Residential Treatment population reduced from 375 placements to 60 placements Psychiatric Inpatient Utilization reduced from 5000 days per year to under 200 days (ave. LOS of 2.8 days) Reduction in Juvenile Correctional Commitments from 385 per year to 285
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Outcomes - Financial Wraparound Milwaukee average monthly costs is $4350 per child per month versus $7200 for residential treatment, $6000 monthly for a correctional placement or $600 per day for psychiatric inpatient care
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Child Behavior Checklist (CBCL), N=219; Youth Self-Report (YSR), N=155; Child & Adolescent Functional Assessment Scale (CAFAS), N=374. Reductions are significant at the p<.001 level of significance using a repeated measures analysis of variance. CAREGIVER, CARE COORDINATOR, & YOUTH REPORTED IMPROVEMENT IN FUNCTIONING FOR CLIENTS Year 2001
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N = 490 Year 2001 REDUCTION IN PERCENTAGE OF CLIENTS REFERRED FOR FELONIES & MISDEMEANORS WHILE ENROLLED & FOLLOWING DISCHARGE
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N = 492 *OTHER OFFENSES CONSIST PRIMARILY OF DISORDERLY CONDUCT Year 2001 REDUCTION IN SPECIFIC OFFENSE TYPES PRIOR TO ENROLLMENT, DURING ENROLLMENT, AND AFTER DISENROLLMENT
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Serving Children and Families with Complex Needs Operated by Milwaukee County Behavioral Health Division Child & Adolescent Services Branch
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Operated by Milwaukee County Behavioral Health Division Child & Adolescent Services Branch
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