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Overview
The Children’s Bureau in the Office of Mental Health and Substance Abuse Services (OMHSAS) has been working with the University of Pittsburgh and its community partners to develop, implement, and manage the Pennsylvania Youth and Family Training Institute. This Institute is the next phase in the evolution of the children’s behavioral health movement in Pennsylvania. It builds on the work of the former CASSP Institute, and will be the centerpiece of the OMHSAS effort to transform the Pennsylvania's Children's Behavioral Health System. The Institute will provide training, technical assistance and monitoring to engage and empower youth and their families in the treatment and recovery process.
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. The Institute, in conjunction with the Children’s Bureau, has named six counties to serve as “early implementers” of youth and family teams, using the High Fidelity Wraparound practice model. The six counties are Allegheny, Chester, Erie, Fayette, Lehigh and Montgomery.
In addition to working with these early implementer counties, the Institute will continue to provide an orientation and training on the High Fidelity Wraparound model to all interested parties. Public information efforts have been held as the Institute becomes established and begins to marshal the energy and dedication of so many people who are committed to transforming the children’s behavioral health system in Pennsylvania.
In general, 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 is intended to be carried out in four distinct phases. Each phase consists of specific tasks, which are essential to maintaining fidelity to the model.
- Engagement
- Initial Plan Development
- Implementation
- Transition
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 Institute Advisory Board Updates
The Youth and Family Training Institute (YFTI) is working with the Children’s Bureau of the Office of Mental Health and Substance Abuse Services (OMHSAS) to transform Pennsylvania’s Children’s Mental Health Service System to one that is family driven and youth guided. In order to do so, YFTI has formed an Advisory Board of family members, young adults and professionals that represent the diversity (age, gender, ethnicity, socioeconomic, geographic and background) of Pennsylvania. The Advisory Board provides input to the Institute and oversees its development and implementation by setting priorities, monitoring progress and communicating results to youth, family members and professional groups across the commonwealth.
Advisory Board meetings began in June 2008. The first meetings allowed the members to get to know each other, and have provided an orientation to High Fidelity Wraparound and the work of the Institute and established some of the operating policies. The board meets monthly. Below are the dates for 2010:
2010 Advisory Board Meeting Dates
- July 14
- August 11
- September 8
- October 13
- November 10
- December 8
Guests are welcome to attend the meetings and are required to RSVP. All RSVP’s should be sent to Lori Kramer at least 10 days prior to each meeting. Contact Lori at kramerla@upmc.edu, 412-683-7598 or 866-462-3292. Guests will be charged $10.00 for lunch and materials.
The meetings are held at the Pennsylvania Child Welfare Training Center, 403 East Winding Hill Road, Mechanicsburg, PA 17055; 717-795-9048. For additional information, please contact the Youth and Family Training Institute at YFTI@upmc.edu.
Youth and Family Training Institute Advisory Board Membership
The YFTI Advisory Board is comprised of equal representation of family, youth and professional members. Members were selected by a review committee that was comprised of family members, youth and professionals using criteria developed to assure a range of experience and diversity.
Following is a list of Youth and Family Training Institute Advisory Board members:
| Anthony Ansill |
Youth Member |
Allegheny County |
| Lonnie Barnes |
Professional |
PA Dept of Health Bureau of Drug & Alcohol Programs |
| Bernadette Bianchi |
Professional |
PA Council of Children, Youths & Family Services |
| Darlene Black |
Professional |
Bureau of Policy & Program Development, OCYF |
| Rick Boyle |
Professional |
Educational Consultant, PaTTAN |
| Jennifer Cherak |
Youth Member |
Allegheny County |
| Dylis Doe |
Youth Member |
Philadelphia |
| Jacqueline Deppen |
Family Member |
Dauphin County |
| Valarie Dunbar |
Family Member |
Philadelphia |
| Brenda Ellman |
Family Member |
Erie County |
| Crystal Karenchak |
Family Member |
Elk County |
| Andrew Kind-Rubin |
Family Member |
Bucks County |
| Shelby Line |
Professional |
Community Action Association of Pennsylvania |
| Corey Ludden |
Youth Member |
Luzerne County |
| Jenna Mehnert |
Professional |
National Assoc. of Social Workers |
| Connell O’Brien |
Professional |
Pennsylvania Community Providers Association |
| Jennifer Parke |
Youth Member |
Cumberland County |
| Margaret Parke |
Family Member |
Cumberland County |
| Arlene Prentice |
Professional |
Juvenile Court Consultant/Judges’ Commission |
| Jill Santiago |
Family Member |
Chester County |
| Brian Satterfield |
Youth Member |
Philadelphia County |
| Karan Steele |
Family Member |
Westmoreland County |
| Donna Tuttle |
Family Member |
Lackawanna County |
| Jacob Vandall |
Youth Member |
Westmoreland County |
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