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Measuring Wraparound Fidelity using the  Wraparound Fidelity Index   (WFI) 4.0 EMQ FamiliesFirst (EMQ FF) Mary Ann Wong Ca...
Presentation Overview <ul><li>Introduction to Wraparound & Wraparound at EMQ FF </li></ul><ul><li>Defining Wraparound Fide...
What is Wraparound?
EMQ FamiliesFirst’s Influence on Wraparound in California <ul><li>In  1991  EMQ served 130 emotionally disturbed or mental...
Wraparound Growth in California Green  –  counties providing Wrap services Yellow –  counties planning to implement Wrap G...
EMQ FamiliesFirst’s  Wraparound Principles <ul><li>Team-based </li></ul><ul><li>Natural Supports </li></ul><ul><li>Communi...
EMQ FamiliesFirst’s Phases and Activities of Wraparound <ul><li>Phase 1: Engagement and team preparation </li></ul><ul><li...
Number of Youth Served <ul><li>Total Number of Youth Served in Wraparound:  3,331 </li></ul>
Youth’s Profile <ul><li>Average Age at Admission:  14 years </li></ul><ul><li>62% Male; 38% Female </li></ul><ul><li>Youth...
Primary Diagnosis at Admission
Living Situation at Admission
Outcomes for Discharged Youth <ul><li>Number of Youth Discharged from Wraparound:   2,762 </li></ul><ul><li>Average Length...
Living Situation: Admit vs. Discharge
Child and Adolescent Functional Assessment Scale (CAFAS) <ul><li>CAFAS Subscale Score:  0 - 30   </li></ul><ul><li>CAFAS S...
CAFAS Outcomes   (n=1,539) p>.001 Timeframe
Wraparound Fidelity <ul><li>What is it and why is it important? </li></ul><ul><li>The Wraparound Fidelity Assessment Syste...
What is the WFI? <ul><li>Measures implementation of wraparound process </li></ul><ul><li>Set of interviews – Facilitator, ...
Evolution of the WFI Measure <ul><li>Earlier versions: (1 through 3) </li></ul><ul><ul><li>No consistent practice model on...
Wraparound Fidelity Administration <ul><li>WFI Administration at EMQ FamiliesFirst </li></ul><ul><ul><li>9 traditional wra...
Results
Demographics of WFI Youth <ul><li>Average Age at Admission:  13 years </li></ul><ul><li>55% Male; 45% Female </li></ul><ul...
Primary Diagnosis at Admission for WFI Youth
Living Situation at Admission for WFI Youth
Outcomes for Discharged WFI Youths
Living Situation: Admit vs. Discharge for WFI Youth
CAFAS Outcomes  for WFI Youth p>.001 Timeframe
Summary of Respondents <ul><li>385 interviews were administered over the phone </li></ul><ul><li>123 caregiver interviewed...
EMQ FF vs National Data  Overall Fidelity
EMQ FF vs National Data  Combined Fidelity Scores by Principle
EMQ FF vs National Data  Combined Fidelity Scores by Principle Con’t
EMQ FF vs National Data  Fidelity Scores by Phase
CAFAS Reliable Change Index (RCI) by Program 18% 28% 18% 18% 9% 14% Worse 17% 23% 24% 23% 23% 0% Same 66% 50% 58% 60% 68% ...
Average Total WFI Scores   by Program 18.43 PGM 6 15.32 PGM 5 11.54 PGM 4 15.70 PGM 3 6.38 PGM 2 12.84 PGM 1 Average Total...
Data Implications <ul><li>Further studies employing the WFI on Outcomes </li></ul><ul><ul><li>CAFAS  </li></ul></ul><ul><u...
Challenges <ul><li>New programs and staff </li></ul><ul><li>Difficult populations </li></ul><ul><li>Language barriers </li...
Lessons Learned <ul><li>Program buy-in </li></ul><ul><li>Work with Wrap teams </li></ul><ul><li>Use EMQ FF language certif...
A Caregiver’s Experience
<ul><li>Future Directions </li></ul>
Q & A
References   <ul><li>Bruns, E. (nd).  Wraparound Fidelity Assessment System.  Retrieved April 15, 2010, from Wrap Info web...
Contact Information <ul><li>Mary Ann Wong </li></ul><ul><ul><li>[email_address]  (916) 388-6303 </li></ul></ul><ul><li>Cat...
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Measuring Wraparound Fidelity

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Using Wraparound Fidelity Index 4.0.

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Measuring Wraparound Fidelity

  1. 1. Measuring Wraparound Fidelity using the Wraparound Fidelity Index (WFI) 4.0 EMQ FamiliesFirst (EMQ FF) Mary Ann Wong Catherine Aspiras Michelle Coufal Elisha Heruty Abram Rosenblatt Caregiver Presenter: Epifania Marshall
  2. 2. Presentation Overview <ul><li>Introduction to Wraparound & Wraparound at EMQ FF </li></ul><ul><li>Defining Wraparound Fidelity & Implementation of the WFI at EMQ FF </li></ul><ul><li>WFI Outcomes and Feedback </li></ul><ul><li>Sharing a Caregiver’s Experience </li></ul>
  3. 3. What is Wraparound?
  4. 4. EMQ FamiliesFirst’s Influence on Wraparound in California <ul><li>In 1991 EMQ served 130 emotionally disturbed or mentally ill children </li></ul><ul><li>In July 1996 , Gov. Pete Wilson signed into a law authorizing a pilot project </li></ul><ul><li>In 1997 , Legislature expanded the pilot project state wide </li></ul><ul><li>In 2004 , Prop 63 allotted new funds </li></ul>
  5. 5. Wraparound Growth in California Green – counties providing Wrap services Yellow – counties planning to implement Wrap Gray – no Wrap
  6. 6. EMQ FamiliesFirst’s Wraparound Principles <ul><li>Team-based </li></ul><ul><li>Natural Supports </li></ul><ul><li>Community-based </li></ul><ul><li>Culturally Competent </li></ul><ul><li>Family Voice and Choice </li></ul><ul><li>Individualized </li></ul><ul><li>Strength-based </li></ul><ul><li>Collaboration </li></ul><ul><li>Persistence </li></ul><ul><li>Outcome-based </li></ul>
  7. 7. EMQ FamiliesFirst’s Phases and Activities of Wraparound <ul><li>Phase 1: Engagement and team preparation </li></ul><ul><li>Phase 2: Plan Development </li></ul><ul><li>Phase 3: Implementation </li></ul><ul><li>Phase 4: Transition </li></ul>
  8. 8. Number of Youth Served <ul><li>Total Number of Youth Served in Wraparound: 3,331 </li></ul>
  9. 9. Youth’s Profile <ul><li>Average Age at Admission: 14 years </li></ul><ul><li>62% Male; 38% Female </li></ul><ul><li>Youth’s Ethnicity </li></ul>
  10. 10. Primary Diagnosis at Admission
  11. 11. Living Situation at Admission
  12. 12. Outcomes for Discharged Youth <ul><li>Number of Youth Discharged from Wraparound: 2,762 </li></ul><ul><li>Average Length of Stay: 13 months . </li></ul>
  13. 13. Living Situation: Admit vs. Discharge
  14. 14. Child and Adolescent Functional Assessment Scale (CAFAS) <ul><li>CAFAS Subscale Score: 0 - 30 </li></ul><ul><li>CAFAS Subscales: </li></ul><ul><ul><li>School/work role performance </li></ul></ul><ul><ul><li>Home role performance </li></ul></ul><ul><ul><li>Community role performance </li></ul></ul><ul><ul><li>Behavior toward others </li></ul></ul><ul><ul><li>Self-harmful behavior </li></ul></ul><ul><ul><li>Substance Use </li></ul></ul><ul><ul><li>Thinking </li></ul></ul>
  15. 15. CAFAS Outcomes (n=1,539) p>.001 Timeframe
  16. 16. Wraparound Fidelity <ul><li>What is it and why is it important? </li></ul><ul><li>The Wraparound Fidelity Assessment System (WFAS) </li></ul><ul><ul><li>Wraparound Fidelity Index, v.4 (WFI-4) </li></ul></ul><ul><ul><li>Team Observation Measure (TOM) </li></ul></ul><ul><ul><li>Community Supports for Wraparound Inventory (CSWI) </li></ul></ul><ul><ul><li>Document Review Measure (DRM) </li></ul></ul>
  17. 17. What is the WFI? <ul><li>Measures implementation of wraparound process </li></ul><ul><li>Set of interviews – Facilitator, Caregiver, Youth, Team Member </li></ul><ul><ul><li>40 items for Facilitator, Caregiver, Team Member </li></ul></ul><ul><ul><li>32 items for Youth </li></ul></ul><ul><li>Confidential interviews w/multiple respondents  unique perspectives </li></ul>
  18. 18. Evolution of the WFI Measure <ul><li>Earlier versions: (1 through 3) </li></ul><ul><ul><li>No consistent practice model on which to base items </li></ul></ul><ul><ul><li>No specification of phases/activities of process </li></ul></ul><ul><li>WFI version 4 </li></ul><ul><ul><li>Aligned with updated NWI practice model </li></ul></ul><ul><ul><li>Organized by the 4 phases of wraparound </li></ul></ul><ul><ul><li>Items measure: </li></ul></ul><ul><ul><ul><li>Adherence to principles of service delivery </li></ul></ul></ul><ul><ul><ul><li>Conformance to specific principles of the model </li></ul></ul></ul><ul><ul><li>Addition of “Team Member” form </li></ul></ul>
  19. 19. Wraparound Fidelity Administration <ul><li>WFI Administration at EMQ FamiliesFirst </li></ul><ul><ul><li>9 traditional wraparound programs in 8 counties: </li></ul></ul><ul><ul><ul><li>Santa Clara </li></ul></ul></ul><ul><ul><ul><li>Sacramento </li></ul></ul></ul><ul><ul><ul><li>Nevada </li></ul></ul></ul><ul><ul><ul><li>Yolo </li></ul></ul></ul><ul><ul><ul><li>Fresno </li></ul></ul></ul><ul><ul><ul><li>Tulare </li></ul></ul></ul><ul><ul><ul><li>San Bernardino </li></ul></ul></ul><ul><ul><ul><li>Los Angeles </li></ul></ul></ul><ul><li>Selection of families for interviewing </li></ul><ul><li>Eight trained & certified interviewers </li></ul><ul><li>Administered in stages during FY10 </li></ul>
  20. 20. Results
  21. 21. Demographics of WFI Youth <ul><li>Average Age at Admission: 13 years </li></ul><ul><li>55% Male; 45% Female </li></ul><ul><li>Youth’s Ethnicity </li></ul>
  22. 22. Primary Diagnosis at Admission for WFI Youth
  23. 23. Living Situation at Admission for WFI Youth
  24. 24. Outcomes for Discharged WFI Youths
  25. 25. Living Situation: Admit vs. Discharge for WFI Youth
  26. 26. CAFAS Outcomes for WFI Youth p>.001 Timeframe
  27. 27. Summary of Respondents <ul><li>385 interviews were administered over the phone </li></ul><ul><li>123 caregiver interviewed </li></ul><ul><ul><li>24.9 minutes average time </li></ul></ul><ul><li>185 facilitator interviewed </li></ul><ul><ul><li>42.3 minutes average time </li></ul></ul><ul><li>87 youth interviewed </li></ul><ul><ul><li>25.4 minutes average time </li></ul></ul><ul><li>10 team member interviewed </li></ul><ul><ul><li>25.4 minutes average time </li></ul></ul>
  28. 28. EMQ FF vs National Data Overall Fidelity
  29. 29. EMQ FF vs National Data Combined Fidelity Scores by Principle
  30. 30. EMQ FF vs National Data Combined Fidelity Scores by Principle Con’t
  31. 31. EMQ FF vs National Data Fidelity Scores by Phase
  32. 32. CAFAS Reliable Change Index (RCI) by Program 18% 28% 18% 18% 9% 14% Worse 17% 23% 24% 23% 23% 0% Same 66% 50% 58% 60% 68% 86% Better PGM 6 (n=756) PGM 5 (n=102) PGM 4 (n=232) PGM 3 (n=420) PGM 2 (n=22) PGM 1 (n=7) EMQ FF Wraparound Programs RCI Level
  33. 33. Average Total WFI Scores by Program 18.43 PGM 6 15.32 PGM 5 11.54 PGM 4 15.70 PGM 3 6.38 PGM 2 12.84 PGM 1 Average Total WFI Score EMQ Wraparound Program
  34. 34. Data Implications <ul><li>Further studies employing the WFI on Outcomes </li></ul><ul><ul><li>CAFAS </li></ul></ul><ul><ul><li>School Information </li></ul></ul><ul><ul><li>Living Situation </li></ul></ul><ul><ul><li>CANS (Child and Adolescent Needs and Strength) </li></ul></ul>
  35. 35. Challenges <ul><li>New programs and staff </li></ul><ul><li>Difficult populations </li></ul><ul><li>Language barriers </li></ul><ul><li>Ratio of certified interviewers to interviewees </li></ul><ul><li>Relatively low response rates </li></ul>
  36. 36. Lessons Learned <ul><li>Program buy-in </li></ul><ul><li>Work with Wrap teams </li></ul><ul><li>Use EMQ FF language certified employees </li></ul>
  37. 37. A Caregiver’s Experience
  38. 38. <ul><li>Future Directions </li></ul>
  39. 39. Q & A
  40. 40. References <ul><li>Bruns, E. (nd). Wraparound Fidelity Assessment System. Retrieved April 15, 2010, from Wrap Info website: http://depts.washington.edu/wrapeval/WFI.html </li></ul><ul><li>Hodges, K. (2000). Child and adolescent functional assessment scale . Ann Arbor, MI: Functional Assessment Systems. </li></ul><ul><li>Wraparound Evaluation & Research Team. (2010, April 15). The Wraparound Process. Retrieved from http://depts.washington.edu/wrapeval/approach.html </li></ul>
  41. 41. Contact Information <ul><li>Mary Ann Wong </li></ul><ul><ul><li>[email_address] (916) 388-6303 </li></ul></ul><ul><li>Catherine Aspiras </li></ul><ul><ul><li>caspiras @emqff.org (408) 335-1809 </li></ul></ul><ul><li>Michelle Coufal </li></ul><ul><ul><li>mcoufal @emqff.org (408) 335-1888 </li></ul></ul><ul><li>Elisha Heruty </li></ul><ul><ul><li>eheruty @emqff.org (408) 335-1889 </li></ul></ul><ul><li>Abram Rosenblatt </li></ul><ul><ul><li>arosenblatt @emqff.org (408) 364-4016 </li></ul></ul>

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