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Tash conf 2012

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Tash conf 2012

  1. 1. Wraparound for Families of Children with Significant Disabilities Eleanor Castillo Sumi, Ph.D. TASH Conference November 2012
  2. 2. Objectives O Participants will learn: O Overview of EMQ FamiliesFirst O What is Wraparound? O Application: Development of an Individualized Child and Family Team PlanEMQFF: Wraparound for Children with Disabilities 2
  3. 3. Who are we? O 100+ year old agency that provides primarily mental health and foster care services O Active in the legislation of Wraparound O In over 30 counties in California O Sacramento to Fresno to Alameda to Los Angeles to San Bernardino O FY2012: O 8072 children and adolescents O 82% of people served range from 5 to 18 years old O 43% are Latino American O 28% Caucasian O 15% African AmericanEMQFF: Wraparound for Children with Disabilities 3
  4. 4. San Bernardino Region O Inception: 2004 O FY2012: Ethnically diverse population O Latino Americans- 45% O Caucasians- 29% O African Americans- 23% O Ages: O 61% were 13-18 years old O 36% were 5-12 years old O 1% were 19+ years oldEMQFF: Wraparound for Children with Disabilities 4
  5. 5. Developmental Disabilities Wraparound Program O Started serving individuals referred from the Inland Regional Center in 2005 O Riverside and San Bernardino Counties O Wraparound + Evidence-Based practices O ABA treatment and services (e.g., FBA and BSP) O Goal is to keep child in the home O Treatment success is defined by meeting each individual goals and agreement among team membersEMQFF: Wraparound for Children with Disabilities 5
  6. 6. Developmental Disabilities Wraparound Program O Inception to FY2012: 122 youth served O FY2012: O 8% were 19-25 years old O 54% were 13-18 years old O 39% were 5-12 years old O 67% were male O Child and Adolescent Needs Scale (CANS) O EMQFF Reliable change- 63% O National/State Reliable change- 50%EMQFF: Wraparound for Children with Disabilities 6
  7. 7. Outcomes Wraparound Principle EMQFF FY12 National Family Voice and Choice 92% 83% Team-Based 75% 71% Natural Supports 71 64 Collaboration 93 85 Community-Based 84 71 Culturally Competent 97 91 Individualized 78 69 Strengths-Based 89 83 Persistence 84 82 Outcomes-Based 78 67EMQFF: Wraparound for Children with Disabilities 7
  8. 8. Developmental Disabilities Wraparound Program O EMQFF Wraparound Team Staff O Clinical Program Manager O Facilitator O Family Specialists/Behavior Specialists O Parent Partner O BCBA Consultant O Psychiatrist (PRN)EMQFF: Wraparound for Children with Disabilities 8
  9. 9. History: Systems of Care O Since the 1975 passage of the Individuals with Disabilities Education Act (Public Law 94-142), which ensures that all children with disabilities have available to them a free and appropriate education in the least restrictive environment, there has been a growing movement to deliver services to children within their homes, schools, and communities. O It has also become clear that no single child-serving agency, because of policy, programmatic, or financial limitations, has the ability to provide all the services and supports needed by families with children who have disabilities and/or are vulnerable to abuse and neglect. http://www.childwelfare.gov/pubs/soc/soca.cfmEMQFF: Wraparound for Children with Disabilities 9
  10. 10. History: Systems of Care O Early 1980s- Local educational authorities joined child welfare in supporting children with various disabilities, yet children with serious emotional disturbances often remained unserved, underserved, or inappropriately served. O 1984- The National Institute of Mental Health, U.S. Department of Health and Human Services, initiated the Child and Adolescent Service System Program (CASSP) to help States plan for and design systems of care to address the mental health needs of children who were experiencing a serious emotional disturbance. O CASSP articulated core values and guiding principles for a system of care for children and adolescents with severe emotional disturbanceEMQFF: Wraparound for Children with Disabilities 10
  11. 11. CASSP O Major emphases of the CASSP principles are: (1) Individualized care that recognizes strengths in the child, family and community and is tailored to the individual needs and preferences of the child and family; (2) Family inclusion at every level of the clinical process and system development; (3) Collaboration and coordination between different child- serving agencies and integration of services across agencies; (4) Provision of culturally competent services; and (5) Serving youth in their communities, or the least- restrictive setting that meets their clinical needs, using natural supports in the community whenever possible.EMQFF: Wraparound for Children with Disabilities 11
  12. 12. System of Care Original Intent Response to concerns that: O Children in need of mental health treatment were not getting the services they needed O Services were often provided in restrictive out- of-home settings O Few community-based services were available O Service providers did not work together O Families were not adequately involved in their childs care O Cultural differences were rarely taken into account (Stroul, 1996)EMQFF: Wraparound for Children with Disabilities 12
  13. 13. EMQFF Wraparound Principles Wraparound Definition Principal Strengths-Based Development and implementation of a plan of care that identifies, build on, and enhances strengths of the child and family, their community, and other team members. Throughout this process, team interactions demonstrate appreciation for each member’s competenciesEMQFF: Wraparound for Children with Disabilities 13
  14. 14. EMQFF Wraparound Principles Wraparound Definition Principal Family Centered Families/caregivers have a primary decision making role in the care of their children as well as the policies and procedures governing care for all children in their community, state, tribe, territory, and nationEMQFF: Wraparound for Children with Disabilities 14
  15. 15. EMQFF Wraparound Principles Wraparound Definition Principal Team Based The child and family team (CFT) consists f individuals agreed upon by the family and connected to them through natural, community, and formal supports.EMQFF: Wraparound for Children with Disabilities 15
  16. 16. EMQFF Wraparound Principles Wraparound Definition Principal Collaborative and Team members work together Integrative and share responsibility for developing, implementing, monitoring, and evaluating single plan of care that reflects a blending of team members’ perspective and that guides and coordinates each team members’ work with the family.EMQFF: Wraparound for Children with Disabilities 16
  17. 17. EMQFF Wraparound Principles Wraparound Definition Principal Community Based The child and family team implements services and support strategies that take place in the most inclusive, most responsive, most accessible, and least restrictive settings possible, and that safely promote child and family integration into home and community life and roles.EMQFF: Wraparound for Children with Disabilities 17
  18. 18. EMQFF Wraparound Principles Wraparound Definition Principal Individualized The plan of care includes strategies, services, and supports that the team develops and implements in response to the unique needs and aspirations of the child and family.EMQFF: Wraparound for Children with Disabilities 18
  19. 19. EMQFF Wraparound Principles Wraparound Definition Principal Natural Supports The team actively seeks out and welcomes natural supports, and integrates their perspectives fully into the team process. The plan of care reflects activities and interventions undertaken by natural supportsEMQFF: Wraparound for Children with Disabilities 19
  20. 20. EMQFF Wraparound Principles Wraparound Definition Principal Unconditional Regardless of the child’s behavior, legal status, or service setting; the family’s circumstances; or the services availability in the community; the team is unconditional in working with the family toward the goals of the plan of care.EMQFF: Wraparound for Children with Disabilities 20
  21. 21. EMQFF Wraparound Principles Wraparound Definition Principal Needs driven Supports and services are designed to meet unmet family needs across multiple life domains. Formal therapeutic services are viewed as tools to meet normalized needs rather than as needs in and of themselves.EMQFF: Wraparound for Children with Disabilities 21
  22. 22. EMQFF Wraparound Principles Wraparound Definition Principal Flexible/Accessible Services and supports are dynamic and have the ability to change as the needs change for families. These services and supports are accessible to the family given their ability to creatively adapt to change.EMQFF: Wraparound for Children with Disabilities 22
  23. 23. EMQFF Wraparound Principles Wraparound Definition Principal Outcome Based The team ties the goals and strategies of the plan of care to observable or measurable indicators of success, monitors progress in terms of the indicators, and revises the plan accordingly, until the team reaches agreement that a formal process is no longer required.EMQFF: Wraparound for Children with Disabilities 23
  24. 24. EMQFF Wraparound Principles Wraparound Definition Principal Culturally Competent The service process demonstrates respect for and builds on the values, preferences, beliefs, and racial and cultural identity of the family and its community.EMQFF: Wraparound for Children with Disabilities 24
  25. 25. Child and Family Team (CFT): Where the Rubber Meets the Road O Membership O Formal Support O Natural Support O 10- Step Planning Process O 23 Life Domain AssessmentEMQFF: Wraparound for Children with Disabilities 25
  26. 26. 10-Step Planning Process Step 1 Purpose Meet the family Instill hope Build trust with parent Establish parents’ leadership role on the team Parent identifies lists of strengthsEMQFF: Wraparound for Children with Disabilities 26
  27. 27. 10-Step Planning Process Step 2 Purpose Identify family Team sees the child/family as having strengths strengths rather than just problems Family begins to take ownership Setting a blame free environmentEMQFF: Wraparound for Children with Disabilities 27
  28. 28. 10-Step Planning Process Step 3 Purpose Set the stage for Use of jargon free language outcomes and Assure parent voice goal setting Set goals for the teamEMQFF: Wraparound for Children with Disabilities 28
  29. 29. 10-Step Planning Process Step 4 Purpose Needs Assure family voice in identifying their identification own needs Provide guidance to the team to tie strategies to the needs Validate culture, background, and situational aspects of the familyEMQFF: Wraparound for Children with Disabilities 29
  30. 30. 10-Step Planning Process Step 5 Purpose Vote and prioritize Assures team agreement needs to Builds a sense of accomplishment complete in order Makes follow up tasks manageable to assure successEMQFF: Wraparound for Children with Disabilities 30
  31. 31. 10-Step Planning Process Step 6 Purpose Individualized Assures parent voice by identifying Planning to tailor needs for their child interventions to Supports and empowers family in child/family needs meeting targeted needsEMQFF: Wraparound for Children with Disabilities 31
  32. 32. 10-Step Planning Process Step 7 Purpose Commitment and Team members identify tasks they will follow up complete for accountability Builds sense of team Sets expectations for unconditional careEMQFF: Wraparound for Children with Disabilities 32
  33. 33. 10-Step Planning Process Step 8 Purpose Team evaluation Team members evaluate the process, voice concern, and develop strategies to move forwardEMQFF: Wraparound for Children with Disabilities 33
  34. 34. 10-Step Planning Process Step 9 Purpose Documentation Facilitator develops a plan with cost and follow up separations, activities, and outcomes All team members sign to indicate agreement Builds accountability for all team membersEMQFF: Wraparound for Children with Disabilities 34
  35. 35. 10-Step Planning Process Step 10 Purpose Crisis Planning Assure contingencies are coveredEMQFF: Wraparound for Children with Disabilities 35
  36. 36. 23 Life Domains Behavioral Restitution Finances Educational Community Transportation Emotional/ Competency Safety Psychological Language Legal Permanent Immigration Relationships Residence Accountability Work Family Medical Social Culture Recreational Safety Creativity Spiritual OtherEMQFF: Wraparound for Children with Disabilities 36
  37. 37. Activity: Individual Child and Family Plan Development O Think of a child O List the child’s/family’s strengths O Identify needs O Identify strategies and resources to address needs (formal and informal) O Assign individuals to taskEMQFF: Wraparound for Children with Disabilities 37
  38. 38. Questions & Answers O Contact O Brian Thompson, Executive Director bthompson@emqff.org O Eleanor Castillo Sumi, Ph.D. Eleanor.Castillo@emqff.orgEMQFF: Wraparound for Children with Disabilities 38

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