1. Wraparound for Families
of Children with
Significant Disabilities
Eleanor Castillo Sumi, Ph.D.
TASH Conference
November 2012

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 Plan
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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 American
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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 old
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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 members
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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%
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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 67
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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)
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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.cfm
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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 disturbance
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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.
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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
child's care
O Cultural differences were rarely taken into
account (Stroul, 1996)
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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 competencies
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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 nation
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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.
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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.
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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.
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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.
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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 supports
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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.
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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.
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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.
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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.
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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.
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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 Assessment
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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 strengths
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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 environment
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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 team
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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 family
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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 success
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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 needs
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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
care
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33. 10-Step Planning Process
Step 8 Purpose
Team evaluation Team members evaluate the process,
voice concern, and develop strategies
to move forward
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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
members
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35. 10-Step Planning Process
Step 10 Purpose
Crisis Planning Assure contingencies are covered
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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 Other
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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 task
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38. Questions & Answers
O Contact
O Brian Thompson, Executive Director
bthompson@emqff.org
O Eleanor Castillo Sumi, Ph.D.
Eleanor.Castillo@emqff.org
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