Wraparound in Washington State: Coordinating Care and Why it Matters
Skagit Results: Dawn Scott and Terrance Ellison
Pilot Site Results: Ericka Wiggins
Skagit Wraparound
Program Status From: July 08 – June 10
Client Demographics
Total of 20 youth and their families One (1) youth was a readmission,
resulting in an actual unduplicated count of 19
Six (6) were non-Medicaid clients
0
2
4
6
8
10
12
14
Num
ber
Avg A
ge
Avg Stay inM
onths
BoysGirls
Racial Demographics
8
1
2
1
7
0 0
1
0
1
2
3
4
5
6
7
8
Boys Girls
WhiteAfrican AmericanLatinoOther
Age Range at Intake
Boys from 6 – 18 Mean: 12 Median: 12
Girls from 7 – 17 Mean: 12 Median: 11
Living Situation at Intake
Two Parents: 6 30% Biological Mother Only 6 30% Biological Father Only 2 10% Home Of Relative 2 10% Foster Care 1 5% Adopted 3 15%
Referral Source
Referral Source N = 20 Percentage
Mental Health Agency 15 75%
School Based Mental Health
3 15%
Psychiatric Hospital 1 5%
Self Referral 1 5%
14 IEP and One (1) 504
Services Six (6) Months Prior to Wraparound
Police Involved
CPS ARIS Residential Treatment
MH Hospital Outpatient MH
Outpatient Substance
Abuse
Inpatient Substance
Abuse
Specialized Education Services
Boys 3 5 2 0 3 11 1 0 10
Girls 0 4 2 0 4 7 1 1 5
Total 3 9 4 0 7 18 2 1 15
% 15% 45% 20% N/A 35% 90% 10% 5% 75%
Two (2) IEP and One (1) 504
New Services After Entering Wraparound
Police Involved
CPS ARIS Residential Treatment
MH Hospital Outpatient MH
Outpatient Substance
Abuse
Inpatient Substance
Abuse
Specialized Education Services
Boys 2 2 N/A 2 4 N/A 1 1 2
Girls 0 1 N/A 1 2 N/A 1 1 1
Total 2 3 N/A 3 6 N/A 2 2 3
% 10% 15% N/A 15% 30% N/A 10% 10% 15%
School Status Intake Six Months 12
MonthsYes No %
Enrolled in School or Child Care
18 2 90%
School Changes or Disruptions
11 9 55%
Suspended (N/A= 3, 3)
6 11 35%
Expelled (N/A= 2, 3)
2 16 11%
Yes No % % CHG
19 1 95% +5%
5 15 25% -30%
3 17 15% -20%
1 19 5% -6%
Yes No % % CHG
16 4 80% -15%
4 16 20% -10%
1 16 6% -9%
0 17 0% -5%
Youth Risk FactorsIntake Six Months 12
MonthsYES NO %
Police Involvement
3 17 15%
Suicidal Gestures (missing=1)
9 10 47%
Strike Another Person
16 4 80%
Damage Property 15 5 75%
Take Property (missing=1
12 8 60%
Run Away 5 15 25%
Act Worried or Fearful
18 2 90%
Problems Due to Drugs
1 19 5%
Receive Outpatient MH Counseling
18 2 90%
Receive Inpatient MH Treatment
7 13 35%
YES NO % % CHG
1 19 5% NC
5 15 25% NC
8 12 40% -5%
5 15 25% -5%
5 15 25% -17%
2 18 10% -5%
8 12 40% -15%
1 19 5% -5%
14 6 70% -10%
2 18 10% -10%
YES NO % % CHG
1 19 5% -10%
5 15 25% -22%
9 11 45% -35%
6 14 30% -45%
8 11 42% -18%
3 17 15% -10%
11 9 55% -35%
2 18 10% +5%
16 4 80% -10%
4 16 20% -15%
Caregiver Risk Factors Intake Six Months
12 Months YES NO %
Under Supported Chronic Physical Illness
3 17 15%
Untreated Mental Illness 4 16 20%
Untreated Substance Abuse (missing=1)
0 19 0%
Psychiatric Hospitalization 0 20 0%
Incarceration 1 19 5%
Domestic Violence 1 19 5%
Victim of Sexual Abuse 3 17 15%
Poverty (missing=2) 7 11 39%
Exposure to Substance Abuse In The Home
2 18 10%
YES NO % % CHG
3 17 15% NC
2 18 10% -10%
0 20 0% NC
0 20 0% NC
0 20 0% -5%
2 18 10% +5%
0 20 0% -15%
7 13 35% -5%
0 20 0% -10%
YES NO % % CHG
1 19 5% -10%
0 20 0% -10%
0 20 0% NC
1 19 5% +5%
0 20 0% NC
1 19 5% -5%
0 20 0% NC
7 13 35% NC
0 20 0% NC
Loss of Personal Time
10
667
244
55
2
5
2
7
4
0
5
10
15
20
Intake Six Months 12 Months
Not at allA LittleSomewhatQuite a BitVery Much
Loss of Personal Time
Not at All
Not at All
2 21
0
5
10
15
20
Intake Six Months 12 Months
Loss of Personal Time
A LittleA little
0
45
0
5
10
15
20
Intake Six Months 12 Months
Loss of Personal Time
Somewhat
Somewhat
6
4
2
0
5
10
15
20
Intake Six Months 12 Months
Loss of Personal Time
Quite a Bit
Quite a Bit
65
7
0
5
10
15
20
Intake Six Months 12 Months
Loss of Personal Time
Very Much
Very Much
75
4
0
5
10
15
20
Intake Six Months 12 Months
Missing Work or Neglecting Other Duties
32
7
44 56
7
02
9
334
10
5
10
15
20
Intake SixMonths
TwelveMonths
Not at allA littleSomewhatQuite a bitVery Much
Missing Work or Neglecting Other Duties
Not at all
3
5
9
0
5
10
15
20
Intake Six Months 12 Months
Missing Work or Neglecting Other Duties
A little
2 23
0
5
10
15
20
Intake Six Months 12 Months
Missing Work or Neglecting Other Duties
Somewhat
7 7
3
0
5
10
15
20
Intake Six Months 12 Months
Missing Work or Neglecting Other Duties
Quite a Bit
4
0
4
0
5
10
15
20
Intake Six Months 12 Months
Missing Work or Neglecting Other Duties
Very Much
4
21
0
5
10
15
20
Intake Six Months 12 Months
Family Members Having To Do Without Things
332
6644
33
6
9
1
433
0
5
10
15
20
Intake SixMonths
TwelveMonths
Not at allA littleSomewhatQuite a bitVery Much
Family Members Having To Do Without Things
Not at all
34
9
0
5
10
15
20
Intake Six Months 12 Months
Family Members Having To Do Without Things
A Little
34
1
0
5
10
15
20
Intake Six Months 12 Months
Family Members Having To Do Without Things
Somewhat
23
4
0
5
10
15
20
Intake Six Months 12 Months
Family Members Having To Do Without Things
Quite a Bit
6
3 3
0
5
10
15
20
Intake Six Months 12 Months
Family Members Having To Do Without Things
Very Much
6 6
3
0
5
10
15
20
Intake Six Months 12 Months
$$ COSTS BENEFITS $$
Therapeutic Foster Care (CHAP): 4,000.00 (50% From NSMHA & 50% From CA)
Juvenile Detention: 3,720.00 (Detainees do not receive Mental Health Services)
Psychiatric Hospitalization: 41,666.00 CLIP Facility: 9,166.00 Wraparound: 1,500.00
Program Growth
Program Growth Chart
0
2
4
6
8
10
12
14
16
18
Fam
ilie
s se
rved
per
mo
nth
Wraparound Washington Pilot Sites
Skagit County, Grays Harbor, and Cowlitz County
Combined Results
Client Demographics at Intake N %
Age
-5-9 7 21%
-10-14 17 50%
-15-18 10 29%
Gender
-Male 22 65%
-Female 12 35%
Race
-White 27 82%
- African American 2 6%
-Native American 2 6%
-Biracial 2 6%
-Other 1 3%
Hispanic (missing=7)
-Yes 2 7%
-No 25 93%
Referral Source
Referral Source N = 34 Percentage
Mental Health Agency 24 71%
DSHS 2 6%
Parent/Family 1 3%
Juvenile Justice 1 3%
School 1 3%
Other 5 15%
School Status at Intake, 6 Months, and 12 Months (n=34)
Baseline Yes No %
Enrolled in School or Child Care
31 3 91%
School Changes or Disruptions (missing=1)
17 16 52%
Suspended (missing=5)
11 18 38%
Expelled (missing=8)
3 23 12%
6 Months Yes No % % Change
Enrolled in School or Child Care (missing=1)
30 3 91% No Change
School Changes or Disruptions (missing=1)
11 22 33% -19%
Suspended (missing=3)
4 27 13% -25%
Expelled (missing=3)
1 30 3% -9%
12 Months Yes No % % Change
Enrolled in School or Child Care (missing=1)
26 7 79% -12%
School Changes or Disruptions (missing=3)
9 22 29% -4%
Suspended (missing=8)
2 24 8% -5%
Expelled (missing=8)
0 26 0% -3%
Youth Risk Factors at Intake, 6 Months, and 12 Months
Baseline 6 Months 12 Months
Yes No % Yes No % % Change Yes No % %Change
Police Involvement (missing=3)
6 28 17% 3 31 9% -8% 2 29 7% -2%
Suicidal Gestures (missing=1, 2, 3 )
13 20 39% 7 25 25% -14% 6 25 19% -6%
Strike Another Person (missing=1, 1, 2)
23 10 70% 15 18 46% -24% 14 18 43% -3%
Damage Property (missing=2, 2)
23 11 68% 11 21 34% -34% 9 23 28% -6%
Take Property (missing=2, 4, 2)
19 13 59% 13 17 43% -16% 8 24 25% -18%
Run Away (missing=1, 2, 3)
7 26 21% 7 25 22% +1% 4 27 13% -9%
Act Worried or Fearful (missing=2, 2, 2)
27 5 84% 20 12 63% -21% 13 19 41% -22%
Problems Due to Drugs (missing=1, 2, 3)
1 32 3% 2 30 6% +3% 1 30 3% -3%
Receive Outpatient MH Counseling (missing= 1, 1)
31 3 91% 28 5 85% -6% 24 9 73% -12%
Receive Inpatient MH Treatment (missing=1, 2)
9 25 27% 5 28 15% -12% 3 29 9% -6%
Caregiver Risk Factors at Baseline, 6 Months, and 12 Months
Baseline 6 Months 12 Months
Yes No % Yes No % % Change Yes No % %Change
Under Supported Chronic Physical Illness (missing=5, 3, 2)
5 24 17% 6 25 19% +2% 3 29 9% -10%
Untreated Mental Illness (missing=4, 2, 2)
8 22 27% 3 29 9% -18% 2 30 6% -3%
Untreated Substance Abuse (missing=5, 2, 3)
0 29 0% 0 32 0% No Change 0 31 0% No Change
Psychiatric Hospitalization (missing=4, 2, 3)
3 27 10% 1 31 3% -7% 1 30 3% No Change
Incarceration (missing=4, 2, 3)
3 27 10% 2 30 6% -4% 0 31 0% -6%
Domestic Violence (missing=5, 3, 5)
6 23 21% 7 24 23% +2% 1 28 3% -20%
Victim of Sexual Abuse (missing=5, 3, 5)
5 24 17% 1 30 3% -14% 0 29 0% -3%
Poverty (missing=7, 1, 4) 11 16 41% 14 19 42% +1% 12 18 40% -2%
Exposure to Substance Abuse In The Home (missing=4, 3, 4)
3 27 10% 0 31 0% -10% 0 30 0% No Change
Community Supports for Wraparound Inventory (CSWI)
Skagit County
Community Supports for Wraparound Inventory (CSWI) A tool that assesses the level of development of a
particular community’s system-level support for wraparound.
Data collected December-January 08-09. 42 items grouped into 6 themes
1. Community Partnership2. Collaborative Action3. Fiscal Policies and Sustainability4. Access to Needed Supports & Services5. Human Resource Development & Support6. Accountability
Skagit County CSWI
39 invited to take the CSWI 30 of the 39 invitees responded = 76.9%
CSWI Overall and Theme Means-Skagit County
Theme Means: Pilot Sites and Comparison
0 0.5 1 1.5 2 2.5 3
Accountability
Human Resource Development
Availability of Services and Supports
Fiscal Policies and Sustainability
Collaborative Action
Community Partnerships
Cowlitz CountyGrays HarborSkagit CountyNational
Total Score
Cowlitz County 66.3
Grays Harbor 81.2
Skagit County 79.2
National 79.4
Wraparound Fidelity Index
Wraparound Washington
Total Fidelity Scores
Youth InformationNumber of Youth Assessed 56Interviews completed (total)
-Caregiver 31
-Facilitator 55
-Youth 14
Gender (missing=1)
-Male 34
-Female 21
Race (missing=2)
-White 44
-American Indian/Alaskan Native 3
-Mixed Race 3
-Black or African American 1
-Native Hawaiian/Other Pacific Islander 1
-Other 2
Overall Fidelity for All Sites
WF CG Youth
Pilot Sites 84 83 85
National Mean 83 75 73
0
20
40
60
80
100
WF CG Youth
Per
cen
t Fi
del
ity
Pilot SitesNational Mean
Fidelity Scores by Phase for All Sites
Phase 1: Engagement
Phase 2: Plan Development
Phase 3: Implementation
Phase 4: Transition
Pilot Sites 86 81 85 75
National Mean 76 76 81 69
0
20
40
60
80
100
Percent Fidelity
Phase 1:Engagement
Phase 2:Development
Phase 3:Implementation
Phase 4:Transition
Pilot SitesNational Mean
Fidelity Scores by Principle for All Sites
Family Voice and Choice (FVC) Team Based (TB) Natural Supports (NS) Collaboration (CO) Community Based (CB)
Pilot Sites 93 82 76 90 72
National Mean 83 72 64 85 71
0
20
40
60
80
100
Percent Fidelity
FVC TB NS CO CB CC IN SB PE OB
Pilot SitesNational Mean
Culturally Competent (CC) Individualized (IN) Strengths Based (SB) Persistence (PE) Outcome Based (OB)
Pilot Sites 96 77 87 89 69
National Mean 91 69 83 82 67
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