UPLIFT and Compadres have implemented essentially the same program model and staff structure. Program staff are organized into service units composed of clinical program managers, team facilitators, family specialists, and parent partners. Remarkably, in both programs, the family to staff ratio is approximately 1.3 to 1. UPLIFT serves 149 families with a staff of 115 and Compadres has a staff of 46 and can serve up to 46 families. The unique role of each staff position is as follows:
- Clinical program managers administer and supervise the overall program, assign cases to service teams, and approve team decisions.
- Facilitators supervise family specialists, plan and coordinate family team meetings, and write service plans and present them to the community wraparound team for approval. Facilitators have masters' degrees and are licensed clinical social workers or in clinical supervision. One facilitator is assigned to each family.
- Family specialists carry out the service plan. They are the front-line workers who provide services in the family's home. To meet a variety of family needs, specialists work flexible schedules. Most specialists have a bachelor's degree, but those who do not have a degree do have previous experience working with youth. Generally, specialists are younger than other staff members and use this to their advantage in establishing relationships with children in the program. Engaging children in recreation and coaching them in their relationships with peers, parents, and teachers is a large part of their effort. The number of specialists assigned to a family depends on the family's needs and the number of extended family, friends, neighbors, and other community members available to assist. UPLIFT has assigned as many as 12 specialists to a family in crisis to provide round-the-clock coverage.
- Parent partners are paid staff who are recruited from families who have successfully used wraparound services. As parents of special needs children themselves, they are uniquely able to gain the trust of new parents participating in the program. Partners provide parents with emotional support and teach parenting skills. Along with the family specialist, the parent partner links parents to community resources to bridge the gap in their support networks. Parent partners may also represent parents' perspectives in meetings with the program and other service systems.
UPLIFT, the larger of the two programs, has six service units. Each unit consists of 4 facilitators, 12 family specialists, and one parent partner. Service units can serve up to 32 families -- 6 to 8 families per facilitator. In addition to the service teams, UPLIFT employs a staff psychiatrist, a parent partner coordinator, and a community development specialist.
Compadres has two service units. Each unit consists of a clinical program manager, 4 facilitators, and 16 family specialists. Each unit can serve up to 32 children -- 6 to 8 families per facilitator. In addition to the service units, the program also has two parent partners, a substance abuse coordinator, and a behavioral services manager. The behavioral services manager provides staff consultations and implements an occasional behavioral intervention with some children.
Ultimately, the program goal is to enable parents to care for their children without the assistance of wraparound services. Hence, both providers rely first on community resources rather than directly providing or purchasing services. Reliance on community resources requires that program staff develop a thorough knowledge of available resources throughout the county. Compadres builds this knowledge by assigning staff to specific service areas such as education and parks and recreation. UPLIFT's community development specialist compiles information about community resources and disseminates it to the service units.
Family Team. Once a family has been assigned to a service unit, the facilitator organizes a family team. The family team is responsible for planning services and making decisions. Parents are considered the most important members of the team and are the primary decision-makers with regard to developing the service plan -- identifying what their needs are and how they will be addressed. The wraparound philosophy emphasizes a strength-based approach that builds upon families' existing strengths and assets and works to implement the family's vision of a normalized life outside residential care. Professional members of the family team include the facilitator and representatives from each of the agencies working on the case (i.e., DFCS, Mental Health, and Juvenile Probation). Recruitment of "natural supports" to the family team is particularly important because the program expects the family to eventually shift its reliance from program staff to these informal supports. Facilitators consult with the family to develop a list of potential family team members and will approach candidates and ask for their participation. Non-professional team members may include teachers, coaches, pastors, neighbors, friends, former foster parents, and extended family. Because of the demands on the family of caring for an emotionally disturbed child, many parents have severed their social ties with extended family and friends. In these cases, family specialists and parent partners work to reestablish these relationships.
The first family team meeting is held within 30 days of referral. Initially, the team typically meets about once or twice a week. As the case progresses, the team meets less frequently, about twice a month, but may continue to meet more often at the family's request. After developing the initial service plan, the purposes of meetings are to assess progress toward implementing the plan, address issues that have emerged, and revise the plan accordingly.
In addition to the service plan, the family team develops a safety plan for coping with every conceivable crisis -- psychological, educational, and medical -- that may occur in the home, at school, or in the community. If the child's safety is compromised, the DFCS worker, or other professional on the team, may unilaterally decide to remove the child from the home.
DFCS Monitoring. DFCS retains responsibility for the medical, educational, and emotional needs of children that they refer to wraparound programs and provides progress reports to the court. Hence, several mechanisms -- primarily the community and family teams - are in place to assist DFCS with monitoring the status of children in their care.
The wraparound community team is made up of representatives from DFCS, Mental Health, Juvenile Probation, the Office of Education, and the wraparound programs. This team has responsibility for oversight of the wraparound programs and monitoring the agencies' contractual obligations.
The team meets monthly to review progress reports provided by the wraparound facilitator. In addition to reviewing the service plan and family progress, the team approves a proposed itemized budget for services. An official guideline recommends the dollar amount that may be approved for a particular service. Thousands of dollars for services have been approved, but the monthly budget is usually around $500.
DFCS workers assigned to wraparound cases may regularly attend family team meetings. However, the frequency of team meeting attendance is left to individual worker discretion. Some workers meet with the team weekly, and others attend only if there is a crisis. Likewise, the role of the worker on the team also depends on the individual worker. Workers typically view themselves as either team supervisors or collaborators. Those with a supervisory style want to ensure that facilitators are providing the services necessary for the family to succeed and take a more directive approach toward the team. Collaborators also are concerned with adequate service provision but rely more on team deliberation to achieve this goal.