In keeping with the program's individualized and flexible service model, the length of time services are provided varies depending on the family's needs. The providers consider flexible service timeframes to be crucial to the success of the program. Families in the Compadres' program typically receive services for at least 9 months, but service may continue for several years. On average, families remain in the program for about a year. Families in UPLIFT generally remain in the program for 6 months after the child is returned home and the family is stable, and the average length of service is 16 months.
In consultation with the clinical manager, the family team makes the decision to end wraparound services. Their decision is based on a review of the initial service plan and ongoing progress reports and an assessment of the family supports that are in place in the community and how well that system is working. To denote the end of wraparound services, providers have an informal graduation ceremony to recognize the family's accomplishments and staff contributions to their success.
Aftercare. From the time that services begin, providers inform families that wraparound services are temporary and will be withdrawn gradually. After services are terminated, the program provides minimal support to the family. Facilitators remain available for telephone consultations with families; parent partners continue to provide some support to parents, and the DFCS case typically remains open for another 6 months. Non-professional family team members, however, are encouraged to continue their level of support to the family after wraparound services have ended.
Success rate. Providers estimate that, overall, 80 percent of the children who have received wraparound services from their programs have been successfully returned to a family setting. Of the 274 children discharged from the UPLIFT program between December 1996 and December 1999, 82 percent were living with their parents or other relatives, 2 percent resided with foster parents, and 16 percent were placed in group homes. In contrast, for the period of 1998-1999, only 48 percent of other children discharged from level 12-14 group homes were successfully maintained in their families and communities.
Challenges. Despite their overall success with returning children in high-level residential treatment centers to family care, providers identified several areas that continue to challenge the program. Recruiting, training, and retaining staff is a common problem shared by DFCS and wraparound providers. Staff shortages are the result of the high cost of living in the Silicon Valley region and the inability of the social service sector to offer competitive wages to skilled social workers. Providers report that their front-line workers' pay is comparable to that offered in the fast food industry. Although staff attrition is prevalent in many child welfare agencies, problems generally associated with staff turnover are exacerbated in wraparound programs because the paradigm shift from traditional services requires intensive and ongoing training. Moreover, as a result of staff shortages, the program has been unable to operate at full capacity. The total capacity for both providers is 195 children, but only 170 are currently served.
Wraparound programs rely heavily on community resources to meet families' needs, yet providers reported that the availability of affordable housing, respite care, and foster homes in Santa Clara County is quite limited. Affordable housing is so scarce that one program director, out of exasperation, has suggested that families who need housing be transferred to programs in other counties. Indeed, some families already move out of the agencies' service area to more affordable communities before completing the program. The high cost of housing in the county may also contribute to the shortage of foster homes. Foster homes are generally in short supply.
Ideally, providers would include respite care in every family's service plan because most parents identify it as a primary need. But respite care for birth and foster parents is also very limited. For respite care, Compadres relies on the one residential bed that Rebekah Children's Services provides and to a greater extent on the agency's foster families. When these resources are exhausted, they rely on other agencies that provide emergency and 30-day placements. Occasionally, Compadres' parents volunteer to provide respite for other families.