Public and private agency administrators attribute the success of Santa Clara County's wraparound services in returning children to community settings to five critical elements -- multi-agency collaboration, state enabling legislation, program staff, family-centered decision making, and community-based services.
Early collaboration among the multiple public and private agencies adopting the wraparound model ensured a unified effort and a strong commitment to the program. Once established, the multi-agency coalition was instrumental in both implementing the County's pilot program and initiating the state legislation that provides its funding and extends wraparound services to other counties across the state. Furthermore, through each agency's active participation on the RISC, this multi-agency collaborative decision-making process remains central to the administration of the program.
Several aspects of California's wraparound legislation, S.B. 163, and recent changes in its Medicaid policy have been particularly critical to the program's success. Because S.B. 163 does not specify timeframes within which services must be delivered, intensive in-home services may be provided for as long as necessary to stabilize a family after reunification. In addition to flexible timeframes, the legislation also provides for the flexible use of wraparound funds. That is, rather than funding specific services, the legislation allows programs to use wraparound dollars for whatever services are necessary to meet families' individual needs. The program also benefits from the extension of California's Medicaid program to children receiving wraparound services. The MediCal extension ensures that children who are returned to their parents' homes continue to have access to basic medical and dental services.
Perhaps one of the most important aspects of the County's wraparound program is its 1.3 to 1 family-to-staff ratio that adequate funding has made possible. This low family-to-staff ratio helps to ensure that families receive ample supportive services without overburdening program staff. In addition, having a larger staff allows the program to employ workers with a range of skills that can be deployed according to the family's needs. An adequate number of staff also enables front-line workers to keep flexible schedules so that they can be available at the times that families most need their assistance, including nights and weekends.
According to administrators, another indispensable feature is the program's use of experienced parent partners to provide support services to incoming parents. Because they share similar life experiences, these paraprofessionals are uniquely equipped to engage parents in the wraparound effort and provide professional staff with greater insight into parents' perspectives.
Program administrators repeatedly identified family-centered decision-making and community-based services as critical factors in successfully returning children to family settings. Family-centered decision-making requires professionals to not only take the family's perspectives into consideration but to actually let the family identify problems and propose remedies for themselves. Although family-centered decision-making is central to wraparound philosophy, in practice, it may be one of the most difficult aspects of the program to implement. This difficulty arises partly because the philosophy is a departure from traditional decision-making processes that rely almost exclusively on professionals. The family-centered approach to problem solving necessitates that professionals accept a certain degree of risk in relinquishing complete control over the decision-making process. To some extent, professionals have had trouble accepting the idea that, in terms of the families' needs, expertise resides with the family. For many, especially more seasoned professionals, this practice reorientation has required extensive and ongoing training.
A major advantage of flexible service timeframes is that it allows family functioning to guide decisions regarding the duration of services. But despite flexible timeframes, wraparound services do eventually end. To maintain ongoing supportive services for the family, it is essential that the program rely on community-based services and informal supports (e.g., extended family, friends, neighbors, community recreation centers). Reliance on community resources, however, requires a substantial commitment of staff time to building their knowledge of resources, developing relationships with community service providers, and actively linking families to community agencies. Furthermore, staff must develop skills to effectively interact with members of the family's informal and formal support systems and devote time to engaging these people in providing support to the family.
Furthermore, the program's reliance on community resources may make its success partially dependent on whether a range of services actually exists in the community. In Santa Clara County, primary wraparound services -- in-home family support, 24-hour access to wraparound staff, and limited financial assistance -- are provided directly by the program. A second tier of supportive services -- parent support groups and youth mentoring -- is offered by paraprofessionals. The most commonly used community resources include mental health agencies, community schools, and youth centers. Provision of this mix of services has assisted many children to reunify with their biological families or live with a foster family. Statistics provided by the DCFS indicate that of the 268 children served by wraparound services between January 1994 and January 2000, 84 percent (225) were maintained successfully within their families and communities. Wraparound services allow children who would otherwise stay in residential care until they age out of the child welfare system to return to their homes and communities and re-establish a more normal life outside of an institutional setting.