Fixing Pennsylvania’s Children’s Wraparound Services

In Pennsylvania, children and youth who have serious behavioral problems may need more than an hour of talk therapy every week and less than a psychiatric residential placement. When the state received Federal approval to bill for flexible community based services, it was a victory for families and their children, who had lobbied hard for family centered services. These new services were called Wraparound, because the family/provider team was supposed to wrap services around the child. Families, providers, and government staff worked together to launch the services. For more than a decade, we have been “building the airplane while we fly it!”

But PA’s Wraparound services are not actually Wraparound, which is a planning process, not an actual service. What is called Wraparound is usually the Medicaid billable Behavioral Health Rehabilitative Services provided by Mobile Therapists, Behavior Specialists, and Therapeutic Staff Support (TSS). These rehabilitative services are designed to focus on the child and family’s strengths and prevent out of home placements.

Lessons Learned- Quality Wraparound Services

PA has more children receiving home and community based mental health services than any other state.  However, our victory is also our greatest challenge. The demand for these services has always been greater than the number of people able to provide them.  Now the state has started a process to improve home and community based children’s mental health services.

Hi-Fidelity Wraparound

PA secured state and federal funding to develop a new improved wraparound service model called Hi-Fidelity Wraparound. Over the next few years, the improved model will be implemented in all willing counties. The lessons learned of what did not work, and more importantly what did work, will be helping families across the Commonwealth to get the high quality services they need to care for their children.

• To learn more about Hi-Fidelity Wraparound in Pennsylvania, including the state’s family advisory board, please visit the Pennsylvania’s Office of Mental Health and Substance Abuse Services’ (OMHSAS) consumer and family website.
• To learn more about Hi- Fidelity Wraparound read:
  • What Families Should Know About High Fidelity Wraparound, by Eric Bruns and Trina Osher. A description of what wraparound is and is not, and an overview of the High Fidelity Wraparound process.
  • The Wraparound Process User’s Guide: Handbook for Families, a product of the National Wraparound Initiative
  • Manual de Usuario del Proceso del Wraparound (Asistencia Integral): Une Guia para Familias, un producto de la National Wraparound Initiative

More Information

• If you need help now with your child’s mental health services, call your Medical Assistance Behavioral Health Choices Member’s Services or contact the Mental Health Association in PA at info@pachildrensnews.org or 866-578-3659.
• To find out if your county is implementing Hi-Fidelity Wraparound, contact the PA Youth and Family Training Institute at yfti@upmc.edu or 866-462-3292. The Institute is responsible for overseeing Hi-Fidelity Wraparound implementation for OMHSAS.