Winner of 2009 Annie E. Casey Innovations Award announced

Sep 15 2009

The Ash Institute for Democratic Governance and Innovation at the John F. Kennedy School of Government at Harvard University today announced Wraparound Milwaukee of Milwaukee County as the 2009 winner of the Annie E. Casey Innovations Award in Children and Family System Reform. As part of Milwaukee County’s Department of Health and Human Services, Wraparound Milwaukee is the first government-operated managed care service designed to treat emotionally disturbed youth in the home setting. Unlike most of the country’s treatment models, which unnecessarily institutionalize youth and limit family participation, Wraparound Milwaukee offers a notable approach to care. The program is one of six government initiatives honored as Innovations in American Government Award winners at yesterday’s reception in Washington, D.C. The event concluded with the premier of 2009 Visionaries, a PBS-produced documentary highlighting this year’s winners. Wraparound Milwaukee will receive a grant to share its innovative practices for individualizing the treatment of youth through family involvement and a unified set of services.

Innovation Defined

Launched in 1995, Wraparound Milwaukee serves an annual 1,300 youth with diagnosable mental health disorders such as depression, attention deficit disorder, or learning impairments that prevent normal functioning in home, school, or outside community settings. Over 50 percent of these children come from families at or below the federal poverty line. Eligible youth are already being treated by two or more social service systems and are often in the process of moving to more formal residential treatment centers, correctional facilities, or psychiatric hospitals.

Wraparound attempts to reduce costly and arguably ineffective residential care options by offering a host of individualized treatments that allow youth to stay with their families. Care options and services include tutoring and after school programs, group care, recreation and camp, arts programs, and substance abuse treatment as viable alternatives to inpatient treatment. Additionally, the program encourages family members to play a more active role in the treatment process as members of the care planning team.

“Wraparound Milwaukee is leading the nation with a more effective response to treating emotionally disturbed youth,” said Douglas W. Nelson, president and CEO of the Annie E. Casey Foundation. “Our experience has shown that treatment within a home setting is frequently the most effective and lasting treatment for young people. The work of Wraparound Milwaukee demonstrates that improved treatment and significant family involvement play a pivotal role in the successful treatment and stabilization of youth within their own communities.”

Structure

Unlike other state models of care, Wraparound unites all care agencies – including Mental Health and Special Education – into one integrated treatment organization whereby funding is pooled across all agencies. As a result, youth and their families receive one care plan operated by a single case manager regardless of how many services are used. Wraparound includes the country’s first publicly operated public benefits corporation, acting as the single payor for not only mental health needs, but all social services. Families have the opportunity to choose what support and mental health services are appropriate for their individual needs.

Achievements

The program has achieved notable results over its 14-year history and reports significant cost-savings.

• In 2007, the average monthly cost to place a youth at a traditional Wisconsin treatment center was over $8,000. Due to Wraparound’s lessened use of residential options, Wraparound’s average care cost was nearly $4,000 over the same period.
• Wraparound cites a drop in residential placements since its inception: from 375 youth placements in 1996 to 90 placements in 2008.
• The program argues such reduced utilization of costly inpatient and often last-resort services allows mental health workers to focus more on improved treatment. Clinical scores incorporating feedback from youth, families, and clinicians note an average 20 point improvement of clinical health indicators of treated youth.

"Wraparound Milwaukee makes the seemingly impossible, possible,” said Bruce Kamradt, director, Children's Mental Health Services, Milwaukee County and director, Wraparound Milwaukee. “The program integrates services and funding across child serving systems to achieve the best possible outcomes for children with serious emotional and mental health needs. Through its very individualized, strength-based, comprehensive services and focus on family involvement , Wraparound demonstrates that even children with the most complex needs can be effectively and safely cared for in their homes instead of institutions."

“Wraparound Milwaukee’s care model breaks through rigid program silos and delivers cost effective and higher quality care that involves families from day one,” said Stephen Goldsmith, director of the Innovations in American Government program at Harvard Kennedy School. “The program champions a unique approach to care where one size doesn’t fit all. In honoring Wraparound, we hope other states will learn from the program’s innovation and adopt similar practices to ensure improved care of at risk youth.”

The Annie E. Casey Innovations Award in Children and Family System Reform was established in 2006 through a partnership between the Annie E. Casey Foundation and the Ash Institute for Democratic Governance and Innovation. Since its inception in 1985, the Innovations in American Government Awards has recognized over 400 government initiatives that forward innovative practices that benefit citizens.