Model Program: Integrated System of Care for Children with Serious Emotional Disturbances and Their Families

Wraparound Milwaukee

Goal

To offer cost-effective, comprehensive, and individualized care to children with serious emotional disturbances and their families. The children and adolescents that the program serves are under court order in the child welfare or juvenile justice system; 64% are African American.

Features

Provides coordinated system of care through a single public agency (Wraparound Milwaukee) that coordinates a crisis team, provider network, family advocacy, and access to 80 different services. The program's $30 million budget is funded by pooling child welfare and juvenile justice funds (previously spent on institutional care) and by a set monthly fee for each Medicaid-eligible child. (The fee is derived from historical Medicaid costs for psychiatric hospitalization or related services.)

Outcomes

Reduced juvenile delinquency, higher school attendance, better clinical outcomes, lower use of hospitalization, and reduced costs of care. Program costs $4,350 instead of $7,000 per month per child for residential treatment or juvenile detention.86

Biggest challenge

To expand the program to children with somewhat less severe needs who are at risk for worse problems if they are unrecognized and untreated.

How other organizations can adopt

Encourage integrated care and more individualized services by ensuring that funding streams can support a single family-centered treatment plan for children whose care is financed from multiple sources.

Sites

Milwaukee and Madison, Wisconsin; Indianapolis, Indiana; and the State of New Jersey