Wraparound Milwaukee is an effective wraparound service delivery program that integrates the mental health, juvenile justice, and other systems to address the mental health needs of juvenile justice system clientele (average age 14–15) and parental problems at the same time. It began by successfully providing services to youth and their families in the mental health system. Now it is a county-operated collaborative that provides comprehensive care to youth referred from both the child welfare and juvenile justice systems and their families. Wraparound Milwaukee serves as the hub of a comprehensive system linking several human service agencies, thus forming a managed-care continuum of treatment options. The program currently serves more than 650 youth, 400 of whom are adjudicated delinquent.
The program components deemed essential to the success of the Wraparound Milwaukee program are as follows:
- Care coordination (the “cornerstone” of the system).
- The child and family team (wraparound plans are family-driven).
- The Mobile Urgent Treatment Team (a mobile crisis team that is available to meet the needs of youth and families when a care coordinator might not be available).
- The provider network (consisting of more than 170 agencies that respond to the multiple needs of youth and families).
- Blended funding (to break down barriers to service delivery that can arise when multiple agencies are involved).
The use of blended funding has been particularly important to the success of the Wraparound Milwaukee program. The project is sustained by pooled funds that come from the system partners in this integrated, multiservice approach to meeting the needs of youths and their families. The fact that the involved agencies share the expenses of the program helps enormously to break down barriers to system integration. The program receives a flat monthly fee for each client and must pay for all treatment services, including incarceration and residential care. In 1999, the program received more than $26 million in pooled funds. After all funds are pooled and “decategorized,” the program can use them to cover any services that families need, in a mix of formal and informal services. This approach helps ensure that the most appropriate services are purchased. Project staff thus have an incentive to keep as many youth as possible in their homes. The program has shown delinquency reductions among clients in a before-after study.
The Wraparound Milwaukee 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.
General delinquency involvement
High alcohol/drug use
Lack of guilt and empathy
Child maltreatment (abuse or neglect)
Family violence (child maltreatment, partner violence, conflict)
Lack of orderly and structured activities within the family
Parental use of physical punishment/harsh and/or erratic discipline practices
Poor parental supervision (control, monitoring, and child management)
Frequent truancy/absences/suspensions; expelled from school; dropping out of school
Low academic aspirations
Low school attachment/bonding/motivation/commitment to school
Poor school attitude/performance; academic failure
Poor student-teacher relations
Poorly defined rules and expectations for appropriate conduct
Poorly organized and functioning schools/inadequate school climate/negative labeling by teachers
Association with antisocial/aggressive/delinquent peers; high peer delinquency
Association with gang-involved peers/relatives
Center for Effective Collaboration and Practice, American Institutes for Research: Promising program structure
National Gang Center and OJJDP Model Programs Guide: Promising program
Harvard University Kennedy School of Government: Innovations in American Government Award, 2009
Mr. Bruce Kamradt
9201 Watertown Plank Road
Wauwatosa, WI 53226
Phone: (414) 257-7639
Fax: (414) 257-7575
E-mail: [email protected]
Burns, B. J.; Goldman, S. K.; Faw, L.; and Burchard, J. (1999). “The Wraparound Evidence Base.” In B. J. Burns and S. K. Goldman (eds.), Promising Practices in Wraparound for Children With Serious Emotional Disturbances and Their Families. Systems of Care: Promising Practices in Children’s Mental Health, 1998 Series, Vol. 4. Washington, DC: Center for Effective Collaboration and Practice, American Institutes for Research, pp. 77–100.
Kamradt, B. (2000). “Wraparound Milwaukee: Aiding Youth With Mental Health Needs.” Juvenile Justice, 7(1):14–23.