The national community of Wraparound providers, advocates, and Wraparound implementing states have reason to cheer some recent news from the federal Administration for Children and Families (ACF).
On January 5, The Title IV-E Prevention Services Clearinghouse, established as part of the federal Family First Prevention Services Act, announced that Intensive Care Coordination (ICC) Using High Fidelity Wraparound has been planned for systematic review.
The Prevention Services Clearinghouse was established by ACF within the U.S. Department of Health and Human Services (HHS) to systematically review research and evaluation on programs and services intended to provide enhanced support to children and families and prevent foster care placements.
Based on review of research evidence and level of available implementation supports, the Clearinghouse rates programs and services as well-supported, supported, or promising practices, in accordance with statutory requirements. Well-defined practices (e.g., mental health services, substance abuse prevention and treatment services, in-home parent skill-based programs, and kinship navigator programs) that are included in the Clearinghouse as being supported by research evidence have a clearer path for being approved for funding under Title IV-E of the Social Security Act as amended by the Family First Prevention Services Act.
States cannot receive Title IV-E reimbursement for prevention services unless there is a well designed and rigorous evaluation strategy for each service included in their five-year plan. However, the Children’s Bureau may waive the requirement for a well-designed and rigorous evaluation strategy for a well-supported practice if the State meets certain continuous quality improvement requirements in Family First.
Although well-supported practices must still be continuously monitored to ensure fidelity to the practice model and examine child/family outcomes, the waiver of a need to conduct a rigorous outcome study to demonstrate effectiveness lowers the bar for the level of evaluation rigor that states must undertake, clearing the way for inclusion in state plans.
There is reason for hope for a positive review of ICC/Wraparound by the Clearinghouse: A recently completed meta-analysis conducted by Jonathan Olson, Eric Bruns, and the University of Washington Wraparound Evaluation and Research Team has shown that, across 16 controlled studies, Wraparound demonstrated significant, medium-sized effects on outcomes that are critical to child welfare agencies, such as prevention of youth out of home placement.
The National Wraparound Initiative would like to salute the many states, centers of excellence, and others who nominated ICC/Wraparound using the materials the NWI prepared for this purpose. The consistency of terms and evidence included in those nominations was likely instrumental in Wraparound’s inclusion in the Clearinghouse review.
We look forward to keeping you posted on any news from the Clearinghouse. We also plan to keep the Wraparound field informed about implications for states who seek to include ICC/Wraparound in state plans. This will include a summary of the types of evaluations that will need to be included in state plans, depending on the level of research support found for ICC/Wraparound by the Clearinghouse.
As always, if you have questions about the status of the Wraparound evidence base, or seek to use validated quality and fidelity tools developed by UW WERT, please feel free to email us at wrapeval@uw.edu. Information on training, coaching, and technical assistance can also be obtained via inquiries to these emails, or via the website of the National Wraparound implementation Center at www.nwic.org.