Implementing Wraparound care coordination in care management entities versus community mental health centers was associated with higher fidelity to the model and faster implementation.

Background

Wraparound is an approach to intensive care coordination that supports children with complex behavioral health needs and their families. Wraparound has been widely adopted by states, though approaches to state implementation vary. This study assessed how administrative structures impacted Wraparound implementation.

Findings

This study assessed data from 1,178 Wraparound programs, comparing implementation outcomes in states implementing the approach through care management entities (four states) with those implementing the model through community mental health centers (six states). States with Wraparound programs implemented through care management entities were found to have higher fidelity to the Wraparound approach and completed most implementation activities faster. Implementation through care management entities was also associated with completion of more activities supporting sustainable model implementation (not tested for statistical significance). Longer duration of pre-implementation activities was associated with increased model fidelity, while longer duration of implementation activities was associated with less model fidelity.

Program/Policy Takeaways

Administrative structures impact how Wraparound programs are implemented. States implementing Wraparound through community mental health centers may consider how to provide adequate supports for ensuring model fidelity. States may also consider how to support pre-implementation activities to enable effective model implementation.