Amy Muñoz

In November of 2021, Amy Muñoz started her new job as Special Projects Advisor for Arizona’s Children’s System of Care. She had worked in the children’s system for a long time and came into her new position with a clear goal in mind: to improve practice in state’s child and family teams, and to improve outcomes for the approximately 3,000 children identified with complex needs and their families.

At that time, Arizona was using a model of team-based high-needs case management that, in theory, had a lot in common with Wraparound. However, the state had recently completed a formal feedback process among interested parties and found that there had been substantial drift away from the model. In particular, the feedback indicated that families felt that they were not really being heard, and that their ideas were not being incorporated into treatment plans. Families were also finding barriers to accessing care, particularly non-clinical supports and services. Child and family teams did have access to good quality parent peer support services through the state’s family-run organizations, but care coordinators generally were not talking with families about the availability and value of peer support.

Before taking her position at Arizona’s state Medicaid agency, Amy worked in compliance and quality improvement for a large behavioral health agency and was familiar with tracking data metrics for monitoring service delivery. To accomplish her goal, Amy knew it was important to have data that could be used as part of ongoing quality improvement efforts. Metrics for Amy’s position relied primarily on claims data, which meant there was a 6-month lag between when services were provided and when the data became available for use. Additionally, while the state used a comprehensive process for continuous quality assurance for the system of care – including both a chart review and interviews with caregivers and team members – the sample size was low. Amy and the children’s system of care team desired a process that allowed them to evaluate the overall quality of care and outcomes for children with complex needs.

To respond to these shortcomings, Amy wanted to implement a clearly defined model, together with a sustainable quality assurance process to ensure fidelity. She found what she was looking forward with Wraparound, supported by use of a set of tools and services from the National Wraparound Implementation Center (NWIC) at the University of Connecticut and the Wraparound Evaluation and Research Team (WERT) at the University of Washington. NWIC will begin statewide Wraparound training in the next few months and will also be providing training and coaching as the state implements FOCUS, an intensive case management process designed for children who are not at immediate risk for out-of-home placement, and their families. Quality assurance will be made possible in real time, through the use of the suite of Wraparound fidelity and quality assurance assessments, and the online data management system provided through WERT.

Though still in an early phase of the Wraparound journey, Amy looks forward to helping move the Arizona system of care closer to its vision of ensuring that children and families have access to high quality services, so that they can live successfully in their homes and communities.