National Wraparound Initiative's Wraparound Blog

Wraparound to be Reviewed by the Prevention Services Clearinghouse

January 15, 2021 | Eric Bruns

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 (FFPSA), 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. As amended by the Family First Prevention Services Act, 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 designated by 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.

In Federal Fiscal Year 2022 and 2023, States with approved FFPSA Prevention Plans will need to ensure that 50% of their claims are for “supported” and “well-supported” programs; beginning in FY 2024, 50% of claims will have to be for “well-supported” programs.

Additionally, 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 (and, therefore, the cost) 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 of rigorous Wraparound research conducted by Jonathan Olson, Eric Bruns, and the University of Washington Wraparound Evaluation and Research Team (UW WERT) 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. Moreover, although the Clearinghouse’s standards differ, the Washington State Institute for Public Policy Child Mental Health Services Inventory, previously determined Wraparound to be research-based, facilitating its use in Washington under House Bill 2536.

The National Wraparound Initiative would like to salute the many states, centers of excellence, and others that nominated ICC/Wraparound using the materials the NWI prepared for this purpose. The consistency of terms and lists of relevant research studies included in those nominations were likely important factors in Wraparound’s inclusion in the Clearinghouse review. In the coming months, NWI will keep you posted on news from the Clearinghouse, as well as implications for states who seek to include ICC/Wraparound in state plans.

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 (NWIC).

The HHS Children’s Bureau website for Title-IV-E Prevention Services provides information about the FFPSA Prevention Program, including links to the text of the legislation and federal guidance. From this website, the Title IV-E Prevention Services Clearinghouse and an Information Memorandum (ACYF-CB-IM-19-04) on Evaluation Development is also accessible.