Maryland’s Systems of Care and Wraparound Initiatives

Teens in a huddle Systems of Care is the larger picture – it is the connecting of all service delivery systems (mental health, substance abuse, etc.) in order to create a seamless service delivery system for Maryland’s youth.

Wraparound is currently targeted to address the needs of “deep-end” youth, which equates to approximately 2-3% of Maryland’s total youth population.

Wraparound is a key component of systems of care building.

  • "Wraparound" is an important element of system building -- which actually could be applied both to deep-end and at-risk kids -- but it does not in itself constitute a system of care. It is an approach to service planning that needs to be supported by a system of care.

For this “high level of need” population Maryland is working to:

  • Change financing structures,
  • Change provider networks,
  • Create a locus of management accountability for this deep-end population,
  • Provide intensive care management,
  • Provide training,
  • Track outcomes and
  • Manage utilization.

If Maryland were planning to address deep-end youth only, we would succeed in diverting a few kids but not changing the delivery system for the bulk of them.

  • BUT Maryland is not going to just to implement wraparound – wraparound is a funding mechanism and service delivery process that will allow us to shift a portion of our “deep-end” dollars towards prevention and early intervention and foster the growth of more community-based services that can be used by all of Maryland’s youth in need of services.

At the same time, Maryland is working to create a single point of access in each local jurisdiction through the local management boards for all families who have children with special needs (which includes the 2-3% as a subset).

  • This single point of access is going to assist families to get to services but it is not going to actually manage the delivery system -- it's too many families.
  • In contrast, through the Wraparound initiative, the local management boards (and/or the vendors they contract with), starting with Baltimore City and Montgomery Co., are actually going to be managing the delivery system for the “deep-end” (2-3% of the population) kids.

Maryland is not just implementing a wraparound approach to service planning -- we are changing the structure of how youth with special needs and their families access and use services.