Starting a HFW Team - Youth and Family Training Institute

In Pennsylvania, High Fidelity Wraparound Teams are created by the County Administrators in collaboration with their Behavioral Health Managed Care Organizations. Once interest has been determined, the County Administrator should contact one of the following to discuss possible financing options and start-up plans:

Scott Talley, Director, Bureau of Children’s Behavioral Health Services
Shaye Erhard, Division Director – Operations and Service Delivery, Bureau of Children’s Behavioral Health Services
Monica Payne, Executive Director, Youth and Family Training Institute

Counties are responsible for the start-up costs of their HFW team.

The primary funding for HFW in Pennsylvania is authority under federal Medicaid rules (42 CFR 438.208) that guides how managed care entities provide coordination and continuity of care. Most of the youth receiving HFW are eligible for Medicaid because they meet the standard of having a disability as a result of their complex behavioral health disorder. Medicaid requires a comprehensive assessment as well as a treatment or service plan developed in conjunction with the person being served and any provider involved in the service. Pennsylvania refers to this as the joint planning team and applies it to High Fidelity Wraparound. The joint planning team process is treated as an administrative cost (like case management) for youth and families that are eligible for Medicaid Managed Care because it is a planning process and not a medical service. However, cost savings are expected to be realized through decreased out-of-home placement, decreased hospitalization, and a more appropriate use of available community-based services. Counties that are able to demonstrate cost effectiveness are able to have those costs included in their capitation rates.
There are a number of other possible funding sources for the start-up including county funds, grants, County Child Welfare Needs-Based funding, etc., and this information will be shared.

A HFW team for 25 youth and their families includes a coach/supervisor, two facilitators, a family support partner, and a youth support partner. Depending on the county infrastructure needs, a team may cost between $300,000-400,000/year.

At this point, the interested county will begin to work with the Youth and Family Training Institute (YFTI). The YFTI staff will provide technical assistance during every part of the process. Technical assistance includes webinars about the HFW model, how to hire staff (including job descriptions and the interview process), information about the training, coaching and credentialing process, and information about the evaluation process.

Once a county decides to create a HFW team, the county must decide who will hire the workforce. Some counties hire the staff within their Department of Human Services (DHS) and others select a provider(s), often through a competitive selection process. YFTI can provide samples of “Requests for Proposals” (RFPs) that have been successfully used by other counties.

Once the HFW workforce has been hired, the training, coaching, credentialing, and evaluation process begins.

The counties can begin HFW enrollments after day 2 of the Five Day Team Training.

All technical assistance and services provided by YFTI are provided free of charge to the counties/providers.