“HFW has made a difference in the lives of youth and families by improving family dynamics, increasing communication between family members, repairing relationships, and reduction of high cost services (hospitalizations, residential placements, foster care and JPO placements).”
County Administrator
The primary funding for High Fidelity Wraparound (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, (also called high fidelity wraparound), 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.
Some counties use this approach to funding HFW while other counties use funds from the county children and youth agencies to pay for HFW teams to work with youth involved in the child welfare system. Some counties use Medicaid reinvestment funds that counties and the BHMCOs control and some are paying for HFW through county needs-based budget funds.