BY: James E Corbin II

Early November 2019, I had the opportunity of attending an interesting seminar/ training on the U of I campus involving wraparound -care teams, for which help/assistance maintains a consistent care model for individuals who may need it. This type of care system ensures care remains constant during a challenging moment that the individual may routinely experience as a result of their physical or mental challenges.

As an individual who is physical challenged, I can understand the need to have a system such as a wraparound -care system like this in place. I experienced this need to have a handful of helpful individuals around me when I was living in locations too far for immediate family members to reach if necessary. The concept is based on being a contributor to a needs a “circle” and not just looking for what a person can receive.  The goal for a good wrap-around care system consisting of a relationship steep in reciprocity, not dependency.  Here allow me to explain why I found this care method to be beneficial.

Since 2014, I have lived in locations that were far away from immediate family and friends. In short, I was pretty much on my own, believe me, it was not something I planned, but it just turned out that way.  Therefore, I had to improvise and develop alternative care assistants who could help in my wellbeing. So, I always kept a keen eye open for positive well-rounded individuals of like mind and cautiously introduced myself.  What I did next was sought out official care givers like doctors, nurses, and CNA and asked them to recommend any support groups or organizations that share similar challenges as myself.

Usually, professional care givers can recommend a few groups or name someone who may know someone with similar issues, and I follow the leads. Also, I used technology like social media (Facebook, Tweeter) and apps like Meetups to connect with other likeminded individuals. Once connected to amicable individuals who share like interest, I attempt to establish a somewhat reciprocal relationship. Usually, this involves making myself available for social outings and more.

 Trust takes some time to build, and it has to be established on both sides as well.  Therefore, the more casual contact I had; the more trust could be established. Soon I would work my way to work out a sort of “quid pro quo” situation and offer my services like occasional running some errands as my way giving back. Connecting with others in the community helped me mange through difficult challenges and maintain a system of steady care. At the time when I was undergoing my redemption of bonding and connecting, I had no name for it and looked at the process as creating a “network of trust,” which I can rely on in times of need. I had no idea I was utilizing many of the principles involved with the wraparound model. I share my experience to demonstrate how beneficial forming a care circle can be.

The old African motto of “It Takes A Village,” is also true to maintain health care. The Wrap Around Care model has its roots within a movement to change the nonfunctional methods of caring for children who suffered from severe mental disorders. It created as a response to what was not working for the children and their families. Whereas before, care was based on what the professional determined to be what was best and not looked at from a holistic perspective regarding values, beliefs, interest, and community concerns.

Also, there was a lack of resources within the community for the family to draw from if necessary. A few decades ago, family services were very scarce in certain communities, and as a result, many children were sent away too far away from facilities where family and community were not present. In contrast, wraparound programs were established to keep the families together and out of expensive group homes while achieving optimal effects.

Wraparound is a value based collaborative partnership program with roots in local imitative such as Kaleidoscope in Chicago. It is a holistic care system designed to put the individual in need at the center of focus. It is a culturally competent, individualized approach that involves incorporating family, friends, associates as well as health care providers, and other individuals within the community to form a care team to assist with comprehensive care. Success increases when the action plan reflects the perspectives of the family members or those who care for the individual. In short, voice and choice drive the process of actionable care.

With the wraparound method, the family or individual who needs service takes the lead in deciding on what type of care system administered. Team members work in unison to organize a set of visions and goals. Team members work together to implement an individual creative plan of action, which they monitor for effectiveness and make changes if necessary.       

The basic ten principles (Burns and Goldman, 1999) of the wraparound model describe what elements must be available for a successful wraparound team.   

1. Family voice and choice principle involve incorporating family perspectives, which are intentionally prioritized throughout all phases of the wraparound process. This principle ensures that the ones close to the individual have a “say-so” in the long-term care of an individual or family.
2. A team-based model is a principle consists of family, friends, caregivers involved with the wellness of the individual who needs care. These individuals work through formal and informal service relationships as well as community support activities. A team-based system consists of individuals who have the best interest at heart for the individual seeking care.
3. Natural support entails team members be extrapolated from the individual’s environment. The wraparound delivery method is a team-based effort. The action plan should reflect the natural sources involved in the care process. These sources can include family, friends, neighbors, co-workers, support members, and more.  Usually, these different relationships bring value by incorporating a diversity of skill sets and other perspectives on the care process.  
4. Collaboration efforts involve each team member work toward the successful implementation of the effective work plan. Again, the plan should reflect a conglomerate of team member efforts, mandates as well as resources. Each team member shares the responsibility of developing, implementing and monitoring the wraparound plan and make the necessary changes if needed. The team must be committed to the overall goals
5. Community based principle involves the family, and active community life is a key factor in the wellbeing of the individual receiving the intended care. Services and support strategies should be implemented within an accessible environment, and Inclusive environments help to promote integration into the home and community. Providing an accessible environment ensures that individuals receiving care should be able to access a full range of local services offered within the environment the individual lives. These activities should support positive development for the individual.
6. Culturally competent, meaning that values, beliefs, and cultural awareness must be present in a functional wraparound model. Team members must be aligned with cultural values and respect them to have successful collaboration, ensuring that team goals and expectations are achieved.
7. Individualize is based on each plan; strategies, support, and services are customized to ft the personal individual’s needs. Each plan is a series of tailored activities that reflects the family and care givers’ concepts of what care should methods need to be enacted, in addition to what are the most beneficial ending results for the individual. It entails heritage, traditions, and values as a source of strength to be built upon and added to the plan as an undergird structure for advancement.
8. Strength based means that the wraparound plan should help to build strength and competence to the team and individual alike. The team commitment to achieving goals must persist even when adverse situations arise. In the planning process, viewing failures are as learning moments for the team and individual to build and grow is extremely empowering.  
9. The unconditional principle means when faced with a compromising situation, the wraparound team still accepts the induvial regardless of any setbacks. The objective is to stay the course of the plan until the wraparound plan is not needed or must be modified to meet new demands. Revisions are performed regularly until positive desired effects are acquired.
10.  Outcome-based involves benchmarks, or measurements must be in place to identify progress or set-backs.  Using metrics and tools to measure outcomes raises the rate of the successful care system to be in place. Setting goals is fine, but steps to acquire the goals must be acknowledged.

My personal opinion about the wraparound care system is one of admiration because the focus is on establishing functional relationships that help build key elements such as strength and independence. As a physically challenged individual who celebrates his independence, I think this system is a great tool to put in place so that I can maintain my current lifestyle. As I stated earlier, in can be put in place no matter what’s my location. Using a system like this takes care, planning, correctly assessing all available resources, as well as some legal restrictions. But most importantly is that its achievable when done correctly.

Remember, the key to developing a viable wraparound care system involves researched based drivers that focuses on providing optimal human care for the individual or family. If you or someone you know wish to get started using a wraparound care system, there are plenty of places to find help with outlining a care plan. The best place to start is with your professional care giver and the follow up with organizations like the National Wraparound Implementation Center (NWIC), which should be able to assist in locating other resources. Also, I provided a like below to a guide that you can share with your team and go over some of the basics. Remember, it takes a village mindset for this to be successful!

The National Wraparound Implementation Center https://www.nwic.org/

 The Wraparound Process Users Guide https://nwi.pdx.edu/pdf/Wraparound_Family_Guide09-2010.pdf