Wrapping services in an urban setting

Efforts to reform services for children and their families in Baltimore City have included providing Wraparound services to youth returned or diverted from out-of-state residential treatment. We briefly present the history and evolution of the system reform efforts in Baltimore City that were necessary to support the implementation of a Wraparound model of service delivery. The characteristics of the Wraparound service model is presented along with the referral pathway of the youth into the service system, the components of the service delivery system and an overview of step-down services and linkages utilized to transition the youth. Data are presented that demonstrate the level of community adjustment of a subset of the 121 youth served through the Wraparound model in contrast to the level of community adjustment achieved by nonequivalent comparison groups. We discuss the use of “report card” type of outcome measures, its user-friendly features, limitations, and the developmental steps needed to refine it further.