C.A.R.E.S. (Coordination, Advocacy, Resources, Education and Support)

Scientific Rating:
3
Promising Research Evidence
See scale of 1-5
Child Welfare System Relevance Level:
High
See descriptions of 3 levels

About This Program

The information in this program outline is provided by the program representative and edited by the CEBC staff. C.A.R.E.S. (Coordination, Advocacy, Resources, Education and Support) has been rated by the CEBC in the area of: Prevention of Child Abuse and Neglect (Secondary) Programs.

Target Population: Families at high risk for abuse or neglect with children aged 0-17 or a primary caregiver or caregivers of at least one child under the age of 18 whom is at risk for abuse, neglect, or abandonment and their family

For children/adolescents ages: 0 – 17

For parents/caregivers of children ages: 0 – 17

Brief Description

C.A.R.E.S. is a community-based prevention and diversion program utilizing Wraparound Family Team Conferencing to successfully engage and serve families who are at risk of child abuse and neglect. C.A.R.E.S.' mission is to “Protect Children, Strengthen Families and Change Lives, Whatever it Takes!” C.A.R.E.S.’ goal is to engage and build upon families’ strengths using the Wraparound Principles of practice to prevent families from entering or penetrating deeper into the formal child welfare and/or juvenile justice system. C.A.R.E.S. engages the family, identifies strengths and needs, convenes customized Family Team Meetings inclusive of natural and community supports, and drafts an individualized and well-coordinated plan of care to improve family functioning, reduce the likelihood of child abuse and neglect with a focus on family strengthening and measurable goals and outcomes that result in family stabilization and preservation.

Program Goals:

The goals of the C.A.R.E.S. (Coordination, Advocacy, Resources, Education and Support) program are:

  • Engage and build upon families’ strengths using the Wraparound Principles of practice to prevent families from entering or penetrating deeper into the formal child welfare and/or juvenile justice system
  • Reduce child abuse and neglect and future incidences of child abuse and neglect
  • Enhance child safety and improve parenting skills
  • Enhance family functioning across life domains by reducing risks and building protective factors
  • Decrease substance use and maintain sobriety
  • Promote family strengthening, stabilization, and preservation while maintaining children safely at home, in their schools, and local community in the least restrictive environment possible
  • Improve and strengthen family relationships through supportive, stable, and nurturing parent child communication
  • Increase parents’ use of positive parenting strategies in managing children and youth’s behavior
  • Increase social connections to improve social well-being, decrease isolation, and provide concrete support in times of need to help sustain the family beyond exit from the program
  • Promote family self- sufficiency by teaching necessary skills to navigate complex systems, and proactively seek help and support in time of need

Essential Components

The essential components of C.A.R.E.S. (Coordination, Advocacy, Resources, Education and Support) include:

  • High Fidelity Wraparound diversion program which consists of intensive care coordination as opposed to dependency case management
  • Personnel:
    • Management or Supervisory staff
    • Care Coordinators/Wraparound Facilitators
    • Family Partners/Advocates (may consist of community partnerships with family organizations)
    • Youth Advocates (may consist of youth from youth advisory councils)
    • Wraparound Fidelity Liaison/Trainer (optional for programs that implement and can be contracted through the C.A.R.E.S. National Replication Team
  • Adherence to Wraparound Principles of Practice:
    • Wraparound fidelity monitoring process
    • Consumer satisfaction surveys
    • Data and outcome measurement
  • Informal assessment:
    • Strength and cultural discovery
    • Individualized/customized planning:
    • Family-centered practice and engagement/family voice and choice
    • A Family Vision Statement that drives Family Team planning
    • Customized Family Teams and Family Team Conferences
    • An array of services and supports that can be flexed and tailored to meet the unique needs of the family
  • A Wraparound Family Care Plan and Wraparound Family Team Meetings
  • Care coordination and family support and education
  • Flexible and responsive service delivery and support
    • Commitment to team decision making and adherence to the plan of care
    • Minimally weekly contact with the family
    • Monthly face-to-face meetings/home visits (frequency of contact is based upon family needs)
  • After care support and alumni support and education meetings
  • Ability to deliver community-based services in the natural environment
  • Flexible funding for concrete support and material goods
  • Safety management services and planning
    • Mobile response and crisis stabilization support access 24/7
  • Average caseload of 1-15 families

Child/Adolescent Services

C.A.R.E.S. (Coordination, Advocacy, Resources, Education and Support) directly provides services to children/adolescents and addresses the following:

  • Lack of safety and well-being; social, emotional, behavioral and mental health problems; trauma, loss; substance misuse; truancy; academic and special education; social isolation; noncompliance; aggression/anger; running away

Parent/Caregiver Services

C.A.R.E.S. (Coordination, Advocacy, Resources, Education and Support) directly provides services to parents/caregivers and addresses the following:

  • Family conflict and domestic violence, poor parenting skills, mental health conditions, depression, aggression/anger, substance abuse, child abuse, neglect, any stressors that the family is experiencing that impacts parenting ability and compromises safety such as stress management, home and financial management, housing, employment, physical health, substance abuse, mental health, domestic violence, communication and self-care
Services Involve Family/Support Structures:

This program involves the family or other support systems in the individual's treatment: The family and family support system (referred to as the Family Team) are essential to the success and sustainability of the family beyond exit and are included throughout the family’s participation in the program. Each family is assigned a Family Partner who serves as an advocate for the family to ensure natural supports are identified and engaged in the planning process.

Delivery Settings

This program is typically conducted in a(n):

  • Adoptive Home
  • Birth Family Home
  • Community Agency
  • Community Daily Living Settings
  • Religious Organization
  • School

Homework

This program does not include a homework component.

Languages

C.A.R.E.S. (Coordination, Advocacy, Resources, Education and Support) has materials available in a language other than English:

Spanish

For information on which materials are available in this language, please check on the program's website or contact the program representative (contact information is listed at the bottom of this page).

Resources Needed to Run Program

The typical resources for implementing the program are:

The C.A.R.E.S. model typically operates in a family-like office environment and convenes Family Team Meetings (FTM) in the home, community, or location convenient for the family) such as a home that has been converted or family resource center setting. While it can be operated in other settings, the intent is to create a noninstitutionalized family-friendly environment where families feel at ease and welcome. The program resources include:

  • The following personnel:
    • Care Coordinators who typically carry a caseload of 15 families
    • Family Partners who work within the team context to support and strengthen the family, one family partner is teamed with 2 Care Coordinators
    • Youth Liaison or Advocates when available
    • Management and supervisory staff
    • A Wraparound Fidelity Liaison who provides training, orientation, coaching and mentoring and administers and or monitors the Wraparound Fidelity Tools and outcomes.
  • Office space with:
    • Work stations with computers
    • An informal area with a couch, chairs and play area for children
    • A training room with projector
    • Family team meeting rooms, easels, sketch boards (to convene FTMs)
    • A recreational activity area if possible
    • A kitchen with a large table for group gatherings for education and support forums if possible
    • On call access to support families in crisis
  • Staff cell phone access
  • Staff who can use their vehicles for home visits, mileage is paid for all client- and program-related travel

Minimum Provider Qualifications

Program Manager: Requires a Master’s Degree in Human Services field; a minimum of three years’ experience as a Wraparound practitioner and/or developing and implementing wraparound in a Family-Centered System of Care. Requires a minimum of three years of Supervisory and Management experience. This position must also be skilled in analytical reasoning and critical thinking in order to assist staff in addressing complex situations with families and problem solving in a creative and flexible environment in which critical thinking is essential. Must possess the core competencies to provide consultation and expertise in assisting families with complex mental health issues and navigation in managed care systems.

Care Coordinator: Bachelor’s Degree in Human Services, Psychology or Social Work, at least two years of experience working with at-risk families and prior knowledge of mental health, juvenile justice, or child-serving systems. Master Degree preferred; High Fidelity Wraparound training or certification and experience required. (Agencies with a Wraparound Consultant or Trainer who operate an orientation and training program may recruit, hire, and train staff to develop core competencies under the tutelage of skilled practitioners.)

Family Partner: This is paraprofessional liaison position involving the support and coordination of services for families. Minimum qualifications: two years of experience navigating the mental health, special education, juvenile justice, or child welfare system and experience as a consumer, foster, or adoptive parent. Requires a high degree of independent judgment and ability to function under the established policies, procedures, and practices.

Youth Advocate: This is a paraprofessional liaison position involving support and advocacy for youth. Minimum 1 year of juvenile justice, mental health, or child welfare experience as a successful former consumer exiting system at age 18+. Experience navigating complex systems is also is required in order to provide assistance and guidance to other youth in navigating the system. Requires a high degree of independent judgment and ability to function under the established policies, procedures, and practices.

Wraparound Fidelity Liaison/Trainer: Master’s Degree in Human Services or related field; a minimum of five years’ experience as a practitioner in Wraparound required (to ensure fidelity to the model and family voice, choice and ownership and a collaborative and solution-focused manner). Two years of experience as a trainer, consultant, and strong verbal and written communication skills, and supervisory skills are required.

Education and Training Resources

There is a manual that describes how to implement this program, and there is training available for this program.

Training Contacts:
Training is obtained:

The C.A.R.E.S. training location and delivery method is flexible and can be delivered on site in the locality adopting the C.A.R.E.S. model and remotely. Wraparound Proficiency and Competency Based Training is provided in Melbourne Beach, Florida, twice annually over 4.5 days and can be delivered in the locality adopting the model.

Number of days/hours:

Model implementation: 40 hours with additional remote and/or onsite consultation and technical assistance available. Wraparound Proficiency and Competency Based Training: 4.5 days

Additional Resources:

There currently are additional qualified resources for training:

Phebe Powell, Brevard C.A.R.E.S. Executive Director Office
321-632-2737, Ext 1008
phebe.powell@brevardcares.org

Implementation Information

Since C.A.R.E.S. (Coordination, Advocacy, Resources, Education and Support) is rated on the Scientific Rating Scale, information was requested from the program representative on available pre-implementation assessments, implementation tools, and/or fidelity measures.

Show implementation information...

Pre-Implementation Materials

There are pre-implementation materials to measure organizational or provider readiness for C.A.R.E.S. (Coordination, Advocacy, Resources, Education and Support) as listed below:

As part of its initial assessment of the program and/or system of care (SOC) implementing the model, the C.A.R.E.S. National Replication Team devises a customized pre-assessment survey tool that is administered to key stakeholders and/or program leadership in advance of the first site visit to assess, and report on the strengths, needs and developmental stage of the system. This enables the team to provide customized targeted technical assistance and consultation to lead, guide and direct the implementation plan, timeline and develop a roadmap.

To engage SOC partners and stakeholders in the establishment of a new level of care on the service continuum the “How Family Friendly is Your System of Care: Access, Voice and Ownership Test” has been created to foster an inclusive dialogue across the community of practice. The test is designed to enable communities to identify prioritized targeted areas of needed development to establish measurable outcomes and a detailed implementation plan.

Formal Support for Implementation

There is formal support available for implementation of C.A.R.E.S. (Coordination, Advocacy, Resources, Education and Support) as listed below:

The National Replication Team is available to deliver technical assistance, training and coaching through implementation and early adoption of the model. This includes onsite and remote support that is customized to meet the unique needs of the community and/or agency implementing C.A.R.E.S. Agencies desiring a pilot site visit may arrange a visit to Florida to meet with the Brevard C.A.R.E.S. pilot site staff and program for peer to peer support and training.

Fidelity Measures

There are fidelity measures for C.A.R.E.S. (Coordination, Advocacy, Resources, Education and Support) as listed below:

There are a number of Wraparound Fidelity Measures available to the implementation site. To implement C.A.R.E.S. with fidelity use of a tool is required. However, the C.A.R.E.S. National Replication does not prescribe the version to be implemented apart from the use of a validated tool. Options include:

  • Wraparound Fidelity Index, version 4
  • Wraparound Fidelity Index, Brief Version (WFI-EZ)
  • Wraparound Observation Form

Information on where and how to access fidelity tools can be provided by:

  • Patricia Nellius, Chief Executive Officer, National Center for Innovation and Excellence: patricia.nellius@brevardfp.org
  • Valerie Holmes, Senior Executive of Programs & Master Trainer, National Center for Innovation and Excellence: valerie.holmes@brevardfp.org
  • Tracy Little, Wraparound Fidelity Liaison & Master Trainer, National Center for Innovation and Excellence: tracy.little@brevardfp.org

Implementation Guides or Manuals

There are implementation guides or manuals for C.A.R.E.S. (Coordination, Advocacy, Resources, Education and Support) as listed below:

  • C.A.R.E.S. Model Replication Trainer’s Implementation Guide and Toolkit
  • Wraparound 101-201 Training Binder
  • Wraparound Certification Institute Training Binder

Contact People:

Patricia Nellius, Chief Executive Officer, National Center for Innovation and Excellence: patricia.nellius@brevardfp.org

Valerie Holmes, Senior Executive of Programs & Master Trainer, National Center for Innovation and Excellence: valerie.holmes@brevardfp.org

Research on How to Implement the Program

Research has not been conducted on how to implement C.A.R.E.S. (Coordination, Advocacy, Resources, Education and Support).

Relevant Published, Peer-Reviewed Research

This program is rated a "3 - Promising Research Evidence" on the Scientific Rating Scale based on the published, peer-reviewed research available. The practice must have at least one study utilizing some form of control (e.g., untreated group, placebo group, matched wait list study) establishing the practice's benefit over the placebo, or found it to be comparable to or better than an appropriate comparison practice. Please see the Scientific Rating Scale for more information.

Child Welfare Outcome: Safety

Munoz, A. S., Renteria, R. M., Gelwicks, J., & Fasano, M., (2015). Reducing risk: Families in Wraparound intervention. Families In Society, The Journal of Contemporary Social Services, 96(2), 91-98.

Type of Study: Pretest-posttest with control group (secondary data analysis)
Number of Participants: 485

Population:

  • Age — Not specified
  • Race/Ethnicity — Not specified
  • Gender — Not specified
  • Status — Participants were children and caregivers that completed the C.A.R.E.S. program.

Location/Institution: Community-based setting in the United States

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study explored the extent to which children of caregivers in the Brevard C.A.R.E.S. (Coordination, Advocacy, Resources, Education and Support) Wraparound intervention experienced a reduction of maltreatment 6 months postcompletion. Measures utilized include maltreatment reports. The data for this study came from the C.A.R.E.S. de-identified participant database for all children referred to and participating in the program after July 1, 2009, and whose cases were closed by January 1, 2010. The comparison group did not receive the intervention. Results indicated children whose caregivers completed the intervention experienced less verified maltreatment than children in the comparison group. Limitations include lack of randomization, possible selection bias, and comparison group was a convenient sample.

Length of postintervention follow-up: 6 months.

References

Munoz, A. S., Renteria, R. M., Gelwicks, J., & Fasano, M., (2015). Reducing risk: Families in Wraparound intervention. Families In Society: The Journal of Contemporary Social Services, 96(2), 91-98.

Renteria, R. A. M., Schneider-Munoz, A., Nellius, P, Holmes, V., & Little, T. (2010). C.A.R.E.S. Model replication trainer’s implementation guide and toolkit. Melbourne, FL: Brevard Family Partnership, the Academy for Educational Development, and Brevard C.A.R.E.S. Inc.

Contact Information

Name: Dr. Patricia Nellius-Guthrie
Agency/Affiliation: Brevard Family Partnership/National Center for Innovation and Excellence
Website: ncfie.net/cares-replication
Email:
Phone: (321) 752-4650 x3002
Fax: (321) 752-7651

Date Research Evidence Last Reviewed by CEBC: August 2016

Date Program Content Last Reviewed by Program Staff: September 2016

Date Program Originally Loaded onto CEBC: October 2016