FAST Forward (New Hampshire Wraparound)

FAST Forward (New Hampshire Wraparound)
A black father sits on a couch with his toddler on his lap and his young son next to him while they talk to a woman who's listening and writing on a clipboard

What is FAST Forward?

FAST Forward is New Hampshire’s model for youth and family-driven wraparound. Wraparound is a proven planning and care coordination service for children or youth (ages 5 up to 21) experiencing serious emotional or behavioral concerns. Wraparound is specifically designed to bring the child or youth and their caregivers together to address the child's needs and those of the family. Wraparound is best suited for children, youth, and families involved in multiple systems (such as child protection, juvenile justice, special education, and mental health) and have complex needs not being met by other services or supports.

Wraparound was developed in the 1970s by caregivers and advocates who felt that the traditional mental health system was not focusing on the viewpoint of the child or family when making treatment decisions. To that end, the wraparound process puts the voice of the child, youth, and caregivers at the center of the planning and team support process.

The wraparound process is guided by NH Children’s System of Care values:

  • Family and Youth Driven: Your voice and choice are at the core of the work. Your strengths and needs determine the types and mix of services and supports provided. 
  • Community-Based services: are the priority so that your family stays together or, if necessary, your child is in the best environment that meets their needs and working towards returning to the community as soon as possible.
  • Culturally and Linguistically Competent: Services and support are provided to meet your family's individual cultural and language needs. 
  • Trauma-Informed: Services and support are provided in a way that is sensitive to many of the bad experiences that may have happened to your family, your child, or you as a young person. 

Wraparound is led by a trained facilitator called a care coordinator. The coordinator partners with your family and youth to identify your strengths and needs and then works with you to form a team of helpers. Your family and youth choose team members with guidance from your coordinator. Teams often include extended family members, school counselors or teachers, coaches, clergy, therapists, or anyone else who you feel should be there to help your family and child. Your family can also receive services from a trained Family Peer Support Specialist. Youths 12 and older can receive services from a trained Youth Peer Support Specialist. Peer support is provided by someone who has had similar experiences and is there to help you through a very difficult time. 

6x
Children or youth who are involved in more than one system are 6 times more likely to go into residential or institutional level care.

Why do we need FAST Forward or Wraparound?

Research shows that children or youth who are involved in more than one system are 6 time more likely to go into residential or institutional level care, which can be more costly than community-based care and disrupts their relationships and engagement with family members, friends, teachers, and others in their community. Wraparound is designed to address a significant gap in the children’s mental health and substance treatment systems by providing intensive care coordination. The goal is to build supports and services that allow the child or youth to thrive in the home, school, and other community environments. 

Who is FAST Forward for?

FAST Forward is for families with a child or youth who:

  • Is age 5 up to age 21. 
  • Has a significant emotional or behavioral concern.
  • Is involved with multiple providers like (Child Protection, Juvenile Justice, Community Mental Health, etc.)
  • Has not benefited from school or community-based services.
  • Can communicate and participate in the planning process.

Is FAST Forward effective?

New Hampshire's FAST Forward program uses a High-Fidelity Wraparound model, which has been shown to improve the lives of children, youth, and their families by reducing arrests, out-of-home placements, and hospitalizations. Many families and youth report feeling more hopeful and more in control after experiencing Wraparound. The California Evidence-Based Clearinghouse rates Wraparound as a promising practice for keeping children and youth in their homes and improving their emotional and behavioral outcomes. In addition, several Wraparound projects have shown that wraparound reduces involvement in the justice system and improves overall functioning and educational outcomes.

Who provides FAST Forward?

FAST Forward is provided by two agencies in New Hampshire: NFI North and Connected Families NH. These agencies are called Care Management Entities (CMEs). The CMEs employ Wraparound care coordinators. The NH Bureau for Children’s Behavioral Health contracts with these agencies, overseeing the quality and responsiveness of their services.

If you are referred to FAST Forward, you will first be contacted by staff at the Bureau for Children’s Behavioral Health (BCBH), who will talk with you and determine if you are eligible. They will also help you connect to other services, if appropriate. If your family is eligible for Wraparound, the BCBH staff will refer you to NFI or Connected Families NH. Wraparound care coordinators at NFI and Connected Families NH receive rigorous training and consultation to ensure your family receives the highest quality services. In addition, you can receive family peer support provided by NAMI NH and youth peer support from Youth MOVE NH if you are a young person in FAST Forward and are 12 or older. All these agencies work together to ensure you receive the highest quality services and support.

Learn more about NFI and Connected Families NH:

A diverse family poses together for a portrait outside, they're all smiling.

What can I expect if I am enrolled in FAST Forward? 

 

There are 4 major parts to the FAST Forward program:

1. Hello activities allow your family to connect with your Wraparound coordinator and talk about your family’s story, how you got to where you are now, identify your strengths, and think about what is happening under the surface. During this process, your family and child also create your vision for a better future.

4 major parts to the FAST Forward program

2. The Help part of the process is when your family and coordinator develop a team. You identify people in a good position to help your family meet its needs and achieve your vision. Your family, coordinator, and team will also create a Plan of Care (POC). The Plan of Care is important because it puts everything in writing and guides the work. There will be a couple of meetings with your team members to develop your Plan of Care.

3. During the Healing part of the process, your family and your team meet regularly to talk about how it’s going, using the Plan of Care as a guide. The meetings are also designed to ensure you get the help you need. You and your team will look at data every meeting, talk about what is working and what is not, and make changes as needed.

4. The Hope part of the process is when your family meets its goals. Your care coordinator will work with you to plan for leaving Wraparound and the kinds of supports you will access to make sure you and your child continue to succeed. Your Wraparound coordinator will also ask you a few questions after every team meeting to understand how you and your child or youth felt about the meeting and determine if the process meets your needs. Wraparound is not case management. The care coordinator might connect you to services, but those decisions are made in team meetings, and team members pitch in to help make those connections. Wraparound is not mental health treatment either. Treatment providers may be on your team to link your child’s treatment to the Plan of Care goals.

Your care coordinator will also work with you and your youth to develop a Safety Plan as part of the Plan of Care. This is an essential part of the process. The Safety Plan helps your family identify behavior problems, or concerning issues and steps you can take to avoid crisis calls or the need for out-of-home care. FAST Forward can also provide flexible funding to meet needs that are not funded by other programs or services. Finally, FAST Forward can help you access short-term in-home support if you need it to help your family meet its vision.

The Plan of Care has several parts and is an important document that helps you and your team members to stay focused on your family's vision and goals. One of the sections outlines the strategies and benchmarks.

This section outlines specific steps to be taken; who will do it, when they will do it, where it will be done, and what success looks like for each strategy. The goal is to ensure that the team makes good decisions and stays on track. You and your team members will have copies of the Plan of Care. Family and Youth Peer Supporters set up meetings with you based on your schedule and needs. Peer Supporters can also attend to your team members and provide valuable guidance during the wraparound process.

Team meetings are designed to get everyone on the same page to support your family. The views of every team member are important, and sometimes there needs to be a compromise if the process is to work. The Wraparound coordinator is trained to make sure that everyone is heard and stays focused on the goals. The coordinator also helps the team look for creative solutions. 

Your family and youth lead the Wraparound as much as possible. You will also work hard to achieve your goals and change some things that haven’t worked for you. Change is hard work, but all the hard work is worth it!

Family and Youth Peers

Every family in FAST Forward is offered Family Peer Support from a trained person who works for NAMI-NH. Family Peer Supporters have raised a child with mental health challenges, so they have been through many of the same things you are going through. The Family Peer Supporter can connect you to other services, advocate for your family’s needs, and is a valuable member of the Youth and Family Team.

Youth in FAST Forward, ages 12 and older, can receive Youth Peer Support from a trained staff member at Youth MOVE NH. Youth Peer Supporters have experienced mental health challenges themselves, and they are highly trained to help, including making sure their needs and strengths are heard during team meetings, helping them with their goals at home, in school, and in the community, and otherwise being a source of emotional support and hope.

How to access FAST Forward

Anyone can refer a youth or family to FAST Forward. You can apply for FAST Forward by contacting an Intake and Eligibility Coordinator at the NH Bureau of Children’s Behavioral Health (BCBH) handles FAST Forward referrals. You can email or call them at 603-271-5075. You can also complete the FAST Forward NH Wraparound Needs Based Intake & Eligibility form and return to the Bureau for Children’s Behavioral Health (BCBH) at your convenience. This can be sent back via email, Fax (603-271-5040), or mail to:
 

105 Pleasant St,
Concord, NH 03301
Attn: FAST Forward Program.

 

Once the referral is received, the Intake and Eligibility Coordinator will  schedule a time with you to complete the intake together over the phone or by Zoom/Virtual (takes around 45 to 50 minutes). Once completed, the Eligibility Coordinator will discuss the next steps with you.

 

Additional Resources:

Learn more:

Carney, M. M., & Butell, F. (2003). Reducing juvenile recidivism: Evaluating the wraparound services model. Research on Social Work Practice, 13(5), 551–568. https://doi.org/10.1177/1049731503253364

Pullman, M. D., Kerbs, J., Koroloff, N., Veach-White, E., Gaylor, R., & Sieler, D. (2006). Juvenile offenders with mental health needs: Reducing recidivism using wraparound. Crime and Delinquency, 52(3), 375–397. https://doi.org/10.1177/0011128705278632

Mears, S. L., Yaffe, J., & Harris, N. J. (2009). Evaluation of Wraparound services for severely emotionally disturbed youths. Research on Social Work Practice, 19(6), 678–685. https://doi.org/10.1177/1049731508329385

Coldiron, J. S., Hensley, S. W., Parigoris, R. M., & Bruns, E. J. (2019). Randomized control trial findings of a wraparound program for dually involved youth. Journal of Emotional and Behavioral Disorders, 27(4), 195–208. https://doi.org/10.1177/1063426619861074

Olson, J. R., Benjamin, P. H., Azman, A. A., Kellogg, M. A., Pullmann, M. D., Suter, J. C., & Bruns, E. J. (2021). Systematic Review and Meta-analysis: Effectiveness of Wraparound Care Coordination for Children and Adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 60(11), 1353–1366. https://doi.org/10.1016/j.jaac.2021.02.022

Additionally, for any inquiries or follow-ups regarding NH Wraparound or FAST Forward referrals, please feel free to contact:
FASTForward@dhhs.nh.gov| (NH DHHS | (603) 271-5075