In Conversation with Samantha Bond, Practice Manager
This month, we shine a light on the Youth Empowerment Services or YES Waiver program. In the conversation below, Integral Care Practice Manager Samantha Bond gives us an overview of the program and the growing needs the program team is seeing across our community.
Q: For those who may not know, what is the Youth Empowerment Services or YES Waiver program at Integral Care? Which services are involved and what is the enrollment process like?
Samantha Bond: YES Waiver is a Texas Medicaid program whose entire aim is to support children and adolescents who have identified, serious mental health or emotional needs. The goal is to help them stay at home as opposed to ending up in more intensive settings like residential treatment. A unique feature of YES Waiver is the program’s use of wraparound.
Wraparound is a process where a facilitator brings a team together around the family. This team can include a therapist and any formal and informal supports that the child may have. From there, we build an individualized plan of care with that child and family, and that can include therapy, whether traditional or non-traditional (art, equine, music, or recreational therapies), support for caregivers, and more. The plan is built to meet the child’s needs.
Q: Thinking back on your time with the program, where did it begin and how did you get involved?
SB: Integral Care was one of the very first sites to have a YES Waiver pilot program back in 2010. Over the course of my 16 years with the agency, I’ve had the opportunity to work alongside the YES Waiver team in different capacities. Earlier in my career as a therapist, I provided counseling to clients who were also enrolled in YES Waiver and receiving services through the wraparound team. I learned about wraparound and it showed me the value of working not just with the child, but with the entire family system and support network. In 2022, I moved into a leadership position and began directly overseeing the YES Waiver team.
Q: How would you say YES Waiver has evolved as a program?
SB: We have had a lot of shifts; for example, when I think of COVID, we still had to serve very high-need families and figure out how we could get back into the field and see people.
We’ve definitely seen an increase in both the complexity and acuity of mental health needs among the youth we serve. While crisis has always been part of this work, we’re seeing more frequent and more intense crisis presentations than in the past. At the same time, families are navigating a lot of instability – caregivers are sharing real concerns about maintaining stable housing and reliable finances. Those stressors directly impact a caregiver’s capacity to manage, especially when a child is experiencing significant behavioral or emotional challenges in the home. YES Waiver plays a critical role providing wraparound support – to stabilize families and help youth stay safely at home, to try and avoid out-of-home placement.
Q: So much of Integral Care’s work is collaborative; who are some of YES Waiver’s collaborators at the federal, state, and local levels?
SB: YES Waiver is inherently collaborative; we depend on partnerships at every level. Internally, our families are partnering with other Integral Care units. For example, if there is a Therapist at the clinic or on the School-Based Counseling team, we want them to be part of that wraparound team. They need a seat at the table as we are having these meetings so that we can create goals and plans that properly support these families.
On a larger scale, outside of the agency, one of our big collaborators is the Health and Human Services Commission (HHSC), which sets the standards for YES Waiver. They outline our requirements and whether a child is eligible for YES Waiver or not based on our assessments. Another collaborator is the National Wraparound Implementation Center (NWIC), which ensures that we are implementing the wraparound model to fidelity. Our team works with monitors and/or coaches from both of those entities to make sure we are following both sets of criteria.
Locally, we collaborate with lots of entities – this could look like school districts, providers in our network, the probation department, in case a client has juvenile justice involvement, hospital staff, in case a client is hospitalized, and so on.
Q: What are some of the areas of youth mental health where the YES Waiver Program team is seeing an increasing need for support?
SB: There is a growing number of children and adolescents with co-occurring diagnoses across mental health and intellectual and developmental disabilities (IDD). They have to navigate two different support systems and access different sets of services, and for us, this means that we are working very closely with our IDD Division.
Another challenge we’re seeing is a lack of available inpatient beds for children, which puts added pressure on community-based programs across the state. YES Waiver helps bridge that gap by working with families who may be considering out-of-home placement and building the specific wraparound supports needed for the youth to safely remain in the community.
Finally, we are also seeing caregivers or parents of children who are leaving residential treatment inquire about receiving YES Waiver services. The wraparound model has proven to be helpful because it still provides a layer of support as the child returns home.
I think it’s important for families to know that they’re not alone, that they have a whole team behind them, and that their child can be successful.