Referral Guide and Checklist - Montgomery County Collaboration ...

*(i.e. Department of Juvenile Services (DJS), Child Welfare Services (CPS/CWS), Core
Services Agency, the school system, Developmental Disability Administration, etc)
Eligibility Criteria for Wraparound Services
Child is most likely to be eligible for Wraparound process provided by Maryland
Choices if one or more boxes have been checked:
1)The child/youth is presenting with behaviors that are difficult to manage in the
classroom, home or community Y⃞ N⃞
2)The child/youth is truant or has missed several weeks of school Y⃞ N⃞
3)The child/youth is at risk of or is likely to be in a gang Y⃞ N⃞
4)The child/youth is at risk of a Residential Treatment Center placement as indicated
by clinician/therapist due to the emotional, behavioral or other substance abuse issues
Y⃞ N⃞
5)The child/youth is at risk of an out of home placement i.e. kinship care, group
home, foster care, or stuck in an acute care facility Y⃞ N⃞
6)The child has had 1 or more psychiatric hospitalization Y⃞ N⃞
Please fill out the CWIN referral form with as much detail as possible so that we can move quickly
through the process and get the child and family connected with Maryland Choices.