This fact sheet answers the essential questions about who we are, what we do and how we do it. A printable booklet of the fact sheet, titled One Community’s Journey, is also available.

What is Cuyahoga Tapestry System of Care?
Who are the partners within the system of care?
What are CTSOC’s goals?
Why is CTSOC needed?
What data support the system of care approach?
How did CTSOC begin?
What is CTSOC doing today?
What is CTSOC’s financial history?
Who can I contact for more information?

What is Cuyahoga Tapestry System of Care?
Cuyahoga Tapestry System of Care is a partnership of the county child-serving systems and community and neighborhood provider organizations that uses a seamless process to provide the children and families of Cuyahoga County with personalized, compassionate and relevant supports and services.

A “system of care” is a coordinated network of community-based services and supports that is organized to meet the challenges of children and youth with serious mental health needs and their families. Families and youth work in partnership with public systems and private organizations so services and supports are effective, build on the strengths of individuals, and address each person’s cultural and linguistic needs. A system of care helps children, youth, and families function better at home, in school, in the community, and throughout life.

Cuyahoga Tapestry System of Care utilizes a “wraparound” service process that focuses on the strengths and culture of each family, resulting in a unique set of community services and natural supports. Families, along with their wraparound care manager, develop a team of people who can address each family’s individual needs with innovative and non-traditional solutions.

Who are the partners within the system of care?
Partners agencies work together to provide services for youth who are at risk for becoming involved with multiple services, like juvenile justice and drug and alcohol counseling, and their families.

A list of Cuyahoga Tapestry System of Care partners is included below.

Family-to-Family Neighborhood Collaboratives
Cleveland Heights/University Heights Collaborative
Cleveland UMADAOP, Inc.
Cuyahoga Metropolitan Housing Authority
East Cleveland Neighborhood Center
East End Neighborhood House
Euclid YMCA
Friendly Inn Settlement, Inc.
Garfield Heights Collaborative
Harvard Community Services Center
Lakewood Collaborative/City of Lakewood Division of Youth Services
Murtis H. Taylor Multi-Service Center
Parma Area Collaborative Family Services
St. Martin De Porres Family Center
University Settlement
West Side Community House

Alliance of Child-Caring Service Providers
Achievement Centers for Children
Alliance Human Services/Ohio Mentor, Inc.
Applewood Centers, Inc.
Bair Foundation
Beacon Agency
Beech Brook
Bellefaire Jewish Children’s Bureau
Berea Children’s Home
Caring For Kids
Catholic Charities Services
Center for Families & Children
Children’s Community Access Program
Christian Children’s Home of Ohio, Inc.
Cleveland Clinic Children’s Hospital for Rehabilitation
Cleveland Christian Home, Inc.
Continue Life, Inc.
Diversion Foster Care
Homes For Kids of Ohio, Inc.
House of New Hope
In Focus of Cleveland, Inc.
Lutheran Metropolitan Ministry
Ohio Boy’s Town
Ohio Youth Advocate Program
Options for Families & Youth
Pathway Caring For Children
Positive Education Program
Pressley Ridge
Specialized Alternatives for Families and Youth of Ohio, Inc.
The Twelve, Inc.
The Village Network

What are Cuyahoga Tapestry System of Care’s goals?
Cuyahoga Tapestry System of Care was originally envisioned to increase access to services for children with mental health needs and their families, as well as increase the capacity of the mental health system to provide recovery resources to this group. Tapestry began with the goal to serve 240 seriously emotionally disturbed children each year for five years, for a total of 1,200 youth aged 0-21.

Since Tapestry’s inception in autumn of 2003, its integrated system of care, comprised of strong and established community partners, has kept on track to help 240 kids per year, and has identified 800 additional children in need of services and is developing a strategic plan to serve their needs.

Cuyahoga Tapestry System of Care is working hard to integrate all of the county efforts with the child and family team process, including families from these areas:

• Tapestry (240 families per year)
• Positive Education Program (PEP) Connections (450 families)
• Strengthening Communities Youth (SCY) (60 families)
• Family-to-Family Community Wraparound (approximately 500 families)

Why is Cuyahoga Tapestry System of Care needed?
Five to nine percent of children and youth between ages 9 and 17 have serious emotional disturbances that cause substantial functional impairment, and many do not receive the supports and services they need to reach their full potential at home, at school, and in their communities.

A benefit of implementing a system of care in a community is that it opens a conversation between leaders and families about the services and supports children need. “Cuyahoga County is a brave community,” says Beth Dague, Director of Cuyahoga Tapestry System of Care. “Substantive community conversation is occuring around agency performance improvements and cost-effective services delivered in the neighborhoods where families live. Cuyahoga Tapestry System of Care has actively engaged families and neighborhoods in developing teams that support family voice and choice.”

Children and youth with serious mental health needs and their families utilize supports and services from many different child and family serving agencies and organizations. Often, these agencies and organizations are serving the same children, youth, and families. By creating partnerships among these child-serving systems, systems of care are able to coordinate services and supports that meet the ever-changing needs of each child, youth, and family. Coordinated services and a seamless approach utilizing a wraparound team process lead to improved outcomes for children, youth, and families, and help prevent the duplication of services for authorized care among child-serving systems.

What data support the system of care approach?
National data collected for more than a decade confirm the experiences of children, youth, and caregivers: Systems of care work. Data from systems of care related to children, youth, and caregivers reflected the following:

Children and youth improved on clinical outcomes after 6 months.

• Emotional and behavioral problems were reduced or remained stable for 89 percent of children and youth.

Children and youth with suicide-related histories improved after 6 months.

• Almost 91 percent of children and youth with a history of suicide attempts or suicidal ideation improved or remained stable in their emotional and behavioral problems.

Children and youth improved or remained stable on school-related outcomes after 6 months.

• School performance improved or remained the same for 75 percent of children and youth.

Children and youth with co-occurring disorders improved after 6 months.

• Emotional and behavioral problems were reduced or remained stable for 89 percent of children and youth with co-occurring mental health and substance abuse diagnoses.

System of care communities adopted a strength-based approach to planning services.

• Ninety-one percent used child and youth strengths to plan services.
• Eighty-five percent reported that children and youth helped plan services. Families/caregivers were satisfied with the cultural competence of service providers.
• More than 75 percent of families reported that they were satisfied with their providers’ respect for their beliefs and values about mental health, understanding of their traditions, and ability to find services that acknowledged the positive traditions of their cultures.

Source: SAMHSA Fact Sheet on Children’s Mental Health (SMA-4125/2006). More information about the effectiveness of systems of care is available at the United States Department of Health and Human Services Substance Abuse and Mental Health Services Administration.

How did Cuyahoga Tapestry System of Care begin?
Cuyahoga Tapestry System of Care began with a grant application to the Substance Abuse and Mental Health Services Administration (SAMHSA) for the development of “Project Tapestry,” written and submitted by the Cuyahoga County Community Mental Health Board (CCCMHB) and the Family & Children First Council (FCFC) on behalf of the Board of County Commissioners (BOCC) in the spring of 2003. The BOCC accepted the $9.5 million grant from SAMHSA for a six-year period beginning September 30, 2003, and ending September 29, 2009, with the BOCC required to provide matching funds.

Under its original name of “Project Tapestry,” the goal was to adopt the nationally recognized wraparound approach to increase access to services, as well as increase the capacity and integration of mental health services to help an additional 1,200 children and youth. As a result, the effectiveness of the four major child-serving systems of child welfare, education, juvenile justice and substance abuse would also improve. Goals would be accomplished through the integration of the wraparound model with the Annie E. Casey Foundation’s Family-to-Family initiative in the neighborhood settlement house tradition.

The target population was underserved children and their families in Cuyahoga County, such as younger children, youth in transition to adulthood, young females, and Hispanic and Asian-American children.

Integration of systems of care would be accomplished through collaboration with:

• Cuyahoga County Community Mental Health Board
• Department of Children and Family Services
• Board of County Commissioners
• Health and Human Services Department
• Department of Justice Affairs
• Alcohol and Drug Addiction Services Board of Cuyahoga County
• Cuyahoga County Juvenile Court
• Schools
• Cuyahoga County Board of Mental Retardation and Developmental Disabilities
• Family & Children First Council
• Other community partners

This integration has occurred through 10 neighborhood collaboratives that have established Family-to-Family contracts with the Department of Children and Family Services, providing access to mental health services and non-traditional supports for eligible children and youth with mental health problems and their families. PEP workers and parent advocates were co-located in the neighborhood collaboratives.

With the success of the child-serving systems integration, Cuyahoga Tapestry System of Care has identified an additional 800 children who are multi-system and multi-need, and funding is in place to begin serving them.

Cuyahoga Tapestry System of Care encompasses the SCY grant, which funds services to children and their families with alcohol and substance abuse issues, PEP Connections and Tapestry children and families, the 800 new children and families, and the Family-to-Family Community Wraparound specialists in providing high-fidelity wraparound teams for this community.

What is Cuyahoga Tapestry System of Care doing today?
Cuyahoga Tapestry System of Care continues to evolve to better serve children with emotional difficulties and their families. Currently, the community wraparound serves over 400 families, adding vital supports and services within neighborhoods. An additional 800 children who are multi-system and multi-need have been identified as a result of the systems partnership efforts, and funding is in place to begin serving them.

“We know from data and our own experience that systems of care work. Today, we’re seeing the wraparound service process transform Cleveland families and neighborhoods. Kids with mental health needs are getting better!” says Director Beth Dague. “Cuyahoga Tapestry System of Care is a tremendous synergy of the strengths of our existing child-serving systems, with a focus on innovative thinking and serving our families in new, effective ways.”

What is CTSOC’s financial history?
Cuyahoga Tapestry System of Care began with a $9.5 million grant from the Substance Abuse and Mental Health Services Administration (SAMHSA) for a six-year period beginning September 30, 2003, and ending September 29, 2009, submitted by the Cuyahoga County Community Mental Health Board (CCCMHB) on behalf of the Board of County Commissioners (BOCC).

The BOCC shall provide the local match for Cuyahoga Tapestry System of Care in the amount of $8,666,667.

In January 2005, the BOCC contracted with the CCCMHB to be the fiscal agent for Cuyahoga Tapestry on behalf of the System of Care Oversight Committee through December 31, 2009.

In this fiscal agreement, it was specified that the System of Care Oversight Committee, chaired by Rick Werner, Deputy County Administrator for Health and Human Services, will provide the governance of Cuyahoga Tapestry System of Care and shall approve its budget.

Utilizing seed dollars from the Department of Children and Family Services (DCFS), a group of committed partners worked all spring and summer of 2005 to expand the system of care efforts. The Cuyahoga County Health & Human Services Department has received $6 million from the BOCC that was added to the $3 million from DCFS to fully fund the services for 800 additional children and families.

A Request for Proposal was issued in spring 2006 to deliver services to the additional children. Proposal responses will be reviewed and awarded through the System of Care Oversight Committee and the BOCC through the Health and Human Services office.

As a result of the systems partnership of the Cuyahoga Tapestry System of Care, the children and families of Cuyahoga County are soon to receive an additional $9 million of services and supports.

Who can I contact for more information?

Media, please contact:
Clare Warmke
Social Marketing Specialist
216-241-3400, ext. 364
warmke@cccmhb.org
1400 West 25th Street, 4th Floor
Cleveland, Ohio 44113-3199