Frequently Asked Questions

If you have questions about Cuyahoga Tapestry System of Care, review our list of Frequently Asked Questions—chances are, your answer is right here! However, if this list doesn’t answer your questions, call us at 216-443-6062. Please also take a moment to e-mail us at tapestrysoc@cuyahogacounty.us with questions you think should be added to our list.

Questions from Parents, Grandparents and Caregivers
How is Cuyahoga Tapestry System of Care different?
Who is served by Cuyahoga Tapestry System of Care?
What is the first step to getting services for my child and family?
What do I need to know about the referral process?
What can I do to prepare for my first visit or conversation with someone from Tapestry?
What can I expect to happen during my first visit or conversation with someone from Tapestry?
Who is on the child and family teams?
What are the steps in the team process?
What does a care partner do?
What does a parent advocate do?
What is my role on the family and child team?
What is my child’s role?
Who will work with my family, and what will we do together?
Will my care partner respect my opinion, culture and values?
What questions can I ask a care partner when we start working together?
What should I think about when developing my team?
What rights do I have as a parent, grandparent or caregiver?
What can I do to protect my rights?
What support is there within Cuyahoga Tapestry System of Care for parents, grandparents and caregivers?
What is the purpose of the Parent Support Groups?
What is the purpose of the Family Involvement Committee?
What is the purpose of the Parent Advisory Council?
Where can I find definitions of terms I don’t understand, like “eligibility criteria” or “family-driven”?
What are neighborhood collaboratives?

General Questions
What is Cuyahoga Tapestry System of Care?
What is a “system of care”?
Who are the partner agencies within the system of care?
What are the goals of Cuyahoga Tapestry System of Care?
Why is Cuyahoga Tapestry System of Care needed?
How did the Cuyahoga Tapestry System of Care begin?
Where can I get more information about child and adolescent mental health on the internet?
Who do I contact for more information about Cuyahoga Tapestry System of Care?

QUESTIONS FROM PARENTS, GRANDPARENTS AND CAREGIVERS

How is Cuyahoga Tapestry System of Care different?
The programs of Cuyahoga Tapestry System of Care use a wraparound process as a way to plan and implement services and supports for your child and family. The wraparound process also helps to make sure children and youth grow up in their homes and communities. It is a planning process that brings people together from different parts of the whole family’s life and is:

• Based on the strengths of you, your family and your neighborhood.
• Something that your family “does,” not something that you are “given”
• A team effort, with your child, family, professionals, community and neighborhood supports working together toward a common goal
• A process where team members decide to “never give up,” and continue to provide the care, support and commitment necessary to achieve the goal
• A process that respects who you are, with teams that are sensitive and responsive to your family’s culture, language and community

It values the importance of social networks, “natural” supports, the faith community and the neighborhood where you live.

Who is served by Cuyahoga Tapestry System of Care?
Cuyahoga Tapestry System of Care (CTSOC) currently serves children enrolled in:

• Tapestry, a partnership of Cuyahoga County’s Neighborhood Collaboratives and the Positive Education Program
• Strengthening Communities Youth (SCY) designed to assist communities in identification, referral and treatment of youth in need of drug and alcohol services and involved with Cuyahoga County’s Juvenile Justice system
• Community Wraparound

Tapestry serves children who:

• Have serious emotional and mental health needs that severely disrupt their relationships and daily activities
• Have needs that require many more sources of support than are usually provided by traditional mental health services
• Are under 18 years of age when referred
• Are residents of Cuyahoga County
• Are at risk of more intense involvement with Cuyahoga County’s child-serving systems due to their unmet emotional and behavioral health needs

What is the first step to getting services for my child and family?
There are two ways that your family can start receiving services from the Cuyahoga Tapestry System of Care: a self-referral or a referral from a county agency (the Department of Children and Family Services or the Juvenile Court).

A self-referral is when a family member or other concerned individual calls
216-361-2441 ext. 410, and asks that a family be considered for enrollment in the system of care.

Is your child:

• having trouble at home, at school and in your neighborhood?
• at risk of involvement with child welfare, juvenile court, and/or counseling for alcohol and other drugs?
• under 18 years of age?
• a resident of Cuyahoga County?

If your child meets the criteria above, you may call 216-361-2441 ext. 410, for referral information.

A referral from a county agency is when caring professionals from the Department of Children and Family Services or the Juvenile Court identify your child as one who would thrive best with the services of our system of care. The Referral/Enrollment Specialist located at those county agencies introduces your family to the system of care.

What do I need to know about the Tapestry referral process?
As previously stated, your family can start to receive services through a self-referral or a referral from a county agency. After your referral, your family will have an initial screening to determine if your child meets the profile of children served by Tapestry. If he or she does, then your child will then be assessed to determine: Does he or she meet the diagnosis of "severe emotional disturbance"? If the answer is yes, then your family will meet with your Care Partner (who are sometimes also called Care Managers, Care Coordinators, Tapestry Care Coordinators, PEP Connections, Community Wrap Specialists or Wraparound Facilitators) to begin the team process. If your child does not fit the profile of children served by Tapestry, then Tapestry staff will connect you to the right resources in your community.

People who work in Cuyahoga Tapestry System of Care really do want to help your child and family. They will encourage you to speak up and ask questions on behalf of your child and family. Some questions you may want to ask are:

• How is eligibility for services determined?
• What can I expect if my child is eligible and we enroll in services?
• How much do services cost?
• How often will my child and family get Tapestry services and how long can we continue?
• How do I get help if there is a crisis, especially at night or on the weekend when the office is closed?

What can I do to prepare for my first meeting with someone from Tapestry?
Schedule the first meeting at yours and your child’s convenience and at a location where you will be comfortable sharing personal information. If you would like, bring along someone you trust, such as a friend or family member.

It may also be helpful for you to bring:

• Information about other services and supports you’ve tried in the past
• A copy of your child’s social security number; Medicaid or medical insurance card; and income information
• A list of any questions you might have

Also remember to:

• Answer questions honestly and give accurate information about your child and family’s strengths, what they like and do well, as well as their needs
• Request information and ask anything you want to know more about or do not understand; there is no such thing as a dumb or foolish question
• Ask for the name of another parent of someone who has been through the process who is willing to share their experience with you
• Write down the answers to your questions and the names and phone numbers of people you may want to call later
• Get a brochure or write down information about services
• Request a written explanation if you are told that your child and family are not eligible for services and ask for a referral to another service or program that could help you

What can I expect to happen during my first meeting with someone from Tapestry?
You will be asked a lot of questions about your child and family. The person completing the mental health assessment will want to know many things about your child and family such as:

• What is prompting you to ask for services and supports from Tapestry at this time
• Who and what has been helpful to your child or your family in the past as well as who cares about what happens to you
• What your child and members of your family like or do well
• Your child’s needs across the many areas of his/her life and how they affect your family
• The supports and services you’re receiving now or received in the past
• Your goals and how you believe Tapestry can help you achieve them

You will probably be asked to sign a lot of forms such as:

• Permission for your child to participate in Tapestry
• Permission to gather or share information with others
• An explanation of the program’s privacy, ethics and grievance policies
• Financial information

It’s okay if you feel tired and a bit stressed when the first visit is over.

Who is on the child and family teams?
All of Cuyahoga Tapestry System of Care programs work with your family to identify who should be on your child and family team. Members of the child and family team usually include people who are providing services to your family as well as persons who are supportive to your child and family. A typical team might include:

• The Child for whom services were requested
• Parents and/or Caregivers
• Legal Guardian if the child is in the custody of the county
• Care Partner (who are sometimes called Care Managers,
  Care Coordinators, Tapestry Care Coordinators, PEP Connections,
  Community Wrap Specialists or Wraparound Facilitators)
• Parent Advocate, someone who has been through the process and is willing to support you as you participate in the process
• Family, members of the faith community, friends and neighbors who you would like to participate in the process
• Formal supports, those professionals like teachers, therapists, child protective service workers, probation officers, etc., who work with your child and family

What are the steps in the team process?

1. A facilitator meets with your child and family to discuss the wraparound process and how it can be used to help you meet your child’s emotional needs
2. The facilitator listens to your family’s story, including your needs, hopes, dreams, strengths and vision for the future
3. People who are providing services as well as people who care about and are connected in a supportive role to your child and family are identified and, with the facilitator, you agree about who will come to a meeting to develop a plan and where you should have the meeting
4. The team will:
   • Come up with a Mission Statement about what everyone on the team will be working on together
   • Look at your family’s needs
   • Develop a crisis plan
   • Come up with several different ways to meet your family’s needs that match up with your strengths
   • Agree on who will take on different tasks
   • Meet regularly to review accomplishments, make sure the plan is working, makes changes and assign new tasks as necessary
   • Plan for the time when your family is ready to move on and no longer needs to meet regularly with the team

What does a care partner do?
A Tapestry care partner provides mental health services to your child and family and, like the wraparound facilitator or wraparound specialist, supports you by:

• Coordinating the wraparound process for your family
• Helping you share with the team your family’s strengths and needs so that you can use your strengths to accomplish your goals
• Facilitating team meetings
• Making sure your family voice is heard in team meetings
• Summarizing the team’s wraparound plan in writing and distributing it to team members so that each team member is clear about what action steps he or she is responsible to complete
• Actively following up with team members about the success of actions steps in between meetings
• Connecting you to a parent advocate

What does a parent advocate do?
A parent advocate supports you by:

• Sharing their experience as a parent or caregiver of a child who has gone through the process
• Helping you identify your family’s strengths and needs and share them with other team members
• Supporting you in expressing yourself during team meetings
• Working with you, the wraparound facilitator and other team members to identify community resources to assist you in meeting the needs of your family.
• Working with you to complete action steps included in your wraparound plan

What is my role on the family and child team?
You will be asked to:

• Develop a team and make decisions with that team
• Identify your family’s strengths and needs
• Participate in team meetings scheduled at times that meet your needs
• Develop child and family wraparound and crisis plans with your team and, if enrolled in Tapestry, develop a mental health service plan with your care partner and members of your team
• Complete the action steps you agree to during team meetings
• Evaluate the effectiveness of your child and family wraparound plan and mental health service plan with your team
• Become more knowledgeable about your child’s emotional and/or behavioral needs and approaches for assisting him or her in meeting those needs
• Ask questions if something is not clear

What is my child’s role?
Depending on your child’s age, he or she will be asked to:

• Share his or her goals
• Share his or her strengths, including skills, talents, interests and people he or she finds to be supportive
• Participate in team meetings and the development of wraparound, crisis and, if enrolled in Tapestry, mental health service plans
• Be honest with team members and express his or her limits
• Complete the action steps he or she agrees to during team meetings
• Ask for help when he or she needs it
• Ask questions if something is not clear

Who will work with my family, and what will we do together?
The team that you and your care partner agree upon will work together to develop a wraparound plan specifically designed to meet your child and family’s needs and will include:

• Your child and family’s goals for the future (vision) and what your team will be working on together (team mission)
• Strategies to meet your family’s needs and that match your family’s strengths
• Action steps to implement those strategies
• Assignment of tasks to members of the team who will take responsibility for specific actions
• Services and supports provided as close to home as possible;
• Services and supports that match your family’s lifestyle and culture

Additionally, your child and family team will:

• Meet regularly to assess whether the plan is working
• Communicate as needed between team meetings to complete the tasks listed on the plan

Will my care partner respect my opinion, culture and values?
You are the expert. You know your child and family best. You can disagree with your care partner or a service provider, get a second opinion, or reject a service provider’s advice. Your family’s language, spiritual beliefs, and cultural values must be considered and respected when choosing services and providers. You should have the opportunity to speak up, be listened to with respect, and not be judged. Some other ideas to remember:

• Most service providers will talk to you and your child in a clear, courteous, respectful, and sensitive manner in the language you use at home. If members of your team do not speak the language you use, ask for an interpreter—do not let your children translate for you.
• Service providers who work with your child may have a different view of your child and family from yours. Carefully consider the evidence for what they say before reacting. Most service providers are just as eager to see progress as you are.
• Insist that service providers meet when and where your child and family feel comfortable.
• Service providers may ask for your feedback and suggestions. Be honest when you reply.
• Most service providers will help you advocate for the services and supports that will help your child and family achieve goals that you set.
• You may be asked to sign that you agree to the service plan and are accepting the services offered. You can refuse to sign if you do not agree with the plan. Ask for a copy of the service plan if it is not given to you.

What questions can I ask a care partner when we start working together?
You can ask anything at any time. Some good questions to start:

• How will the services and supports in the plan help my child and family?
• What are the service provider’s qualifications? Does he or she have special training, and a track record of working with children and families like mine?
• Can I call service providers at any time of the day or night if there is a crisis?
• How do I change services or providers if things aren’t working out as planned?

What should I think about when developing my team?
Pick your team members carefully and be an active participant on the team. Choose people who:

• Respect and trust you
• Know your child and family and have been supportive
• Have a track record of success dealing with the kinds of challenges you are facing
• Know about services in the community

Share the future you envision for your child and explain how others can help achieve that desire. Let service providers know your child’s and family’s strengths, needs, wants, and expectations, and tell them about your family’s preferences and priorities. You could talk with someone you trust before the meeting so you are confident about what you say.

What rights do I have as a parent, grandparent or caregiver?
In a system of care, your child and family have specific rights and responsibilities. Other families as well as advocates and providers can tell you about these and help you understand how and when to use them. Become a strong advocate for your child and family. Exercise your rights. What you need to know:

• Discrimination in the provision of services on the basis of race, religion, ethnicity, gender, religion, age, or disability is illegal.
• If your child is being evaluated for special education, you have special rights and responsibilities. Ask the school to tell you about these and get a copy of these in writing.
• You can choose service providers that respect and value your language, culture, and spiritual beliefs.
• Services and supports need to be provided in your community so that your child and family can be involved with others from your neighborhood.
• You can refuse any service offered to you without being penalized. Get help from family advocates if you are penalized for making a legitimate complaint or refusing services that could harm your child or family.
• Responsible providers will notify you before they change or stop providing any service. Ask for a written notice and explanation of the change if you are not given one.

You are also entitled to review your child’s and family’s records, have your privacy protected, and file a complaint if the situation warrants it.

What can I do to protect my rights?

• Get to know and understand your rights and all the terms or conditions that apply to the services your child and family are using.
• Read everything carefully. Be sure that you understand and really do agree with anything that you are given before you sign it.
• Remember that although you may be under a lot of stress, you are your child’s best advocate. Clearly, you should listen to the advice of others on your service planning team who know something about your child’s need. Ultimately, you must decide what help is needed, where you want to go for it, and when and how often you need to have a service.
• Take control of the flow of information about your child and family. Carefully consider what reports go to which person, agency, school, and so forth. Think about this before you sign permission for information to be collected or given out.
• Resolve disputes promptly. If you disagree with a decision, speak first to the person most immediately involved. If that doesn’t solve the problem, speak to your service coordinator or the provider’s supervisor before you file a complaint.
• Request help from advocates who know the rules, understand the system of care, and have experience with the providers who are working with you and your family.

What support is there within Cuyahoga Tapestry System of Care for parents, grandparents and caregivers?
In addition to the services and supports provided through your team, several groups exist to support the health and wellbeing of your family, including Parent Support Groups, the Family Involvement Committee, and the Parent Advisory Council.

What is the purpose of the Parent Support Groups?
Parent Support Groups meet in various convenient locations and at various times to accommodate your schedule. Involvement is voluntary.

The Parent Support Groups:

• Offer parents new to the system of care an opportunity to meet families affected by mental health concerns within their neighborhoods.
• Introduces the concept of parents supporting parents from their own unique perspective.
• Offers educational opportunities regarding children’s mental health concerns.
• Help connect parents to informal supports within their own community.

Check our Calendar for meeting times.

What is the purpose of the Family Involvement Committee?
The committee meets at a structured time, and participation is voluntary.

The Family Involvement Committee:

• Provides training and support for families affected by children’s mental health issues.
• Connects parents and caregivers collectively across their support groups into countywide activities.
• Support activities around education and advocacy for children’s mental health.
• Provides education and recreation opportunities countywide for families served by Cuyahoga Tapestry System of Care.
• Offers a unified voice for families around mental health issues.

To learn more, view our Family and Youth Involvement Committee page.

What is the purpose of the Parent Advisory Council?
The purpose of the Parent Advisory Council is to provide the family perspective to Cuyahoga Tapestry System of Care. Having a family from each neighborhood collaborative ensures community participation and a broad voice within the county. The Parent Advisory Council, in conjunction with NAMI Ohio (www.namiohio.org), will: Recruit, train and support parents for peer-to-peer activities within their own neighborhoods; coordinate quarterly activities for families of children with serious emotional disturbances to increase social interaction with other families; work to decrease the parent’s perception of isolation in their own community.

 
Where can I find definitions of terms I don’t understand, like “eligibility criteria” or “family-driven”?
View our online glossary. If you don’t find the word or phrase you are looking for, alert us by e-mailing tapestrysoc@cuyahogacounty.us.

What are neighborhood collaboratives?

• Neighborhood collaboratives are groups of social service agencies, settlement houses, children’s services agencies, schools and neighborhood leaders who provide an array of formal and informal services and supports.
• These services and supports for children and families include such things as: after-school programs, daycare, recreation, mental health services, tutoring, etc.
• Neighborhood-based parent advocates help families find the services and supports they need.

GENERAL QUESTIONS

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.

What is a “system of care”?
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 partner, develop a team of people who can address each family’s individual needs with innovative and non-traditional solutions.

 
Who are the partner agencies within the system of care?
Partner 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 partner agencies:

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 the goals of Cuyahoga Tapestry System of Care?
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 children with serious emotional disturbances 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 not only kept on track to help 240 youth per year, but 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 occurring 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.

How did the Cuyahoga Tapestry System of Care begin?
The 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 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 children of Hispanic and Asian-American descent.

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 at risk for involvement in multiple systems and who have multiple needs, 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.

 
Where can I get more information about child and adolescent mental health on the internet?
There is a lot of information on the internet. You can connect to web sites, free of charge, at many libraries and public schools.

Visit our Links section for a complete list of online resources.

Who can I contact for more information about Cuyahoga Tapestry System of Care?
For general inquiries about Cuyahoga Tapestry System of Care, call 216-443-6062.

If you have a question that you think should be added to our list, e-mail it to tapestrysoc@cuyahogacounty.us.