The Cuyahoga County Tapestry System of Care serves children and youth who are involved in either the child welfare or juvenile court systems. The enrollment process involves an initial assessment to ensure that Tapestry is an appropriate fit for the child and his or her family. That initial assessment is followed by the development of a crisis plan (if needed), and then the family is put in touch with professional helpers who can support them in convening a team and helping the family develop their plan of care.
A “system of care” is a framework that involves collaboration across government and private agencies, providers, families, and youth for the purpose of improving access and expanding the array of coordinated community-based, culturally- and linguistically-competent services and supports for children and youth with serious emotional challenges and the families caring for them.
Tapestry has built on the rich history of collaborative partnerships that is part of the fabric of Cuyahoga County. At the core of Tapestry is a partnership with community service agencies, as well as with public system partners like the child welfare and juvenile court systems. Some of the collaborative partnerships that Tapestry has been a part of include:
- Youth and Family Community Partnership (YFCP)
- Mental Health Court
- Residential Step-Down
- Parent Support Partners
The Begun Center serves as support for Tapestry on its evaluation efforts.
The Importance of Assessment
Being able to evaluate the impact of services and other activities is very important and aligns with the system of care value of “evidenced-based”. The Begun Center helps Tapestry in the collection and the analysis of data in the four outcome goals of:
- Improved family and youth functioning
- Reduced recidivism in juvenile justice
- Reduced recidivism in child welfare
- Increased efficiency and effectiveness
These outcome goals are measured once a year and reported on in an annual report each summer.
Along with the annual evaluation activities, the Begun Center also assists Tapestry with a quarterly continuous quality-improvement (CQI) process. The CQI process is a strategy for performance-based contracting and was developed in partnership with the contract providers for both care coordination and parent advocacy services.
The Tapestry Professionals
The professional helpers that work with a family who is enrolled in Tapestry include a Care Coordinator and a Parent Advocate. The Care Coordinator is a mental health professional who can help the family in addressing their emotional needs. The Parent Advocate is based out of a community-based agency and can help link the family with resources and supports that can help them during a crisis or in the future. The Parent Advocate is someone who has been through what the family is going through and can give a “real life” perspective about how to cope.
In addition to the care coordination and parent advocacy services, families enrolled in Tapestry can also access something called “wrap supports”. These wrap supports are available to help the family in accomplishing their plan of care and can include things like music lessons, respite, camp, therapeutic recreation, skill building, etc.
Tapestry became fully-supported on local Health and Human Services Levy dollars in 2010 and now functions as an administrative services organization managing contracts, access, costs, and quality of services.
Tapestry uses a wraparound process to blend formal/Medicaid billable mental health services with informal, community-based supports. Wraparound is facilitated by care coordinators at private agencies with assistance from Parent Advocates via a partnership with neighborhood collaboratives.
Tapestry merged under the leadership of the Cuyahoga County Department of Children and Family Services (DCFC) in 2011, though it continues to partner with and receive referrals from Juvenile Court and community-based neighborhood organizations in addition to DCFS. The populations served (i.e. approximately 800-1000 families/youth annually) are multi-system involved and at risk for further system involvement and/or at risk of disruption in the home.