Wisconsin CANS Online Training · and Family Acculturation, Child/Youth Behavioral/Emotional Needs, Child/Youth Risk Behaviors, and Strengths. As you’ve heard previously, you do

Wisconsin CANS Online Training Child and Adolescent Needs and Strengths Module 3: Wisconsin Policy

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Wisconsin CANS Online Training: Module 3 1

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Focus of this module:

State policy Documentation requirements

Counties that have CSTs

In this module, you will learn about state policy and documentation requirements, as well as information about how counties that have Coordinated Service Teams (CSTs) use the CANS.


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What the CANS is Used ForThe algorithms and information gathered in the CANS are to be used to:

determine a level of need of 1/2, 3, 4, 5, or 6 for the child

assist with determining the child’s service needs and

developing the child’s case plan

communicate information about the needs and

strengths of the child and child’s family

assist in the development of services and supports needed for a specific child and out-of-

home care provider to promote the stability of the placement

evaluate the match between the knowledge, skills, and abilities of an out-of-home

care provider and the needs and strengths of the child

inform decisions regarding a placement at a level of care that is appropriate to meet

the child’s level of need

If in foster care,determine any supplemental

payments under s. DCF 56.23 (2)

provide a mental health screen to all children entering

out-of-home care

The algorithms and information gathered in the CANS are to be used: 1. To communicate information about the needs and strengths of the child and child’s family. 2. To assist with determining the child’s service needs and developing the child’s case plan. 3. To determine a level of need for the child. 4. To inform decisions regarding a placement at a level of care that is appropriate to meet the child’s level of need. 5. To evaluate the match between the knowledge, skills, and abilities of an out-of-home care provider and the needs and strengths of the child. 6. To assist in the development of services and supports needed for a specific child and out-of-home care provider to promote the stability of the placement. 7. To provide a mental health screen to all children entering out-of-home care. 8. If a child is in foster care, to determine any supplemental payments under s. DCF 56.23 (2).


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Wisconsin Comprehensive Version

•Trauma

•Life Functioning

•School

•Child/Youth Family Acculturation

•Child/Youth Behavioral/Emotional Needs

•Child/Youth Risk Behaviors

•Strengths

•Current Caregiver

•Identified Permanent Resource

Domains of WI Comprehensive Version

Remember:You do not need to complete the items in order

Narration: The Wisconsin Comprehensive version of the CANS has 7 Domains for rating a child, and Domains with items for rating the Current Caregiver and the Identified Permanent Resource. The 7 Domains for rating the child are: Trauma, Life Functioning, School, Child/Youth and Family Acculturation, Child/Youth Behavioral/Emotional Needs, Child/Youth Risk Behaviors, and Strengths. As you’ve heard previously, you do not need to complete the items in the order they are presented in the CANS, but all items must be rated.


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Wisconsin Comprehensive Version

3 Different Algorithms...used to determine

(LON)Level of Needof the child

Mental Health screen results

Supplemental points / rate for child

•These algorithms are a compilation of selected items that are rated in the tool.

•Not every item rated is used for all of the algorithms, but all must be rated.

•eWiSACWIS will do all of the calculations.

Learn more: Wisconsin’s rate setting policy (PDF)

Narration: In addition, the Wisconsin Comprehensive version has three algorithms, which are used to determine three different things: the Level of Need (the “LON”) for the child, the results for the Mental Health screen, and the supplemental portion of the foster care rate for the child. An algorithm is really just a formula that is used to calculate a result based on specific items. Not every item that you rate is used for each algorithm, but again, each item must be rated. You will not have to calculate anything for these algorithms, eWiSACWIS will do this for you. For more information on Wisconsin’s algorithms and the items used, please see Wisconsin’s Uniform Foster Care Rate setting policy: http://dcf.wisconsin.gov/memos/num_memos/DSP/2011/2011-03.pdf. You’ll hear more about Wisconsin’s policy on CANS and rate-setting in the following slides.


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Certification and Completing the CANS

Must be trained and certified to

complete CANS

Re-certified every year

Must be completed:• within 30 days of

placement in foster care

• prior to GH or RCC placement

• every 6 months thereafter when placed with same provider

Required to gatherpertinent info from

child’s team

Required to shareCANS results with

child’s team

Individuals who rate a CANS are required to be trained and certified in its use. In order to maintain certification, individuals are required to be re-certified on a yearly basis. When completing the CANS, the caseworker must gather information to complete the CANS through a review of the child’s case record, interviews, and discussions with the child’s team members. Whoever is completing the CANS is required to then share the results with the child’s team and incorporate the results into case planning for the child, family, and caregivers. A CANS must be completed within the following timelines: • Within 30 days of placement into foster care. • Prior to a placement in a Group Home or Residential Care Center. • Within 30 days of a new placement, but prior to a new placement in a higher level of care if

the child is not already in a Group Home or Residential Care Center. • Every six months thereafter when the child has been placed with the same provider.


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Uniform Foster Care Rate

1

2

3

Basic Maintenance Rate

Supplemental Rate

Learn more: Uniform Foster Care Rate Policy

Initial Clothing Allowance

4 Exceptional Rate

Determined by adding items scored as a ‘2’ or ‘3’ on items included in Supplemental Rate algorithm and multiplying by $5.50.

Established to provide consistency statewide in foster care payments

Narration: The Uniform Foster Care Rate Policy was established to provide consistency statewide in foster care payments. The Uniform Foster Care Rate has four components: the Initial Clothing Allowance, the Basic Maintenance Rate, the Supplemental Rate, and the Exceptional Rate. Completion of the CANS will determine the Supplemental Rate by adding the items scored as a ’2’ or ‘3’ on those items included in the Supplemental Rate algorithm and multiplying that number by $5.50. This calculation will be done automatically in eWiSACWIS. Only foster parents licensed and certified at or above Level 2 are eligible for Supplemental and Exceptional payments.


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Documentation Requirements

Completed in eWiSACWIS; will require supervisor approval.

Can leave a CANS pending.

Able to copy over most recent CANS.

‘Made in error’

Primary worker receives tickler:— to complete CANS within 30 days of each

new Out-of-Home placement

— every 6 months when child’s Out-of-Homeplacement does not change

Used to track completion / mental health screen

eWiSACWIS Project Team

The CANS will be completed in eWiSACWIS and will require supervisor approval. You can leave a CANS pending if necessary, and you will be able to copy over the most recent CANS for a child. If an Out-of-Home Placement is ‘made in error,’ the CANS associated with that placement will become ‘made in error’ as well. If you make mistakes in the CANS, you can ‘make in error’ the incorrect CANS as well. There will be two CANS ticklers: the Primary Worker will receive a tickler to complete the CANS within 30 days of each new Out-of-Home Placement, and the Primary worker will receive a tickler every 6 months when the child’s Out-of-Home Placement does not change. Supervisors cannot delete these ticklers, and case closure will be prevented if a CANS is not documented. A template is available on the Results tab of the CANS that will include information from each tab of the CANS that you can share with team members. You’ll hear more about these templates on a later slide. You will have the ability to track completion of the CANS and to determine whether CANS are being completed in a timely manner, as well as information regarding the results of the mental health screen. The following several slides will walk you through the process of documenting a CANS in eWiSACWIS. If you have additional questions regarding documentation of the CANS in eWiSACWIS, please contact your eWiSACWIS liaison. If you are unsure of who your liaison is, please click on this link for contact information:


http://dcf.wisconsin.gov/wisacwis/knowledge_web/project-support/project-support-home.htm.


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Creating a CANS

Click Create to continue

Narration: The CANS will be found in two places: under the Planning icon, and also under the Placements icon for those children in an Out-of-Home Placement. A CANS can only be created under Planning. Choose the CANS drop-down to initiate the CANS.


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Child/Youth Needs: 5-17 VersioneWiSACWIS will choose the 0-5 or 5-17 version based on the child’s age at the time of the assessment.

eWiSACWIS will choose “Assessment Type” based

on whether or not the system reflects that the

child is in placement at the time of assessment.

In eWiSACWIS, the CANS is broken up into six tabs, and the default tab is the “Child/Youth Needs” tab. Remember that you do not need to start here! You’ll also see at the top of the screen a link for the Manual and Glossary of Terms if you need them as you complete the CANS. Each tab is broken into the Life Domains as you see them on the results sheet. This screenshot is the Child/Youth Needs tab for the 5-17 version. The next slide will show you the Child/Youth Needs tab for the 0-5 version. The two versions are created the same way in eWiSACWIS, but they will look different as you’re filling them out due to the two versions having different items in some Domains.


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Child/Youth Needs: 0-5 Version

This is the Child/Youth Needs tab for the 0-5 version. You’ll see that it looks very similar to the 5-17 version: you still have the link for the Manual and Glossary of Terms if you need them as you complete the CANS.


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Definitions of Ratings & Notes: 5-17 version

If you need the definitions of the ratings for a given item, you can hover over the details tab and you will see the definitions for each of the ratings for that item. You‘ll also see a “Notes” expando, which you can use if you’d like to add some notes for any item. The notes that you enter will not print on the template, but they can be printed by clicking the Print icon at the top right of the page, which would need to be done tab by tab.


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Definitions of Ratings & Notes: 0-5 Version

Just as in the 5-17 version, if you need the definitions of the ratings for a given item, you can hover over the details tab and you will see the definitions for each of the ratings for that item. Also just as in the 5-17 version, you’ll have a “Notes” expando, which you can use if you’d like to add some notes for any item. The notes that you enter will not print on the template, but they can be printed by clicking the Print icon at the top right of the page, which would need to be done tab by tab.


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Child/Youth Strengths: 5-17 Version

The “Child/Youth Strengths” tab is similar to the “Child/Youth Needs” tab. Please remember when you’re rating the strengths to flip your ratings – a “0” is a centerpiece strength and a “3” signifies that no strength has been identified for that item.


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Child/Youth Strengths: 0-5 Version

Here you see the “Child/Youth Strengths” tab for the 0-5 version. And, as you’ve heard before, please remember when you’re rating the strengths to flip your ratings – a “0” is a centerpiece strength and a “3” signifies that no strength has been identified for that item.


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Current Caregiver

The “Current Caregiver” tab has some additional information in order to denote the caregiver by name. This tab is the same on both the 0-5 and the 5-17 versions as the items for Current Caregiver are the same on both versions. Remember as you rate the Current Caregiver (and the Identified Permanent Resource(s)) that you are rating that person in relation to the child whose CANS is being completed, not as a general care provider. As with the Needs and Strengths tabs, you can hover over the Details link to see the definitions, and you can also add notes under each item if needed. The current caregiver is whoever the child is living with at the time the CANS is completed, whether that be parents, foster parents, relatives, or the group home or RCC setting.


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Identified Permanent Resource

The Identified Permanent Resource is any person named on the Permanency Plan, or anyone being considered for a permanence option for the child (which may include the child’s parents). The “Identified Permanent Resource” tab allows you to add multiple people as possible Identified Permanent Resources. This tab is the same on both the 0-5 and the 5-17 versions as the items for Identified Permanent Resource are the same on both versions. You can only name one as the “Primary” Identified Permanent Resource, but you can add multiple “Considered” resources. This is especially helpful if you are attempting to choose a permanent resource for a child – the CANS can help you to see which provider can best meet the needs of that child by comparing the identified needs and strengths of the child to the identified skills of the provider.


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Actionable Items (1 of 3): 5-17 Version

View Next Screenshot >

The next 2 screenshots show what would be seen if you scrolled down the

Actionable Items tab.

The “Actionable Items” tab will organize the items by rating to assist you in treatment planning. The items rated as ‘3’s will appear at the top of the page, then those rated as ‘2’s and so forth. In addition to grouping the items, this tab provides narrative boxes for each item to allow you to add notes on how you plan to address those needs or build those strengths. As you can see in these screenshots, the results are also broken up into results for the child, the Current Caregiver, and the Identified Permanent Resource.


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The next 2 screenshots show what would be seen if you scrolled down the

Actionable Items tab.

Here you see the “Actionable Items” tab for the 0-5 version. As with the 5-17 version, this tab will organize the items by rating to assist you in treatment planning. The items rated as ‘3’s will appear at the top of the page, then those rated as ‘2’s and so forth. In addition to grouping the items, this tab provides narrative boxes for each item to allow you to add notes on how you plan to address those needs or build those strengths. As you can see in these screenshots, the results are also broken up into results for the child, the Current Caregiver, and the Identified Permanent Resource.


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Continue >


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Results (1 of 2): 5-17 Version


0-5 version template


The “Results” tab for the 5-17 version, shown here, will display the child’s Level of Need (LON) as well as the provider’s Level of Care certification (LOC). If, as you see on this screenshot, the child’s Level of Need exceeds the provider’s Level of Care certification, an exception must be documented in order to maintain that placement. The child does NOT need to be moved in this case! In the narrative box shown, you will need to document why this placement is still appropriate for the child, and also document how you will support that provider as they care for that child. You will document the services and supports you will put into place to maintain the placement. You’ll also see the outcome of the Mental Health Screen – whether the child needs to be seen by a mental health professional. As you can see from these screenshots, you will see the results of each Life Domain and of any breakout modules completed for that child, the Current Caregiver, and the Identified Permanent Resource(s). The information on the “Results” tab can be printed on the CANS Templates in order to share with the child, the child’s family, other team members, and with the courts. Click here for links to blank templates for both versions of the CANS:

http://dcf.wisconsin.gov/wisacwis/knowledge_web/training/CANS/CANS%200-5.pdf (0-5 version) http://dcf.wisconsin.gov/wisacwis/knowledge_web/training/CANS/CANS%205-17.pdf (5-17 version).


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Results (2 of 2): 5-17 Version

Continue >


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Results: 0-5 Version



The “Results” tab for the 0-5 version will show the same information as the 5-17 version: the child’s Level of Need (LON) as well as the provider’s Level of Care certification (LOC). If the child’s Level of Need exceeds the provider’s Level of Care certification, an exception must be documented in order to maintain that placement. You’ll also see the outcome of the Mental Health Screen – whether the child needs to be seen by a mental health professional. You will see the results of each Life Domain and of any breakout modules completed for that child, the Current Caregiver, and the Identified Permanent Resource(s). The information on the “Results” tab can be printed on the CANS Templates in order to share with the child, the child’s family, other team members, and with the courts. Click here for links to blank templates for both versions of the CANS:

http://dcf.wisconsin.gov/wisacwis/knowledge_web/training/CANS/CANS%200-5.pdf (0-5 version) http://dcf.wisconsin.gov/wisacwis/knowledge_web/training/CANS/CANS%205-17.pdf (5-17 version).


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Foster Care Rate Page

To access the Foster Care Rate Page, which will be shown on the next slide, you will choose “Foster Care Rate” from the “Placement/Services” drop-down.


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Foster Care Rate Page

Once the CANS is completed, you can see the Supplemental Rate on the Foster Care Rate Page. This page will show additional information about the CANS, including the effective date, the child’s Level of Need, the provider’s Level of Care, and the Supplemental Rate. On this page, you’ll also see the information for the other portions of the rate for this child, as well as the narrative boxes for justifying the Exceptional Rates for a child.


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Desktop View

Have more questions?Check out the “How Do I?” guide

You can see on this screenshot that once you’ve completed a CANS, you will see it on your desktop under “Placements” with the child’s rate if the child has an Out of Home Placement. The CANS always appears under “Planning,” including in-home and out-of-home CANS.


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CST Specific InformationCoordinated Service Teams

2008 2010 2011

Mental Health version Comprehensive version 40 CSTs using CANS

WI CST Timeline

How CSTs are using the CANS with children in mental health system:

– Inform initial and ongoing plans of care

– Monitor child and family during enrollment with the CST– Used as a portion of “Assessment of Summary of Strengths and Needs” form

(assessment for CCS and TCM); CANS is approved tool for pre-authorization of MA in-home therapy benefit.

CST Resource website DHS: CST website

Wisconsin counties who have Coordinated Service Teams (CSTs) have been using a Mental Health version of the CANS since 2008, and began using the CANS Comprehensive version in 2010. As of mid-summer 2011, there are 40 CSTs in Wisconsin using the CANS in their work with children in the mental health system. The CSTs use the CANS to inform their initial and ongoing plans of care and to monitor the child and family during their enrollment with the CST. The CSTs use the CANS as a portion of their “Assessment of Summary of Strengths and Needs” form, which is an approved assessment for Comprehensive Community Services (CCS) and Targeted Case Management (TCM), and the CANS is an approved tool for pre-authorization of the MA in-home therapy benefit. The CSTs enter CANS data into the CST Citrix web data system, and this system will generate reports to show when the next CANS is due as well as reports showing the child’s progress during enrollment with the CST. Training and technical assistance is available specific to CSTs through the Department of Health Services (DHS), and on the CST Resource website: http://wicollaborative.org/. This site contains information specific to CST programs as well as CANS information, and contact information for questions and technical support. In addition, information regarding CSTs can be found on the DHS website: http://www.dhs.wisconsin.gov/mh_bcmh/cstisp.htm.


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Begin Knowledge Check

Wisconsin’s CANS policy

Documentation in eWiSACWIS

How counties with CSTs use the CANS

Coming up in Module 4: practice time!

Narration: You have learned about Wisconsin’s CANS policy and the requirements for documentation in eWiSACWIS. You’ve also learned about counties with CSTs and how they use the CANS. Given all of the information that you have learned in these two modules, you are now ready to try this for yourself. The next module is a guided practice vignette, in which you’ll be given a case scenario for two brothers and you will rate them on the CANS items. You will be given feedback on your ratings for this vignette, and then you will have the opportunity to practice with additional vignettes. After completing the practice vignette, you will be given a review prior to taking the certification exam.


Documents

Wisconsin CANS Online Training · and Family Acculturation, Child/Youth Behavioral/Emotional Needs, Child/Youth Risk Behaviors, and Strengths. As you’ve heard previously, you do