Administrators

Administrator Overview. The Administrator overview presentation lays out for administrators how the CANS can inform their system-design and system-management functions. The presentation shows administrators how the CANS can be used to address issues of importance at each level of the system.



Decision-Making Tools. Decision-making tools were created specifically to provide administrators with ways to help insure and monitor quality of care and minimize risk to the client at key choice points in the system. These tools have been implemented with great care. Previous efforts in the system to widely use algorithm-based level of care tools for placement decisions led to widespread distrust regarding the ultimate recommendations made, largely because providers using the instruments also were in a position to benefit from specific level of care recommendations.
In order to minimize conflict of interest in the rating of client needs and subsequent care received, decisions to implement CANS-based level of care algorithms at key cross-system access points have been carefully implemented.
CANS-based tools with explicit level of care algorithms and recommendations are currently used only by Civil Service (non-contract) assessment teams who do not also provide treatment. These teams include a Child Protective Services interface team, a Juvenile Justice behavioral health triage team, and the 24-hour Crisis services / hospitalization team. In addition, a structured CANS-based tool is in use as a group-based case review and decision-support tool for very high need, high-risk cases. This tool is used explicitly to identify the client’s core treatment need and the process used to address that need. In a structured group discussion, treatment recommendations are then made based on the information gathered regarding the client’s core treatment need and the usefulness of current strategies for addressing the client’s core need. A version of this case review tool is attached.



Programs
Integration of the Incredible Years and the CANS 0-5: A Practical Guide for System Administrators: The Incredible Years® (IY) training programs are a series of complementary evidence-based programs intended to promote child social, emotional, and academic competence and reduce child behavior problems. They were developed by Dr. Carolyn Webster-Stratton and have over 30 years of research support demonstrating their effectiveness. The Child and Adolescent Needs and Strengths® (CANS) 0-5 version is an evidence-based communication tool developed by Dr. John Lyons. The CANS is a multi-purpose tool that supports decision making in services for young children by facilitating communication about child and family strengths and needs within and between systems. This document integrates the CANS 0-5 with the skill domains of the seven IY parent training programs for caregivers of children ages 0 to 5. It has been developed in close consultation with the developers of IY and the CANS is intended to serve as a guide for system administrators, program managers, clinical supervisors, and other stakeholders responsible for implementation of the CANS and IY for Project LAUNCH.



Reports. Administrators have access to reports which can zoom in to any level of the system: client, clinician, supervisor, program, and system. These reports allow administrators to see client needs and service effects at any level of the system (client, clinician, supervisor, program, system levels). Other states have begun to use the CANS to benchmark change rates and build contract performance indicators which provide incentives for meeting an effectiveness standard (example provided in the document attached below). Administrators can also monitor compliance with Assessment and charting requirements.


In addition to these pre-built reports, custom reports are also readily available. Because the CANS database captures longitudinal data about client functioning, reports can quickly be generated about client characteristics on entry, at any reassessment time point in care, and at exit. These reports can be generated for any identifiable sub-group within the system. Examples of both pre-built and custom reports are described in the 'Administrator Overview' presentation (above).

In-depth Information about the CANS Philosophy and Applications
You may want to know more about the CANS, the philosphical basis of its development, and its applications in multiple settings. John Lyons, the developer of the CANS, has authored, co-authored, and edited a number of books and papers on the CANS. These range from entirely applied pieces to very academic pieces. Below is John's latest work which describes the underlying philosophy driving the way in which the CANS was created, and how it can be applied.


For additional resources, the Praed Foundation (which holds the copyright to all CANS-based instruments, in order to keep their use free and appropriate) is a great place to explore the background, various uses, and forms of the CANS. Their address is: www.praedfoundation.org