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eWiSACWISand

Levels of Care

Jónelle Brom, OHC SpecialistJonelle.Brom@wisconsin.gov 608.264.6933

Jenny Weber, eWiSACWISJenny.Weber@wisconsin.gov 608.261.7658

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CANS

Child and Adolescent Needs and Strengths

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Purpose of the CANS in WI

• Provide a comprehensive assessment of the needs of each child placed in Out of Home Care (OHC)

• In turn, the identified needs will be used to determine: The Level of Need (LON) of the child to inform

placement decisions and Administrative costs to Child Placing Agencies, Group Homes, and Residential Care Centers

A Mental Health Screening of all children entering OHC;

The Supplemental Rate portion of the Uniform Foster Care Rate Setting

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Overview of the CANS

• WI has chosen a Comprehensive version of the CANS that provides an opportunity to assess a child’s strengths and needs across several Life Domains.

• In addition to looking at the child, the WI version of the CANS looks at the child in comparison to the Current Caregiver and Identified Permanent Resource(s). This information will be used to assist with

placement decision, identification of services that may need to be put in place, or identify specific items that may need to be planned for.

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Key Principles of the CANS

• Items were selected because they are each relevant to service/treatment planning. An item exists because it might lead you down a different pathway in terms of planning actions.

• Each item uses a 4-level rating system. These levels are designed to translate immediately into action levels. Different action levels exist for needs and strengths.

• Rating should describe the child, not the child in services. If an intervention is present that is masking a need but must stay in place, that is factored into the rating and would result in the ration of an ‘actionable’ need (i.e. ‘2’ or ‘3’).

• This is a descriptive tool. It is about the ‘what’ not the ‘why.’ Only two items, Adjustment to Trauma and Social Behavior, have any cause-effect judgments.

• A 30-day window is used for ratings in order to make sure assessments stay ‘fresh’ and relevant to the child or youth’s present circumstances. However, the action levels can be used to over-ride the 30-day rating period.

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Domains in the WI Child Welfare CANS

• Trauma• Life Functioning• School• Child/Youth & Family Acculturation• Child/Youth Behavioral/Emotional Needs• Child/Youth Risk Behaviors• Strengths • Current Caregiver • Identified Permanent Resource

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Algorithms

• The WI CANS will have 3 different Algorithms Level of Need of the child Mental Health screen Supplemental Points

• 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

• eWiSACWIS will do all of the calculations for the users, so they do not have to

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Validity and Reliability of the Tool

• An individual must be TRAINED and CERTIFIED to score a CANS

• In order to be considered a valid and reliable user of the CANS tool, there are yearly re-certification requirements

• Wisconsin policy will require certified users of the CANS tool

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Training of the CANS

• Training will occur statewide this fall and into the beginning of next year for public and private agency staff

• In addition, there will be several opportunities through conferences, listening sessions, and web casts for agency staff and foster parents to learn more

• Dates: January 3rd through January 7th

January 12th through January 14th

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How and When is a CANS Completed?

• A CANS must be completed within 30 days of a child’s placement into OHC or a new placement and every six months thereafter

• The individual completing the CANS is required to gather pertinent information from the child’s family team

• The CANS results shall be shared with the child’s family team

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What will the CANS Replace?

• The Current Uniform Foster Care Rate Setting Process. The Supplemental Points will already be determined for a worker.

• Reports will be generated on a case-by-case basis and across programs in the next release

• Incremental phasing into eWiSACWIS… future planning possibilities include, but are not limited to: Performance Based Contracting Part A and B to Physical Custodians Part of the Integrated Case Plan Placement Resource Mapping and Sharing

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Learn More about the CANS

• Visit the Praed Foundation at:

www.praedfoundation.org

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Foster Care Licensing Standard1-Background Checks2-Physical Plant Checks3-Assessment Process4-Designated Non-Safety Related Regulations for Exceptions for Licensed Relatives

Levels of Care Description

Level 1Child-Specific Foster Care

Level 2Basic Foster Care

Level 3Moderate Foster Care

Level 4Specialized Foster Care

Level 5Exceptional Foster Care

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Placement Complexity Matrix

Placement OptionsChild’s LON Foster Care Group Home Residential Care Center Provider’s Certification Level

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2

Child-Specific 1

Basic 2

3 Moderate Basic 3

4 Specialized Moderate 4

5 Exceptional Moderate 5

6 Specialized 6

Step-down levels to be used for transition planning.

Placement of children in these levels is not appropriate.

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Placement and Child Level of Need

A child can be served at a level lower than his or her assessed level of need if an exception has been granted by the placing agency, and the agency can show that services and supports are provided to address the assessed needs.

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Identified Permanent Resource (IPR)

• Defined as the person(s) identified in the Permanency Plan as the child’s permanent resource

• There are four options, the first two should be consistent with those named in the child’s Permanency Plan, if applicable: Primary Concurrent Considered (prior to or when considering additional

permanent resources not named in the child’s Permanency Plan)

Not applicable – no identified caregiver• Only one primary and concurrent resource can be identified,

however you can have multiple considered• There cannot be a concurrent IPR without a primary IPR

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WI CANS

• In Home “Current Caregiver” is

who the child lives with No “Identified

Permanent Resource” Does not calculate

Supplemental Points

• OHC “Current Caregiver” is

who the child lives with “Identified Permanent

Resources” are the named or considered permanency options for the child, if applicable

Calculation of the child’s Level of Need, Supplemental Points, and LOC/LON Differential

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Creating a CANS

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Creating a CANS

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CANS - Child/Youth Needs

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CANS - Child/Youth Needs

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CANS - Child/Youth Needs

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CANS - Child/Youth Strengths

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CANS - Current Caregiver

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CANS - Current Caregiver (In Home)

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CANS - Identified Permanent Resource

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CANS - Identified Permanent Resource

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CANS - Actionable Items

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CANS - Actionable Items

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CANS - Actionable Items

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CANS - Results

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CANS - Results

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CANS Information

• CANS requires supervisor approval• Workers will be able to leave the CANS pending• CANS will appear under the Planning icon• If the child is in an Out of Home Placement (OHP), the

CANS will appear under the Placements icon as well• Workers will be able to copy the most recent CANS for

a child• When an OHP is ‘made in error,’ the associated CANS

will become ‘made in error’ as well• Workers will also be able to ‘make in error’ an

incorrect CANS

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Desktop View

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Additional CANS Information

• E-mail notification when the child’s LON exceeds the provider’s LOC

• There will be a template available that will include information from all of the tabs• CANS template

• There will be two CANS ticklers

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CANS Tickler

• The Primary Worker will receive a tickler to complete the CANS within 30 days of each new Out of Home Placement

• 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• Case closure will be prevented if a CANS is not

documented

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Other Changes

• Addition of Certification Levels 3, 4, and 5 to the Foster Home License for Home Providers

• Removal of the Treatment Foster Home template• Administrative Code changes reflective for

denials and exceptions/waivers• Service types

Home Provider Private Provider

• Rate Setting page• Out of Home Placement page

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Licensing Page

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Edit Licensed Services Page

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LOC Monitoring Report

• PM04A100 - Level of Care Monitoring• 7 tabs:

• LOC Read Me• LOC Summary• LOC Overdue Next 30 Days• LOC Due Beyond 30 Days• LOC Completed Process• LOC Newly Licensed Providers• LOC Detail

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LOC Read Me

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LOC Summary

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LOC Overdue Next 30 Days

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Withdrawn Applications

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Withdrawal Reasons

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Withdrawn Application

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LOC Completed Process

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Completed Applications

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