Our Provider Collaborative would like to offer training and supports that are most helpful to your learning of the CANS & ANSA tools. Before we do that, we wanted to get your input to guide the development of the supports we will provide. Your input will let us know what topics are most important to you, as well as what you already know and do well.
To best support you, we ask about three things:
The survey will run between April 29th through May 10th, 2019 and it should take about 15 minutes to complete. The survey is completely voluntary and you can withdraw at any time. Survey responses will be analyzed by the training provider, Chapin Hall, and results will be reported as a group, so that your identity and responses remain confidential. Survey data will be used by BHCS & our Provider Collaborative to learn how we can best support you through training, consultation, and policy alignment. Thank you for taking a few moments to help us better understand and support your work!!
Stars Community Services has had outstanding CANS/ANSA completion rates. We interviewed them to highlight this accomplishment and find out directly how they achieve it. Great job Stars team! Hopefully other providers will benefit from learning about your processes.
When asked what Stars staff attributed their stellar CANS completion rates to, they first stated “It’s required” candidly. But there is more to it than that or every agency would have the same level of CANS completion rates. They shared the following strategies that they think supports their outstanding completion rates. They have Opening, 30-day, 6-month, Annual and Discharge document checklists which include the CANS as one of the required documents. These checklists require signatures of the primary clinician and initials of supervisors and administrative staff are also required after they review the packets to help ensure all documents are present and complete for increased accountability. On these they have a prompt to supervisors to print the CANS and scan these into the EHR which keeps the supervisor more engaged in ensuring that the CANS is completed and submitted. Stars staff shared that their assessment and CANS are separate documents and though Stars has their own EHR, their primary clinicians enter their CANS directly into Objective Arts (OA). This has allowed the Research department to extract the CANS data from OA and produce some program level reporting. The clinicians are also utilizing CANS rating decreases to track the improvements of their clients in their treatment.
Training seems to be another key factor that has supported high completion rates for Stars. Veronique Lee stated that they have an all-day CANS Certification Training in their New Employee Orientation including time built in for trainees to take the test and this usually occurs within 2 weeks of hire. There are different tiers of training after New Employee Orientation to train staff on the clinical loop. Agency wide, Stars works to titrate trainings and do refreshers as well as provides program level trainings. Mattie’ Nogaye stated “It’s not a one stop shop”. Stars has 4 Leadership staff that have been certified as CANS Trainers. Having 4 Leaders is intentional to ensure that there is no void of training even when there is turnover or scheduling conflicts. In addition, Esmeralda Gonzalez emails all clinical staff CANS related training opportunities provided through the CANS Collaborative as they arise and she is also readily available as a consultant on an ongoing basis for clinical staff. When asked about any challenges they have had and how they overcame them, Chris shared that when the Praed Foundation switched to Schoox, the Training and QA department created a process map to ensure that CANS certifications were linked to the agency’s OA account. This helped prevent delays in staff being able to enter CANS in Objective Arts and so he stated he wished they had done this sooner.
It is clear that Stars has great systems in place to train and support their staff to not only get their CANS completed consistently when required, but also to hold themselves and each other accountable to a high level of compliance with all requirements which are in place to support their staff and the clients they serve.
We are excited to announce the upcoming Collaborative Trainings including:
The online training calendar has details for upcoming trainings. In addition, the Collaborative is happy to plan agency specific trainings at your site! Just reach out to your collaborative coach or contact us to submit a request!
One of the important questions that agencies ask about the State-wide CANS implementation is how to use the data collected to support improvement of client care. In order to respond to the need for expanded information on this topic, a comprehensive guide has been developed for administrators and supervisors to help generate data reports for their programs utilizing Objective Arts (OA).
The Objective Arts Key Reports: User Manual for Alameda County details four reports with direct agency usefulness for basic compliance tracking, as well as examining service efficacy. The user manual provides step-by-step instructions with illustrations for each of the four key reports, including the creation of customized report templates, how to run reports, and report interpretation.
The Objective Arts Key Reports: User Manual for Alameda County will be available to download online starting in late Spring.
Have you ever been asked to score something on a number scale? How sure were you that your number rating meant the exact same thing as the person asking for the rating? With communimetrics, the number scale is not subjective because each number is clearly linked to a specific concept but you may still find yourself in need of more support in order to effectively bring the CANS/ANSA into supervision and the treatment planning process across your agency within Alameda County Behavioral Health Care Services
We are here to help with that! There are a variety of NEW tools on our website that are now available for you to print and utilize which can help to guide engagement with your clients and families. Erin Rosenblatt, from Westcoast Children’s Clinic created these new tools with the intention of “enhancing [the] provider’s practice when using the TCOM tools (CANS/ANSA). While many who are new to using the CANS/ANSA focus on proficiency with the tool, these new tools will help providers understand how to integrate the principles and practices into work with clients, families, and in supervision.”
We would “encourage anyone that is looking to know how to further integrate the CANS/ANSA or TCOM into their practice to explore and see what tools resonate” and align most with their current space and processes. The updated documents can be found in the following sections:
“I think people will be surprised about how much they already are doing and how easy it can be to integrate these aspects into their day to day work with clients.”- Erin Rosenblatt
In the Dear Collaborative column, we answer YOUR questions about TCOM or the TCOM tools (CANS, ANSA-T, ANSA). Have questions and want answers? Submit your questions through the Contact page and look for the answer in the next edition of Dear Collaborative.
Q1: I find the strengths and needs scoring differences difficult to remember. Can you help?
A1: Absolutely. It can be confusing that the ratings for strengths go in the opposite direction as the ratings for needs. A simple way to remember is that a zero is always the most positive in both areas and go from there. A zero in needs means there is no evidence of a need which is generally positive. A zero in strengths means there is a centerpiece strength which is also positive. So, if you start with a zero in your mind equaling positive you can go from there on any item, be it a need or a strength.
Q2: Asking all these questions to families and clients takes too long and isn’t what I became a therapist for. Why do I have to do this?
A2: Great question! I bet you became a therapist to help people and support them to make their lives better. This is what the TCOM tools were developed for as well. Without tools to organize all the information families and clients share with us, we won’t have a roadmap to know where we’re going. The CANS/ANSA framework helps us make sure that the client, family, and therapist all share an understanding of what treatment is for and what we’re doing together. CANS/ANSA helps us to organize client needs and strengths and track progress throughout our work. Using the tools doesn’t look any one way with clients. Every therapist should think about their own family, client engagement style and strengths and then work with their supervisor to figure out how to share the CANS/ANSA with the clients and their families so they understand the tool and can work with you to identify what their own needs, strengths, and shared goals are for treatment. If you don’t have a roadmap, you’re likely to be lost a lot!
Q3: As a supervisor, how can I help my supervisees learn to be really good at using the CANS/ANSA?
A3: Supervisors are so important in helping the CANS/ANSA be more than just “another form that has to be completed.” You can make sure it’s what it should be: a strategic tool that helps everyone involved in a case communicate and support transformation and change. Learning takes time and has stages. Supervisors can support staff from the first stage of just getting certified through to becoming advanced CANS/ANSA users if you integrate learning into supervision sessions. A few suggestions for early stage users: Ask them to pretend they are explaining to another professional why they use the CANS or ANSA. Make sure you can explain it too! If either you or your supervisor are stuck here, go back to the website materials and videos or sign up for one of our in person trainings like “TCOM in supervision.” Our training calendar is always posted on Schoox.
Did you know Alameda Behavioral Health Care Services recently created two positions to support providers in utilizing the CANS and ANSA tools in a more coordinated and effective manner? Meet Christine Mukai, CANS Coordinator, and Michael Castilla, ANSA Coordinator.
Welcome to the team Christine and Michael!
Would you mind telling us a little about your job experience prior to coming into your new position?
Christine: My work experience started back in the late 90’s with SUD in NYC, then day treatment in LA, and outpatient in SF. Then I joined Alameda County in 2002 in outpatient, then to the AB3632 unit, which later became the ERMHS unit. The past 6 years have been with the CEC School based program until switching over to becoming the CANS Coordinator. I have used the CANS since 2014.
Michael: My work history has primarily been in Supported Employment. For eight years I assisted individuals with mental health, dual diagnosis, and with developmental disabilities to find and maintain employment. I’ve worked with adults and Transition Aged Youth populations. I’m currently working as a Social Worker Supervisor with In Home Support Services (IHSS). We serve Minor Children cases and assess their needs in order for them to remain safely in their homes and to avoid premature out of home placement. As a supervisor, I review the assessments provided by the Social Workers in my unit. We assess each individual’s Functional Index Ranking and work to promote independence.
What is the county’s current focus and future hopes for the CANS and ANSA tools?
Christine: The Alameda County Behavior Health (ACBH) is focusing on providing mental health and substance use services to limited income individuals and families. ACBH very recently had a logo and branding update to reduce the stigma and negative connotation towards people who suffer from mental health and substance use. The county is also putting efforts into providing a continuum of care and has recently started an FSP for wrap services under the Children and Young Adult System of Care.
The future for CANS is to have more users understand how it can be a tool that is useful beyond the needs and strengths assessment. CANS can be helpful in treatment planning, engagement, supervision and understanding outcomes.
Michael: I am very eager to get started and will know more as I become immersed in my new role. I am a big proponent of recognizing people’s strengths and what they can do. My career for the last 12 years has been around assisting individuals with maintaining independence and utilizing natural supports. My passion is coaching and supporting others with discovering new goals. My hopes are to assist all program recipients with recognizing their strengths and finding success with meeting their goals and continuing to dream for more.
What CANS or ANSA item do you most identify with?
Christine: The Sleep question is what I identify most with. Good restful sleep is essential in daily functioning and it’s a good indicator to understand the other areas. When I get consistent good sleep, I feel great and feel like I can conquer anything!
Michael: I most identify with Talents and Interests under Individual Strengths. I truly believe that we should continue to be curious with the world around us and to seek to improve our current talents as well as discovering new ones.
What is something that you do for fun?
Christine: Something I like to do for fun is go hiking or to the beach.
What is the last book you read that you enjoyed?
Michael: The last book that I really enjoyed was the “Power of Habit” by Charles Duhigg. I found it to be inspirational and very informative.
In the Dear Collaborative column, we’ll answer YOUR questions about TCOM or the TCOM tools (CANS, ANSA-T, ANSA).
Each newsletter features top questions submitted to the Alameda TCOM Collaborative. If you have an urgent or critical CANS-related question, you can contact your agency's CANS/TCOM Coordinator or one of the Collaborative Members at any time.
Have questions and want answers? Submit your questions through the Contact page and look for the answer in the next edition of Dear Collaborative. Submissions are treated confidentially.
Q1: Are the CANS/ANSA considered Communimetric tools? What the heck does that mean?
A1: According to tool developer John Lyons, Communimetrics is designed to make thinking processes transparent and provide a conceptual organization or framework for the thinkers to be attuned to the relevant factors that must be thought through in any particular circumstance. In other words, a Communimetric tool (like the CANS/ANSA) attempts to delineate common factors in the lives of participants that are important to address, measure, and/or recognize. What makes it a Communimetric tool rather than just a metric tool, is the agreed upon numeric designations that are designed to be easily communicated and understood by all members of the system, creating an enhanced opportunity for collaborating in a shared vision of treatment.
Q2: Why is there so much information on TCOM? What does it mean? Why is it a part of the CANS/ANSA?
A2: TCOM is an acronym that stands for Transformation Collaborative Outcomes Management. TCOM is the philosophy/framework developed to ensure greater collaboration between providers and consumers as well as to enhance the efficiency and effectiveness of services provided in a complex, mental health system. The CANS and ANSA are communimetric (see Q1) assessment tools developed to accomplish the principles of TCOM; it measures transformation change, creates a structure for collaboration, and makes outcomes transparent and quantifiable. Consequently, it is important to focus on TCOM and its greater philosophy in an effort to foster a more in-depth understanding of the CANS and ANSA tools.
Q3: Why are there so many versions of the Alameda CANS/ANSA? How do I know which version to certification test to take?
A3: The different versions of the Alameda CANS/ANSA were created to be slightly different based on the age of the participants being assessed. It is important to note that getting certified in any one version enables a clinician to administer any of the various versions of the assessment. This is helpful for those service providers who work with different age groups.
Here is a breakdown of the currently available tools; each has an available certification test on www.tcomtraining.com:
Esmeralda Gonzalez is the Training Coordinator for STARS Behavioral Health Group. She was recently welcomed as a new addition to the Alameda County TCOM Collaborative.
She is “loving everything the CANS has to offer” and is excited to learn more about how the CANS can enrich the treatment planning process.
Esmeralda’s own children (3 and 6 years old) inspire her engagement in mental health work with youth. She is proud to support direct service staff through advocacy and the development of critical resources.
Esmeralda's superpower is in event planning, which provides an outlet for her creative tendencies. Her crafting specialties include huge paper flowers, backdrops for dessert tables and decorative photo booths. The Collaborative will definitely benefit from the infusion of fun and enthusiasm that Esmeralda brings. Welcome!
A recent picture of the Collaborative membership is below.
Blog content is created by the shared effort of the Alameda TCOM Collaborative members. Send feedback through the Contact page.