Dear Collaborative-CANS/ANSA Frequently Asked Questions (FAQs)

Question 1 (Using CANS in Supervision?):
Dear Collaborative,
I’m a fairly new supervisor and I supervise several new clinicians. I’m not sure how to integrate the CANS into my weekly individual or group supervision meetings. Should we be looking at the CANS together and discussing it or do I just review and approve it when I get one and provide any feedback I have afterward? What do you recommend? I want to do a good job at supporting my clinical team to most effectively use the CANS.
Thanks! -FS

Dear FS,
Thanks for the question. We think the CANS should definitely be discussed in supervision since it’s a collaborative tool! Clinical staff completing the CANS don’t need to hold everything alone; many voices should be a part of determining CANS ratings and discussing treatment goals and progress. The CANS is a great tool to organize information gathered and a great framework for discussing all aspects of cases. We suggest CANS focused discussions be a frequent part of the supervision meetings including looking at progress being made, strengths being developed, and new needs arising. If you’re not sure you’ve got all the skills needed right now to do so or you want to get even better at integrating CANS into supervision, did you know that the Alameda County TCOM collaborative can come to your agency and provide a “CANS and Supervision” roadshow training for you and your team? Just have your program director/team leader reach out to any of the members of the CANS/ANSA Provider Collaborative and we can schedule a training that works with your schedule!

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CANS/ANSA TIP SHEET FOR SUPERVISORS

Schedule a ROADSHOW training

Question 2 (CANS requirements for short episodes of care?):
Dear Collaborative,
For clients whose episode is less than 60 days, what is your policy for doing an initial and closing CANS?  We have staff do one CANS but often with cases that are quicker open/close cases, we don't have enough data to accurately represent them on the CANS.  I know we can fill in 0 for needs items or a 3 for strengths items if we have not identified those needs or strengths items but I'm also cognizant of the data going to the State and all that entails.  Are staff required to do any CANS (either initial or closing or both) for clients who open and close their episode within 60 days?
-BFT
 
Dear BFT,
The short answers is: It depends.  Both an initial and discharge CANS are often still required even for short episodes of care but it is completely okay and understandable if there is not much change between the two.  If a case closes before an initial assessment has been completed then a CANS is not required at all but if an initial CANS is completed (and this includes when the CANS is integrated into in the assessment for some agencies), a discharge CANS is required regardless of the time frame between the two.  Just so you know, if your agency staff enter CANS directly into Objective Arts, you can review the last CANS completed which can give staff a great deal of information that they may not have been able to gather individually with the youth or family.  In addition,  staff can at times auto-populate ratings from the last CANS into the current CANS and then the staff can just make applicable updates based on what information that they have gathered.  Hopefully that will help in these short episodes of care. Also, sometimes it can help to shift the focus away from "How do you rate this?" to "What did you and your client decide were actionable needs?" and that completing the CANS is an opportunity to document the current actionable priorities in their life (regardless of the service provider involved).
 
Question 3 (Monitoring Semi-annual CANS Completion?):
Dear Collaborative,
How can we track and ensure completion of semi-annual CANS or ANSA at the 6-month points between utilization reviews?
-SW
 
Dear SW,
For agencies who enter CANS and/or ANSA directly into Objective Arts (OA), a staff or supervisor can easily run a "Tickler Report" to see upcoming due dates for CANS/ANSA and this includes indications when a CANS/ANSA is overdue.  For agencies with staff who enter the CANS/ANSA in their own Electronic Health Records (EHRs), some agencies have:

• Created their own "Tickler Report" in their EHRs;
• Programmed the EHR to automatically lock people out of writing progress notes if a CANS has not been completed; and/or
  
• Set up their system to flag overdue items in red so that supervisors can monitor and address outstanding documents.
  

Some agencies (regardless of where they input their CANS) conduct a brief semi-annual chart review in order to track CANS/ANSA completion along with other intra-cycle requirements.