Youth enrolled in Coordinated System of Care (CSoC) are required to complete a standardized assessment to support clinical eligibility determinations. The assessment includes the Child and Adolescent Needs and Strengths (CANS) Comprehensive and the Independent Behavioral Health Assessment (IBHA). It is completed within the first 30-days of referral and every 180-days thereafter as part of a face-to-face interview with the youth and their primary caregiver. The assessment is then used by the youth’s Child and Family Team (CFT) to determine what behavioral health and substance use needs are addressed as part of the youth’s individualized plan of care (POC).
In CSoC, Wraparound Agencies (WAAs) oversee the end-to-end process for administering assessments. They are responsible for ensuring the assessments are completed timely and administered by qualified Licensed Mental Health Professionals (LMHP) with current CANS certification through the Praed Foundation. Further, the WAAs are responsible for ensuring all behavioral health service providers on the youth’s POC have an electronic copy of any assessment and POC completed throughout the youth’s enrollment in CSoC. You can find this along with other pertinent guidance about CSoC in the CSoC Standard Operating Procedure Manual.
At Magellan, we encourage all providers working with CSoC members to actively participate in the CFT meetings, which generally take place every 30 – 45 days, and to use this comprehensive assessment to guide and inform treatment planning. This will ensure that you are working with the youth and family to address the actionable needs identified on IBHA and CANS, while providing services in the type, frequency, duration and amount specified in the youth’s POC.
A copy of the current IBHA, CANS and POC is required to be in a CSoC member’s treatment record. If you do not have these documents for a CSoC youth you are working with, please contact your regional WAA to access a copy.
Here is a brief description of the assessment tools used in CSoC and links for more information.
The CANS is a multi-purpose tool developed to support care planning and level of care decision- making, to facilitate quality improvement initiatives and to allow for the monitoring of outcomes of services. The CANS was developed from a communication perspective in order to facilitate the linkage between the assessment process and the design of individualized service plans including the application of evidence-based practices. Domains assessed through the CANS include: child emotional and behavioral needs, risk behaviors, developmental functioning, personal/interpersonal functioning, and family functioning. The CANS is an open domain tool. The copyright is held by the Praed Foundation to ensure that it remains free to use.
The IBHA is a supplementary psychosocial assessment completed with CANS Comprehensive. It provides a narrative description of the youth’s behavioral health history and current mental status. It includes finding from the CANS Comprehensive, medical records, objective evaluation of functional ability and any other available records.
Screenings are informal symptom checks, such as checklists or questionnaires, that can be used to as part of an assessment or at different points in treatment to measure progress. They ask an individual to consider if they have recently experienced feelings and/or behaviors that are related to a particular mental health disorder. Screening tools are easy to understand and can help provide a common language between a client and a provider when discussing symptoms.
We pulled together a few screening tools available to the public that can be helpful when working with CSoC youth and families. Please note that practitioners and providers should implement established procedures to guide and support the appropriate use of these or any screening tools.
- Patient Health Questionnaire 9 (PHQ-9) – This brief 9-question tool can be used with youth 12 and older to screen for the presence of depressive symptoms within the past two weeks to determine whether further evaluation/treatment is needed. The PHQ-9 is also available in Spanish.
- Mood and Feelings Questionnaire – Short Version (MFQ-SV) Child Version – This screening tool includes 13 questions to assess how a youth has been feeling or acting during the previous two weeks. This simple questionnaire is phrased in simple terms that are easily understood by children aged 11 and younger. There is also a Parent Version available available for use by the youth’s guardian when deemed clinically appropriate. Translations of the MFQ can be requested in Spanish, Portuguese, Norwegian, German, Finnish, Filipino, Arabic-Iraq and Arabic-Modern Standard from Duke University.
- The Adverse Childhood Experience (ACEs) survey – The ACEs survey is a brief 10-question screen that can help youth and families identify childhood events that could be associated with trauma. It is also available in both child and parent/caregiver versions. The goal of the ACEs is to increase awareness about of how these experiences may negatively impact the youth’s long-term behavioral and physical health. The ACEs survey is also available in Spanish. **Please note the Spanish version has the same questions as the English version; however, they are presented in a different order.**