1 eWiSACWIS and Levels of Care Jónelle Brom, OHC Specialist Jenny Weber, eWiSACWIS

2 CANS Child and Adolescent Needs and Strengths

3 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

4 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.

5 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.

6 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

7 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

8 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

9 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 3 rd through January 7 th  January 12 th through January 14 th

10 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

11 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

12 Learn More about the CANS Visit the Praed Foundation at:

13 Foster Care Licensing Standard 1-Background Checks 2-Physical Plant Checks 3-Assessment Process 4-Designated Non-Safety Related Regulations for Exceptions for Licensed Relatives Levels of Care Description Level 1 Child-Specific Foster Care Level 2 Basic Foster Care Level 3 Moderate Foster Care Level 4 Specialized Foster Care Level 5 Exceptional Foster Care

14 Placement Complexity Matrix Placement Options Child ’ s LON Foster CareGroup HomeResidential Care Center Provider ’ s Certification Level 1212 Child-Specific 1 Basic 2 3 ModerateBasic 3 4 SpecializedModerate 4 5 ExceptionalModerate 5 6 Specialized 6 Step-down levels to be used for transition planning. Placement of children in these levels is not appropriate.

15 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.

16 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

17 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

18 Creating a CANS

19 Creating a CANS

20 CANS - Child/Youth Needs

21 CANS - Child/Youth Needs

22 CANS - Child/Youth Needs

23 CANS - Child/Youth Strengths

24 CANS - Current Caregiver

25 CANS - Current Caregiver (In Home)

26 CANS - Identified Permanent Resource

27 CANS - Identified Permanent Resource

28 CANS - Actionable Items

29 CANS - Actionable Items

30 CANS - Actionable Items

31 CANS - Results

32 CANS - Results

33 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

34 Desktop View

35 Additional CANS Information 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

36 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

37 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

38 Licensing Page

39 Edit Licensed Services Page

40 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

41 LOC Read Me

42 LOC Summary

43 LOC Overdue Next 30 Days

44 Withdrawn Applications

45 Withdrawal Reasons

46 Withdrawn Application

47 LOC Completed Process

48 Completed Applications

49