Implementing CANS/FAST: Casey’s Practice Base Experience

Ada Lopez MAChild Welfare Supervisor

Vanessa Carrillo MSWChild Welfare Social Worker

Tina Stern MSWPractice Advisor

Child & Family Services

Casey Family Programs | An Overview

• Started in 1966 as a Direct Service Agency

• Mission: to provide and improve – and ultimately prevent the need for – foster care

• Operate 10 sites in 5 states that deliver supplemental child welfare services

• Strategic Consulting, ICW and Public Policy work across the country

• Achieving 2020: Building Communities of Hope

Casey Journey | CANS & FAST

• Selection of the instruments• Embracing Transformational Collaborative

Outcomes Management (TCOM) • Embedding in the electronic case

management system• Training and development of staff• Completion via multi-disciplinary team

Developing the Child and Adolescent Needs and Strengths (CANS) for Casey

• Specific domains include:– Traumatic/Adverse Childhood Experiences– Strengths– Life Domain Functioning – Development– Culture – Behavioral/Emotional– Risk Behaviors– Children Under Five– Transition to Adulthood – Caregiver Resources and Needs

• Total of 122 items

Developing the Family Advocacy & Support Tool for Casey

• Domains • New Family

Together strengths • Update to electronic

case management system

• Consultant role

Successes:• Conversations during the training

and group discussions about ratings

• Explanations on how to rate- actionable item or not (1 vs.2)

• Explanations to the rating during the training session

• Utilizing in clinical to practice• Clickers during the training• Organization chooses the items

that are relevant to their population- tool allows for customization to fit specific organizational needs

• Narrative boxes and keep a running tab of updated dates will help tell the story.

Challenges: • More people in the new hire

training would have been more helpful

• Discussions as to individual ratings vs the actual rating

• Some trainers did not know why things were rated their rating- trainers should have accurate information on the suggested rating

• Time consuming at first- • Vignette world vs real world

Where are we at now:

• Still utilizing the reference guide• Still need reminders referencing 3 for strengths and 0 for needs for no

evidence • Our system requires to update every 90-days however no reminders to

update and approve• Explanation of CANS with families and their ratings• Recertification and the need for fidelity • Still difficult to implement with younger children• The ratings are not black and white- can be left for interpretation

Next Steps | Implementation

• Coaching– Provide coaching during this period and learn from

successes and challenges• Plan for continued staff development

– Ongoing coaching and supplemental training (family engagement, substance use etc.)

• Ongoing CANS/FAST certification• Practice integration (Consultation & Information Sharing

Framework (CISF) and Neurosequential Model of Therapeutics (NMT)

• Evaluation

Questions & Dialogue