Frequently Asked Questions about Using the CBHI CANS Application on the Virtual Gateway, the Paper CANS, and CANS Content and Data Use Questions about the CBHI CANS application on the Virtual Gateway 1. What is the CBHI CANS application? EOHHS developed the Web-based CBHI CANS application (referred to as “the application”) to permit providers to enter and view CANS data in a secure environment, and to transmit CANS data to MassHealth. The application is accessible through EOHHS’ Virtual Gateway Web portal. To enter the application for the first time, providers must have a valid CANS certification key. The application is generally available around the clock, seven days a week. When routine maintenance is needed, it will ordinarily be scheduled at night between 7 P.M. and 7 A.M. Since the application relies on other running business applications (such as MMIS) for certain functions, maintenance of other applications may sometimes bring the application offline. 2. When do I start to use the application for my CANS data? You should be using it now! The application has been available since 2009, and MassHealth regulations require providers to use the application each time CANS is completed or updated. MassHealth requires its MCEs to ensure that the application is used each time CANS is completed or updated. Demographic and SED data must be entered without requiring consent. Subject to client consent, providers must enter the entire CANS assessment data into the application. (For more information on the consent process, see the FAQ on Requirement, Billing and Consent, Questions about Client Consent.) 3. How do I get access to the application? To access the Virtual Gateway and the application, your provider organization must execute a Virtual Gateway Services Agreement (VGSA) and designate an Access Administrator who will administer individual account access on behalf of your organization. The Access Administrator must request a Virtual Gateway User ID for each provider (Certified Assessor), clerical staff person (Data Entry Operator), and organizational administrator (Organization) who will be entering and viewing data in the application. These security roles are explained in more detail below. (See “Who at my organization is authorized to see the information entered into the application?”) If you are in private practice, you must register with the Virtual Gateway to execute a VGSA and become designated as an individual Access Administrator. To assist your organization in the process of being granted access to the application, please send the following information to VirtualGatewayCBHI@state.ma.us * name of your organization; * name, address, phone number, and e-mail address for a CANS point of contact for your organization; * Whether your organization already has access to the Virtual Gateway Web portal; * the number of providers or data entry operators who need access to the CANS tool; and * whether anyone from your organization has completed the CANS tool-assessment training, and, if so, the number of individuals who have completed training. If you have any comments or concerns, please send them to VirtualGatewayCBHI@state.ma.us. 4. What support is available for end-users of the application? The Reference Guides listed below are all are available on the CANS section of the CBHI website (www.mass.gov/masshealth/cans). Click on Using the CANS on the Virtual Gateway to access all of these guides). * Virtual Gateway Login Assistance: CANS is accessed through the Virtual Gateway. Review this job aid first to learn how to access and log in to the Virtual Gateway. * CBHI Certified Assessor: This Reference Guide explains to providers how to use and navigate the functionality of the application that is available to CAs. * CBHI Data-Entry Operator: This Reference Guide explains to data-entry operators (DEOs) who enter information into the application on behalf of providers how to use and navigate the functionality of the application available to DEOs. * CBHI Organization: This Reference Guide explains to case managers and provider organization supervisors/administrators how to view specific member details within the application that is available in the organization role. * Virtual Gateway Customer Service: This reference guide explains to all users how to reach Virtual Gateway Customer Service. * Export/File Import to MS Excel: This reference guide explains to all users how to export and import CANS data to MS Excel. * (Online Tutorial) Learn how a CBHI Data Entry Operator adds a SED/CANS Assessment: This provides DEOs with an easy, interactive online lesson that steps them through adding a CBHI SED/CANS Assessment. * (Online Tutorial) Learn how a CBHI Certified Assessor edits a SED/CANS Assessment: This provides certified assessors with an easy, interactive online lesson that steps them through activating their Certification Key and how to edit a CBHI SED/CANS Assessment. If you don’t find the help you need in these resources, you may contact the VG Customer Service group Monday-Friday 8:30 A.M. to 5:00 P.M. at 800-421–0938 (TTY (617) 847-6578 for individuals with partial or total hearing loss). Please leave a voicemail if calling after hours. 5. Will new functionality be added to the application? CBHI periodically updates the application to fix defects or to add new features. Input from users is very important in alerting CBHI to problems and in establishing priorities for development of new features. Please contact CBHI with any suggestions about how to improve the application, at cbhi@state.ma.us 6. Where can I get additional help with using the application? If you need technical assistance with the Virtual Gateway, you may contact the Virtual Gateway Customer Service group Monday-Friday 8:30 A.M. to 5:00 P.M at 800-421–0938 (TTY (617) 847-6578 for individuals with partial or total hearing loss). Please leave a voicemail if calling after hours. Questions about security roles and about the organization’s Access Administrator 1. Who at my organization is authorized to see the information entered into the application? Access to information in the application is based upon security roles. A person’s security role governs what information that person can see, as well as his or her ability to enter or change information, to generate reports, or to export information from the application. The application is designed to be compliant with the Health Insurance Portability and Accountability Act (HIPAA) and other statutory and regulatory requirements that protect individual privacy. All security access occurs through the Virtual Gateway. An individual’s role is determined by his or her organization once the organization has signed a Virtual Gateway Services Agreement, requested a Virtual Gateway ID for the individual, and enrolled the individual with the Virtual Gateway for the application by choosing a CBHI security role for him or her. Organizations can assign the following three security roles to an individual: * Certified Assessor (CA): This role is for providers who are certified to use CANS. The application validates the CA’s certification status by requiring entry of a certification key the first time the CA uses the application. CAs can initiate and submit records in the application. For each record they submit, they must certify that the CANS is “complete” or (if unable to complete the CANS) “incomplete but final.” * Data Entry Operator (DEO): This role is for clerical or administrative staff who work at a provider organization. DEOs can initiate records on behalf of CAs within the same provider organization. The DEO must identify the specific CA for whom they are entering data. If a DEO initiates a record on behalf of a CA, the CA must eventually access the application and certify the CANS is “complete” or “incomplete but final” or order for it to be submitted. * Organization: This role is for supervisory staff within a provider organization. A person in this role may view CANS data entered by CAs and DEOs at the organization, but may not enter information. (Some organizations may enroll themselves with the VG as having multiple clinics or sites, in which case they may choose to limit access of this role by site. In that event, the individual will be required to select one site before entering the application.) 2. Who in an organization must notify the Virtual Gateway of any changes in a user’s status or security role? Every provider organization has at least one person designated as an Access Administrator (AA). The AA is the person who contacts the Virtual Gateway to enroll new users (when a person joins the organization and needs to be set up, for example, as a Certified Assessor or Data Entry Operator). 3. What is the function of the Virtual Gateway User ID? A Virtual Gateway User ID (Username) provides access to the application and is specific to each individual at that provider organization. If a user works at multiple organizations, he or she will ordinarily have just one username and will choose the appropriate organization when logging in. A user working for multiple organizations must apply (through the organization’s AA) for access to the application at each organization. 4. What is the process when a user leaves a provider organization? When a user is no longer employed by a provider organization, the provider must notify the AA of the organization so that he or she can immediately remove (deactivate) the user from the Virtual Gateway active list. If a user works for more than one provider organization, the user will have a single username but have options to choose more than one organization when they log in. Deactivating the user from one organization will not remove his/her access from the other organization(s). 5. Why is it so important to deactivate users? By failing to deactivate users who should no longer have access, your organization would create a serious privacy risk for MassHealth members, analogous to allowing ex-employees to retain keys to your records room. 6. What is the CANS Training ID? The CANS Training ID, which is different from the Virtual Gateway user ID, provides access to the MassCANS Training and Certification Web site where providers can register for and take training for certification in CANS. Additional CANS-related information and support is also available on this site. The CANS Training ID stays with the provider and never changes. 7. What is the CANS Certification Key? A CANS Certification Key is provided to providers upon successful completion of CANS certification. The key number never changes and it stays with the provider if he or she changes organizations. A user‘s CANS certification key is contingent upon current certification. To access your Certification Key number at any time, go to the CANS training website at masscans.ehs.state.ma.us, log into your CANS Training record and click on “Edit My Information” on the right side of the screen. Your certification key will appear near the top of the page. If you need assistance you may send an e-mail to the MASSCANS training program at: masscans@umassmed.edu 8. Does MassHealth keep a record of access to CANS records? Yes. The application logs all access to CANS records, which are classified as Protected Health Information (PHI) under HIPAA. It documents any time any user accesses individual information in the application for any purpose. 9. Who else is authorized to see the information in the application? In addition to the access described above, MCEs and EOHHS MassHealth/CBHI) have additional access for security purposes. * MCEs: This allows appropriate individuals within an MCE to view data for members enrolled in that MCE. This role does not permit entering of information. * MassHealth/CBHI: This allows certain individuals at CBHI and MassHealth to view information in order to manage and improve services, monitor implementation, or to comply with other requirements. Access to the application by these security functions is documented in a permanent audit log, the same as with all other security Roles. Note that other state agencies do not have access to data in the application. Questions about the “paper CANS” documents 1. What is the “paper CANS”? MassHealth provides a printable “paper CANS” form on the CBHI Web site (www.mass.gov/masshealth/cbhi). Select Child and Adolescent Needs and Strengths (CANS) (www.mass.gov/masshealth/cans) and then CANS Forms. The “paper CANS” is a long form, available for both MassCANS tools (“Birth through Four” and “Five through Twenty”), which includes complete item descriptions, and a short form “rating sheet” (“bubble sheet”). * The long form is helpful for people who are not very familiar with the CANS, because it explains the meaning of each item. The long forms are designed to be completed on paper, and are available in both rich-text format (RTF) and non-editable PDF format. * The short form “ratings sheet” indicates the items by name only. The ratings sheets can be filled by opening them on your computer, and can be saved electronically. They are available in RTF format and in editable PDF format. Both the long and short forms include space for narrative at the end of each domain, to allow you to capture information that would not be clear from the item ratings alone. Supporting documentation such as CANS User Guides may also be downloaded from the CBHI website. Go to Child and Adolescent Needs and Strengths (CANS) (www.mass.gov/masshealth/cans) and then click on Clinical Guidance on the CANS to download CANS User Guides. 2. Since providers can enter CANS data into the application, what is the purpose of the “paper CANS” documents? If a member declines to give consent to enter all CANS information into the application, then the provider must complete CANS on paper and retain it as part of the medical record. (And remember even when consent is not given, the provider must still enter some member information into the application). 3. I understand that CANS must become part of the medical record. Am I required to keep a filled-out paper copy of CANS, or may I keep it in electronic form? You may keep it in either paper or electronic form. The application will automatically generate a copy of your member’s CANS in the form of a PDF file, which you can print out to keep for your records. If the member does not consent to having CANS information entered into the Web-based system, then the provider must keep a paper record of the CANS. 4. I want to put some additional information onto the paper CANS form to conform to my medical record policies. Is that permitted? Yes, as long as it preserves faithfully the substance of the documents. This includes all of the SED section verbatim, all the demographic information, the names and order of CANS domains and items, and any item content, along with space for the narrative sections (text boxes) following each domain. You must also preserve the CANS copyright information. You may alter the formatting to meet your organization’s standards and unique needs. CBHI has published the paper version of CANS in rich-text format to permit provider customization. 5. What happens if EOHHS/CBHI revises MassCANS? The CANS may evolve over time. Any EOHHS/CBHI revisions to CANS will be simultaneously implemented in the application and posted on the CANS website (www.mass.gov/masshealth/cans) under CANS Forms. While CBHI will actively publicize any updates, the provider is responsible for checking the Web site periodically to ensure the use of the current version. 6. How do I update CANS in the application? It is easy to update CANS in the application by using the ”copy” feature to make a copy of the previous CANS. Then you edit any data elements that have changed. The update is finished when the record is finalized by the Certified Assessor as either “Complete” or “Incomplete but final.” 7. How do I update CANS that has been filled-out on paper? Do I need to print out a blank copy and fill it in? Yes. If the member does not consent to having CANS information entered into the application, then the provider must update the CANS on paper. Questions about CANS content and data use 1. CANS includes a section on Race, Ethnicity, and Language (REL) information. Why is collecting REL information important? It is important to collect REL data because knowing who CBHI is serving is a way for MassHealth to ensure that all MassHealth members have access to medically necessary behavioral health services. Massachusetts has the seventh-largest immigrant population in the United States. Nearly one-quarter of Massachusetts children are children of immigrants. Consistent data collection in these areas will help us address health care disparities by improving the planning, delivery, monitoring, and evaluation of services and programs. Key to our efforts is that data must be collected consistently, accurately, and professionally. For more detailed information, go to www.mass.gov/masshealth/cans and click on Clinical Guidance on the CANS and refer to the posted REL Information documents. 2. How can I use CANS data in my daily practice? CANS can assist you to develop goals and interventions specific to the child and the family. CANS capitalizes on identified strengths to address specified needs, thereby easing the treatment planning process with families. Sharing CANS is a great way to communicate key information to team members and collaterals. In addition, you can share CANS with members and their families to track progress on the CANS items they have identified as high priorities. Provider agencies can download their accumulated data from the CBHI CANS application on the Virtual Gateway to use for their own purposes in supervision, program management, program planning and evaluation, and in making an evidence-based case for support to their donors and funders. In addition, MassHealth and its Managed Care Entities use CANS data to enhance care at all three levels: incorporating CANS information into the process of authorizing care for a child or youth, working with providers around management of quality and outcomes, and designing and improving the overall system of interrelated services in conjunction with other child-serving state agencies and initiatives. MassHealth is just beginning to analyze CANS data from all levels of care; over time, CBHI will be able to use the rich information that CANS provides to understand which youth are getting which services, and with what outcomes. 3. Where can I get additional information about CANS? For other questions, contact the Children’s Behavioral Health Initiative at cbhi@state.ma.us. Revised (03.05.12) - 1 -