Title: CANS NEWS logo

“News for the CANS Community” 
Volume 3, Number 2 - December 2012 

Supporting a New Way of Serving Children and Families 

 

As readers of this newsletter probably know, Children’s Behavioral Health 
Initiative (CBHI) is about system transformation – part of a broad effort by 
EOHHS to shift towards services that are more family and youth driven, 
culturally informed, collaborative and integrated, and guided by outcomes and 
evidence. In 2008, Massachusetts adopted the CANS for use in virtually all 
Medicaid-funded behavioral health services for children ages birth to 21, in 
compliance with the Rosie D. court order. What does the CANS have to do with 
the vision of CBHI? 

Dr. John Lyons, the developer of the CANS, tells us that when it is initially 
implemented, providers view the CANS as just a form to fill out. After some 
experience, they begin to see it as a useful tool for communication 
and collaboration. Finally, in the most developed phase of using CANS, providers 
understand how CANS supports a new way of serving children and families – a 
system transformation. Typically, the transition from seeing the CANS as a form 
to using it as a tool and moving toward system change takes several years. In an 
implementation such as Massachusetts, where CANS adoption involves thousands of 
clinicians, hundreds of agencies, multiple managed care entities, and many 
levels of care, this transition takes longer. 

In this edition, you will learn about a wide range of exciting targeted efforts 
for the upcoming year that will help bring us closer to meeting compliance 
standards and transforming our behavioral health system to better serve 
children and families in their communities. Your participation is critical. In 
the near future we will be reaching out to providers to talk about ways you can 
help inform these next steps. Thank you for your continued efforts to use the 
CANS in your work to help children and families meet their treatment goals. 

CBHI Mission - The Children’s Behavioral Health Initiative (CBHI) is an 
interagency initiative of the Commonwealth’s Executive Office of Health and 
Human Services. Our mission is to strengthen, expand and integrate Massachusetts 
state services into a comprehensive community-based system of care to ensure 
that families and their children with significant behavioral, emotional 
and mental health needs obtain the services necessary for success in home, 
school and community. 

 

 

 

 

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Commonwealth of Medicine logo
CBHI logo
UMass Commonwealth Medicine Logo
CANs News logo

Table of contents
Table of Contents 

Supporting a new way of serving children and families…………………..1 

How does the CANS support the vision of CBHI……………………………...2 

Consent Changes Underway…………………………………………………………...3 

CANS Training Program - Looking Forward……………………………………..3 

CANS Technology Buzz…………………………………………………………………...4 

Did You Know………………………………………………………………………………….5 

CANS Contacts…………………………………………………………………………………6 


How does the CANS support the vision of CBHI? 


• CANS is family friendly – designed to be completed by the clinician as part of 
an ongoing, vital discussion with the family and youth about their strengths and 
needs. Printing the Brief CANS Summary (the two-page summary you can print from 
the Virtual Gateway) gives you a good document for discussing progress and plans 
with families. 
• CANS supports culturally informed practice, asking you to discuss and document 
Cultural Considerations that will affect how the youth and family use services 
and supports. 
• CANS is designed for collaboration, to provide a common language for talking 
about needs and strengths with families across providers and state agencies. New 
IT improvements planned for 2013 will allow providers, with consent, to access 
and copy CANS created by other providers for the same youth, saving provider 
time and effort and making collaborative use of the CANS much easier. 
• Finally, CANS supports outcome-based practice. In discussions with youth and 
family and in clinical supervision, CANS items provide a way to track the most 
important issues identified by the youth and family. Closely tracking progress 
may help to avert dropouts and keep treatment focused on key issues. 


In collaboration with families and providers, CBHI and related initiatives at 
EOHHS agencies are bringing us a long way toward an integrated system of care, 
but we’re not at the end of the road. As we enter the fifth year of CANS 
implementation, CBHI plans to improve the effective use of the CANS through 
three new developments: 

• Making it easier for clinicians to share CANS information and data across 
providers on the Virtual Gateway through an enhanced consent process. 
• Making it easier for clinicians to display and interpret their clients’ data 
through the use of an improved reporting tool. 

• Identifying and developing new training and certification approaches that 
focus on CANS use in clinical practice within the framework of CBHI’s values. 

 

 

 

 

A collaborative effort of CBHI and 

UMass Medical School 

 

Send your comments and suggestions 

about this newsletter to: 

CANSnews@state.ma.us 

 

Newsletter Coordination 

Deborah McDonagh & Gretchen Hall 

Design, Layout & Production 
Lena Riccardi 

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Consent Changes Underway 

 

CBHI recognizes that families and providers want assurances that their 
information is highly secure, while being accessible to specific providers who 
are working together to deliver treatment and services in a timely 
manner. As a result, CBHI is developing a revised consent form that will be 
adopted late in 2013. The new form will be more easily understood and more 
family-friendly. It will also incorporate a change in the scope of consent that 
will allow clinicians to save time and effort and make it easier to use the CANS 
collaboratively in everyday practice. 

The new consent procedure will allow providers to use the Virtual Gateway as a 
platform for sharing the CANS across providers when consent is given. Providers 
have consistently told us this would make the CANS a more useful tool. The new 
consent form will provide the basis for a broader process of sharing information 
with user-friendly language for families and providers alike. This change will 
require extensive IT development and is on track to be in place by the end of 
2013. It will also require that all old consents be replaced with new consents. 
As the transition point approaches, we will provide extensive notice and 
education to providers, so the change brings a minimum of confusion or distress. 

Sharing CANS across providers is particularly important for children who are in 
multiple levels of care or have changing levels of care over the course of 
treatment. For example, a child receiving Outpatient treatment may 
also be receiving In-Home therapy or ICC. Sharing across these levels will 
reduce time spent in assessment and will enhance communication around treatment 
goals and progress. If a child goes into CBAT or inpatient, the provider in the 
24-hour service will be able to view and copy the CANS previously created by 
other providers. 
On discharge, the CANS from the 24-hour level of care will be immediately 
available to the aftercare providers. 
If the caregiver gives consent to all the providers, all authorized parties will 
be able to communicate efficiently with each other to build a process that 
reflects a comprehensive understanding of the child’s needs and strengths. 

CANS Training Program – Looking Forward 

Since its initial launch of the CANS certification training in 2008, over 10,000 
professionals have become certified using the Mass CANS training and 
certification program. Now, as we enter the fifth year of CANS implementation, 
the Training Program is embarking on an evaluation of CANS training, 
certification, and post certification support. 

The training evaluation will involve a review of the on-line CANS certification 
training, the CANS certification test, and the post-certification support 
materials. Preparation for re-certification will also be considered with an 
eye toward redesign. We are particularly interested in developing a “toolbox” of 
resources to help clinic supervisors and trainers inform, motivate and train 
staff at all levels of care to improve the quality of CANS practice. 

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CANS Training Program – Looking Forward Continued from page 3 

Provider and MCE input will be essential in this redesign, which will also 
incorporate information about the new CANS sharing and reporting options that 
are coming in 2013. The CANS Training Program will be reaching out to providers 
and MCEs for input on improving training and support. We’ll seek provider input 
through a combination of phone interviews, online surveys, and focus group 
sessions. 

As the Training Program conducts its review, we will focus especially on 
improving CANS utilization for outpatient providers, who treat more children and 
families than providers at other levels of care. One way to provide needed 
training and technical assistance to this important group of providers is 
through CANS initial training, topic-specific training, and biannual 
recertification activities. 

Ultimately, the primary purpose of this evaluation is to make CANS training more 
effective in helping providers use the CANS in everyday practice. The revised 
online training will include updated materials and user-friendly learning 
technology to support using CANS in practice in ways that encompass CBHI values 
and Wraparound principles of care. 

 
CANS Technology Buzz 
 

Significant efforts are underway that are focused on two major endeavors. First, 
work is in progress to get the new consent form operational. CBHI is developing 
a revised consent form that will be more easily understood and more family-
friendly. It will also save time and effort, make it easier to use the CANS 
collaboratively, and allow clinicians to share CANS information with other team 
members providing services. 

The second important technical effort underway is the development of a CANS 
reporting application that will allow providers to have quick, easy, and 
immediate access to the CANS data on their clients. This will allow 
providers to visualize and document an individual child’s progress over time in 
treatment, as reflected in the CANS data. Providers will be able to view ratings 
and changes for an individual child over time, identify areas of improvement, 
and better understand the needs over time. This project is complex and it is 
anticipated that the reporting application will be available at the end of 2013. 


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Did You Know . . . 

. There is a link on the CBHI website which includes a chart of the top five 
reasons why CANS users call the VG Helpdesk and the CANS Training Program 
Helpdesk. This chart provides solutions and resources for resolving these 
frequently asked questions: 
http://www.mass.gov/eohhs/docs/masshealth/cbhi/cans-vg-troubleshooting.pdf 

. You can Save time and Copy! You don’t have to Re-enter CANS data when 
performing the 90-day re-assessment. Copy the previous record and then edit it 
to update only those questions (and text fields) that reflect any clinical or 
life changes that have occurred since the previous CANS. This also works if the 
child or youth has a CANS assessment entered at another level of care within 
your organization. When the new consent form is released, you will also be able 
to use the copy function in the CANS to share data across providers. 

. There is a “Save and Next” work-around for a defect in the CANS Application 
If you have encountered a known defect within the CANS Application known as the 
"Save and Next” issue, here is a quick “work-around” to the problem. If you are 
stuck in the domain after clicking “Save and Next” (it doesn't go on to the next 
domain), and the green checks on the left disappear, it is possible that 
clicking more than once on “Save and Next” will exacerbate the problem. So, try 
(!) to resist the impulse to do that. 
Not all MassHealth IDs are affected, so if you have trouble with child A you may 
be fine with child B. Until this is fixed, the following workaround may work for 
you: 

Using the mouse and the navigation bar on the left of the screen, navigate to 
“SED Determination”. Click “Save and Next”. The green checks should reappear and 
you should be able to navigate to the section you want. Always use the mouse and 
navigation bar for navigation (not the browser's back button, as that will 
cause problems). 

 
If this work-around does not work for you, you might have success logging out 
and logging in again. Be sure to close all browser windows and reopen Internet 
Explorer before logging in again. We recommend clearing your cookies and cache 
(deleting temporary Internet files) in your browser if the application 
responds slowly. CBHI apologizes for this inconvenience and the time you may 
need to spend on this issue, which we will eventually resolve. Please note that 
not all MassHealth IDs are affected, so if you have trouble with child A, you 
may be fine with child B. 

Don’t forget that you can always contact CBHI at CBHI@state.ma.us if you have 
questions about the CANS application. 

CANSNews provides a rich resource for support in CANS implementation. Many of 
the articles in earlier editions are still timely and informative, so we 
encourage you to use this resource for you and your staff at all 
levels. View all past issues of CANSNews are available at the CBHI website. 


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CANS Contacts

Children’s Behavioral Health Initiative 

. Mailbox: CBHI@state.ma.us 
. CBHI Website; choose on the CBHI logo located in the bottom left-hand column 


MassHealth Customer Service Center 

. Tel: 800-841-2900 
. TTY: 800-497-4648 


CANS Training Program 

. Tel: 508-856-1016 
. Mailbox: masscans@umassmed.edu 
. CANS Training Website 


Virtual Gateway Customer Service 

. Tel: 800-421-0938 
. TTY: 617-988-3301 


The University of Massachusetts Medical School is the contracted provider for 
MASS CANS Training and Certification for the Children’s Behavioral Health 
Initiative (CBHI) of the Massachusetts Executive Office of Health and Human 
Services. 

 

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