FY16 Data Review Completed CANS-F Assessments by Jurisdiction, FY16 - PowerPoint PPT Presentation

Child and Adolescent Needs and Strengths - Family Version for In-Home Services (CANS-F) FY16 Data Review

Completed CANS-F Assessments by Jurisdiction, FY16 Jurisdiction Number of Families Number of Caregivers Number of Youth with at least one with at least one with at least one CANS-F Assessment CANS-F Assessment CANS-F Assessment Allegany 189 263 392 Anne Arundel 528 856 1109 Baltimore City 688 756 1422 Baltimore County 542 892 1156 Calvert 95 151 203 Caroline 53 90 120 Carroll 180 284 364 Cecil 191 255 387 Charles 176 238 419 Dorchester 114 143 267 Frederick 307 443 656 Garrett 42 55 85 Harford 108 143 227 Howard 144 203 303 Kent 32 43 68 Montgomery 224 312 441 Prince George’s 548 629 1178 Queen Anne’s 43 65 79 Somerset 58 82 137 St. Mary’s 144 194 331 Talbot 50 67 106 Washington 295 424 618 Wicomico 117 161 263 Worcester 159 261 360 Families/Caregivers/ Youth 5,027 7,010 10,691 Total # of Assessments 7,906 10,905 17,015

Change Over Time • In-home families that completed a CANS-F at two different time points were examined to determine any changes in youth, caregiver, and family well-being. • Initial and end of service assessments were selected for mandatory needs and strengths sections of the CANS-F (family functioning, caregiver advocacy, caregiver assessment, and child functioning) • Since non-mandatory sections of the CANS-F (child behavioral/emotional needs and child risk behaviors) are filled out less frequently, the earliest and latest assessments were used, regardless of time frame.

Change Over Time • Needs were calculated by creating sectional scores (items were aggregated using the full range of responses 0-3), with scores reflecting both actionable and potential needs (scores of 1). – Maximum score for a scale with 10 items = 30 • Strengths were assessed based upon counts of items (a strength was either present or not). – Maximum strengths for a scale with 10 items = 10

Family Service Breakdown Among Families with an Initial and End of Service CANS-F Service Type (n=849)* Service Type (n=602) Average Length 13% of Stay (days)^ 12% Consolidated In-Home 75% 189 Family Services Interagency Family 147 Preservation Services Services to Families with 157 Children - Intake Consolidated In-Home Family Services Interagency Family Preservation Services Services to Families with Children - Intake *Service types and length of stay are linked from a separate data file. ^Since some cases are only opened briefly to pay a bill; or had Some families were not able to be linked to a specific service, or not been closed out, length of stay includes families served changed services, and are not included in the pie chart above. between 30 and 365 days.

Family Functioning 10 Need Items, 10 Strength Items Needs and Strengths at Initial % of Family Change - Needs and End of Service (n=949) (n=949) 6.00 5.02 5.00 Improved (Fewer Needs) 23% 4.00 Declined 3.11 (More Needs) 61% 3.00 15% No Change 2.00 1.57 1.48 1.00 0.00 Needs Strengths Initial End of Service

Caregiver Advocacy 9 Need Items, 9 Strength Items Needs and Strengths at Initial % of Family Change - Needs and End of Service (n=949) (n=949) 3.00 2.47 2.50 Improved (Fewer Needs) 2.00 1.60 Declined 1.46 46% 1.41 42% (More Needs) 1.50 No Change 1.00 12% 0.50 0.00 Needs Strengths Initial End of Service

Caregiver Assessment 12 Need Items, 5 Strength Items Needs and Strengths at Initial % of Caregiver Change - Needs and End of Service (n=1,246) (n=1,246) 4.50 4.13 4.00 3.50 Improved 3.10 (Fewer Needs) 3.00 Declined 31% 2.50 (More Needs) 49% 2.00 No Change 1.50 20% 0.90 0.87 1.00 0.50 0.00 Needs Strengths Initial End of Service

Child Functioning 16 Need Items, 13 Strength Items Needs and Strengths at Initial % of Youth Change - Needs and End of Service (n=2,050) (n=2,050) 4.00 3.44 3.50 Improved 3.00 (Fewer Needs) 2.52 2.50 42% 39% Declined (More Needs) 2.00 1.69 1.58 No Change 1.50 19% 1.00 0.50 0.00 Needs Strengths Initial End of Service

Child Behavioral/Emotional Needs 10 Need Items Needs at Earliest and Latest % of Youth Change - Needs Assessments (n=291) (n=291) 6.00 4.77 4.76 5.00 Improved (Fewer Needs) 4.00 33% 36% Declined (More Needs) 3.00 No Change 2.00 31% 1.00 0.00 Needs Earliest Assessment Latest Assessment

Child Risk Behaviors 12 Need Items Needs at Earliest and Latest % of Youth Change - Needs Assessments (n=101) (n=101) 7.00 5.85 6.00 5.51 Improved 5.00 (Fewer Needs) 34% 34% Declined 4.00 (More Needs) 3.00 No Change 2.00 33% 1.00 0.00 Needs Earliest Assessment Latest Assessment

CANS-F Summary • Overall, most families, caregivers, and youth appeared to improve. – 61% of families had fewer family functioning needs at discharge, while nearly half of families, caregivers, and youth improved in caregiver advocacy, caregiver assessment, and child functioning sections. – Improvement differed by service (not shown), as IFPS cases experienced the greatest reduction in needs, partially because they had the most needs to begin with • Strengths tended to remain unchanged and may suggest that strengths are harder to develop in a short period of time. However, there were several limitations to the data: – Strengths were not measured on a scale as needs were; rather strengths were present or not. – Both caregiver assessment and child functioning strengths contained fewer items than their respective needs sections

CANS-F Next Steps • CANS user supports will be administered to local jurisdictions to assess baseline data needs regarding each worker’s comfort and ability in using the CANS/CANS-F instruments. • County-specific plans will then be created from the baseline data collected.

Case Review Process • A pilot assessment was conducted on 20 in-home cases • The following two questions were examined: 1. What was the quality of CANS-F implementation? 2. Did workers link identified needs from the CANS-F to referrals for services and/or their in-home service plan?

Sample • a case had to contain an initial and end of service CANS-F entered between July 1, 2015 – March 31, 2016. • Multiple steps: 1) cases were sorted by jurisdiction 2) at least 5 families were randomly selected from five of the largest jurisdiction 3) 35 additional cases were randomly selected from the remaining jurisdictions 4) From the 60 cases, a sample of 20 families were selected for review. – Reviewers started with Howard, Anne Arundel, and Allegany counties, and then began to select cases from additional jurisdictions.

Jurisdiction Program Allegany Anne Arundel Calvert Cecil Consolidated In-Home Family Services (IHFS) Interagency Family Preservation Services (IFPS) Charles Howard St. Mary's Wicomico Service to Families with Children (SFC-I) 10% 10% 15% 10% 25% 20% 20% 65% 5% 10% 10%

Methods • a case review instrument was created in Qualtrics (a web-based survey system used for recording data from the case reviews) – instrument examined 8 sections of the CANS-F: 1) family functioning; 2) caregiver functioning; 3) caregiver advocacy; 4) acculturation; 5) child functioning; 6) trauma experiences; 7) child behavioral/emotional needs; and, 8) child risk behaviors.

② Did workers link identified ① What was the quality of needs from the CANS-F to CANS-F implementation? referrals for services and/or their in-home service plan?  For each section of the CANS-F, the reviewers  For all items with a rating of 2 examined whether the CWW (ACT to address need) or 3 provided a rating for each (ACT immediately, intensely), item, and then reviewed the the reviewers explored case comments to determine documentation (e.g., service plan, service plan tasks, whether the CWW justified contact log, CWW comments) the rating (comments were to identify whether the need required for all ratings ≥ 1). was reflected in the service plan, and whether the need resulted in a referral to a service .

What was the quality of CANS-F implementation ?

Quality of Implementation Without comments Comments provided 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Acculturation (n=2) 100.0% Caregiver #1 ratings 6.7% 93.3% (n=15) Child #1 ratings 6.7% 93.3% (n=15) Child #2 ratings 9.1% 90.9% (n=11) Caregiver Advocacy 20.0% 80.0% (n=10) Child #3 ratings (n=5) 20.0% 80.0% Child #4 ratings (n=4) 25.0% 75.0% Family Functioning 33.3% 66.7% (n=18) Caregiver #2 ratings 33.3% 66.7% (n=3)

Did workers link identified needs from the CANS-F to referrals for services and/or their in-home service plan? See Figures 2 and 3