The Role of the CANS in Reducing Residential Treatment Placement and Length of Stay in New Jersey
One of the more compelling stories from the 12th annual TCOM Conference was the KEYNOTE provided by Liz Manley, the Assistant Commissioner of New Jersey’s System of Care. Having been involved with this project since its inception more than a decade ago, Liz provided both a personal description and a description based on the data collected, of the role of the CANS and TCOM in New Jersey.
Since 2008 when full statewide implementation of the system of care was completed, the number of children and families served in case management programs in New Jersey has nearly doubled.
However, during that same period of time the number of children and youth in out of home behavioral health placement (i.e. residential treatment) declined by about 30%. So the rate at which system-involved children and youth are placed has declined even more dramatically. Out-of-state placements have been practically eliminated.
In addition to the DRAMATIC reduction in the use of residential treatment, though the use of algorithms the lengths of stay of placements when they occur have been reduced by 25% even though the complexity of children and youth placed has increased. Further, New Jersey has closed 6 of its 17 detention centers due to under-utilization and the detention population has been reduced by 60%.
Beginning in 2004 with the initiation of the children’s system of care in New Jersey, the comprehensive version of the CANS was used in their child and family teams. Called the IMDS tools, the CANS was used to support planning through the child and family teams and the Care Management Organizations. Algorithms were developed and used to support decision making about the use of out of community placements with specific youth. Higher need children and youth are now successfully served in the community. While the success of New Jersey’s system of care is attributable to many factors including the increased use of Mobile Response in community setting and the hard work of many caring people working in the system, the use of a uniform assessment process with built-in decision supports to improve placement decision-making had an important role in this success. The CANS helps helpers help.