By: Shelly Paule, Policy Analyst

County of San Diego Child Welfare Services (CWS)

Hi, my name is Shelly Paule. As a policy analyst with the County of San Diego Child Welfare Services (CWS), I was the lead for managing the Child and Adolescent Needs and Strengths (CANS) implementation. My role included drafting the policy, training roll out and completion, and coordinating with our Behavioral Health Services partners. As a trainer and an advocate for the positive impact CANS will have on the children and families we serve, I also have the privilege of being the face of CANS via road shows.

We started our CANS journey in June 2018 by organizing a committee to discuss potential implementation plans. Who would complete the CANS? How would we know which children and families needed the program? How would we successfully integrate this new assessment into the Child and Family Team (CFT) meeting? How would we help families understand its purpose and how this conversation will come alive in the case plan?

Our committee completed an analysis of these questions and provided some answers to County leadership. Simultaneously, we were invited to participate in the Behavioral Health Services CANS Training for Trainers (T4T), with three of us fortunate enough to be able to attend.

Each of us successfully certified at the .70 level, but hitting the .80 required to become a certified trainer was a bit more challenging! This was a great time for us to pull together, review vignettes and practice using the CANS together. This collaborative effort reflects not only the vision of the CANS completion, but also the heart of CWS and the entire Health And Human Services Agency. We know that together we make better assessments and decisions than we do alone.

At CWS, we have also been working collaboratively with the San Diego County Behavioral Health Services (BHS) CANS team led by Eileen Quinn-O’Malley. Eileen has been a great support since BHS completed the CANS roll out in July to its providers. She has shared successful strategies with us and we are scheduled to co-present at Community Presentations to demonstrate our collaboration as large systems.

The CWS training and implementation roll out is scheduled to occur through spring 2019 with additional trainings to follow. More than 700 staff will be trained and certified by April 2019. The first cohort of training was our Pathways to Well Being Social Workers, who started in October and will complete the intake CANS within the CFT meeting on all new cases. They also will assist with coaching and support as more social workers become trained and certified in the CANS. As we complete the phased training roll out, all staff who are trained and certified will start utilizing the CANS within the CFT meeting prior to every case plan update.

We are also reminding staff that the Voice of the Family is a critical factor in the choice to utilize the CANS in the CFT meeting. Children, youth and families have shared concerns that their voices have not always been heard in the assessment of their families, as well as in the decisions around the case plan services and expectations. As we message to staff about the CANS, we are sharing with them the benefits of collaborative completion of the assessment in the CFT meeting to guide the creation of the case plan. We will increase our collaboration and transparency with families to ensure their voice is heard and becomes part of the case plan. As families assist with the creation of case plans they will be more engaged, which may increase the speed of reunification or permanency to ensure children safely remain home.

When speaking with staff, we remind them there is no item on the CANS we have not historically discussed and addressed in CFT meetings. We are helping staff realize this is not a practice shift, but rather a guide to discussing potential areas of needs for a child or family along with the discussion about how to address those needs, whether services should be referred, or another intervention put into place. We are also sharing that the Strengths section focuses on evidence-based areas of resiliency. The CANS helps to inform the CFT to look at ways to build a strength, which in turns increases resiliency for the child / youth we are serving.

Are we excited about CANS and the positive impact this will have our Families? Yes we are! In fact, we have two mottoes at CWS in San Diego – Viva La CANS and Yes we CANS! That being said, we are also aware this is a big shift in our practice. We are supporting our staff through training, coaching and ongoing implementation discussions. Though they are not always easy, these discussions are essential to the successful engagement of our teams.

For more information regarding CANS implantation in County of San Diego Child Welfare Services, please contact Shelly Paule, Policy Analyst at 858-616-5942.

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