The CANS (children and adolescents), ANSA (adults) and CAT (crises—all ages) are used in public behavioral health systems around the country. Several jurisdictions have implemented lifetime approaches, calling the tool the Comprehensive Assessment of Needs and Strength (CANS) for ease of communication. In behavioral health, these tools are used for three primary purposes within the TCOM framework:
Decision support – Decision support applications are made up for treatment planning approach and formal decision models for level of care, intensity of case management, and specific referrals to evidence-based treatments. The treatment planning approach allows the creation of a customized theory of change that focuses interventions on putative causes of the challenges people are currently experiencing. The Foundation support the custom development of level of care and intensity of case management models for jurisdictions based on the current functioning of their system.
Quality Improvement – Quality improvement approaches are generally ad hoc uses of the person-centered information from the TCOM tools to inform potential adjustments in practice and or policy. In addition to ad hoc quality improvement approaches, the Foundation supports ongoing monitoring of decision models to ensure that they continue to optimize the positive impact of decisions on the lives of those helped within the system.
Outcome Monitoring – Outcome monitoring initiatives include inclusion in performance and value contracting applications, provider profiling, and effectiveness assessment. Given the flexibility of the tools, there are a variety of possible metrics to use to monitor the impact of treatment interventions.