The CANS and the CAT: Two Windows into Vermont’s System of Care Outcomes of the Placement Stability Project Alison Krompf and Valerie Wood, Ph.D.
Overview of f the Pla lacement Stability Project The Placement Stability Project aims Three trauma related concerns were identified in 2013: to improve placement stability and permanence by enhancing the social • Placement Stability Rate • Children in Out-of-Home Care and emotional well-being of • Dissolution of Adoptions Vermont’s children and youth who are pre and post permanence, with the broader vision to reach all children in the Vermont child welfare system through the implementation These concerns were addressed by: of family engaged , adoption • Statewide Collaboration and Workforce Development competent , trauma Informed, and • Screening, Progress Monitoring, and Collaborative Case Planning (CANs) evidence based services and • Caregiver Training, Supports, and Mentoring supports . • Evaluation and National Dissemination UVM College of Education and Social Services Project of the Vermont Child Welfare Training Partnership Children’s Bureau Project No. 90CO1119
PSP Core Activities • Developed UVM’s Academy for Trauma Informed Practice Statewide Collaboration and supported approximately 80 students to receive the graduate certificate of completion. and Workforce • Adoption Competency, Trauma, and CANS Online Trainings Development • Supported evidence-based child trauma treatment training in PCIT, TCPP, and ARC • Inter-organizational database matching CANS data from DAs Screening, Progress with DCF data (Vertical Change) Monitoring, and • Analyze CANS data to better understand strengths and needs for kids in care Collaborative Case Planning • Comprehensive case study on CANS implementation (CANS) • CANS toolkit and online video training modules University of Vermont Department of Social Work Project of the Vermont Child Welfare Training Partnership Children’s Bureau Project No. 90CO1119
PSP Core Activities • Offered over 30 RPC+ TIPS trainings across state for over 300 caregivers Caregiver Training, • Developed mobile app to supplement training • Developed statewide Caregiver Mentoring Program Supports and Mentoring • Collaborated w/ local & state partners on journal publications Evaluation and National • Presented at several national conferences, webinars, & Dissemination created training modules University of Vermont Department of Social Work Project of the Vermont Child Welfare Training Partnership Children’s Bureau Project No. 90CO1119
View 1: The CANS CANS and Placement Data Preliminary Findings
Vertical Change ✓ Integrates data from community mental health agencies and Vermont State Family Service Division (Child demographics and outcome: placement stability, child abuse reporting and substantiation, and school placement). ✓ Shares de-identified data with University of Vermont for evaluation purposes. UVM College of Education and Social Services Project of the Vermont Child Welfare Training Partnership Children’s Bureau Project No. 90CO1119
Progress Monitoring every 6 months CANS Baseline CANS 2 9/1/2017 3/1/2018 Overall % Overall % 2% 4% 8% 4% 3's 3's 2's 22% 2's 22% 1's 1's 0's 50% 50% 0's 22% 16% NA NA Vertical Change Dashboard shows progress on the overall actions needed as reported by the CANS UVM College of Education and Social Services Project of the Vermont Child Welfare Training Partnership Children’s Bureau Project No. 90CO1119
How Placement Change effects Child Strengths and Needs School Strength and Needs 9.5 10 9 7.3 Avg Number of Placements 8 6.5 7 6.1 6 4.8 4.3 4.3 5 4.2 4 3 2 1 0 School Behavior School Achievement School Attendance All Education 0-Strength 3-ImmediateNeed UVM College of Education and Social Services Project of the Vermont Child Welfare Training Partnership Children’s Bureau Project No. 90CO1119
How Placement Change effects Child Strengths and Needs Family and Community Resiliency 8 6.9 6.8 7 6 Avg Number of Placements 6 5 5 4.3 4.1 3.9 3.8 4 3 2 1 0 Family Strengths Optimism Community Connections Resiliency 0-Strength 3-ImmediateNeed UVM College of Education and Social Services Project of the Vermont Child Welfare Training Partnership Children’s Bureau Project No. 90CO1119
Placement Change by Severity Score Placement Change By Severity Score 70 60 50 Severity Score 40 30 20 10 0 1 5 10 >15 # of Placement Changes UVM College of Education and Social Services Project of the Vermont Child Welfare Training Partnership Children’s Bureau Project No. 90CO1119
CANS Profiles per Caregiver Type Average CANS Severity Score per Caregiver Type • Severity Score is a general indication Severity Score = Sum of 2’s and 3’s of acuity and level of supports needed for the child and family 30 • 25 Severity Score is calculated by adding up only scores of 2 or higher on all items of the CANS 20 Score of 2 (Need) = 2 Score of 3 (Intensive Need) = 3 15 • Severity Scores for this population ranged from 0 – 83 10 Mean = 22.75 Bio Foster Kinship Adoptive University of Vermont Department of Social Work Project of the Vermont Child Welfare Training Partnership Children’s Bureau Project No. 90CO1119
Caregiver Needs Average Caregiver Needs Domain Score per % of Caregiver with Need or Intensive Need for Caregiver Type (Range of 0-35) Natural Supports (Score of 2 or 3 on CANS Item) 8.00 35% 7.00 30% 6.00 25% 5.00 20% 4.00 15% 3.00 10% 2.00 5% 1.00 0% 0.00 Bio Foster Kinship Adoptive Bio Foster Kinship Adoptive UVM College of Education and Social Services Project of the Vermont Child Welfare Training Partnership Children’s Bureau Project No. 90CO1119
What CANS tells us about kids in custody Highest Aggregate Scoring Items on the CANS for Children/Youth in DCF Custody (N = 750) Lack of Community Connections Lack of Resiliency • 6 out of 9 r egions had an absence of Adjustment to Trauma Community Connections as their highest Family Discord aggregate scoring item on the CANS for Lack of Optimism this population Lack of Child Involvement with Care Anxiety • Absence of Resiliency , Optimism , and Attention Deficit Impulse Control Child Involvement with Care are Lack of Interpersonal Skills consistently within the top 10 for all Lack of Relationship Permanence regions Oppositional Lack of Stable Family Strength • Adjustment to Trauma , Family Discord Anger Control and Anxiety are consistently in the top 10 School Behavior for all regions Living Situation Depression School Achievement 0 200 400 600 800 1000 1200 1400 University of Vermont Department of Social Work Project of the Vermont Child Welfare Training Partnership Children’s Bureau Project No. 90CO1119
Prevalence of Needs Over Time for Children/Youth Receiving Services % of Individuals with a Need or Immediate/Intensive % of Individuals with Need or Intensive Immediate Need Need (Score of 2 or 3 on CANS) to Address Family (Score of 2 or 3 on CANS) to Address Adjustment to Discord Over Time Trauma Over Time 60% 60% 50% 50% 40% 40% 30% 30% 20% 20% 10% 10% 16.72% 16.11% 14.09% 14.29% 13.78% 13.89% 8.33% 5.88% 5.88% 3.57% 0% 0% Baseline 6MO 12MO 18MO Discharge Baseline 6MO 12MO 18MO Discharge Immediate/Intensive Need (3) Need (2) Immediate/Intensive Need (3) Need (2) UVM College of Education and Social Services Project of the Vermont Child Welfare Training Partnership Children’s Bureau Project No. 90CO1119
Anxiety Over Time for Children/Youth in Custody Receiving Services % of Individuals in DCF Custody with a Need or Immediate/Intensive Need (2 or 3) to Address Anxiety over Time 45% • Anxiety appears harder to move the 40% needle on for children and youth in DCF custody 35% 30% • 25% Anxiety slightly increases over time with a notable increase at 12 Months for those 20% scoring a 3 – Intensive and Immediate 15% Need 10% 15.28% 11.76% 10.71% 5% 7.38% 6.74% 0% Baseline 6MO 12MO 18MO Discharge Immediate/Intensive Need (3) Need (2) University of Vermont Department of Social Work Project of the Vermont Child Welfare Training Partnership Children’s Bureau Project No. 90CO1119
Build ildin ing Resili iliency Over Time for Children/Youth in Custody Receiving Services % of Individuals with Resiliency as a Centerpiece or Useful Strength (0 or 1) Over Time Of all of the items on the CANS, Resiliency 70% consistently scores as the top one or two most prevalent and intense needs for 60% children and youth in our community 50% Only 12% of children/youth in DCF custody 40% are assessed as having Resiliency as a 27.78% 52.94% 46.43% Centerpiece Strength (Score of 0) at Baseline 30% 35.57% 31.75% on the CANS 20% 10% 19.44% The GOOD NEWS: 12.17% 11.41% 7.14% 5.88% Resiliency appears to be a strength that is 0% buildable through services and supports over Baseline 6MO 12MO 18MO Discharge time Centerpiece Strength (0) Useful Strength (1) University of Vermont Department of Social Work Project of the Vermont Child Welfare Training Partnership Children’s Bureau Project No. 90CO1119
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