CANS Family Guide

What is the CANS? 

MassHealth requires behavioral health providers to do a comprehensive assessment when they first start working with children and youth aged 20 years and younger. This assessment helps the provider get a sense of the challenges and strengths that are unique to the young person receiving services and their caregivers. The tool used in Massachusetts is called the CANS, which stands for Child and Adolescent Needs and Strengths. This tool both collects information about many areas of your strengths and needs and helps the team prioritize areas for support.

Working With Your Provider

The CANS results can and should be shared with you, both to get your feedback on whether the information collected is accurate, and to help you work with your team to set priorities for the treatment plan. The CANS will be completed at intake, discharge and six-month intervals in between to help you all assess how well the treatment plan is addressing your prioritized needs. The provider you work with (for example, an outpatient or in home therapist, a case manager, or a psychologist) will usually begin filling out the CANS assessment during the first meeting, and you may notice that they are asking questions that might seem to follow a checklist or form. The reason we do this is to ensure that the treatment team doesn’t miss something important in the assessment process. Together with the provider, filling out the CANS should help you both come up with a complete picture of your needs and strengths for future work together. It’s better that you answer “no” than that we forget to ask!

The Results

To receive services through the Children’s Behavioral Health Initiative, a young person must qualify as having a serious emotional disturbance (this is a federally defined category of service). Research on caregivers of youth with SED document unusually high levels of stress, driven largely by the challenges of managing the needs of their child, the stigma faced by their child and family, and/or the unpredictability of life with a child with these kinds of needs. Our teams expect that caregivers have needs as a result, and the research on treatment of children with SED shows that supporting caregivers is the key to supporting youth. Needing help is not indicative of a failure of a caregiver in these situations.

Frequently Asked Questions

1. How Are CANS Ratings Given?

The CANS is made up of five sections that focus on different areas in the young person’s life. Two of the sections also help assess for caregiver needs and strengths. The provider gives a number rating to each of these items from zero to three. A three suggests this need is an immediate priority, where a zero indicates that no need in a particular area exists. Of course, ratings do not tell the whole story of a child’s strengths and needs. Each CANS section also has a comment space where a provider can give more information about that area of life.

2. Why do you ask questions about the caregivers?

To receive services through the Children’s Behavioral Health Initiative, a young person
must qualify as having a serious emotional disturbance (this is a federally defined
category of service). Research on caregivers of youth with SED document unusually
high levels of stress, driven largely by the challenges of managing the needs of their
child, the stigma faced by their child and family, and/or the unpredictability of life with
a child with these kinds of needs. Our teams expect that caregivers have needs as a
result, and the research on treatment of children with SED shows that supporting
caregivers is the key to supporting youth. Needing help is not indicative of a failure of
a caregiver in these situations.

3. Does the CANS report have any relationship with whether I can access services?

No. The CANS is not an eligibility determination tool. You do not need to have a certain score in order to qualify for services, nor do you have to show improvement over time to maintain services.

4. Where does the data go? Who has access to it?

Your child’s provider will ask for your consent or permission to enter the CANS ratings and comments into MassHealth’s secure online database known as the e-CAS/CANS. When you give permission, you are allowing MassHealth, your child’s managed-care plan, and other providers within the MassHealth system (edited from "within the same organization) who work with your child to see his or her CANS records. Your consent does not allow other state agencies, such as the Department of Youth Services or the Department of Children and Families, to see your child’s CANS record. To protect your child’s privacy, MassHealth keeps tight control over who has access to the database. Access to your CANS record is restricted and protected under state and federal privacy laws.