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Frequently Asked Questions

Frequently Asked Questions

Frequently Asked Questions about the Michigan Child and Adolescent Needs and Strengths (MichiCANS) Tool for Community Mental Health Service Programs (CMHSPs) and Prepaid Inpatient Health Plans (PIHPs)

The Michigan Department of Health and Human Services (MDHHS) created this frequently asked questions (FAQ) document to help partners better understand the Michigan Child and Adolescent Needs and Strengths (MichiCANS) tool and answer common questions related to the tool.

FAQ about MichiCANS for CMHSPs PIHPs

    • What is the Child and Adolescent Needs and Strengths (CANS) and MichiCANS?
      • The CANS is a multipurpose information integration tool designed to summarize information gathered from multiple sources and the assessment process. It is not a standalone clinical assessment or evaluation. Rather, it is a multipurpose information integration tool meant to be used as the comprehensive summary of information gathered from a variety of sources, including assessment results. The CANS is comprised of a core set of 50 items and is customizable based on the needs of the state/agency that is utilizing the tool. The version of the tool that MDHHS has developed is called the MichiCANS. This tool is used to support Family Driven, Youth Guided care planning and level of care decisions, facilitate quality improvement initiatives, and monitor outcomes of services.
    • What does the MichiCANS include?
      • The MichiCANS has two components – the Screener and Comprehensive. MDHHS uses both tools in conjunction with each other, as the information collected through the Screener is used to inform the completion of the Comprehensive. The Comprehensive includes all the information obtained from the Screener plus additional domains, modules, and submodules. Both tools gather information on the child/youth's and parents/caregivers' needs and strengths. Strengths are the child/youth’s assets: areas in life where they are doing well or have an interest or ability. Needs are areas where a child/youth requires help or intervention. Strengths and needs are organized through the use of ratings. These ratings help the provider, child/youth, and family, understand where intensive or immediate action is needed.
    • What age demographic will PIHPs and CMHSPs use MichiCANS with?
      • The MichiCANS Screener is used with all infants, toddlers, children, youth, and young adults ages birth through age 20 (until the day prior to 21).
        Based on the results of the Screener, the MichiCANS Comprehensive is used with all infants, toddlers, children, youth, and young adults ages birth through age 20 with Serious Emotional Disturbance and/or Intellectual and Developmental Disability.
      • In addition, based on the results of the Screener, the Devereux Early Childhood Assessment (DECA) is used for intake and treatment planning with infants, toddlers, and children ages one month through age five who have (1) SED or (2) SED and IDD.
    • Is the MichiCANS used with children diagnosed with Autism Spectrum Disorder (ASD)?
      • Yes, this tool is used with all children, youth, and young adults from birth through age 20, including those presenting with SED and/or IDD, including ASD. Additional assessment will be required if an indication of ASD is present.
    • When did the MichiCANS become a requirement?
      • October 1, 2024.
    • What data exists on the reliability and validity of this tool, and its effectiveness in achieving positive outcomes?
    • Does the MichiCANS identify the need for additional assessments?
      • Yes, the MichiCANS may identify the need for additional assessments. In addition, information from outside assessment tools also informs the MichiCANS ratings and level of care decisions.
    • Does the MichiCANS determine level of care decisions?
      • Yes, the MichiCANS Screener provides an indication of appropriate level of care. A logic model, called a Decision Support Model (DSM) will run in the background of the Electronic Health Record (EHR) to provide recommendations for related levels of need and services. If you do not use an EHR to complete the MichiCANS, and instead use the CareConnect360 (CC360) application, the DSM will also be active in the background and provide the necessary recommendations. These DSMs help ensure statewide standardization of initial recommendations related to level of care. Additional DSMs will be utilized to determine eligibility for the Michigan Intensive Child and Adolescent Services as well as the Serious Emotional Disturbance (SED) Waiver. *Note – please see #8.
    • Is the MichiCANS embedded into already existing EHRs?
      • Yes, it is embedded into existing EHRs (PCE, NetSmart and Streamline) for the October 1, 2024, requirement. The MichiCANS will also be accessible via CareConnect360 (CC360).
    • Who has access to the MichiCANS Screener and/or Comprehensive data?
      • All data from the MichiCANS tools is sent to Care Connect 360 (CC360) electronically. This data is available to CC360 users who have rights/permissions to the data.
    • If a MichiCANS Screener or Comprehensive was completed elsewhere in the state of Michigan, how can that data be accessed?
      • All information is accessible via CareConnect360 and EHR vendors are working to create an interchange to share information from CC360 to each EHR.
    • If a MichiCANS Screener or Comprehensive was completed elsewhere in the state of Michigan, what should be done with that data?
      • As with any previous assessment completed outside of your organization, you should recognize, value, and accept that information. We suggest you review previous MichiCANS scores and information with the youth/family and update as needed to ensure the new MichiCANS document in your clinical workflow represents the child and family's current strengths and needs.
    • Is there a plan for this to be applicable to adult services?
      • The adult equivalent of the MichiCANS tool is known as the Adult Needs and Strengths Assessment (ANSA) tool. The use of the ANSA is not required. Providers can choose to implement the use of the ANSA for their adult population if they desire; however, this is not a current or pending requirement.
        How can I find more information related to the CANS?
      • More information related to the CANS can be located at https://praedfoundation.org/ or www.iph.uky.edu
    • How can I find more information about the MichiCANS?
    • Is the MichiCANS used with children diagnosed with Autism Spectrum Disorder (ASD)?
      • Yes, this tool is used with all children, youth, and young adults from birth through age 20, including those presenting with SED and/or IDD, including ASD.  Additional assessment will be required if an indication of ASD is present.
    • When did the MichiCANS become a requirement?
      • October 1, 2024. 
    • Does the MichiCANS determine level of care decisions?
      • Yes, the MichiCANS Screener provides an indication of appropriate level of care. A logic model, called a Decision Support Model (DSM) will run in the background of the Electronic Health Record (EHR) to provide recommendations for related levels of need and services. If you do not use an EHR to complete the MichiCANS, and instead use the CareConnect360 (CC360) application, the DSM will also be active in the background and provide the necessary recommendations. These DSMs help ensure statewide standardization of initial recommendations related to level of care.  Additional DSMs will be utilized to determine eligibility for the Michigan Intensive Child and Adolescent Services as well as the Serious Emotional Disturbance (SED) Waiver. *Note – please see CAFAS/PECFAS section in FAQs.
    • If a MichiCANS Screener or Comprehensive was completed elsewhere in the state of Michigan, how can that data be accessed?
      • All information is accessible via CareConnect360 and EHR vendors are working to create an interchange to share information from CC360 to each HER.
    • If a MichiCANS Screener or Comprehensive was completed elsewhere in the state of Michigan, what should be done with that data?
      • As with any previous assessment completed outside of your organization, you should recognize, value, and accept that information.  We suggest you review previous MichiCANS scores and information with the youth/family and update as needed to ensure the new MichiCANS document in your clinical workflow represents the child and family's current strengths and needs.
    • Is there a plan for this to be applicable to adult services?
      • The adult equivalent of the MichiCANS tool is known as the Adult Needs and Strengths Assessment (ANSA) tool.  The use of the ANSA is not required.  Providers can choose to implement the use of the ANSA for their adult population if they desire; however, this is not a current or pending requirement.
    • How will end users increase their skill level in using the MichiCANS?
      • MichiCANS Certification Training is required for all MichiCANS users.  MDHHS has developed Supervisor Community of Practice learning collaboratives to support continued learning in the use of the MichiCANS.  These meetings are for clinical supervisors and provide opportunities to come together in a learning community with a focus on building practical skills to support meaningful use of the MichiCANS across the state and at the organizational level.
      • Please indicate interest in attending via this link: https://forms.office.com/g/rkLXJ2iFKz.  
      • In addition, technical assistance is available to provide end users with additional information related to the MichiCANS and can be requested by emailing MDHHS-MichiCANS@michigan.gov.
    • What specific MichiCANS training is needed for end users?
      • All staff completing the MichiCANS Screener and/or Comprehensive, and the supervisors who oversee these staff members, are required to complete specific training, and pass an initial certification assessment. 
      • To become a certified user of the MichiCANS, clinician/raters who administer the MichiCANS, and their supervisors, are required to complete initial training, which includes two sessions: TCOM Orientation (3.5 hours) and MichiCANS Overview (3.5 hours).
      • Individuals are required to pass a vignette-based assessment following training to be considered certified in the use of the tool.  Clinicians/raters must also complete and receive a passing assessment score annually for re-certification purposes.  
      • The Department also requires MichiCANS Action Planning training for all certified MichiCANS staff who participate in any component of a planning process, and their supervisors.  This training will assist users with the overall use and understanding of the tool and its role in service planning. 
      • Supervisors are also required to attend Supervisor Training. 
    • Does all staff, including those who only complete the MichiCANS Screener, need to be certified in the use of the tool?
      • Yes, all staff completing the MichiCANS, and the supervisors who oversee these staff members, are required to complete the full training, and achieve successful certification even if they are only administering the Screener.
    • Who conducts MichiCANS training?
      • All training for MichiCANS is now conducted by certified state trainers.  PIHPs and CMHSPs will not need to develop trainers.  In addition, the cost associated with training is covered by the State.
    • Can training be completed by watching recorded training sessions? 
      • No, training must be completed via live virtual training.
    • When will training take place?
      • Statewide training for the hard launch of the MichiCANS started in April and continued through September 2024 to prepare for the October 1, 2024, implementation of the tool.  Regular training sessions are now available.  All training for MichiCANS will be conducted by certified state trainers after October 1, 2024.  PIHP and CMHSP’s will not need to develop trainers.  In addition, the cost associated with training is covered by the State.
    • Does the MichiCANS replace the Child and Adolescent Functional Assessment Scale (CAFAS) and Preschool and Early Childhood Functional Assessment (PECFAS)?
      • Yes, the MichiCANS replaced the CAFAS and PECFAS on October 1, 2024.
        *Update- The Michigan Department of Health and Human Services (MDHHS) is providing the following information related to Medicaid-funded specialty behavioral health services. Effective October 1, 2024, MDHHS will require Prepaid Inpatient Health Plans (PIHP), Community Mental Health Services Programs (CMHSP), and Certified Community Behavioral Health Clinics (CCBHC) to use the Michigan Child and Adolescent Needs and Strengths (MichiCANS) tool to support eligibility determinations for services, assist with initial determination of needs and strengths, and provide information for appropriate referrals for behavioral health services.
      • MDHHS established specific requirements for the use of the MichiCANS in bulletin MMP 24-38. Please refer to MMP 24-38 (Final-Bulletin-MMP-24-38-MichiCANS-final.pdf (michigan.gov)) for additional information. You can access the bulletin at www.michigan.gov/medicaidproviders >>Policy, Letters and Forms.
      • MDHHS also established contractual requirements for the PIHPs to specifically use the MichiCANS to support eligibility determinations for the Waiver for Children with Serious Emotional Disturbances (SEDW) and the 1915(i) SPA. At this time, CMS has not provided approval for the amendment to the 1915(i) SPA or provided approval for the renewal of the SEDW. For this reason, PIHPs should continue to use the Child and Adolescent Functional Assessment Scale (CAFAS) and Preschool and Early Childhood Functional Assessment Scale (PECFAS) to support eligibility determinations for the 1915(i) SPA and SEDW only, until MDHHS receives approval from CMS. PIHPs must enter CAFAS and PECFAS scores into the Waiver Support Application (WSA) for these programs as part of the enrollment process. The PIHPs must continue to fulfill all other contractual requirements.
      • In order to continue the temporary use of the CAFAS and PECFAS, MDHHS is entering into an agreement with Functional Assessment Systems (FAS) to allow for continued, but limited, electronic use of the CAFAS and PECFAS. Data will not be exported from the FAS system and the use of these tools will be used for the 1915(i) and SEDW eligibility determinations only, until the time that MDHHS receives approval from CMS.