Sunday, August 10, 2008

Pediatricians and CANS: You can, but you don't have to.

There has been some confusion in the Pediatric community regarding the Child Behavioral Health Initiative and the CANS, stemming from the word "screening".  Let me try to clarify, and suggest some language that may avoid confusion in the future.
1)  PRIMARY SCREENING:  Last January, MassHealth Primary Care providers were asked to initiate Behavioral Health Screening, using one of nine State-approved screening instruments. (See this blog from last December here for the details)  We've been screening, which means dividing our patients into two groups:  those who need further evaluation and those who don't.  The assumption was that many of those who need further evaluation would be referred into the Mental Health system.  That would lead to:
2)  SECONDARY SCREENING:  As of November, 30, 2008, the children who are referred for further evaluation will need to be screened/evaluated with the CANS.  This is a secondary screening, which is going to form the basis of the determination of whether or not the family is part of the class of families eligible for Intensive Care Coordination services.  Now, there is no reason that a pediatrician couldn't learn to do this, if they planned to offer intensive mental health or behavioral health services.  But this is NOT required of you as a primary care provider.  It is required of MENTAL HEALTH WORKERS who are planning to work with these children and families.
The confusion seems to be about the word "screening", and would be clarified by using the terms primary and secondary as modifiers.   The Mass Chapter sent out a clarification last weekend, that we hope will make all clear.

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