Additional Features and Considerations
This topic is devoted to a few key areas we've decided to bring to your attention because they are things you will need to make decisions about as an organization. You may decide not to use some of the features that are available in the program, including the ones mentioned below, or you may need to make guidelines and protocols for your staff so that these features are used properly and consistently. Decisions about these features should be made fairly early on so that all staff can be trained in the same procedures to keep quality assurance high.
You may want to make guidelines about:
Inactivating a client is a useful way of indicating which clients in your system are no longer receiving treatment. When treatment ends for a client, the practitioner can easily inactivate the client from the Edit Client Screen by simply clicking the link "Inactivate". The status of a client, whether active or inactive, is a criteria in many of the tools in the system, so setting a client as inactive when they leave services will make it easy for you to generate reports, for example, for only youth in services or only youth not currently in services.
Note: Once you inactivate a client the link changes to "Activate" making it easy to re-activate the client at any time. If a client comes back for services you just have to activate the client's case.
You will want to give your staff guidelines on when to
inactivate clients. You may want to instruct them to inactive a client
when they do an Exit CAFAS
The program has a built-in alert that assists you in identifying cases that may no longer be receiving services but are still active, allowing you to easily see when a clinician may have forgotten to inactivate a client. There is an indicator "Active Cases with no new assessments in the last 5 months" to alert you to cases that may need inactivation:
This indicator appears on both your Supervisor Dashboard and each staff's My Dashboard to keep them on track. It shows you a list of active clients who have not had an assessment in the last five months. You can drill down by clicking the underlined number of cases, and directly inactivate the clients from the table that displays.
When assessors have completed the CAFAS
Marking an assessment as "signed" indicates
that the CAFAS
If you do require the CAFAS
As mentioned above, when an assessment has been signed
you can't make any changes to the CAFAS
A pop-up will appear to confirm that you want to make an amendment and asking you to provide a reason justifying the amendment.
After this you can make the necessary changes to the
CAFAS
Note that the application keeps track of amendments in
an audit log, which can be viewed by clicking on the link "View Audit
Details" at the bottom of the screen. Also note that the Treatment
Plan is not affected by the CAFAS
There are a number of pieces of information asked about on the Edit Client screen that aren't required that you'll want to have guidelines about for your staff as to what information you want collected.
The information gathered by these questions is available in the Data Export. Because this information is not required, if you would like to have this client information you'll have to direct your staff accordingly.
On the Edit Client screen there are three sections you'll want to consider. You can collect information on:
Whether the youth is a ward of the state.
If the youth's primary language is something other than English.
Whether the youth lives in a single-parent household.
The application enables you to easily record any Evidence Based Treatments or practices, typically referred to as EBTs, the youth may receive in the program. There is a pre-populated list of EBTs, shown below in the "Treatment" column. You can see the source of the EBT (author or manual) in parenthesis after the name. EBTs are added at the client level - it is one of the tabs from the "Edit Client" screen.
You can add a treatment to client by clicking "Add New Treatment".
Select the appropriate EBT by either typing the name (or part of the name) into the treatment field to search for it or by clicking on the link next to the treatment field and scrolling through the list. After you have selected the treatment, fill in the agency delivering services and the primary service delivery method (in-home, residential, office, etc). You can add as many EBTs as you want to a client's record.
Tracking EBTs allows you to easily evaluate the effectiveness of EBTs among your clients. For example, you may want to compare the outcomes and length of treatment for EBTs versus treatment-as-usual. You will need to decide if you are recording EBTs and, if so, instruct your staff accordingly.
If you would like to see an EBT added to the list, you need to send your request to FAS. Include a reference to the EBT manual and the source where it was designated an EBT.
Also accessible from the Edit Client screen is the Client Labels tab, where you can specify particular Client Labels. Client Labels are optional fields that you can customize to link information to clients that is not routinely collected on the Demographics tab of the Edit Client screen. You should use Client Labels for collecting extra information about your clients that you might want to link to assessment data. One common example is using a Client Label for your client's funding source.
Below is an example of an organization that has customized its Client Labels. This organization uses all five Client Labels: for "Referral Source", "Funding Source", "Wraparound", "Educational Placement", and "Charges". In the example, you can see that "Funding Source" has four possible drop-down options: "Public Funds", "Private Insurance", "Medicaid", and "No Insurance - Out of Pocket".
Client Labels are optional, customizable categories that an organization can use to specify additional information for a client. You can search by these Client Labels in the Admin Search and they are one of the variables you can choose to include in the Data Export. They can be used for any number of purposes.
Along with the other administrators in your organization, determine whether your organization wants to use Client Labels and if so what they should be. If you wish to use Client Labels, then you need to give instructions to the Super IT Admin for your organization specifying what they should be. Next, you'll have to decide which drop down options you will include. These fields would then be entered by the IT person. Each organization can have up to five client labels - your organization's IT Admin can change the name of the labels from "Custom Label 1 - 5" to something more meaningful and can create all of the potential choices you want to have available. Although you can only have five categories, the number of dropdown options within each of the five areas is limitless.
This section reviews several features that help you keep
track of your clients over time. We've organized these into a few separate
scenarios based on whether your agency only does initial assessments,
does regular periodic assessments throughout treatment (e.g. quarterly),
or if your agency works with youth who have multiple courses of treatment
throughout their lives. Before starting an assessment with a youth, on
the assessment setup screen you must choose an administration for the
assessment (e.g. Initial CAFAS
For each scenario previously mentioned, we will discuss how to select the appropriate administration when assessing youth and what effect your choice of administration has on the system.
Some agencies only perform initial assessments. For example,
an assessment center may perform an Initial CAFAS
If your agency will only be doing initial assessments, then there isn't much more you need to worry about. You'll always choose "Initial CAFAS" from the dropdown menu.
For those agencies that plan to assess their youth more than once, such as those delivering treatment that would like to track progress over time, you must choose the correct administration when performing an assessment.
The option of Initial CAFAS
In between the Initial and Exit CAFAS
Note that you cannot select an administration that has already been completed, for example, you cannot have two administrations labeled as "3 Months". If you need to complete a second administration within the same month, we recommend choosing the closest administration and making a notation in the Additional Description field.
In addition to the Initial, Exit, and monthly time periods to choose from, there are two special types of Administrations that your staff can choose to use under certain circumstances, these are "Revised Initial" and "Special Circumstances".
You'll want to decide whether your staff should use the
administration referred to as the "Revised Initial". We included
this option in the event that within weeks of doing the Initial Assessment
it becomes apparent that, for whatever reason, the Initial Assessment
is not an accurate reflection of the youth if, for example, additional
information was not divulged until a few sessions into treatment. This
option ensures your credibility by maintaining an accurate record of the
assessment history by keeping the Initial CAFAS
You may also notice an administration called Special Circumstances - in order to maintain a clean database that is easily analyzed, we recommend that you do not use this administration.
If your agency deals with youth that may return to services after a large gap in services or need treatment for a new problem, you will want to start a new Episode of Care to distinguish between the different times the youth was in treatment. Episodes are important because the system generates data from the start and end of an episode. If a client comes in for a new problem, you can track their progress from the start of treatment for the new problem and not just from the first time they came in for treatment ever. The system allows you to generate pre-post data for episodes by looking at the initial assessment for that episode and comparing it to that episode's most recent assessment, so starting new episodes for new problems will allow you to get pre-post data for each course of treatment and not just for their whole history with your agency.
A new Episode of Care is automatically started each time "Initial" is chosen as the administration. You will likely want to develop guidelines for your staff to follow regarding when a new episode should be started. We recommend that you only start a new Episode of Care when the youth returns, after a gap in services, for a different presenting problem. Starting a new episode is an important decision, so you'll want to make sure that you have a good starting point so you generate relevant outcomes.
Be careful when choosing when to start a new episode, because assessments cannot be moved between episodes. For this reason, we recommend that you only start a new Episode of Care when the issues being addressed in treatment change. Consider the following example of Tommy, who has multiple courses of treatment, as illustrated in the image below. Tommy first came for treatment to help him through the transition of his parents' divorce. As you can see, he was in treatment for four months in our outpatient program. Two years later Tommy was back--this time to treat depression and aggressive behavior in the home and community through our home-based services program. Because it had been several years since Tommy had been in treatment and he was referred for a new presenting problem, a new Episode of Care was started. After about six months in treatment Tommy showed great improvement and he was transferred from the home-based services to the outpatient program, where he continued services for another four months before being discharged.
The system tries to anticipate when you might want to start a new episode by suggesting that you choose Initial as the administration under the following circumstances:
There are no existing assessments for the client (ever)
The last assessment was an Exit Assessment
The client has been inactive since the last assessment
The last assessment was greater than twelve months ago
The client has been transferred from one service area to another
Note that in this case, although the system will tell you to consider starting a new episode, we actually recommend against doing so. As we learned in the previous section, to maintain data that is easy to analyze, you should only start a new episode when there has been a gap in services.
Client transfers, though oftentimes not needed, can be a useful tool. Many times there is no need to use the transfer feature, however it is another one of those features that you will likely want to be familiar with and establish guidelines about for your staff to follow.
The feature exists because at any given time a client can "belong" to only one Service Area/Program combination in the system. If staff who do not have access to the client's current Service Area/Program need to assess the client, the client's record must be transferred from the current Program (the "originating" Service Area/Program) to the Program where the staff has access (the "receiving" Service Area/Program).
Whether or not your organization will have a need to transfer clients is something each agency must decide for themselves. A common reason for needing to move clients from one Program to another is because their treatment needs change. When organizations have chosen to restrict access to client information by using Service Areas and Programs there are benefits to using the transfer feature. It keeps client information confidential by allowing you to limit which clients staff have access to. If you need to change which staff have access to a client, Service Areas and Programs is a great way to do this.
Note that every time a CAFAS
The process to transfer a client is easy. From the "Edit Client Details" screen you will see a link to "Transfer Client". In order to transfer a client you must have access to both the originating and receiving Service Area/Program. Realize that the "receiving" Service Area and Program will be able to see all of the previous assessments for the clients. Once you click on the transfer link, you will be asked to select the Service Area and Program the client should be moved to. Then read the terms and conditions and click the box next to the statement "I accept the above terms and conditions". You are now ready to finish the transfer process.
Note: This feature can be very useful for some organizations, but on the other hand, your organization may never have a need to transfer clients. You can manage your users so that they always have direct access to the clients they need to assess.
In the example above, the client being transferred has
an unsigned Initial CAFAS
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