Finding the PATH to Better Behavioral Health Outcomes

The IM+CANS Training Office, which launched in 2018 to provide training and support for community behavioral health providers in the state of Illinois, initially received a rather chilly reception from some providers.

In part, that was because the training was mandated by the state. And it added one more item on an already overloaded to-do list for behavioral health providers.

Now, three years later, the reception has warmed considerably.

“We typically have 90 to 95 percent positive rates on our course evaluations,” says Matt Stinson, assistant director of Clinical Services for the Provider Assistance & Training Hub (PATH).

Providing Broad Support to Providers

PATH evolved from the IM+CANS (Illinois Medicaid Comprehensive Assessment of Needs and Strengths) Training Office to reflect the expanding course offerings coming from the office. “As we began to be more involved in support, technical assistance, and training on new initiatives from HFS [the Illinois Department of Healthcare and Family Services], we were no longer just an IM+CANS training office,” Stinson says. “The current name of our program is more reflective of the broader support and training for the additional behavioral health implementation efforts across the state. We’re working on all sorts of new service development, coaching support development, that extends well beyond training on the IM+CANS.”

PATH is a partnership between HFS, the School of Social Work at the University of Illinois Urbana-Champaign, and the Office of Medicaid Innovation. Its mission is to train and support community providers in using tools such as the IM+CANS, along with other tools and services, to transform Illinois behavioral health.

“We serve HFS as they roll out new behavioral initiatives and new services,” says Judy Howard, assistant director of Training, Development and Operations at the University of Illinois Urbana-Champaign. “They’re in the middle of an overall statewide behavioral health transformation, and our job is to educate and train the providers on the new services and also to provide ongoing support and coaching to help them as they implement the services and to ensure that we are evaluating how well we’re doing.”

IM+CANS: A Lifespan Assessment Tool

The IM+CANS is a comprehensive, lifespan tool for assessing the needs and strengths of people who require mental health treatment in Illinois. This unique tool was built for Illinois in consultation with national expert Dr. John Lyons and his team, and with input from state agency partners. The IM+CANS integrates assessment and treatment planning into a single process. It contains a complete set of core items that assess function across multiple life domains such as risk behaviors, trauma exposure, behavioral/emotional needs, substance use, and cultural factors, as well as a physical health risk assessment. CANS itself is used in 33 countries and all 50 states.

Surging Forward with Training

As mentioned, the providers give high evaluation scores to the trainings—and the numbers aren’t light.

“We’ve had about 15,000 people go through our courses,” says Stinson. “About 12,000 alone have been trained through IM+CANS.”

IM+CANS, Howard says, is for anyone who might ever do a mental health assessment on a person covered by Medicaid: independent practitioners, LCSWs, psychologists, case managers, care coordinators, psychiatric nurses, and many others.

Howard says PATH has 31 courses in development, which has necessitated greatly growing the team at PATH, which now numbers 29. Howard is in charge of the curriculum development unit and the learning management system; Stinson runs the clinical support side.

“Developing some of those natural clinical relationships, those professional relationships, Judy and I have tried to lead the way, but our team has been completely responsible for the successes,” Stinson says.

That clinical support, Howard adds, is vital, because “you train, you take the test, but some agencies find when they go forward to use it, they have questions about this section or that section. Matt’s team has really been able to get those teams over those hurdles.”

Achieving Better Outcomes

A lot of hurdles have been cleared in creating a “baseline across the state,” Howard says. “IM+CANS is the tool that has helped everyone assess the same way, share the same language, and be able to understand the same treatment plans,” she explains. “That’s where we started, at ground level.

“Now we’re going into Phase Two, adding other new services that HFS is adding in as part of this transformation. IM+CANS was just the first one.”

PATH’s quick evolution and swift development of tools and services comes at just the right time, Howard notes. “Illinois’ behavioral health service network has been challenged for years,” she says. “The point of the Illinois Behavioral Health transformation project is to help address those challenges, and make more services available in our communities.”

Stinson sees PATH as giving providers the practical solutions they need to serve people in the best way possible. “Providers have been very thoughtful about how do we remain compliant to policy while trying to do our best to serve the individuals who need help,” he says. “That’s not always an easy balance. So, we take new research and make it practical, and we help providers understand how to remain compliant and implement best practices without having to be fearful of having to close their doors. It’s a tedious balance, and sometimes those policy structures can seem confining.”

For Howard, it comes down to a very clear bottom line.

“We’re partnering with agencies to achieve better outcomes for individuals and families,” she says.