As we are regularly reminded: “The CANS (or ANSA, or FAST …) is not just a tool.” We do not rate TCOM tools separately from our work: we use the tools to assess needs, build on strengths, and make good treatment plans. In this time of pandemic, TCOM implementation should help focus your efforts. There are many ways this will happen, but now I want to focus on the acute need of preparing for consumers manifesting Covid-19 symptoms (fever, hacking cough & shortness of breath).
Because Covid-19 is so dangerous, I think it is safe to say you should score a 3 (i.e. “Immediate and/or intensive action needed”) on the relevant physical health items your tool may have (on the CDR CANS, it’s the “Physical/Medical” item for the child, and the “Caregiver-Physical/Behavioral health” for the caregiver). That means you’re ready to ‘jump’ on it and address this problem fast. Now the question is: how does that get done in your community?
Does your organization have a plan in place for when a child or caregiver is presenting Covid-19 symptoms?
I know most of us are currently making the first moves in this direction, by moving the majority of our workforce to work from home. This keeps the workers safe as they help others. Now we need to start thinking about the next steps: What do we do when we identify someone with these symptoms?
The answer for this will be very local, so I do not want to leap in with a guide that does not know your local realities. However, here are a few guide-posts to consider, that are already embedded in the logic of a TCOM tool.
First, medical problems need to be addressed by medical specialists. Helping our consumers connect to their PCP (if they have one), and follow that professional’s advice, will be an acute challenge in the months ahead. Every client will have unique issues in their ability to access the physical care they need. We need to be ready to support our workforce in doing such things as three-way phone calls with consumer PCPs, getting consumers to a hospital if the symptoms are really advanced, and then seeing how we can emotionally support them through what will be a complicated, and terrifying, time.
Second, there are a myriad of resources currently becoming available: From municipalities deferring on evictions, to pop-up medical facilities, to (hopefully soon) getting widely available corona virus testing. Our front-line needs to be kept up to pace with these. A client with symptoms will be sick, and likely not able to get themselves to some newly existing resource they have never heard of. We can help here.
Third, clear communication is essential. Clients will need clear, supportive and simple communication about their options, and workers too will need such information from their supervisors, etc.. Everyone should feel free to take your time to say it simply, to not rush things, and—most importantly—to listen. Effective collaboration is the only way to keep as many people safe, and hopefully into Covid-19 recovery, as possible.
This is just a few things to consider in responding to Covid-19, and I’m sure if your team gathers together and talks them out, you’ll realize all sorts of hurdles and opportunities for which to prepare. This is the time for planning, because soon will be the time for many immediate and intensive actions. Let your TCOM tool be a resource here. Sit with your team, go down your tool (CANS, ANSA, etc.) and talk through all of the new issues that may emerge for any item on your tool, because those items are not just for scoring – they are things that people will need done, and for which it would be wise to prepare in advance.
Of course, there are many other things to consider for those both suffering from Covid-19 symptoms, as well as the rest of people who are dealing with the trauma of our current situation. We will discuss more of them in upcoming blogs. If you have any insights or ideas on planning the right interventions for our clients in the current Covid-19 crisis, please reach out, and I’d love to include it in future blog posts.
Dan Warner Ph.D.