Attachment 9 - SUPRT-A Codebook_0.xlsx
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About this file
This file is a CMHS and CSAT SUPRT-A Codebook, a technical reference document from the Substance Abuse and Mental Health Services Administration (SAMHSA) designed to assist grantees in understanding data entry fields and requirements for the SUPRT-A administrative assessment tool. The codebook provides detailed specifications for batch upload and data download functionality across multiple sections including record management, behavioral health history, screening assessments, diagnoses, services received, and demographic information. The document, effective September 2025, serves as the authoritative guide for organizations implementing the SUPRT-A tool to ensure consistent data collection and reporting standards for clients receiving behavioral health services. The codebook contains detailed field definitions, valid value sets, data type specifications, and conditional logic requirements for approximately 200+ data elements organized into six primary sections, with each field mapped to specific assessment questions and documented with skip logic and warning edits to maintain data integrity.
The codebook establishes standardized coding conventions for insurance types, crisis indicators, substance use screening results, behavioral health diagnoses using ICD-10 codes, service provision and referral tracking across 16 categories of behavioral health services plus medication-specific substance use disorder treatments, and comprehensive demographic data including race and ethnicity with extensive ethnic subcategories. Data validation rules are embedded throughout, requiring consistency checks across related fields (such as ensuring all insurance fields contain valid responses when any insurance is indicated), with special handling for missing data, not applicable responses, and not documented scenarios identified through specific numeric codes (-1, -5, -9). The codebook indicates that assessment data collection is triggered at baseline intake, reassessment, annual review, and record closeout stages, with conditional requirements for certain fields based on client age, program type, and prior responses. This technical specification document serves grantees administering federal behavioral health programs by providing the precise field-level requirements necessary for accurate data submission and federal reporting compliance.
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Explanation
| Explanation of CMHS and CSAT SUPRT-A Codebook Elements | Description for the decision process flowchart depicted below is located in cell B6. |
| Note: This CMHS and CSAT SUPRT-A Codebook is intended to aid grantees in understanding the current SUPRT-A tool used for administrative data entry. While the codebook is as accurate as possible at this time, additional updates may be required as a result of changes identified by users of data entry and batch upload processes. It is expected that any changes will be minor. Please check the SPARS Resource site to ensure you are working with the most current version of the codebook. |
Overview: This CMHS and CSAT SUPRT-A Codebook contains information about the fields available for batch upload and data download for the current SUPRT-A tool used for administrative assessments.
Codebook columns: Columns A and B indicate if a field is used for batch upload and/or appears in data download. Grantees should filter based on these columns to determine all the fields needed for batch upload and all the fields to expect in a data download.
Column C indicates the section of the SUPRT-A tool in which the field appears.
Column D indicates the field name that should be used for batch upload and the name that appears in data download. Note that not all field names appear in the tool as some are system derived.
Column E indicates the question number from the SUPRT-A tool associated with the field.
Column F indicates the question text from the SUPRT-A tool associated with the field.
Columns G and H should be referenced to determine the valid values that can be used for batch upload and the valid values to expect when viewing a data download file.
Column I indicates the data type of the field.
Column J indicates additional notes related to warnings, skip logic, and conditions for the field.
| Codebook rows: There is a row in the codebook for every field that is required when batch uploading data or that will appear in a download of current tool data. |
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| CSAT GPRA Codebook | |
| End of worksheet |
Version: July 2023 &A &P
Codebook
| CMHS and CSAT SUPRT-A Tool Codebook (September 2025) | ||||||
| Batch Upload Field | Data Download Field | Tool Section | Field Name | Question | ||
| Number | Question and/or Description | Value Definitions (Batch Upload) | Value Definitions (Data Download) | Data Type | Warning Edits / Skip Logic | |
| No | Yes | A. RECORD MANAGEMENT | Region | N/A | Region associated with the grant under which the client record falls | |
| . | 1 = CT, ME, MA, NH, RI, VT |
2 = NJ, NY, PR, VI
3 = DE, DC, MD, PA, VA, WV
4 = AL, FL, GA, KY, MS, NC, SC, TN
5 = IL, IN, MI, MN, OH, WI
6 = AR, LA, NM, OK, TX
7 = IA, KS, MO, NE
8 = CO, MT, ND, SD, UT, WY
9 = AZ, CA, HI, NV, AS, MP, FM, GU, MH, PW
10 = AK, ID, OR, WA Text(2) AUTOFILL - System Derived Each region consists of a set of states/territories
| No | Yes | A. RECORD MANAGEMENT | StateCode | N/A | State associated with the grant under which the client record falls | . | Two letter postal code abbreviation | |||
| (Three letters may be used for certain US territories.) | Text(2) | AUTOFILL - System Derived | ||||||||
| Yes | Yes | A. RECORD MANAGEMENT | ClientID | N/A | Unique identifier for a person within a grant. | |||||
| Assigned by grantee. | Grant-generated ID number | Grant-generated ID number | Alphanumeric(9) | |||||||
| Yes | Yes | A. RECORD MANAGEMENT | SiteID | N/A | Site ID | Site ID | Site ID | Alphanumeric(50) | ||
| Yes | Yes | A. RECORD MANAGEMENT | GrantID | N/A | Contract/Grant ID | Assigned by SAMHSA | Assigned by SAMHSA | Alphanumeric(20) | ||
| Yes | Yes | A. RECORD MANAGEMENT | Program | N/A | Program | Assigned by SAMHSA | Assigned by SAMHSA | Text(80) | AUTOFILL - System Derived | |
| No | Yes | A. RECORD MANAGEMENT | GrantInactFlag | N/A | Grant status (active or inactive) | 0 = Active | ||||
| 1 = Inactive | AUTOFILL - System Derived | |||||||||
| Yes | Yes | A. RECORD MANAGEMENT | BirthMonthYear | A1 | Birth month and year | MM/YYYY | MM/YYYY | Date | Date must be on the date of entry, or earlier. Date cannot be earlier than 1/1900. | |
| Yes | Yes | A. RECORD MANAGEMENT | AssessmentDate | A2 | Date assessment completed | MMDDYYYY | MMDDYYYY | Date | Date must be on the date of entry, or earlier. Date cannot be earlier than 1/1/1900. | |
| Yes | Yes | A. RECORD MANAGEMENT | AssessmentType | A3 | Assessment type | 1 = Baseline |
2 = Reassessment 3 = Annual 4 = Record Closeout 1 = Baseline 2 = Reassessment 3 = Annual
| 4 = Record Closeout | Numeric | ||||||
| No | Yes | A. RECORD MANAGEMENT | InactFlag | N/A | Client Active Status (active or inactive) | 0 = Active | |
| 1 = Inactive | Numeric | AUTOFILL - System Derived |
A client can have multiple intakes - the most current intake is "active" (inactflag='0') and the rest are set to "inactive" (inactflag='1').
For regular Services: When a new Intake is added all existing assessments are marked inactive.
| Yes | Yes | A. RECORD MANAGEMENT | FirstServicesDate | A4 | Month and year client first received services. Completed only at baseline only | MM/YYYY | MM/YYYY | Date | |
| Yes | Yes | A. RECORD MANAGEMENT | RecentServicesDate | A5 | Month of year client most recently received services. Completed at reassessment, annual, or closeout only | MM/YYYY | MM/YYYY | Date | Cannot be before date in FirstServicesDate. |
if question A3 = 4, cannot be after the date identified in question A2.
Yes Yes A. RECORD MANAGEMENT CloseoutStatus A6 Reason for clients closeout. At closeout only 1 = Completed the program 2 = No contact 3 = Withdrew from/Refused treatment 4 = Referred out 5 = Transferred to a different grant program 6 = Incarceration 7 = Moved 8 = Death 9 = Other 1 = Completed the program 2 = No contact 3 = Withdrew from/Refused treatment 4 = Referred out 5 = Transferred to a different grant program 6 = Incarceration 7 = Moved 8 = Death 9 = Other Numeric IF A3 = 4 (Assessment type = closeout)
If answer to question 6 = 8, go to question 6a.
Yes Yes A. RECORD MANAGEMENT DeathCause A6a Cause of death 1 = Suicide 2 = Overdose 3 = Other behavioral health cause 4 = Other cause -1 = Not applicable -5 = Not documented in record 1 = Suicide 2 = Overdose 3 = Other behavioral health cause 4 = Other cause -1 = Not applicable
| -5 = Not documented in record | Numeric | ||||||
| Yes | Yes | B. BEHAVIORAL HEALTH HISTORY | InsuranceMedicare | B1 | What insurance does the client or guarantor have? Select all that apply. - Medicare | 0 = Unchecked |
1 = Checked -9 = MISSING DATA 0 = Unchecked 1 = Checked
-9 = MISSING DATA
Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual)
If any B1 Insurance field =1, then any other B1 Insurance field cannot = -9, but must = 0 or 1.
Yes Yes B. BEHAVIORAL HEALTH HISTORY InsuranceMedicaid B1 What insurance does the client or guarantor have? Select all that apply. - Medicaid 0 = Unchecked 1 = Checked -9 = MISSING DATA 0 = Unchecked 1 = Checked -9 = MISSING DATA Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual)
If any B1 Insurance field =1, then any other B1 Insurance field cannot = -9, but must = 0 or 1.
Yes Yes B. BEHAVIORAL HEALTH HISTORY InsurancePrivate B1 What insurance does the client or guarantor have? Select all that apply. - Private insurance 0 = Unchecked 1 = Checked -9 = MISSING DATA 0 = Unchecked 1 = Checked -9 = MISSING DATA Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual)
If any B1 Insurance field =1, then any other B1 Insurance field cannot = -9, but must = 0 or 1.
Yes Yes B. BEHAVIORAL HEALTH HISTORY InsuranceMilitary B1 What insurance does the client or guarantor have? Select all that apply. - TRICARE or other military health insurance 0 = Unchecked 1 = Checked -9 = MISSING DATA 0 = Unchecked 1 = Checked -9 = MISSING DATA Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual)
If any B1 Insurance field =1, then any other B1 Insurance field cannot = -9, but must = 0 or 1.
Yes Yes B. BEHAVIORAL HEALTH HISTORY InsuranceTribal B1 What insurance does the client or guarantor have? Select all that apply. - Indian Health Service Tribal Health care 0 = Unchecked 1 = Checked -9 = MISSING DATA 0 = Unchecked 1 = Checked -9 = MISSING DATA Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual)
If any B1 Insurance field =1, then any other B1 Insurance field cannot = -9, but must = 0 or 1.
Yes Yes B. BEHAVIORAL HEALTH HISTORY InsuranceAssistance B1 What insurance does the client or guarantor have? Select all that apply. - Assistance program 0 = Unchecked 1 = Checked -9 = MISSING DATA 0 = Unchecked 1 = Checked -9 = MISSING DATA Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual)
If any B1 Insurance field =1, then any other B1 Insurance field cannot = -9, but must = 0 or 1.
Yes Yes B. BEHAVIORAL HEALTH HISTORY InsuranceOther B1 What insurance does the client or guarantor have? Select all that apply. - Any other type of insurance or health coverage plan 0 = Unchecked 1 = Checked -9 = MISSING DATA 0 = Unchecked 1 = Checked -9 = MISSING DATA Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual)
If any B1 Insurance field =1, then any other B1 Insurance field cannot = -9, but must = 0 or 1.
Yes Yes B. BEHAVIORAL HEALTH HISTORY InsuranceNone B1 What insurance does the client or guarantor have? Select all that apply. - No insurance 0 = Unchecked 1 = Checked -9 = MISSING DATA 0 = Unchecked 1 = Checked -9 = MISSING DATA Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual)
If InsuranceNone = 1, all other insurance variables must = 0.
Yes Yes B. BEHAVIORAL HEALTH HISTORY InsuranceNotDoc B1 What insurance does the client or guarantor have? Select all that apply. - Not documented in client's records 0 = Unchecked 1 = Checked -9 = MISSING DATA 0 = Unchecked 1 = Checked -9 = MISSING DATA Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual)
If InsuranceNotDoc = 1, all other insurance variables must = 0.
Yes Yes B. BEHAVIORAL HEALTH HISTORY HospitalAdmitted B2 In the past 30 days, was the client admitted to a hospital? 1 = Yes – Behavioral health reasons, for example mental health or substance use disorder 2 = Yes – Other health reasons, for example injury or illness 0 = No -5 = Not documented in records or not documented in records using this standard -9 = MISSING DATA 1 = Yes – Behavioral health reasons, for example mental health or substance use disorder 2 = Yes – Other health reasons, for example injury or illness 0 = No -5 = Not documented in records or not documented in records using this standard
| -9 = MISSING DATA | Numeric | IF A3 = 1, 2, or 3 (baseline, reassessment, or annual) | |||||
| Yes | Yes | B. BEHAVIORAL HEALTH HISTORY | EDVisit | B3 | In the past 30 days, did the client visit an emergency department? | 1 = Yes – Behavioral health reasons, for example mental health or substance use disorder |
2 = Yes – Other health reasons, for example injury or illness 0 = No -5 = Not documented in records or not documented in records using this standard -9 = MISSING DATA 1 = Yes – Behavioral health reasons, for example mental health or substance use disorder 2 = Yes – Other health reasons, for example injury or illness 0 = No -5 = Not documented in records or not documented in records using this standard
| -9 = MISSING DATA | Numeric | IF A3 = 1, 2, or 3 (baseline, reassessment, or annual) | |||||
| Yes | Yes | B. BEHAVIORAL HEALTH HISTORY | BHCrisis | B4 | In the past 30 days, did the client experience a behavioral health crisis or request crisis response, for example 988 or 911? | 1 = Yes |
0 = No -5 = Not documented in records or not documented in records using this standard -9 = MISSING DATA 1 = Yes 0 = No -5 = Not documented in records or not documented in records using this standard -9 = MISSING DATA Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual)
If answer to B4 = 1, go to question B4a.
Yes Yes B. BEHAVIORAL HEALTH HISTORY CrisisIssue B4a What is the primary crisis issue? 1 = Suicide risk 2 = Other risk of harm to self or others 3 = Mental health 4 = Substance use other than overdose 5 = Overdose 6 = Other -1 = Not applicable -5 = Not documented in records or not documented in records using this standard -9 = MISSING DATA 1 = Suicide risk 2 = Other risk of harm to self or others 3 = Mental health 4 = Substance use other than overdose 5 = Overdose 6 = Other -1 = Not applicable -5 = Not documented in records or not documented in records using this standard -9 = MISSING DATA Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual)
IF B4 = 0, then B4a = -1 Yes Yes B. BEHAVIORAL HEALTH HISTORY Residential B5 In the past 30 days, did the client spend one or more nights at a residential behavioral health treatment facility, for example crisis stabilization or residential substance use disorder treatment facility, including for withdrawal management? 1 = Yes 0 = No -5 = Not documented in records or not documented in records using this standard -9 = MISSING DATA 1 = Yes 0 = No -5 = Not documented in records or not documented in records using this standard
| -9 = MISSING DATA | Numeric | IF A3 = 1, 2, or 3 (baseline, reassessment, or annual) | ||||
| Yes | Yes | B. BEHAVIORAL HEALTH HISTORY | Arrested | B6 | In the past 90 days, was the client arrested, taken into custody, or detained? | |
| 1 = Yes |
0 = No -1 = Not applicable -5 = Not documented in records or not documented in records using this standard -9 = MISSING DATA 1 = Yes 0 = No -1 = Not applicable -5 = Not documented in records or not documented in records using this standard -9 = MISSING DATA Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual)
Answered for clients 11 years or older.
Yes Yes B. BEHAVIORAL HEALTH HISTORY Detained B7 In the past 90 days, did the client spend one or more nights in jail or a correctional facility? 1 = Yes 0 = No -5 = Not documented in records or not documented in records using this standard -1 = Not applicable -9 = MISSING DATA 1 = Yes 0 = No -5 = Not documented in records or not documented in records using this standard -1 = Not applicable -9 = MISSING DATA Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual)
Answered for clients 11 years or older.
Yes Yes B. BEHAVIORAL HEALTH HISTORY ProbationSupervision B8 In the past 90 days, has the client been on probation, parole, or intensive pretrial supervision for one or more days? 1 = Yes 0 = No -5 = Not documented in records or not documented in records using this standard -1 = Not applicable -9 = MISSING DATA 1 = Yes 0 = No -5 = Not documented in records or not documented in records using this standard -1 = Not applicable -9 = MISSING DATA Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual)
Answered for clients 11 years or older.
Yes Yes C. BEHAVIORAL HEALTH SCREENINGS ScreenedSuicidality C1 Within the past 30 days, was the client screened or assessed by your program for risk of suicidality 1 = Yes – Screening result was negative (no or low risk) 2 = Yes – Screening result was positive (at risk) 0 = No, not screened or assessed -5 = Not documented in records or not documented in records using this standard -9 = MISSING DATA 1 = Yes – Screening result was negative (no or low risk) 2 = Yes – Screening result was positive (at risk) 0 = No, not screened or assessed -5 = Not documented in records or not documented in records using this standard
| -9 = MISSING DATA | Numeric | IF A3 = 1, 2, or 3 (baseline, reassessment, or annual) | |||||
| Yes | Yes | C. BEHAVIORAL HEALTH SCREENINGS | ScreenedSubstanceUse | C2 | Within the past 30 days, was the client screened or assessed by your program for substance use? | 1 = Yes – Screening result was negative (no or low risk) |
2 = Yes – Screening result was positive (at risk) 0 = No, not screened or assessed -5 = Not documented in records or not documented in records using this standard -9 = MISSING DATA 1 = Yes – Screening result was negative (no or low risk) 2 = Yes – Screening result was positive (at risk) 0 = No, not screened or assessed -5 = Not documented in records or not documented in records using this standard -9 = MISSING DATA Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual)
If C2 = 1 or 2, complete C3.
Yes Yes C. BEHAVIORAL HEALTH SCREENINGS AlcoholUse C3a During the screening and assessment process, what was the reported use for the following substances? - Alcohol 1 = Recent use 2 = Past use 0 = Never used -5 = Not documented
-9 = MISSING DATA
-1 = Not applicable 1 = Recent use 2 = Past use 0 = Never used -5 = Not documented
-9 = MISSING DATA
-1 = Not applicable Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual)
IF C2 = 0, then -1 Yes Yes C. BEHAVIORAL HEALTH SCREENINGS OpioidsUse C3b During the screening and assessment process, what was the reported use for the following substances? - Opioids 1 = Recent use 2 = Past use 0 = Never used -5 = Not documented
-9 = MISSING DATA
-1 = Not applicable 1 = Recent use 2 = Past use 0 = Never used -5 = Not documented
-9 = MISSING DATA
-1 = Not applicable Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual)
IF C2 = 0, then -1 Yes Yes C. BEHAVIORAL HEALTH SCREENINGS CannabisUse C3c During the screening and assessment process, what was the reported use for the following substances? - Cannabis 1 = Recent use 2 = Past use 0 = Never used -5 = Not documented
-9 = MISSING DATA
-1 = Not applicable 1 = Recent use 2 = Past use 0 = Never used -5 = Not documented
-9 = MISSING DATA
-1 = Not applicable Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual)
IF C2 = 0, then -1 Yes Yes C. BEHAVIORAL HEALTH SCREENINGS SedativeUse C3d During the screening and assessment process, what was the reported use for the following substances? - Sedative, hypnotic, or anxiolytics 1 = Recent use 2 = Past use 0 = Never used -5 = Not documented
-9 = MISSING DATA
-1 = Not applicable 1 = Recent use 2 = Past use 0 = Never used -5 = Not documented
-9 = MISSING DATA
-1 = Not applicable Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual)
IF C2 = 0, then -1 Yes Yes C. BEHAVIORAL HEALTH SCREENINGS CocaineUse C3e During the screening and assessment process, what was the reported use for the following substances? - Cocaine 1 = Recent use 2 = Past use 0 = Never used -5 = Not documented
-9 = MISSING DATA
-1 = Not applicable 1 = Recent use 2 = Past use 0 = Never used -5 = Not documented
-9 = MISSING DATA
-1 = Not applicable Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual)
IF C2 = 0, then -1 Yes Yes C. BEHAVIORAL HEALTH SCREENINGS MethamphetamineUse C3f During the screening and assessment process, what was the reported use for the following substances? - Methamphetamine 1 = Recent use 2 = Past use 0 = Never used -5 = Not documented
-9 = MISSING DATA
-1 = Not applicable 1 = Recent use 2 = Past use 0 = Never used -5 = Not documented
-9 = MISSING DATA
-1 = Not applicable Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual)
IF C2 = 0, then -1 Yes Yes C. BEHAVIORAL HEALTH SCREENINGS OtherStimUse C3g During the screening and assessment process, what was the reported use for the following substances? - Other stimulants 1 = Recent use 2 = Past use 0 = Never used -5 = Not documented
-9 = MISSING DATA
-1 = Not applicable 1 = Recent use 2 = Past use 0 = Never used -5 = Not documented
-9 = MISSING DATA
-1 = Not applicable Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual)
IF C2 = 0, then -1 Yes Yes C. BEHAVIORAL HEALTH SCREENINGS HallucinogensUse C3h During the screening and assessment process, what was the reported use for the following substances? - Hallucinogens or psychedelics 1 = Recent use 2 = Past use 0 = Never used -5 = Not documented
-9 = MISSING DATA
-1 = Not applicable 1 = Recent use 2 = Past use 0 = Never used -5 = Not documented
-9 = MISSING DATA
-1 = Not applicable Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual)
IF C2 = 0, then -1 Yes Yes C. BEHAVIORAL HEALTH SCREENINGS InhalantsUse C3i During the screening and assessment process, what was the reported use for the following substances? - Inhalants 1 = Recent use 2 = Past use 0 = Never used -5 = Not documented
-9 = MISSING DATA
-1 = Not applicable 1 = Recent use 2 = Past use 0 = Never used -5 = Not documented
-9 = MISSING DATA
-1 = Not applicable Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual)
IF C2 = 0, then -1 Yes Yes C. BEHAVIORAL HEALTH SCREENINGS OtherPsychoactiveUse C3j During the screening and assessment process, what was the reported use for the following substances? - Other psychoactive substances 1 = Recent use 2 = Past use 0 = Never used -5 = Not documented
-9 = MISSING DATA
-1 = Not applicable 1 = Recent use 2 = Past use 0 = Never used -5 = Not documented
-9 = MISSING DATA
-1 = Not applicable Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual)
IF C2 = 0, then -1 Yes Yes C. BEHAVIORAL HEALTH SCREENINGS TobaccoNicotineUse C3k During the screening and assessment process, what was the reported use for the following substances? - Tobacco or nicotine 1 = Recent use 2 = Past use 0 = Never used -5 = Not documented
-9 = MISSING DATA
-1 = Not applicable 1 = Recent use 2 = Past use 0 = Never used -5 = Not documented
-9 = MISSING DATA
-1 = Not applicable Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual)
IF C2 = 0, then -1 Yes Yes C. BEHAVIORAL HEALTH SCREENINGS ScreenDepression C4a Within the past 30 days, was the client screened or assessed by your program for the following disorders? - Depression disorders 1 = Screened/Assessed 0 = Not screened -5 = Not documented -9 = MISSING DATA 1 = Screened/Assessed 0 = Not screened -5 = Not documented
| -9 = MISSING DATA | Numeric | IF A3 = 1, 2, or 3 (baseline, reassessment, or annual) | |||||
| Yes | Yes | C. BEHAVIORAL HEALTH SCREENINGS | ScreenAnxiety | C4b | Within the past 30 days, was the client screened or assessed by your program for the following disorders? - Anxiety disorders | 1 = Screened/Assessed |
0 = Not screened -5 = Not documented -9 = MISSING DATA 1 = Screened/Assessed 0 = Not screened -5 = Not documented
| -9 = MISSING DATA | Numeric | IF A3 = 1, 2, or 3 (baseline, reassessment, or annual) | |||||
| Yes | Yes | C. BEHAVIORAL HEALTH SCREENINGS | ScreenBipolar | C4c | Within the past 30 days, was the client screened or assessed by your program for the following disorders? - Bipolar disorders | 1 = Screened/Assessed |
0 = Not screened -5 = Not documented -9 = MISSING DATA 1 = Screened/Assessed 0 = Not screened -5 = Not documented
| -9 = MISSING DATA | Numeric | IF A3 = 1, 2, or 3 (baseline, reassessment, or annual) | |||||
| Yes | Yes | C. BEHAVIORAL HEALTH SCREENINGS | ScreenPsychosis | C4d | Within the past 30 days, was the client screened or assessed by your program for the following disorders? - Psychosis disorders | 1 = Screened/Assessed |
0 = Not screened -5 = Not documented -9 = MISSING DATA 1 = Screened/Assessed 0 = Not screened -5 = Not documented
| -9 = MISSING DATA | Numeric | IF A3 = 1, 2, or 3 (baseline, reassessment, or annual) | |||||
| Yes | Yes | C. BEHAVIORAL HEALTH SCREENINGS | ScreenTrauma | C4e | Within the past 30 days, was the client screened or assessed by your program for the following disorders? - Trauma disorders | 1 = Screened/Assessed |
0 = Not screened -5 = Not documented -9 = MISSING DATA 1 = Screened/Assessed 0 = Not screened -5 = Not documented
| -9 = MISSING DATA | Numeric | IF A3 = 1, 2, or 3 (baseline, reassessment, or annual) | |||||
| Yes | Yes | C. BEHAVIORAL HEALTH SCREENINGS | ScreenDevelopmental | C4f | Within the past 30 days, was the client screened or assessed by your program for the following disorders? - Developmental, neurologic disorders | 1 = Screened/Assessed |
0 = Not screened -1 = Not applicable -5 = Not documented -9 = MISSING DATA 1 = Screened/Assessed 0 = Not screened -1 = Not applicable -5 = Not documented -9 = MISSING DATA Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual)
Complete this question only if the client is younger than 18 years.
If client is > 18 years old, then C4f = -1 Yes Yes C. BEHAVIORAL HEALTH SCREENINGS ScreenBehavioral C4fg Within the past 30 days, was the client screened or assessed by your program for the following disorders? - Behavioral, emotional disorders 1 = Screened/Assessed 0 = Not screened -1 = Not applicable -5 = Not documented -9 = MISSING DATA 1 = Screened/Assessed 0 = Not screened -1 = Not applicable -5 = Not documented -9 = MISSING DATA Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual)
Complete this question only if the client is younger than 18 years.
If client is > 18 years old, then C4g = -1 Yes Yes D. BEHAVIORAL HEALTH DIAGNOSIS SUDDiagnosis1 D1a ICD-10 Substance use disorder diagnosis code See ICD10sheet tab (column B).
1 = No diagnosis -9 = MISSING DATA See ICD10sheet tab (column B).
1 = No diagnosis -9 = MISSING DATA Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual)
If SUDDiagnosis1 = 1, then SUDDiagnosis2 and SUDDiagnosis3 = 1.
If SUDDiagnosis1 = -9, then SUDDiagnosis2 and SUDDiagnosis3 = -9. If SUDDiagnosis1 does not = -9, then SUDDiagnosis2 and SUDDiagnosis3 cannot = -9.
Always applies.
* Cannot select the same F code more than once across the three Diagnosis fields. Only 1 or -9 can be selected more than once across the three Diagnosis fields.
* For Substance Use Disorders, cannot select more than one diagnosis in each category range:
F10 F11 F12 F13 F14 F15 F16 F18 F19 F17 Yes Yes D. BEHAVIORAL HEALTH DIAGNOSIS SUDDiagnosis2 D1b ICD-10 Substance use disorder diagnosis code See ICD10sheet tab (column B).
1 = No diagnosis -9 = MISSING DATA See ICD10sheet tab (column B).
1 = No diagnosis -9 = MISSING DATA Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual)
If SUDDiagnosis1 = 1, then SUDDiagnosis2 and SUDDiagnosis3 = 1.
If SUDDiagnosis1 = -9, then SUDDiagnosis2 and SUDDiagnosis3 = -9. If SUDDiagnosis1 does not = -9, then SUDDiagnosis2 and SUDDiagnosis3 cannot = -9.
Always applies.
* Cannot select the same F code more than once across the three Diagnosis fields. Only 1 or -9 can be selected more than once across the three Diagnosis fields.
* For Substance Use Disorders, cannot select more than one diagnosis in each category range:
F10 F11 F12 F13 F14 F15 F16 F18 F19 F17 Yes Yes D. BEHAVIORAL HEALTH DIAGNOSIS SUDDiagnosis3 D1c ICD-10 Substance use disorder diagnosis code See ICD10sheet tab (column B).
1 = No diagnosis -9 = MISSING DATA See ICD10sheet tab (column B).
1 = No diagnosis -9 = MISSING DATA Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual)
If SUDDiagnosis1 = 1, then SUDDiagnosis2 and SUDDiagnosis3 = 1.
If SUDDiagnosis1 = -9, then SUDDiagnosis2 and SUDDiagnosis3 = -9. If SUDDiagnosis1 does not = -9, then SUDDiagnosis2 and SUDDiagnosis3 cannot = -9.
Always applies.
* Cannot select the same F code more than once across the three Diagnosis fields. Only 1 or -9 can be selected more than once across the three Diagnosis fields.
* For Substance Use Disorders, cannot select more than one diagnosis in each category range:
F10 F11 F12 F13 F14 F15 F16 F18 F19 F17 Yes Yes D. BEHAVIORAL HEALTH DIAGNOSIS MHDiagnosis1 D2a ICD-10 Mental health diagnosis code See ICD10sheet tab (column B).
1 = No diagnosis -9 = MISSING DATA See ICD10sheet tab (column B).
1 = No diagnosis -9 = MISSING DATA Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual)
If MHDiagnosis1 = 1, then MHDiagnosis2 and MHDiagnosis3 = 1.
If MHDiagnosis1 = -9, then MHDiagnosis2 and MHDiagnosis3 = -9. If MHDiagnosis1 does not = -9, then MHDiagnosis2 and MHDiagnosis3 cannot = -9.
* Cannot select the same F code more than once across the three Diagnosis fields. Only 1 or -9 can be selected more than once across the three Diagnosis fields.
* For Mental Health Diagnoses, can select more than one diagnosis in each category range:
F20-F34 F39-F45 F48 F50-F51 F60 F63 F7-F8 F90 F91 F93-F95 F98-F99 Yes Yes D. BEHAVIORAL HEALTH DIAGNOSIS MHDiagnosis2 D2b ICD-10 Mental health diagnosis code See ICD10sheet tab (column B).
1 = No diagnosis -9 = MISSING DATA See ICD10sheet tab (column B).
1 = No diagnosis -9 = MISSING DATA Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual)
If MHDiagnosis1 = 1, then MHDiagnosis2 and MHDiagnosis3 = 1.
If MHDiagnosis1 = -9, then MHDiagnosis2 and MHDiagnosis3 = -9. If MHDiagnosis1 does not = -9, then MHDiagnosis2 and MHDiagnosis3 cannot = -9.
* Cannot select the same F code more than once across the three Diagnosis fields. Only 1 or -9 can be selected more than once across the three Diagnosis fields.
* For Mental Health Diagnoses, can select more than one diagnosis in each category range:
F20-F34 F39-F45 F48 F50-F51 F60 F63 F7-F8 F90 F91 F93-F95 F98-F99 Yes Yes D. BEHAVIORAL HEALTH DIAGNOSIS MHDiagnosis3 D2c ICD-10 Mental health diagnosis code See ICD10sheet tab (column B).
1 = No diagnosis -9 = MISSING DATA See ICD10sheet tab (column B).
1 = No diagnosis -9 = MISSING DATA Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual)
If MHDiagnosis1 = 1, then MHDiagnosis2 and MHDiagnosis3 = 1.
If MHDiagnosis1 = -9, then MHDiagnosis2 and MHDiagnosis3 = -9. If MHDiagnosis1 does not = -9, then MHDiagnosis2 and MHDiagnosis3 cannot = -9.
* Cannot select the same F code more than once across the three Diagnosis fields. Only 1 or -9 can be selected more than once across the three Diagnosis fields.
* For Mental Health Diagnoses, can select more than one diagnosis in each category range:
F20-F34 F39-F45 F48 F50-F51 F60 F63 F7-F8 F90 F91 F93-F95 F98-F99 Yes Yes D. BEHAVIORAL HEALTH DIAGNOSIS OtherHealth1 D3a ICD-10 Other factors influencing health status code See ICD10sheet tab (column B).
1 = No diagnosis -9 = MISSING DATA See ICD10sheet tab (column B).
1 = No diagnosis -9 = MISSING DATA Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual)
If OtherHealth1 = 1, then OtherHealth2 and OtherHealth3 = 1.
If OtherHealth1 = -9, then OtherHealth2 and OtherHealth3 = -9. If OtherHealth1 does not = -9, then OtherHealth2 and OtherHealth3 cannot = -9.
* Cannot select the same Z code more than once across the three Diagnosis fields. Only 1 or -9 can be selected more than once across the three Diagnosis fields.
*Can select more than one diagnosis in each category range:
Z55-57 Z59-60 Z62-Z65 Yes Yes D. BEHAVIORAL HEALTH DIAGNOSIS OtherHealth2 D3b ICD-10 Other factors influencing health status code See ICD10sheet tab (column B).
1 = No diagnosis -9 = MISSING DATA See ICD10sheet tab (column B).
1 = No diagnosis -9 = MISSING DATA Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual)
If OtherHealth1 = 1, then OtherHealth2 and OtherHealth3 = 1.
If OtherHealth1 = -9, then OtherHealth2 and OtherHealth3 = -9. If OtherHealth1 does not = -9, then OtherHealth2 and OtherHealth3 cannot = -9.
* Cannot select the same Z code more than once across the three Diagnosis fields. Only 1 or -9 can be selected more than once across the three Diagnosis fields.
*Can select more than one diagnosis in each category range:
Z55-57 Z59-60 Z62-Z65 Yes Yes D. BEHAVIORAL HEALTH DIAGNOSIS OtherHealth3 D3c ICD-10 Other factors influencing health status code See ICD10sheet tab (column B).
1 = No diagnosis -9 = MISSING DATA See ICD10sheet tab (column B).
1 = No diagnosis -9 = MISSING DATA Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual)
If OtherHealth1 = 1, then OtherHealth2 and OtherHealth3 = 1.
If OtherHealth1 = -9, then OtherHealth2 and OtherHealth3 = -9. If OtherHealth1 does not = -9, then OtherHealth2 and OtherHealth3 cannot = -9.
* Cannot select the same Z code more than once across the three Diagnosis fields. Only 1 or -9 can be selected more than once across the three Diagnosis fields.
*Can select more than one diagnosis in each category range:
Z55-57 Z59-60 Z62-Z65 Yes Yes D. BEHAVIORAL HEALTH DIAGNOSIS CurrentlyPregnant D4 Is the client currently pregnant? 1 = Yes 0 = No -5 = Not documented in records or not documented in records using this standard -1 = Not applicable -9 = MISSING DATA 1 = Yes 0 = No -5 = Not documented in records or not documented in records using this standard -1 = Not applicable
| -9 = MISSING DATA | Numeric | IF A3 = 1, 2, or 3 (baseline, reassessment, or annual) | |||||
| Yes | Yes | D. BEHAVIORAL HEALTH DIAGNOSIS | PsychosisEpisode | D5 | Has the client experienced an episode of psychosis since their last assessment? | 1 = Yes |
0 = No -1 = Not applicable -5 = Not documented in records or not documented in records using this standard -9 = MISSING DATA 1 = Yes 0 = No -1 = Not applicable -5 = Not documented in records or not documented in records using this standard -9 = MISSING DATA Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual) Completed if Program = CHR-P, AND AssessmentType = 2 or 3 AND client is a high risk pychosis client
Else (Program not equal CHR-P, OR AssessmentType = 1 OR client is not a high risk pychosis client), then D5 = -1 Yes Yes D. BEHAVIORAL HEALTH DIAGNOSIS Overdose D6 In the previous 30 days, did the client experience an overdose or take too much of a substance that resulted in needing supervision or medical attention? 1 = Yes 0 = No -5 = Not documented in records or not documented in records using this standard -1 = Not applicable -9 = MISSING DATA 1 = Yes 0 = No -5 = Not documented in records or not documented in records using this standard -1 = Not applicable -9 = MISSING DATA Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual) If answer to question D1 contains at least one diagnosis code, else -1 Yes Yes D. BEHAVIORAL HEALTH DIAGNOSIS OverdoseNaloxone D6a After taking too much of a substance or overdosing, what intervention(s) did the client receive? Select all that apply. - Naloxone 1 = Yes 0 = No -1 = Not applicable -5 = Not documented in records or not documented in records using this standard -9 = MISSING DATA 1 = Yes 0 = No -1 = Not applicable -5 = Not documented in records or not documented in records using this standard -9 = MISSING DATA Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual) If one overdose item equals -1, all should equal -1. If one overdose item equals -5, all should equal -5. If one overdose item equals -9, all should equal -9.
Yes Yes D. BEHAVIORAL HEALTH DIAGNOSIS OverdoseED D6a After taking too much of a substance or overdosing, what intervention(s) did the client receive? Select all that apply. - Care in emergency department 1 = Yes 0 = No -1 = Not applicable -5 = Not documented in records or not documented in records using this standard -9 = MISSING DATA 1 = Yes 0 = No -1 = Not applicable -5 = Not documented in records or not documented in records using this standard -9 = MISSING DATA Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual) If one overdose item equals -1, all should equal -1. If one overdose item equals -5, all should equal -5. If one overdose item equals -9, all should equal -9.
Yes Yes D. BEHAVIORAL HEALTH DIAGNOSIS OverdosePCP D6a After taking too much of a substance or overdosing, what intervention(s) did the client receive? Select all that apply. - Care from a primary care provider 1 = Yes 0 = No -1 = Not applicable -5 = Not documented in records or not documented in records using this standard -9 = MISSING DATA 1 = Yes 0 = No -1 = Not applicable -5 = Not documented in records or not documented in records using this standard -9 = MISSING DATA Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual) If one overdose item equals -1, all should equal -1. If one overdose item equals -5, all should equal -5. If one overdose item equals -9, all should equal -9.
Yes Yes D. BEHAVIORAL HEALTH DIAGNOSIS OverdoseHospital D6a After taking too much of a substance or overdosing, what intervention(s) did the client receive? Select all that apply. - Admission to a hospital 1 = Yes 0 = No -1 = Not applicable -5 = Not documented in records or not documented in records using this standard -9 = MISSING DATA 1 = Yes 0 = No -1 = Not applicable -5 = Not documented in records or not documented in records using this standard -9 = MISSING DATA Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual) If one overdose item equals -1, all should equal -1. If one overdose item equals -5, all should equal -5. If one overdose item equals -9, all should equal -9.
Yes Yes D. BEHAVIORAL HEALTH DIAGNOSIS OverdoseSupervision D6a After taking too much of a substance or overdosing, what intervention(s) did the client receive? Select all that apply. - Supervision by someone else 1 = Yes 0 = No -1 = Not applicable -5 = Not documented in records or not documented in records using this standard -9 = MISSING DATA 1 = Yes 0 = No -1 = Not applicable -5 = Not documented in records or not documented in records using this standard -9 = MISSING DATA Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual) If one overdose item equals -1, all should equal -1. If one overdose item equals -5, all should equal -5. If one overdose item equals -9, all should equal -9.
Yes Yes D. BEHAVIORAL HEALTH DIAGNOSIS OverdoseOther D6a After taking too much of a substance or overdosing, what intervention(s) did the client receive? Select all that apply. - Other 1 = Yes 0 = No -1 = Not applicable -5 = Not documented in records or not documented in records using this standard -9 = MISSING DATA 1 = Yes 0 = No -1 = Not applicable -5 = Not documented in records or not documented in records using this standard -9 = MISSING DATA Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual) If one overdose item equals -1, all should equal -1. If one overdose item equals -5, all should equal -5. If one overdose item equals -9, all should equal -9.
Yes Yes D. BEHAVIORAL HEALTH DIAGNOSIS OverdoseNotDoc D6a After taking too much of a substance or overdosing, what intervention(s) did the client receive? Select all that apply. - Not documented in records or not documented in records using this standard 0 = Unchecked 1 = Checked -9 = MISSING DATA 0 = Unchecked 1 = Checked -9 = MISSING DATA Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual) If OverdoseNotDoc = 1 then all other overdose questions should = -5 (not documented) Yes Yes D. BEHAVIORAL HEALTH DIAGNOSIS OverdoseNotApp D6a After taking too much of a substance or overdosing, what intervention(s) did the client receive? Select all that apply. - Not applicable 0 = Unchecked 1 = Checked -9 = MISSING DATA 0 = Unchecked 1 = Checked -9 = MISSING DATA Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual) If OverdoseNotApp = 1 then all other overdose questions should = -1 (not applicable) Yes Yes D. BEHAVIORAL HEALTH DIAGNOSIS HIVPositivetest D7 Has the client ever tested positive for HIV? 1 = Yes, HIV-positive 0 = No, HIV-negative -5 = Not documented in records or not documented in records using this standard -1 = Not applicable -9 = MISSING DATA 1 = Yes, HIV-positive 0 = No, HIV-negative -5 = Not documented in records or not documented in records using this standard -1 = Not applicable -9 = MISSING DATA Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual) Answered if Program = MAI-SI.
If D7 = 1, go to question 7a. If D7 = 0, go to question D7b.
Yes Yes D. BEHAVIORAL HEALTH DIAGNOSIS HIVART D7a Is the client currently on ART? 1 = Yes, Currently taking ART 0 = No, not currently taking ART -5 = Not documented in records or not documented in records using this standard -1 = Not applicable -9 = MISSING DATA 1 = Yes, Currently taking ART 0 = No, not currently taking ART -5 = Not documented in records or not documented in records using this standard -1 = Not applicable -9 = MISSING DATA Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual) Answered if HIVPositivetest = 1, else -1 Yes Yes D. BEHAVIORAL HEALTH DIAGNOSIS HIVPrEP D7b Is the client currently taking HIV PrEP? 1 = Yes, currently on PrEP 0 = No, not currently on PrEP -5 = Not documented in records or not documented in records using this standard -1 = Not applicable -9 = MISSING DATA 1 = Yes, currently on PrEP 0 = No, not currently on PrEP -5 = Not documented in records or not documented in records using this standard -1 = Not applicable -9 = MISSING DATA Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual) Answered if HIVPositivetest = 0, else -1 Yes Yes D. BEHAVIORAL HEALTH DIAGNOSIS HepCPositivetest D8 Has the client ever tested positive for Hepatitis C? 1 = Yes, active or previous Hepatitis C infection 0 = No, never had Hepatitis C -5 = Not documented in records or not documented in records using this standard -9 = MISSING DATA 1 = Yes, active or previous Hepatitis C infection 0 = No, never had Hepatitis C -5 = Not documented in records or not documented in records using this standard -9 = MISSING DATA Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual) If D8 = 1, go to question D8a.
Yes Yes D. BEHAVIORAL HEALTH DIAGNOSIS HepCTreatment D8a Is the client currently taking viral Hepatitis C treatment? 1 = Yes, currently taking viral Hepatitis C treatment 2 = No, took treatment and cured 3 = Hepatitis C infection naturally cleared without need for treatment 4 = No, not currently taking treatment -5 = Not documented in records Hepatitis not documented in records using this standard -1 = Not applicable -9 = MISSING DATA 1 = Yes, currently taking viral Hepatitis C treatment 2 = No, took treatment and cured 3 = Hepatitis C infection naturally cleared without need for treatment 4 = No, not currently taking treatment -5 = Not documented in records Hepatitis not documented in records using this standard -1 = Not applicable -9 = MISSING DATA Numeric IF A3 = 1, 2, or 3 (baseline, reassessment, or annual) If D8 = 1
If D8 not equal 1, then D8a = -1 Yes Yes E. SERVICES RECEIVED BHServices E1 Since the previous administrative assessment, did the project provide or refer the client for one or more behavioral health services? 1 = Yes 0 = No -5 = Not documented in records -9 = MISSING DATA 1 = Yes 0 = No -5 = Not documented in records -9 = MISSING DATA Numeric IF A3 = 2, 3, or 4 (reassessment, annual, or closeout)
If E1 = 1, go to E1a.
if E1 = 0, then E1a-E1p = 0 if E1 = -5, then E1a-E1p = -5 if E1 = -9, then E1a-E1p = -9 if any of E1a-E1p = 1, then E1 = 1 Yes Yes E. SERVICES RECEIVED CaseManagement E1a Since the previous administrative assessment, did the project provide or refer the client for one or more behavioral health services? - Case Management services 1 = Yes - provided 2 = Referred for service 0 = No - not provided or referred -5 = Not documented in records/unknown -1 = Not applicable -9 = MISSING DATA 1 = Yes - provided 2 = Referred for service 0 = No - not provided or referred -5 = Not documented in records/unknown -1 = Not applicable -9 = MISSING DATA Numeric IF A3 = 2, 3, or 4 (reassessment, annual, or closeout)
If E1 = 1 if E1 = 0, then E1a-E1p = -1 if E1 = -5, then E1a-E1p = -5 if E1 = -9, then E1a-E1p = -9 Yes Yes E. SERVICES RECEIVED PersonFamTxPlan E1b Since the previous administrative assessment, did the project provide or refer the client for one or more behavioral health services? - Person- or family-centered treatment planning 1 = Yes - provided 2 = Referred for service 0 = No - not provided or referred -5 = Not documented in records/unknown -1 = Not applicable -9 = MISSING DATA 1 = Yes - provided 2 = Referred for service 0 = No - not provided or referred -5 = Not documented in records/unknown -1 = Not applicable -9 = MISSING DATA Numeric IF A3 = 2, 3, or 4 (reassessment, annual, or closeout)
If E1 = 1 if E1 = 0, then E1a-E1p = -1 if E1 = -5, then E1a-E1p = -5 if E1 = -9, then E1a-E1p = -9 Yes Yes E. SERVICES RECEIVED Supsychoeducation E1c Since the previous administrative assessment, did the project provide or refer the client for one or more behavioral health services? - Substance use psychoeducation 1 = Yes - provided 2 = Referred for service 0 = No - not provided or referred -5 = Not documented in records/unknown -1 = Not applicable -9 = MISSING DATA 1 = Yes - provided 2 = Referred for service 0 = No - not provided or referred -5 = Not documented in records/unknown -1 = Not applicable -9 = MISSING DATA Numeric IF A3 = 2, 3, or 4 (reassessment, annual, or closeout)
If E1 = 1 if E1 = 0, then E1a-E1p = -1 if E1 = -5, then E1a-E1p = -5 if E1 = -9, then E1a-E1p = -9 Yes Yes E. SERVICES RECEIVED Mhpsychoeducation E1d Since the previous administrative assessment, did the project provide or refer the client for one or more behavioral health services? - Mental health psychoeducation 1 = Yes - provided 2 = Referred for service 0 = No - not provided or referred -5 = Not documented in records/unknown -1 = Not applicable -9 = MISSING DATA 1 = Yes - provided 2 = Referred for service 0 = No - not provided or referred -5 = Not documented in records/unknown -1 = Not applicable -9 = MISSING DATA Numeric IF A3 = 2, 3, or 4 (reassessment, annual, or closeout)
If E1 = 1 if E1 = 0, then E1a-E1p = -1 if E1 = -5, then E1a-E1p = -5 if E1 = -9, then E1a-E1p = -9 Yes Yes E. SERVICES RECEIVED MentalHealthTherapy E1e Since the previous administrative assessment, did the project provide or refer the client for one or more behavioral health services? - Mental health therapy 1 = Yes - provided 2 = Referred for service 0 = No - not provided or referred -5 = Not documented in records/unknown -1 = Not applicable -9 = MISSING DATA 1 = Yes - provided 2 = Referred for service 0 = No - not provided or referred -5 = Not documented in records/unknown -1 = Not applicable -9 = MISSING DATA Numeric IF A3 = 2, 3, or 4 (reassessment, annual, or closeout)
If E1 = 1 if E1 = 0, then E1a-E1p = -1 if E1 = -5, then E1a-E1p = -5 if E1 = -9, then E1a-E1p = -9 Yes Yes E. SERVICES RECEIVED CooccuringTherapy E1f Since the previous administrative assessment, did the project provide or refer the client for one or more behavioral health services? - Co-occurring therapy (substance use and mental health) 1 = Yes - provided 2 = Referred for service 0 = No - not provided or referred -5 = Not documented in records/unknown -1 = Not applicable -9 = MISSING DATA 1 = Yes - provided 2 = Referred for service 0 = No - not provided or referred -5 = Not documented in records/unknown -1 = Not applicable -9 = MISSING DATA Numeric IF A3 = 2, 3, or 4 (reassessment, annual, or closeout)
If E1 = 1 if E1 = 0, then E1a-E1p = -1 if E1 = -5, then E1a-E1p = -5 if E1 = -9, then E1a-E1p = -9 Yes Yes E. SERVICES RECEIVED GroupCounseling E1g Since the previous administrative assessment, did the project provide or refer the client for one or more behavioral health services? - Group Counseling 1 = Yes - provided 2 = Referred for service 0 = No - not provided or referred -5 = Not documented in records/unknown -1 = Not applicable -9 = MISSING DATA 1 = Yes - provided 2 = Referred for service 0 = No - not provided or referred -5 = Not documented in records/unknown -1 = Not applicable -9 = MISSING DATA Numeric IF A3 = 2, 3, or 4 (reassessment, annual, or closeout)
If E1 = 1 if E1 = 0, then E1a-E1p = -1 if E1 = -5, then E1a-E1p = -5 if E1 = -9, then E1a-E1p = -9 Yes Yes E. SERVICES RECEIVED IndivCounseling E1h Since the previous administrative assessment, did the project provide or refer the client for one or more behavioral health services? - Individual counseling 1 = Yes - provided 2 = Referred for service 0 = No - not provided or referred -5 = Not documented in records/unknown -1 = Not applicable -9 = MISSING DATA 1 = Yes - provided 2 = Referred for service 0 = No - not provided or referred -5 = Not documented in records/unknown -1 = Not applicable -9 = MISSING DATA Numeric IF A3 = 2, 3, or 4 (reassessment, annual, or closeout)
If E1 = 1 if E1 = 0, then E1a-E1p = -1 if E1 = -5, then E1a-E1p = -5 if E1 = -9, then E1a-E1p = -9 Yes Yes E. SERVICES RECEIVED FamilyCounsel E1i Since the previous administrative assessment, did the project provide or refer the client for one or more behavioral health services? - Family counseling 1 = Yes - provided 2 = Referred for service 0 = No - not provided or referred -5 = Not documented in records/unknown -1 = Not applicable -9 = MISSING DATA 1 = Yes - provided 2 = Referred for service 0 = No - not provided or referred -5 = Not documented in records/unknown -1 = Not applicable -9 = MISSING DATA Numeric IF A3 = 2, 3, or 4 (reassessment, annual, or closeout)
If E1 = 1 if E1 = 0, then E1a-E1p = -1 if E1 = -5, then E1a-E1p = -5 if E1 = -9, then E1a-E1p = -9 Yes Yes E. SERVICES RECEIVED PsychRehab E1j Since the previous administrative assessment, did the project provide or refer the client for one or more behavioral health services? - Psychiatric rehabilitation services 1 = Yes - provided 2 = Referred for service 0 = No - not provided or referred -5 = Not documented in records/unknown -1 = Not applicable -9 = MISSING DATA 1 = Yes - provided 2 = Referred for service 0 = No - not provided or referred -5 = Not documented in records/unknown -1 = Not applicable -9 = MISSING DATA Numeric IF A3 = 2, 3, or 4 (reassessment, annual, or closeout)
If E1 = 1 if E1 = 0, then E1a-E1p = -1 if E1 = -5, then E1a-E1p = -5 if E1 = -9, then E1a-E1p = -9 Yes Yes E. SERVICES RECEIVED RxMedicationMHDx E1k Since the previous administrative assessment, did the project provide or refer the client for one or more behavioral health services? - Prescription medication for mental health disorder 1 = Yes - provided 2 = Referred for service 0 = No - not provided or referred -5 = Not documented in records/unknown -1 = Not applicable -9 = MISSING DATA 1 = Yes - provided 2 = Referred for service 0 = No - not provided or referred -5 = Not documented in records/unknown -1 = Not applicable -9 = MISSING DATA Numeric IF A3 = 2, 3, or 4 (reassessment, annual, or closeout)
If E1 = 1 if E1 = 0, then E1a-E1p = -1 if E1 = -5, then E1a-E1p = -5 if E1 = -9, then E1a-E1p = -9 Yes Yes E. SERVICES RECEIVED MedicationSUDSvc E1l Since the previous administrative assessment, did the project provide or refer the client for one or more behavioral health services? - Medication for substance use disorder 1 = Yes - provided 2 = Referred for service 0 = No - not provided or referred -5 = Not documented in records/unknown -1 = Not applicable -9 = MISSING DATA 1 = Yes - provided 2 = Referred for service 0 = No - not provided or referred -5 = Not documented in records/unknown -1 = Not applicable -9 = MISSING DATA Numeric IF A3 = 2, 3, or 4 (reassessment, annual, or closeout)
If E1 = 1 if E1 = 0, then E1a-E1p = -1 if E1 = -5, then E1a-E1p = -5 if E1 = -9, then E1a-E1p = -9 Yes Yes E. SERVICES RECEIVED IntensiveDayTx E1m Since the previous administrative assessment, did the project provide or refer the client for one or more behavioral health services?
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