BHMS DATA SPECIFICATIONS

FY27 MIS-FUNDED BY GRANT (FBG) Data Rules

5-14-2026

FY27 MIS Client and Treatment Data Rules Page 1 of 48

Note: New fields for FY27 are highlighted in yellow. FY27 changes to existing fields are in red text.

Abbreviations have been used in each field to indicate which Transaction Status(es) require that field. They are: “A” (Admission), “I” (Interim), and “D” (Discharge). See GR-23 Transaction Status for details. In addition, “MH” is Mental Health and “SUD” is Substance Use Disorder.

MIS Data Completeness Rule: An MIS form is only allowed up to 4 Unknowns in all of the fields with this designation.

Client Demographic Data

#GR-1 First Name FirstName Rules:

Required for all records Alpha up to 50 characters; can include spaces and hyphens, but no other special characters.

GR-1 FirstName first letter must match the first digit in GR-11 ClientID

#GR-2 Last Name LastName Rules:

Required for all records Alpha up to 50 characters; can include spaces and hyphens, but no other special characters.

#GR-3 Address Unknown AddressUnknown 0 No 1 Yes Rules:

Required for all records Must be 0 or 1 If GR-3 AddressUnknown = 1 (Yes), then GR-4 AddressLine1, GR-5 AddressLine2, GR-6 City, GR-7 State, GR-8 ZipCode must be blank If GR-3 AddressUnknown = 0 (No), then GR-4 AddressLine1, GR-6 City, GR-7 State, GR-8

ZipCode must have a value entered

#GR-4 AddressLine1 AddressLine1 Street address, PO Box, etc.

Rules:

Required when GR-3 AddressUnknown = 0 (No) for all records

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Must be blank when GR-3 AddressUnknown = 1 (Yes). Report as <AddressLine1></AddressLine1> or <AddressLine1 />

When GR-4 AddressLine1 is blank, then GR-3 AddressUnknown must be = 1 (Yes) Alphanumeric up to 255 characters; can include spaces and hyphens but no other special characters.

#GR-5 AddressLine2 AddressLine2 Apartment, Suite, Unit, etc.

Rules:

Optional when GR-3 AddressUnknown = 0 (No) Must be blank when GR-3 AddressUnknown = 1 (Yes). Report as

<AddressLine2></AddressLine2> or <AddressLine2 /> Alphanumeric up to 255 characters; can include spaces and hyphens but no other special characters.

#GR-6 City City Rules:

Required when GR-3 AddressUnknown = 0 (No) for all records Must be blank when GR-3 AddressUnknown = 1 (Yes). Report as <City></City> or <City /> When GR-6 City is blank, then GR-3 AddressUnknown must be = 1 (Yes) Alpha up to 100 characters

#GR-7 State State Rules:

Required when GR-3 AddressUnknown = 0 (No) for all records Must be blank when GR-3 AddressUnknown = 1 (Yes). Report as <State></State> or <State /> When GR-7 State is blank, then GR-3 AddressUnknown must be = 1 (Yes) Alpha 2 characters

#GR-8 ZipCode ZipCode Rules:

Required when GR-3 AddressUnknown = 0 (No) for all records Must be blank when GR-3 AddressUnknown = 1 (Yes). Report as <ZipCode></ZipCode> or

<ZipCode /> When GR-8 ZipCode is blank, then GR-3 AddressUnknown must be = 1 (Yes) 5 or 9 digits

#GR-9 Phone Number PhoneNumber Rules:

10 digits (digits only) If GR-9 PhoneNumber is blank, then GR-10 Email must be entered

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If GR-9 PhoneNumber is blank, report as <PhoneNumber></PhoneNumber> or <PhoneNumber

#GR-10 Email Email Rules:

Alphanumeric up to 50 characters Can include dots and underscores Need to follow standard email format. In Ex: XXX_XX@test.com If GR-10 Email is blank, then GR-9 PhoneNumber must be entered If GR-10 Email is blank, report as <Email></Email> or <Email />

#GR-11 Client ID ClientID Enter the 14-digit (letters and numbers) Client Identification Number. That number is derived by using the following State-approved procedure:

o Space 1: First letter of client’s first name (e.g., Charlotte = C) o Space 2: Last letter of client’s last name – (e.g., Ross = S) o Space 3: Letter for Sex of client (M = Male, F = Female, U = Unknown) o Space 4 & 5: Two-digit number for birth month of client (e.g., January = 01, November = 11) o Space 6 & 7: Two-digit number for birthday of client (e.g., 14th day of month = 14) o Space 8, 9 & 10: Birth century of client (one-digit number in space 8 which is the second digit of the century date, e.g., second digit of century in 1948 = 9; plus birth year in spaces 9 & 10, e.g., birth year of person born in 1948 = 48) o Space 11 – 14: Last 4 digits of the client’s Social Security Number

Using the examples above, the Client Identification Number using this system would be:

CSF01149481234

Rules:

Required for all records First 2 spaces of Client ID can be any alpha character (A-Z or a-z).

Third space of Client ID must be F, M, or U (or f, m, or u).

Third space designation of Sex must match GR-13 Sex Last 11 spaces of Client ID must be a number 0-9 Last 4 spaces of Client ID must match last 4 characters of GR-18 SocialSecurityNumber.

Birth date in Client ID must match GR-12 DateOfBirth Birth date in Client ID must not be the same as GR-20 TransactionDate Birth date in Client ID must not be after GR-20 TransactionDate Birth date must not be before 1900 GR-11 ClientID first digit must match the first letter in GR-1 FirstName

#GR-12 Date of Birth DateOfBirth The date of birth of the client – enter two digits for birth month (e.g., April = 04), two digits for day of the month on which person was born (e.g., the 14th day of the month = 14) and four digits for the century and year in which person was born (e.g., 1962 = 1962).

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Required for all records Must be a valid date GR-12 DateOfBirth must match the date used in GR-11 ClientID Must not be prior to 1900 Must not be in the future Format options o mm/dd/yyyy o mm-dd-yyyy o mm,dd,yyyy o mmddyyyy o yyyy/mm/dd o yyyy-mm-dd o yyyy,mm,dd

NOTE: The above date formats are those that are permitted in both the online system and through upload. Additional formats are allowable through upload. Some of these formats are:

mm dd yyyy, yyyy mm dd, yyyy October dd (or any other month in place of October), January 1 2008.

#GR-13 Sex Sex The client's immutable biological classification as either male or female. (Changed to reflect updated HHS guidance.)

1 Male 2 Female 3 Unknown Rules:

Required for all records Must match Sex in GR-11 ClientID Must be 1 - 3 If GR-13 Sex is 1 (Male), then GR-99 SAFemale must be 0 (Not Applicable) If GR-13 Sex is 2 (Female), then GR-99 SAFemale cannot be 0 (Not Applicable)

#GR-14 Gender Identity GenderIdentity One’s internal, personal sense of their gender.

1 Cisgender Male (Assigned male at birth and identifies as male) 2 Cisgender Female (Assigned female at birth and identifies as female)

3 Transgender Man/Trans Man/Female-To-Male (Assigned female at birth and identifies as male)

4 Transgender Woman/Trans Woman/Male-To-Female (Assigned male at birth and identifies as female)

5 Genderqueer/Gender Non-Conforming/Neither Exclusively Male Nor Female (A person who does not follow gender norms; identifies as neither male nor female, or both male and female)

6 Additonal Gender Category (or Other)

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9 Unknown/Preferred Not to Respond

Required for all records Can be blank for clients 5 and under. Report as <GenderIdentity></GenderIdentity> or

<GenderIdentity /> Must be 1-6 or 9

#GR-15 Sexual Orientation SexualOrientation Describes the emotional, romantic, and/or physical feelings of attraction-usually over a period of time.

1 Straight or Heterosexual (Sexually oriented toward people of a different, usually binary, gender) 2 Lesbian or Gay (Sexually oriented toward people of the same, usually binary, gender) 3 Bisexual (Sexually oriented toward both men and women) 4 (not a valid code)

Additional Sexual Orientation Category (or Other) Queer (A general term referring to all non-heterosexual people) Pansexual (Sexually oriented toward people of any gender) Questioning (Uncertain about sexual orientation identity)

Unknown/Preferred Not to Respond Asexual (A person who experiences little or no sexual attraction to others and/or a lack of interest in sexual relationships/behavior.)

Rules:

Required for all records Can be blank for clients 5 and under. Report as <SexualOrientation></SexualOrientation> or

<SexualOrientation /> Must be 1-3, or 5-10

#GR-16 Provider Client ID ProviderClientID Each agency may enter their own client ID here for agency cross check and internal audit. It is essential that these ID’s remain the same for a specific client.

Rules:

Alphanumeric up to 30 characters; can include spaces and hyphens but no other special characters.

No value or not available should be reported as <ProviderClientID></ProviderClientID> or

<ProviderClientID />

#GR-17 Agency Code AgencyCode o Enter the six-digit agency code of the MH or SUD grant-funded program delivering services Rules:

Required for all records Must have a valid Agency Code for a grant-funded program (checked against codes in the lookup table) Must be 6 characters

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The data submitted is checked to see if the person logged in has rights to submit this agency code. (i.e., someone from one agency group cannot submit data for another agency group.)

#GR-18 Social Security Number SocialSecurityNumber Must be 9 digits Rules:

Required for all records The last 4 characters must match last 4 characters of GR-11 ClientID Must be 9 characters

#GR-19 Transaction Status TransactionStatus This code identifies the type of record to be submitted.

1 A Admission 2 D Discharge 3 (not a valid code) 4 I Interim Record (key data updates) 5 (not a valid code)

Rules:

Required for all records Must be 1, 2, or 4

#GR-20 Transaction Date TransactionDate Records the month, day, and year for GR-19 Transaction Status.

Rules:

Required for all records Must be a valid date Must not be in the future GR-20 TransactionDate must not be before 1970 Must not be prior to GR-12 DateOfBirth Must not be the same as GR-12 DateOfBirth Format options o mm/dd/yyyy o mm-dd-yyyy o mm,dd,yyyy o mmddyyyy o yyyy/mm/dd

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#GR-21 First Contact Date FirstContactDate Records the date (month, day, and year) of the client’s first inquiry for services (for the current treatment episode) Rules:

Required for A records For I and D records, field may be blank. Report as <FirstContactDate></FirstContactDate> or

<FirstContactDate /> If a value is entered on I or D records, that value must match the value on the A record Must be a valid date Must not be in the future Must not be prior to GR-12 DateOfBirth Must not be the same as GR-12 DateOfBirth Must not be after GR-20 TransactionDate Format options o mm/dd/yyyy o mm-dd-yyyy o mm,dd,yyyy o mmddyyyy o yyyy/mm/dd

#GR-22 Client Declined Offered Appointment DeclinedAppt Did the client decline the earliest offered appointment?

1 Yes 2 No Rules:

Required for A records For I or D records, field may be blank. Report as <DeclinedAppt></DeclinedAppt> or

<DeclinedAppt /> If a value is entered on I or D records, that value must match the value on the A record Must be 1 or 2

#GR-23 Race Race 1 White 2 Black 3 Native American/Alaskan 4 Asian

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Required for A records For I or D records, field may be blank. Report as <Race></Race> or <Race /> If a value is entered on I or D records, that value must match the value on the A record Must be 1-4 or 6-9 MIS Data Completeness Rule Applies: An MIS is only allowed up to 4 Unknowns in all of the fields with this designation.

#GR-24 Hispanic Origin HispanicOrigin 1 (not a valid code) 2 Not of Hispanic Origin 3 Cuban 4 Puerto Rican 5 Mexican 6 Other Hispanic 7 Unknown Rules:

Required for A records For I or D records, field may be blank. Report as <HispanicOrigin></HispanicOrigin> or

<HispanicOrigin /> If a value is entered on I or D records, that value must match the value on the A record Must be 2-7

#GR-25 Medicaid Number MedicaidNumber Rules:

Required if available If present, must be 9 or 10 digits If Medicaid Number is not available, field must be blank. Report as

<MedicaidNumber></MedicaidNumber> or <MedicaidNumber />

Demographic Data Fields

#GR-26 County of Residence CountyOfResidence The county the client normally lives in and has a mailing address.

1 Natrona

5 (not a valid code) 6 Native Hawaiian/Other Pacific Islander

More Than One Race Reported Other Race Not Listed Unknown

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2 Laramie 3 Sheridan 4 Sweetwater 5 Albany 6 Carbon 7 Goshen 8 Platte 9 Big Horn 10 Fremont 11 Park 12 Lincoln 13 Converse 14 Niobrara 15 Hot Springs 16 Johnson 17 Campbell 18 Crook 19 Uinta 20 Washakie 21 Weston 22 Teton 23 Sublette 98 Non-Wyoming Resident 99 Unknown Rules:

Required for all records Must be 1-23, 98 or 99

#GR-27 Employment Employment Current Employment Status - This is a key functional measurement in mental health and substance use disorder reporting.

1 Unemployed: Employable; no work available 2 Part Time: less than 30 hours per week 3 Full Time: greater than or equal to 30 hours per week 4 Homemaker: Adult not in workforce 5 Retired: Retired from active employment 6 Disabled Unemployed: Unable to work for disability reasons 7 Child: Under 16 years of age, not in the labor force 8 Student: 16 years of age or older, not in the labor force 9 Inmate of an Institution 10 (not a valid code)

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(not a valid code) Volunteer Position

Rules:

Required for all records Must update on I’s Must be 1-9 or 12 Value 7 (Child: Under 16 years of age, not in the labor force) cannot be selected for a client 16 years of age or older Value 8 (Student: 16 years of age or older, not in the labor force) cannot be selected for a client under 16 years of age Value 7 (Child: Under 16 years of age, not in the labor force) must be selected for a client aged

9 or under.

#GR-28 Residence Residence Current Residential Status - This is a key functional measurement in mental health and substance use disorder reporting.

1 Lacks a fixed, regular, night-time residence (includes shelters, time-limited transitional housing, street, vehicle, or succession of friends/relatives) 2 Private Residence/Household 3 Group Home 4 Residential Treatment Center 5 Boarding/Foster Home 6 Jail/Correctional Facility 7 Hospital 8 Other Residential Setting

Unknown Nursing Home

Rules:

Required for all records Must update on I’s Must be 1-10

#GR-29 Marital Status MaritalStatus 1 Never Married 2 Now Married 3 Legally or Otherwise Absent 4 Divorced 5 Widowed 6 Minor Child 7 Unknown

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Must be 1-7 Value 6 (Minor Child) cannot be selected for a client 18 years of age or older MIS Data Completeness Rule Applies: An MIS is only allowed up to 4 Unknowns in all of the fields with this designation.

#GR-30 Veteran Status VeteranStatus Veteran status identifies whether the client has served in the uniformed services (Army, Navy, Air Force, Marines, Coast Guard, or Public Health Service Commissioned Corps) and if so identifies if the client is a non-combat veteran or combat veteran.

1 Veteran: Non-Combat 2 Not a Veteran 3 Veteran: Combat 9 Unknown

Rules:

Required for A records For I or D records, field may be blank. Report as <VeteranStatus></VeteranStatus> or

<VeteranStatus /> If a value is entered on I or D records, that value must match the value on the A record Must be 1, 2, 3 or 9 Value 2 (Not a Veteran) must be selected for a client under 18 years of age

#GR-31 Education Education Choose the value that most closely matches the highest completed level of schooling.

0 No Schooling 1 Kindergarten or 1st Grade 2 2nd Grade 3 3rd Grade 4 4th Grade 5 5th Grade 6 6th Grade 7 7th Grade 8 8th Grade 9 9th Grade 10 10th Grade 11 11th Grade 12 High School Degree/GED 13 1 Year of College 14 2 Years of College/Associates Degree 15 3 Years of College 16 Bachelors Degree

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17 (not a valid code) 18 Masters Degree 19 (not a valid code) 20 Doctoral Degree 21-24 (not valid codes) 99 Unknown

Rules:

Required for all records Must be 0-16, 18, 20, or 99 MIS Data Completeness Rule Applies: An MIS is only allowed up to 4 Unknowns in all of the fields with this designation.

Treatment Data – Both Mental Health and Substance Use Disorder

#GR-32 Referral Source Referral Source of Referral at Admission

1 Self 2 Family/Friends 3 Police/Law Enforcement 4 Court (not Title 25 clients) 5 Private Psychiatrist 6 Other Physician 7 Other Private Mental Health Practitioner 8 Clergy 9 Wyoming State Hospital 10 Other Inpatient Psychiatric Service 11 Drug/Alcohol Abuse Treatment Center 12 (not a valid code) 13 Shelter 14 Behavioral Health Center 15 Other 16 Schools 17 Employer 18 DFS (Department of Family Services) 19 DVR (Division of Vocational Rehabilitation) 20 Nursing Home 21 Medical Hospital 22 DD (Developmental Disability) 23 Drug Court 24 (not a valid code) 25 Adult Probation and Parole 26 Juvenile Probation (DFS) 27 Early Childhood Setting

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28 Attorney 29 Veterans Affairs 30 Department of Corrections

Court Order (Title 25 clients) Social Security/Disability WLRC (Wyoming Life Resource Center) 988 System Youth Crisis Center Wyoming Behavioral Institute (WBI)

99 Unknown Rules:

Required for A records For I or D records, field may be blank. Report as <Referral></Referral> or <Referral /> If a value is entered on I or D records, that value must match the value on the A record Must be 1-11, 13-23, 25-36 or 99

#GR-33 Primary Income Source PrimaryIncomeSource Choose the code that best describes the primary source of the client's income.

1 Self 2 Family (Parent/Guardian/Spouse/Adult Children) 3 SSI (Supplemental Security Income) 4 SSDI (Social Security Disability Income) 5 Other Disability 6 Retirement 7 DFS (Department of Family Services/Welfare) 8 Other/Unemployment 99 Unknown Rules:

Required for all records Must be 1-8 or 99

#GR-34 Probation Under Supervision ProbationUnderSupervision Probation status identifies the client under supervision by the court at the time of granting probation or at any later time in accordance with Wyo. Stat. Ann. § 7-13- 410(b).

Are you currently on probation under supervision?

Yes – I am currently on Probation Under Supervision (at Transaction Date)

No – I am not currently on Probation Under Supervision (at Transaction Date)

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If GR-35 ProbationNotUnderSupervision is 1=Yes, then GR-34 ProbationUnderSupervision must be 2=No

#GR-35 Probation Not Under Supervision ProbationNotUnderSupervision Probation status identifies whether the client is currently serving a sentence through the courts without confinement which imposes conditions of the sentence in accordance with Wyo. Stat. Ann. § 7-13- 401(a)(x).

Are you currently on probation not under supervision?

Yes – I am currently on Probation Not Under Supervision (at Transaction Date)

No – I am not currently on Probation Not Under Supervision (at Transaction Date)

Required for all records Must be 1 or 2 If GR-34 ProbationUnderSupervision is 1=Yes, then GR-35 ProbationNotUnderSupervision must be 2=No

#GR-36 Parole Parole Parole status identifies whether the client is currently on a conditional release from an institutional confinement or imprisonment in accordance with Wyo. Stat. Ann. § 7-13-401(a)(vii).

Are you currently on parole?

Yes – I am currently on Parole (at Transaction Date)

No – I am not currently on Parole (at Transaction Date)

#GR-37 First Presenting Problem FirstPresentingProblem The client’s primary complaint at the time of service 1 Marital/Family 2 Social 3 Coping 4 Medical 5 Mood Disorder 6 Suicide 7 Alcohol 8 Drugs 9 Criminal Justice System 10 Eating Disorder 11 Thought Disorder 12 Abuse/Assault/Rape Victim 13 Runaway Behavior

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Must be 1-16 GR-37 FirstPresentingProblem may not have the same value as GR-38

SecondPresentingProblem, GR-39 ThirdPresentingProblem, or GR-40 FourthPresentingProblem

#GR-38 Second Presenting Problem SecondPresentingProblem The client’s secondary complaint at the time of service 0 Not Applicable 1 Marital/Family 2 Social 3 Coping 4 Medical 5 Mood Disorder 6 Suicide 7 Alcohol 8 Drugs 9 Criminal Justice System 10 Eating Disorder 11 Thought Disorder 12 Abuse/Assault/Rape Victim 13 Runaway Behavior 14 Perpetrator

Evaluation Gambling

Rules:

Required for all records Must be 0-16 GR-38 SecondPresentingProblem must not be the same value as GR-37 FirstPresentingProblem, GR-39 ThirdPresentingProblem, or GR-40 FourthPresentingProblem, unless the values are 0 (Not Applicable)

#GR-39 Third Presenting Problem ThirdPresentingProblem The client’s tertiary complaint at the time of service

0 Not Applicable 1 Marital/Family 2 Social 3 Coping

14 Perpetrator

Evaluation Gambling

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4 Medical 5 Mood Disorder 6 Suicide 7 Alcohol 8 Drugs 9 Criminal Justice System 10 Eating Disorder 11 Thought Disorder 12 Abuse/Assault/Rape Victim 13 Runaway Behavior 14 Perpetrator

Evaluation Gambling

Rules:

Required for all records Must be 0-16 GR-39 ThirdPresentingProblem must not be the same as GR-37 FirstPresentingProblem, GR-38

SecondPresentingProblem, or GR-40 FourthPresentingProblem, unless the values are 0 (Not Applicable)

#GR-40 Fourth Presenting Problem FourthPresentingProblem The client’s quaternary complaint at the time of service

0 Not Applicable 1 Marital/Family 2 Social 3 Coping 4 Medical 5 Mood Disorder 6 Suicide 7 Alcohol 8 Drugs 9 Criminal Justice System 10 Eating Disorder 11 Thought Disorder 12 Abuse/Assault/Rape Victim 13 Runaway Behavior 14 Perpetrator

Evaluation Gambling

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Must be 0-16 GR-40 FourthPresentingProblem must not be the same as GR-37 FirstPresentingProblem, GR-38

SecondPresentingProblem, or GR-39 ThirdPresentingProblem, unless the values are 0 (Not Applicable)

#GR-41 Diagnosis 1 Diagnosis1 Refer to Appendix F for valid ICD-10 codes Rules:

Required for all records GR-41 Diagnosis1 must not be the same as GR-42 Diagnosis2, GR-43 Diagnosis3, GR-44

Diagnosis4, GR-45 Diagnosis5, or GR-46 Diagnosis6

#GR-42 Diagnosis 2 Diagnosis2 Refer to Appendix F for valid ICD-10 codes Rules:

No value or not available should be reported as <Diagnosis2></Diagnosis2> or <Diagnosis2 /> GR-42 Diagnosis2 must not be the same as GR-41 Diagnosis1, GR-43 Diagnosis3, or GR-44

Diagnosis4, GR-45 Diagnosis5, or GR-46 Diagnosis6 unless it is null

#GR-43 Diagnosis 3 Diagnosis3 Refer to Appendix F for valid ICD-10 codes Rules:

No value or not available should be reported as <Diagnosis3></Diagnosis3> or <Diagnosis3 /> GR-43 Diagnosis3 must not be the same as GR-41 Diagnosis1, GR-42 Diagnosis2, or GR-44

Diagnosis4, GR-45 Diagnosis5, or GR-46 Diagnosis6 unless it is null

#GR-44 Diagnosis 4 Diagnosis4 Refer to Appendix F for valid ICD-10 codes Rules:

No value or not available should be reported as <Diagnosis4></Diagnosis4> or <Diagnosis4 /> GR-44 Diagnosis4 must not be the same as GR-41 Diagnosis1, GR-42 Diagnosis2, or GR-43

Diagnosis3, GR-45 Diagnosis5, or GR-46 Diagnosis6 unless it is null

#GR-45 Diagnosis 5 Diagnosis5 Refer to Appendix F for valid ICD-10 codes Rules:

No value or not available should be reported as <Diagnosis5></Diagnosis5> or <Diagnosis5 /> GR-45 Diagnosis5 must not be the same as GR-41 Diagnosis1, GR-42 Diagnosis2, or GR-43

Diagnosis3, GR-44-Diagnosis4, or GR-46 Diagnosis6 unless it is null

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#GR-46 Diagnosis 6 Diagnosis6 Refer to Appendix F for valid ICD-10 codes Rules:

No value or not available should be reported as <Diagnosis6></Diagnosis6> or <Diagnosis6 /> GR-46 Diagnosis6 must not be the same as GR-41 Diagnosis1, GR-42 Diagnosis2, or GR-43

Diagnosis3, GR-44 Diagnosis4, or GR-45 Diagnosis5 unless it is null

#GR-47 DLA-20 : Health Practices DLA20HealthPractices

1 Extremely severe functional impairment, needs pervasive level of continuous paid supports

Very severe functional impairment, needs extensive level of continuous paid supports Severe functional impairment, needs moderate level of continuous paid supports Moderate functional impairment, needs low level of continuous paid supports WNL/Strength, Mild functional impairment, needs moderate level of intermittent paid supports WNL/Strength, Intermittent mild functional impairment, needs low level of paid supports WNL/Strength, Independent, Optimal functioning, no need for paid supports

Rules:

Required on all records for clients aged 6 and over Must be blank for clients under age 6 When entering a DLA-20 Assessment, at least 15 of the DLA-20 activity fields (GR-47 through

GR-66) must have a value.

If entering a DLA-20 Assessment, GR-67 DLA-20 AverageScore must have a value.

If not entering a DLA-20 assessment, all DLA-20 fields (GR-47 through GR-66) must be blank DLA-20 fields are required on discharges when GR-68 DischargeStatus is 2=AMA, 5=Evaluation

Only, 6=Death, 9=Unknown, 10=No Show, or 12=Moved; Values on the discharge must match the values on the most recent interim/admit.

When used, must be 1-7 Must update on I’s No value or not available should be reported as

<DLA20HealthPractices></DLA20HealthPractices> or <DLA20HealthPractices /> Mental Health Definition: Takes care of health issues, manages moods, infections; takes medication as prescribed;follows up on medical appointments.

Substance Abuse Definition: Biomedical concerns WNL. HALTS to avoid relapse – Manages to avoid getting Hungry, Angry, Lonely or Tired. Manages exercise. Negative TB.

#GR-48 DLA-20 : Housing Stability, Maintenance DLA20Housing

1 Extremely severe functional impairment, needs pervasive level of continuous paid supports

Very severe functional impairment, needs extensive level of continuous paid supports Severe functional impairment, needs moderate level of continuous paid supports Moderate functional impairment, needs low level of continuous paid supports WNL/Strength, Mild functional impairment, needs moderate level of intermittent paid supports WNL/Strength, Intermittent mild functional impairment, needs low level of paid supports WNL/Strength, Independent, Optimal functioning, no need for paid supports

Required on all records for clients aged 6 and over

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Must be blank for clients under age 6 When entering a DLA-20 Assessment, at least 15 of the DLA-20 activity fields (GR-47 through

GR-66) must have a value.

If entering a DLA-20 Assessment, GR-67 DLA-20 AverageScore must have a value.

If not entering a DLA-20 assessment, all DLA-20 fields (GR-47 through GR-66) must be blank DLA-20 fields are required on discharges when GR-68 DischargeStatus is 2=AMA, 5=Evaluation

Only, 6=Death, 9=Unknown, 10=No Show, or 12=Moved; Values on the discharge must match the values on the most recent interim/admit.

When used, must be 1-7 Must update on I’s No value or not available should be reported as <DLA20Housing></DLA20Housing> or

<DLA20Housing /> Mental Health Definition: Maintains stable housing; organizes possessions, cleans, abides by rules and contributes to maintenance if living with others.

Substance Abuse Definition: The household living environment is independent and sufficiently supportive of recovery, e.g., new recovery skills or new environment or new significant support networks.

#GR-49 DLA-20 : Communication DLA20Communication

1 Extremely severe functional impairment, needs pervasive level of continuous paid supports

Very severe functional impairment, needs extensive level of continuous paid supports Severe functional impairment, needs moderate level of continuous paid supports Moderate functional impairment, needs low level of continuous paid supports WNL/Strength, Mild functional impairment, needs moderate level of intermittent paid supports WNL/Strength, Intermittent mild functional impairment, needs low level of paid supports WNL/Strength, Independent, Optimal functioning, no need for paid supports

Rules:

Required on all records for clients aged 6 and over Must be blank for clients under age 6 When entering a DLA-20 Assessment, at least 15 of the DLA-20 activity fields (GR-47 through

GR-66) must have a value.

If entering a DLA-20 Assessment, GR-67 DLA-20 AverageScore must have a value.

If not entering a DLA-20 assessment, all DLA-20 fields (GR-47 through GR-66) must be blank DLA-20 fields are required on discharges when GR-68 DischargeStatus is 2=AMA, 5=Evaluation

Only, 6=Death, 9=Unknown, 10=No Show, or 12=Moved; Values on the discharge must match the values on the most recent interim/admit.

When used, must be 1-7 Must update on I’s No value or not available should be reported as

<DLA20Communication></DLA20Communication> or <DLA20Communication /> Mental Health Definition: Listens to people, expresses opinions/feelings; makes wishes known effectively.

Substance Abuse Definition: Responsive, listens, expresses feelings, anger effectively with others.

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#GR-50 DLA-20 : Safety DLA20Safety

1 Extremely severe functional impairment, needs pervasive level of continuous paid supports

Very severe functional impairment, needs extensive level of continuous paid supports Severe functional impairment, needs moderate level of continuous paid supports Moderate functional impairment, needs low level of continuous paid supports WNL/Strength, Mild functional impairment, needs moderate level of intermittent paid supports WNL/Strength, Intermittent mild functional impairment, needs low level of paid supports WNL/Strength, Independent, Optimal functioning, no need for paid supports

Rules:

Required on all records for clients aged 6 and over Must be blank for clients under age 6 When entering a DLA-20 Assessment, at least 15 of the DLA-20 activity fields (GR-47 through

GR-66) must have a value.

If entering a DLA-20 Assessment, GR-67 DLA-20 AverageScore must have a value.

If not entering a DLA-20 assessment, all DLA-20 fields (GR-47 through GR-66) must be blank DLA-20 fields are required on discharges when GR-68 DischargeStatus is 2=AMA, 5=Evaluation

Only, 6=Death, 9=Unknown, 10=No Show, or 12=Moved; Values on the discharge must match the values on the most recent interim/admit.

When used, must be 1-7 Must update on I’s No value or not available should be reported as <DLA20Safety></DLA20Safety> or

<DLA20Safety /> Mental Health Definition: Safely moves about community – adequate vision, hearing, makes safe decisions. Safely uses small appliances, ovens/burners, matches, knives, razors, other tools.

Substancy Abuse Definition: Avoids high-risk places, situations for AOD relapse, physical abuse.

#GR-51 DLA-20 : Managing Time DLA20Time

1 Extremely severe functional impairment, needs pervasive level of continuous paid supports

Very severe functional impairment, needs extensive level of continuous paid supports Severe functional impairment, needs moderate level of continuous paid supports Moderate functional impairment, needs low level of continuous paid supports WNL/Strength, Mild functional impairment, needs moderate level of intermittent paid supports WNL/Strength, Intermittent mild functional impairment, needs low level of paid supports WNL/Strength, Independent, Optimal functioning, no need for paid supports

Rules:

Required on all records for clients aged 6 and over Must be blank for clients under age 6 When entering a DLA-20 Assessment, at least 15 of the DLA-20 activity fields (GR-47 through

GR-66) must have a value.

If entering a DLA-20 Assessment, GR-67 DLA-20 AverageScore must have a value.

If not entering a DLA-20 assessment, all DLA-20 fields (GR-47 through GR-66) must be blank DLA-20 fields are required on discharges when GR-68 DischargeStatus is 2=AMA, 5=Evaluation

Only, 6=Death, 9=Unknown, 10=No Show, or 12=Moved; Values on the discharge must match the values on the most recent interim/admit.

When used, must be 1-7

FY27 MIS Client and Treatment Data Rules Page 21 of 48

Must update on I’s No value or not available should be reported as <DLA20Time></DLA20Time> or

<DLA20Time /> Mental Health Definition: Follows regular schedule for bedtime, wake-up, meal times, rarely tardy or absent for work, day programs, appointments, scheduled activities.

Substance Abuse Definition: Rarely tardy or absent for treatment program, work, appointments, adequate task management, follows regular sleep cycles, mealtimes.

#GR-52 DLA-20 : Managing Money DLA20Money

1 Extremely severe functional impairment, needs pervasive level of continuous paid supports

Very severe functional impairment, needs extensive level of continuous paid supports Severe functional impairment, needs moderate level of continuous paid supports Moderate functional impairment, needs low level of continuous paid supports WNL/Strength, Mild functional impairment, needs moderate level of intermittent paid supports WNL/Strength, Intermittent mild functional impairment, needs low level of paid supports WNL/Strength, Independent, Optimal functioning, no need for paid supports

Rules:

Required on all records for clients aged 6 and over Must be blank for clients under age 6 When entering a DLA-20 Assessment, at least 15 of the DLA-20 activity fields (GR-47 through

GR-66) must have a value.

If entering a DLA-20 Assessment, GR-67 DLA-20 AverageScore must have a value.

If not entering a DLA-20 assessment, all DLA-20 fields (GR-47 through GR-66) must be blank DLA-20 fields are required on discharges when GR-68 DischargeStatus is 2=AMA, 5=Evaluation

Only, 6=Death, 9=Unknown, 10=No Show, or 12=Moved; Values on the discharge must match the values on the most recent interim/admit.

When used, must be 1-7 Must update on I’s No value or not available should be reported as <DLA20Money></DLA20Money> or

<DLA20Money /> Mental Health Definition: Manages money wisely (independent source of funds); controls spending habits.

Substance Abuse Definition: Manages money wisely, pays bills 1st, controls spending habits & responsible with money; no theft or deceit with money.

#GR-53 DLA-20 : Nutrition DLA20Nutrition

1 Extremely severe functional impairment, needs pervasive level of continuous paid supports

Very severe functional impairment, needs extensive level of continuous paid supports Severe functional impairment, needs moderate level of continuous paid supports Moderate functional impairment, needs low level of continuous paid supports WNL/Strength, Mild functional impairment, needs moderate level of intermittent paid supports WNL/Strength, Intermittent mild functional impairment, needs low level of paid supports WNL/Strength, Independent, Optimal functioning, no need for paid supports

FY27 MIS Client and Treatment Data Rules Page 22 of 48

GR-66) must have a value.

If entering a DLA-20 Assessment, GR-67 DLA-20 AverageScore must have a value.

If not entering a DLA-20 assessment, all DLA-20 fields (GR-47 through GR-66) must be blank DLA-20 fields are required on discharges when GR-68 DischargeStatus is 2=AMA, 5=Evaluation

Only, 6=Death, 9=Unknown, 10=No Show, or 12=Moved; Values on the discharge must match the values on the most recent interim/admit.

When used, must be 1-7 Must update on I’s No value or not available should be reported as <DLA20Nutrition></DLA20Nutrition> or

<DLA20Nutrition /> Mental Health Definition: Eats at least 2 basically nutritious meals daily.

Substance Abuse Definition: Eats >= 2 nutritious meals; fluids, vital signs, blood reports WNL

#GR-54 DLA-20 : Problem Solving DLA20ProblemSolving

1 Extremely severe functional impairment, needs pervasive level of continuous paid supports

Very severe functional impairment, needs extensive level of continuous paid supports Severe functional impairment, needs moderate level of continuous paid supports Moderate functional impairment, needs low level of continuous paid supports WNL/Strength, Mild functional impairment, needs moderate level of intermittent paid supports WNL/Strength, Intermittent mild functional impairment, needs low level of paid supports WNL/Strength, Independent, Optimal functioning, no need for paid supports

Rules:

Required on all records for clients aged 6 and over Must be blank for clients under age 6 When entering a DLA-20 Assessment, at least 15 of the DLA-20 activity fields (GR-47 through

GR-66) must have a value.

If entering a DLA-20 Assessment, GR-67 DLA-20 AverageScore must have a value.

If not entering a DLA-20 assessment, all DLA-20 fields (GR-47 through GR-66) must be blank DLA-20 fields are required on discharges when GR-68 DischargeStatus is 2=AMA, 5=Evaluation

Only, 6=Death, 9=Unknown, 10=No Show, or 12=Moved; Values on the discharge must match the values on the most recent interim/admit.

When used, must be 1-7 Must update on I’s No value or not available should be reported as

<DLA20ProblemSolving></DLA20ProblemSolving> or <DLA20ProblemSolving /> Mental Health Definition: Resolves basic problems of daily living, asks questions for clarity and setting expectations.

Substance Abuse Definition: WNL cognitive functioning, concentrating, remembering, making decisions; resolves basic problems, thoughts/plans of suicide, asks questions for clarity.

#GR-55 DLA-20 : Family Relationships DLA20Family

1 Extremely severe functional impairment, needs pervasive level of continuous paid supports 2 Very severe functional impairment, needs extensive level of continuous paid supports

FY27 MIS Client and Treatment Data Rules Page 23 of 48

Severe functional impairment, needs moderate level of continuous paid supports Moderate functional impairment, needs low level of continuous paid supports WNL/Strength, Mild functional impairment, needs moderate level of intermittent paid supports WNL/Strength, Intermittent mild functional impairment, needs low level of paid supports WNL/Strength, Independent, Optimal functioning, no need for paid supports

Rules:

Required on all records for clients aged 6 and over Must be blank for clients under age 6 When entering a DLA-20 Assessment, at least 15 of the DLA-20 activity fields (GR-47 through

GR-66) must have a value.

If entering a DLA-20 Assessment, GR-67 DLA-20 AverageScore must have a value.

If not entering a DLA-20 assessment, all DLA-20 fields (GR-47 through GR-66) must be blank DLA-20 fields are required on discharges when GR-68 DischargeStatus is 2=AMA, 5=Evaluation

Only, 6=Death, 9=Unknown, 10=No Show, or 12=Moved; Values on the discharge must match the values on the most recent interim/admit.

When used, must be 1-7 Must update on I’s No value or not available should be reported as <DLA20Family></DLA20Family> or

<DLA20Family /> Mental Health Definition: Gets along with family, positive relationships as parent, sibling, child, significant other family member.

Substance Abuse Definition: Practices healthy relationship-communication skills with family;

works to resolve conflicts & learn about impact of SA on family.

#GR-56 DLA-20 : Alcohol/Drug Use DLA20AlcoholDrug

1 Extremely severe functional impairment, needs pervasive level of continuous paid supports

Very severe functional impairment, needs extensive level of continuous paid supports Severe functional impairment, needs moderate level of continuous paid supports Moderate functional impairment, needs low level of continuous paid supports WNL/Strength, Mild functional impairment, needs moderate level of intermittent paid supports WNL/Strength, Intermittent mild functional impairment, needs low level of paid supports WNL/Strength, Independent, Optimal functioning, no need for paid supports

Rules:

Required on all records for clients aged 6 and over Must be blank for clients under age 6 When entering a DLA-20 Assessment, at least 15 of the DLA-20 activity fields (GR-47 through

GR-66) must have a value.

If entering a DLA-20 Assessment, GR-67 DLA-20 AverageScore must have a value.

If not entering a DLA-20 assessment, all DLA-20 fields (GR-47 through GR-66) must be blank DLA-20 fields are required on discharges when GR-68 DischargeStatus is 2=AMA, 5=Evaluation

Only, 6=Death, 9=Unknown, 10=No Show, or 12=Moved; Values on the discharge must match the values on the most recent interim/admit.

When used, must be 1-7 Must update on I’s No value or not available should be reported as <DLA20AlcoholDrug></DLA20AlcoholDrug> or <DLA20AlcoholDrug />

FY27 MIS Client and Treatment Data Rules Page 24 of 48

Mental Health Definition: Avoids abuse or abstains from alcohol/drugs, cigarettes; understands signs and symptoms of abuse or dependency; avoids misuse or combining alcohol, drugs, medication.

Substance Abuse Definition: Abstains from AOD use, cigarettes & any medication over the counter or prescribed without direct supervision of M.D. knowledgeable of special risks.

#GR-57 DLA-20 : Leisure DLA20Leisure

1 Extremely severe functional impairment, needs pervasive level of continuous paid supports

Very severe functional impairment, needs extensive level of continuous paid supports Severe functional impairment, needs moderate level of continuous paid supports Moderate functional impairment, needs low level of continuous paid supports WNL/Strength, Mild functional impairment, needs moderate level of intermittent paid supports WNL/Strength, Intermittent mild functional impairment, needs low level of paid supports WNL/Strength, Independent, Optimal functioning, no need for paid supports

Rules:

Required on all records for clients aged 6 and over Must be blank for clients under age 6 When entering a DLA-20 Assessment, at least 15 of the DLA-20 activity fields (GR-47 through

GR-66) must have a value.

If entering a DLA-20 Assessment, GR-67 DLA-20 AverageScore must have a value.

If not entering a DLA-20 assessment, all DLA-20 fields (GR-47 through GR-66) must be blank DLA-20 fields are required on discharges when GR-68 DischargeStatus is 2=AMA, 5=Evaluation

Only, 6=Death, 9=Unknown, 10=No Show, or 12=Moved; Values on the discharge must match the values on the most recent interim/admit.

When used, must be 1-7 Must update on I’s No value or not available should be reported as <DLA20Leisure></DLA20Leisure> or

<DLA20Leisure /> Mental Health Definition: Relaxes with a variety of activities; attends/participates in sports or performing arts events; reads newspapers, magazines, books; recreational games with others;

involved arts/crafts; goes to movies.

Substance Abuse Definition: Participates in drug-free activities, books, movies, plays sports, board games, music, dances; avoids A/D places alone or with others.

#GR-58 DLA-20 : Community Resources DLA20Community

1 Extremely severe functional impairment, needs pervasive level of continuous paid supports

Very severe functional impairment, needs extensive level of continuous paid supports Severe functional impairment, needs moderate level of continuous paid supports Moderate functional impairment, needs low level of continuous paid supports WNL/Strength, Mild functional impairment, needs moderate level of intermittent paid supports WNL/Strength, Intermittent mild functional impairment, needs low level of paid supports WNL/Strength, Independent, Optimal functioning, no need for paid supports

Rules:

FY27 MIS Client and Treatment Data Rules Page 25 of 48

GR-66) must have a value.

If entering a DLA-20 Assessment, GR-67 DLA-20 AverageScore must have a value.

If not entering a DLA-20 assessment, all DLA-20 fields (GR-47 through GR-66) must be blank DLA-20 fields are required on discharges when GR-68 DischargeStatus is 2=AMA, 5=Evaluation

Only, 6=Death, 9=Unknown, 10=No Show, or 12=Moved; Values on the discharge must match the values on the most recent interim/admit.

When used, must be 1-7 Must update on I’s No value or not available should be reported as <DLA20Community></DLA20Community> or

<DLA20Community /> Mental Health Definition: Uses other community services, self-help groups, telephone, public transportation, religious organizations, shopping.

Substance Abuse Definition: Participates in treatment program & self-help support groups; uses employment assistance programs & arranges safe transportation.

#GR-59 DLA-20 : Social Network DLA20Social

1 Extremely severe functional impairment, needs pervasive level of continuous paid supports

Very severe functional impairment, needs extensive level of continuous paid supports Severe functional impairment, needs moderate level of continuous paid supports Moderate functional impairment, needs low level of continuous paid supports WNL/Strength, Mild functional impairment, needs moderate level of intermittent paid supports WNL/Strength, Intermittent mild functional impairment, needs low level of paid supports WNL/Strength, Independent, Optimal functioning, no need for paid supports

Rules:

Required on all records for clients aged 6 and over Must be blank for clients under age 6 When entering a DLA-20 Assessment, at least 15 of the DLA-20 activity fields (GR-47 through

GR-66) must have a value.

If entering a DLA-20 Assessment, GR-67 DLA-20 AverageScore must have a value.

If not entering a DLA-20 assessment, all DLA-20 fields (GR-47 through GR-66) must be blank DLA-20 fields are required on discharges when GR-68 DischargeStatus is 2=AMA, 5=Evaluation

Only, 6=Death, 9=Unknown, 10=No Show, or 12=Moved; Values on the discharge must match the values on the most recent interim/admit.

When used, must be 1-7 Must update on I’s No value or not available should be reported as <DLA20Social></DLA20Social> or

<DLA20Social /> Mental Health Definition: Gets along with friends, neighbors, coworkers, other peers.

Substance Abuse Definition: Finds and participates in drug-free social network, peer groups. Gets along with neighbors, coworkers, community.

#GR-60 DLA-20 : Sexuality DLA20Sexuality

FY27 MIS Client and Treatment Data Rules Page 26 of 48

Severe functional impairment, needs moderate level of continuous paid supports Moderate functional impairment, needs low level of continuous paid supports WNL/Strength, Mild functional impairment, needs moderate level of intermittent paid supports WNL/Strength, Intermittent mild functional impairment, needs low level of paid supports WNL/Strength, Independent, Optimal functioning, no need for paid supports

Rules:

Required on all records for clients aged 6 and over Must be blank for clients under age 6 When entering a DLA-20 Assessment, at least 15 of the DLA-20 activity fields (GR-47 through

GR-66) must have a value.

If entering a DLA-20 Assessment, GR-67 DLA-20 AverageScore must have a value.

If not entering a DLA-20 assessment, all DLA-20 fields (GR-47 through GR-66) must be blank DLA-20 fields are required on discharges when GR-68 DischargeStatus is 2=AMA, 5=Evaluation

Only, 6=Death, 9=Unknown, 10=No Show, or 12=Moved; Values on the discharge must match the values on the most recent interim/admit.

When used, must be 1-7 Must update on I’s No value or not available should be reported as <DLA20Sexuality></DLA20Sexuality> or

<DLA20Sexuality /> Mental Health Definition: Appropriate behavior toward others; comfortable with gender, respects privacy and rights of others, practices safe sex or abstains.

Substance Abuse Definition: No behavior known to be high risk for STDS, AIDS, unwanted pregnancies; sexually appropriate behavior - not hostile, exploiting.

#GR-61 DLA-20 : Productivity DLA20Productivity

1 Extremely severe functional impairment, needs pervasive level of continuous paid supports

Very severe functional impairment, needs extensive level of continuous paid supports Severe functional impairment, needs moderate level of continuous paid supports Moderate functional impairment, needs low level of continuous paid supports WNL/Strength, Mild functional impairment, needs moderate level of intermittent paid supports WNL/Strength, Intermittent mild functional impairment, needs low level of paid supports WNL/Strength, Independent, Optimal functioning, no need for paid supports

Rules:

Required on all records for clients aged 6 and over Must be blank for clients under age 6 When entering a DLA-20 Assessment, at least 15 of the DLA-20 activity fields (GR-47 through

GR-66) must have a value.

If entering a DLA-20 Assessment, GR-67 DLA-20 AverageScore must have a value.

If not entering a DLA-20 assessment, all DLA-20 fields (GR-47 through GR-66) must be blank DLA-20 fields are required on discharges when GR-68 DischargeStatus is 2=AMA, 5=Evaluation

Only, 6=Death, 9=Unknown, 10=No Show, or 12=Moved; Values on the discharge must match the values on the most recent interim/admit.

When used, must be 1-7 Must update on I’s No value or not available should be reported as <DLA20Productivity></DLA20Productivity> or

<DLA20Productivity />

FY27 MIS Client and Treatment Data Rules Page 27 of 48

Mental Health Definition: Independently working, volunteering, homemaking, or learning skills for financial selfsupport.

Substance Abuse Definition: Independently learning skills for financial self-support or working, volunteering, homemaking, finishing GED.

#GR-62 DLA-20 : Coping Skills DLA20Coping

1 Extremely severe functional impairment, needs pervasive level of continuous paid supports

Very severe functional impairment, needs extensive level of continuous paid supports Severe functional impairment, needs moderate level of continuous paid supports Moderate functional impairment, needs low level of continuous paid supports WNL/Strength, Mild functional impairment, needs moderate level of intermittent paid supports WNL/Strength, Intermittent mild functional impairment, needs low level of paid supports WNL/Strength, Independent, Optimal functioning, no need for paid supports

Rules:

Required on all records for clients aged 6 and over Must be blank for clients under age 6 When entering a DLA-20 Assessment, at least 15 of the DLA-20 activity fields (GR-47 through

GR-66) must have a value.

If entering a DLA-20 Assessment, GR-67 DLA-20 AverageScore must have a value.

If not entering a DLA-20 assessment, all DLA-20 fields (GR-47 through GR-66) must be blank DLA-20 fields are required on discharges when GR-68 DischargeStatus is 2=AMA, 5=Evaluation

Only, 6=Death, 9=Unknown, 10=No Show, or 12=Moved; Values on the discharge must match the values on the most recent interim/admit.

When used, must be 1-7 Must update on I’s No value or not available should be reported as <DLA20Coping></DLA20Coping> or

Mental Health Definition: Knows about nature of…