Colorado BHA FHIR Implementation Guide
0.3.0-current - ci-build
Colorado BHA FHIR Implementation Guide
0.3.0-current - ci-build
Colorado BHA FHIR Implementation Guide, published by Colorado Behavioral Health Administration. This guide is not an authorized publication; it is the continuous build for version 0.3.0-current built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/CoBHA/CoBHRM-FHIR-IG/ and changes regularly. See the Directory of published versions
| Page standards status: Trial-use | Maturity Level: 1 |
@prefix fhir: <http://hl7.org/fhir/> . @prefix owl: <http://www.w3.org/2002/07/owl#> . @prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> . @prefix xsd: <http://www.w3.org/2001/XMLSchema#> . # - resource ------------------------------------------------------------------- <http://hl7.org/fhir/Questionnaire/BHAAdmissionQuestionnaire> a fhir:Questionnaire ; fhir:nodeRole fhir:treeRoot ; fhir:Resource.id [ fhir:value "BHAAdmissionQuestionnaire"] ; fhir:Resource.meta [ fhir:Meta.profile [ fhir:value "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire|4.0.0-ci-build" ; fhir:index -1 ; fhir:link <http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire|4.0.0-ci-build> ] ] ; fhir:Resource.language [ fhir:value "en"] ; fhir:DomainResource.text [ fhir:Narrative.status [ fhir:value "extensions" ] ; fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Questionnaire BHAAdmissionQuestionnaire</b></p><a name=\"BHAAdmissionQuestionnaire\"> </a><a name=\"hcBHAAdmissionQuestionnaire\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"https://build.fhir.org/ig/HL7/sdc/StructureDefinition-sdc-questionnaire.html\">SDC Base Questionnaire</a> version: 4.0.0-ci-build</p></div><table border=\"1\" cellpadding=\"0\" cellspacing=\"0\" style=\"border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;\"><tr style=\"border: 2px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top\"><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"The linkID for the item\">LinkID</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Text for the item\">Text</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Minimum and Maximum # of times the item can appear in the instance\">Cardinality</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"The type of the item\">Type</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Additional information about the item\">Description & Constraints</a><span style=\"float: right\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"data:image/png;base64,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\" alt=\"doco\" style=\"background-color: inherit\"/></a></span></th></tr><tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_q_root.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"QuestionnaireRoot\" class=\"hierarchy\"/> BHAAdmissionQuestionnaire</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Questionnaire used during admission process to collect demographic, social, clinical, and administrative information from patients entering behavioral health services</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Questionnaire</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">http://bha.colorado.gov/fhir/bha-ig/Questionnaire/BHAAdmissionQuestionnaire#0.3.0-current</td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.lastUpdated\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-datetime.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"dateTime\" class=\"hierarchy\"/> lastUpdated</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Last Updated DateTime of the data in the QuestionnaireResponse</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-dateTime\">dateTime</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.SERVICE_IDENTIFIER\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> SERVICE_IDENTIFIER</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Service Identifier</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Value Set: <a href=\"ValueSet-bha-service-identifier-vs.html\">ValueSet for BHA Service Identifier Codes</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.FIRST_CONTACT_DATE\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-date.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"date\" class=\"hierarchy\"/> FIRST_CONTACT_DATE</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Date of First Contact</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-date\">date</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.FIRST_APPOINTMENT_OFFERED_DATE\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-date.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"date\" class=\"hierarchy\"/> FIRST_APPOINTMENT_OFFERED_DATE</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Date of First Appointment Offered</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-date\">date</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.MEDICATION_ASSISTED_THERAPY\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-boolean.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"boolean\" class=\"hierarchy\"/> MEDICATION_ASSISTED_THERAPY</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Medication Assisted Therapy</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean\">boolean</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.REFERRAL_SOURCE\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> REFERRAL_SOURCE</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Referral Source</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Value Set: <a href=\"ValueSet-bha-referral-source-vs.html\">ValueSet for BHA Referral Source</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.ARRESTS_PAST_30_DAYS\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-integer.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"integer\" class=\"hierarchy\"/> ARRESTS_PAST_30_DAYS</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Arrests in Past 30 Days</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer\">integer</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.EMPLOYMENT_STATUS\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> EMPLOYMENT_STATUS</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Employment Status</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Value Set: <a href=\"ValueSet-bha-employment-status-vs.html\">ValueSet for BHA Employment Status</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.LIVING_SITUATION\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> LIVING_SITUATION</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Living Situation</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Value Set: <a href=\"ValueSet-bha-living-situation-vs.html\">ValueSet for BHA Living Situation</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.MONTHLY_INCOME\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-decimal.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"decimal\" class=\"hierarchy\"/> MONTHLY_INCOME</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Monthly Income</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal\">decimal</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.PRIMARY_INCOME_SOURCE\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> PRIMARY_INCOME_SOURCE</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Primary Source of income/support for client (or for client's parent if client >18 years of age)</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Value Set: <a href=\"ValueSet-bha-income-source-vs.html\">ValueSet for BHA Income Source</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.PREGNANCY_STATUS\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-boolean.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"boolean\" class=\"hierarchy\"/> PREGNANCY_STATUS</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Pregnancy Status</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean\">boolean</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.WITHIN_1_YEAR_POSTPARTUM_STATUS\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-boolean.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"boolean\" class=\"hierarchy\"/> WITHIN_1_YEAR_POSTPARTUM_STATUS</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Within 1 Year Postpartum Status</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean\">boolean</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.SPECIAL_CONNECTIONS_ENROLLMENT\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-boolean.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"boolean\" class=\"hierarchy\"/> SPECIAL_CONNECTIONS_ENROLLMENT</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enrollment in Special Connections</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean\">boolean</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.ACT_ENROLLMENT\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-boolean.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"boolean\" class=\"hierarchy\"/> ACT_ENROLLMENT</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enrollment in ACT?</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean\">boolean</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.ASCENT_ENROLLMENT\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-boolean.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"boolean\" class=\"hierarchy\"/> ASCENT_ENROLLMENT</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enrollment in Ascent (FEP)?</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean\">boolean</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.NUMBER_DEPENDENT_CHILDREN\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-integer.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"integer\" class=\"hierarchy\"/> NUMBER_DEPENDENT_CHILDREN</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Number of Dependent Children</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer\">integer</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.SELF_HELP_ATTENDANCE\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-integer.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"integer\" class=\"hierarchy\"/> SELF_HELP_ATTENDANCE</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Self Help Attendance (Last 30 days at admission)/ Peer Support Attendance</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer\">integer</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.TOTAL_SUBSTANCE_USE_PRIOR_TREATMENT\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-integer.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"integer\" class=\"hierarchy\"/> TOTAL_SUBSTANCE_USE_PRIOR_TREATMENT</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Substance Use Prior Treatment (Total Lifetime admissions)</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer\">integer</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.PSYCHIATRIC_HOSPITAL_ADMISSION\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-boolean.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"boolean\" class=\"hierarchy\"/> PSYCHIATRIC_HOSPITAL_ADMISSION</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Psychiatric Hospital Admission (Last 30 days)</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean\">boolean</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.LEGAL_STATUS\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> LEGAL_STATUS</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Legal Status</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Value Set: <a href=\"ValueSet-bha-legal-status-vs.html\">ValueSet for BHA Legal Status</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.INVOLUNTARY_COMMITMENT_REASON\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> INVOLUNTARY_COMMITMENT_REASON</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Involuntary Commitment Reason</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <ul><li><a href=\"#item.LEGAL_STATUS\">LEGAL_STATUS</a> = 72-hour evaluation and treatment (BHA Legal Status#04)</li><li><a href=\"#item.LEGAL_STATUS\">LEGAL_STATUS</a> = Short-term certification (BHA Legal Status#05)</li><li><a href=\"#item.LEGAL_STATUS\">LEGAL_STATUS</a> = Long-term certification (BHA Legal Status#06)</li><li><a href=\"#item.LEGAL_STATUS\">LEGAL_STATUS</a> = Emergency/Involuntary Alcohol/Drug Commitment (BHA Legal Status#09)</li></ul><br/>Value Set: <a href=\"ValueSet-bha-involuntary-commitment-reason-vs.html\">ValueSet for BHA Involuntary Commitment Reason</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.CRIMINAL_JUSTICE_INVOLVEMENT\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-boolean.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"boolean\" class=\"hierarchy\"/> CRIMINAL_JUSTICE_INVOLVEMENT</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Criminal Justice Involvement</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean\">boolean</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.EDUCATION_LEVEL\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> EDUCATION_LEVEL</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Education Level</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Value Set: <a href=\"ValueSet-bha-education-level-vs.html\">ValueSet for BHA Education Level</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.SCHOOL_ATTENDANCE_STATUS\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> SCHOOL_ATTENDANCE_STATUS</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">School Attendance Status (in the previous 3 months)</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Value Set: <a href=\"ValueSet-bha-school-attendance-status-vs.html\">ValueSet for BHA School Attendance Status</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.PSYCHIATRIC_ER_VISIT_6_MONTHS\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-integer.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"integer\" class=\"hierarchy\"/> PSYCHIATRIC_ER_VISIT_6_MONTHS</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Visit to Psychiatric ER in last 6 months</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer\">integer</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.COMMUNICATION_ACCOMMODATIONS\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-boolean.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"boolean\" class=\"hierarchy\"/> COMMUNICATION_ACCOMMODATIONS</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Communication Accommodations</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean\">boolean</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.episodeOfCare\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-reference.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"reference\" class=\"hierarchy\"/> episodeOfCare</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Episode of Care Information</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-reference\">reference</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)\" id=\"item.diagnosis\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-reference.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"reference\" class=\"hierarchy\"/> diagnosis</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Diagnosis Information</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-reference\">reference</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr><td colspan=\"5\" class=\"hierarchy\"><br/><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"data:image/png;base64,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\" alt=\"doco\" style=\"background-color: inherit\"/> Documentation for this format</a></td></tr></table></div>" ] ; fhir:DomainResource.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/artifact-versionAlgorithm" ] ; fhir:Extension.valueCoding [ fhir:Coding.system [ fhir:value "http://hl7.org/fhir/version-algorithm" ] ; fhir:Coding.code [ fhir:value "semver" ] ; fhir:Coding.display [ fhir:value "SemVer" ] ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm" ] ; fhir:Extension.valueInteger [ fhir:value "1"^^xsd:integer ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom" ] ; fhir:Extension.valueCanonical [ fhir:value "http://bha.colorado.gov/fhir/bha-ig/ImplementationGuide/us.co.bha-ig" ; fhir:link <http://bha.colorado.gov/fhir/bha-ig/ImplementationGuide/us.co.bha-ig> ] ] ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status" ] ; fhir:Extension.valueCode [ fhir:value "trial-use" ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom" ] ; fhir:Extension.valueCanonical [ fhir:value "http://bha.colorado.gov/fhir/bha-ig/ImplementationGuide/us.co.bha-ig" ; fhir:link <http://bha.colorado.gov/fhir/bha-ig/ImplementationGuide/us.co.bha-ig> ] ] ] ] ; fhir:Questionnaire.url [ fhir:value "http://bha.colorado.gov/fhir/bha-ig/Questionnaire/BHAAdmissionQuestionnaire"] ; fhir:Questionnaire.version [ fhir:value "0.3.0-current"] ; fhir:Questionnaire.name [ fhir:value "BHAAdmissionQuestionnaire"] ; fhir:Questionnaire.title [ fhir:value "BHA Admission Questionnaire"] ; fhir:Questionnaire.status [ fhir:value "active"] ; fhir:Questionnaire.subjectType [ fhir:value "Patient" ; fhir:index -1 ] ; fhir:Questionnaire.date [ fhir:value "2025-12-13"^^xsd:date] ; fhir:Questionnaire.publisher [ fhir:value "Colorado Behavioral Health Administration"] ; fhir:Questionnaire.contact [ fhir:index -1 ; fhir:ContactDetail.name [ fhir:value "Colorado Behavioral Health Administration" ] ; fhir:ContactDetail.telecom [ fhir:index -1 ; fhir:ContactPoint.system [ fhir:value "url" ] ; fhir:ContactPoint.value [ fhir:value "https://bha.colorado.gov" ] ], [ fhir:index -1 ; fhir:ContactPoint.system [ fhir:value "email" ] ; fhir:ContactPoint.value [ fhir:value "FHIRFeedback@state.co.us" ] ] ] ; fhir:Questionnaire.description [ fhir:value "Questionnaire used during admission process to collect demographic, social, clinical, and administrative information from patients entering behavioral health services"] ; fhir:Questionnaire.jurisdiction [ fhir:index -1 ; fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "urn:iso:std:iso:3166" ] ; fhir:Coding.code [ fhir:value "USA" ] ] ] ; fhir:Questionnaire.item [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "lastUpdated" ] ; fhir:Questionnaire.item.text [ fhir:value "Last Updated DateTime of the data in the QuestionnaireResponse" ] ; fhir:Questionnaire.item.type [ fhir:value "dateTime" ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ], [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "SERVICE_IDENTIFIER" ] ; fhir:Questionnaire.item.text [ fhir:value "Service Identifier" ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerValueSet [ fhir:value "http://bha.colorado.gov/fhir/bha-ig/ValueSet/bha-service-identifier-vs" ; fhir:link <http://bha.colorado.gov/fhir/bha-ig/ValueSet/bha-service-identifier-vs> ] ], [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "FIRST_CONTACT_DATE" ] ; fhir:Questionnaire.item.text [ fhir:value "Date of First Contact" ] ; fhir:Questionnaire.item.type [ fhir:value "date" ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ], [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "FIRST_APPOINTMENT_OFFERED_DATE" ] ; fhir:Questionnaire.item.text [ fhir:value "Date of First Appointment Offered" ] ; fhir:Questionnaire.item.type [ fhir:value "date" ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ], [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "MEDICATION_ASSISTED_THERAPY" ] ; fhir:Questionnaire.item.text [ fhir:value "Medication Assisted Therapy" ] ; fhir:Questionnaire.item.type [ fhir:value "boolean" ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ], [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "REFERRAL_SOURCE" ] ; fhir:Questionnaire.item.text [ fhir:value "Referral Source" ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerValueSet [ fhir:value "http://bha.colorado.gov/fhir/bha-ig/ValueSet/bha-referral-source-vs" ; fhir:link <http://bha.colorado.gov/fhir/bha-ig/ValueSet/bha-referral-source-vs> ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/minValue" ] ; fhir:Extension.valueInteger [ fhir:value "0"^^xsd:integer ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/maxValue" ] ; fhir:Extension.valueInteger [ fhir:value "30"^^xsd:integer ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "ARRESTS_PAST_30_DAYS" ] ; fhir:Questionnaire.item.text [ fhir:value "Arrests in Past 30 Days" ] ; fhir:Questionnaire.item.type [ fhir:value "integer" ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ], [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "EMPLOYMENT_STATUS" ] ; fhir:Questionnaire.item.text [ fhir:value "Employment Status" ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerValueSet [ fhir:value "http://bha.colorado.gov/fhir/bha-ig/ValueSet/bha-employment-status-vs" ; fhir:link <http://bha.colorado.gov/fhir/bha-ig/ValueSet/bha-employment-status-vs> ] ], [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "LIVING_SITUATION" ] ; fhir:Questionnaire.item.text [ fhir:value "Living Situation" ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerValueSet [ fhir:value "http://bha.colorado.gov/fhir/bha-ig/ValueSet/bha-living-situation-vs" ; fhir:link <http://bha.colorado.gov/fhir/bha-ig/ValueSet/bha-living-situation-vs> ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-unit" ] ; fhir:Extension.valueCoding [ fhir:Coding.system [ fhir:value "urn:iso:std:iso:4217" ] ; fhir:Coding.code [ fhir:value "USD" ] ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/minValue" ] ; fhir:Extension.valueDecimal [ fhir:value "0"^^xsd:decimal ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/maxValue" ] ; fhir:Extension.valueDecimal [ fhir:value "9999"^^xsd:decimal ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "MONTHLY_INCOME" ] ; fhir:Questionnaire.item.text [ fhir:value "Monthly Income" ] ; fhir:Questionnaire.item.type [ fhir:value "decimal" ] ; fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ] ], [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "PRIMARY_INCOME_SOURCE" ] ; fhir:Questionnaire.item.text [ fhir:value "Primary Source of income/support for client (or for client's parent if client >18 years of age)" ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerValueSet [ fhir:value "http://bha.colorado.gov/fhir/bha-ig/ValueSet/bha-income-source-vs" ; fhir:link <http://bha.colorado.gov/fhir/bha-ig/ValueSet/bha-income-source-vs> ] ], [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "PREGNANCY_STATUS" ] ; fhir:Questionnaire.item.text [ fhir:value "Pregnancy Status" ] ; fhir:Questionnaire.item.type [ fhir:value "boolean" ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ], [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "WITHIN_1_YEAR_POSTPARTUM_STATUS" ] ; fhir:Questionnaire.item.text [ fhir:value "Within 1 Year Postpartum Status" ] ; fhir:Questionnaire.item.type [ fhir:value "boolean" ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ], [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "SPECIAL_CONNECTIONS_ENROLLMENT" ] ; fhir:Questionnaire.item.text [ fhir:value "Enrollment in Special Connections" ] ; fhir:Questionnaire.item.type [ fhir:value "boolean" ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ], [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "ACT_ENROLLMENT" ] ; fhir:Questionnaire.item.text [ fhir:value "Enrollment in ACT?" ] ; fhir:Questionnaire.item.type [ fhir:value "boolean" ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ], [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "ASCENT_ENROLLMENT" ] ; fhir:Questionnaire.item.text [ fhir:value "Enrollment in Ascent (FEP)?" ] ; fhir:Questionnaire.item.type [ fhir:value "boolean" ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/minValue" ] ; fhir:Extension.valueInteger [ fhir:value "0"^^xsd:integer ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/maxValue" ] ; fhir:Extension.valueInteger [ fhir:value "99"^^xsd:integer ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "NUMBER_DEPENDENT_CHILDREN" ] ; fhir:Questionnaire.item.text [ fhir:value "Number of Dependent Children" ] ; fhir:Questionnaire.item.type [ fhir:value "integer" ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/minValue" ] ; fhir:Extension.valueInteger [ fhir:value "0"^^xsd:integer ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/maxValue" ] ; fhir:Extension.valueInteger [ fhir:value "30"^^xsd:integer ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "SELF_HELP_ATTENDANCE" ] ; fhir:Questionnaire.item.text [ fhir:value "Self Help Attendance (Last 30 days at admission)/ Peer Support Attendance" ] ; fhir:Questionnaire.item.type [ fhir:value "integer" ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/minValue" ] ; fhir:Extension.valueInteger [ fhir:value "0"^^xsd:integer ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/maxValue" ] ; fhir:Extension.valueInteger [ fhir:value "30"^^xsd:integer ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "TOTAL_SUBSTANCE_USE_PRIOR_TREATMENT" ] ; fhir:Questionnaire.item.text [ fhir:value "Substance Use Prior Treatment (Total Lifetime admissions)" ] ; fhir:Questionnaire.item.type [ fhir:value "integer" ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ], [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "PSYCHIATRIC_HOSPITAL_ADMISSION" ] ; fhir:Questionnaire.item.text [ fhir:value "Psychiatric Hospital Admission (Last 30 days)" ] ; fhir:Questionnaire.item.type [ fhir:value "boolean" ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ], [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "LEGAL_STATUS" ] ; fhir:Questionnaire.item.text [ fhir:value "Legal Status" ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerValueSet [ fhir:value "http://bha.colorado.gov/fhir/bha-ig/ValueSet/bha-legal-status-vs" ; fhir:link <http://bha.colorado.gov/fhir/bha-ig/ValueSet/bha-legal-status-vs> ] ], [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "INVOLUNTARY_COMMITMENT_REASON" ] ; fhir:Questionnaire.item.text [ fhir:value "Involuntary Commitment Reason" ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.enableWhen [ fhir:index -1 ; fhir:Questionnaire.item.enableWhen.question [ fhir:value "LEGAL_STATUS" ] ; fhir:Questionnaire.item.enableWhen.operator [ fhir:value "=" ] ; fhir:Questionnaire.item.enableWhen.answerCoding [ fhir:Coding.system [ fhir:value "http://bha.colorado.gov/fhir/bha-ig/CodeSystem/bha-legal-status" ] ; fhir:Coding.code [ fhir:value "04" ] ; fhir:Coding.display [ fhir:value "72-hour evaluation and treatment" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.enableWhen.question [ fhir:value "LEGAL_STATUS" ] ; fhir:Questionnaire.item.enableWhen.operator [ fhir:value "=" ] ; fhir:Questionnaire.item.enableWhen.answerCoding [ fhir:Coding.system [ fhir:value "http://bha.colorado.gov/fhir/bha-ig/CodeSystem/bha-legal-status" ] ; fhir:Coding.code [ fhir:value "05" ] ; fhir:Coding.display [ fhir:value "Short-term certification" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.enableWhen.question [ fhir:value "LEGAL_STATUS" ] ; fhir:Questionnaire.item.enableWhen.operator [ fhir:value "=" ] ; fhir:Questionnaire.item.enableWhen.answerCoding [ fhir:Coding.system [ fhir:value "http://bha.colorado.gov/fhir/bha-ig/CodeSystem/bha-legal-status" ] ; fhir:Coding.code [ fhir:value "06" ] ; fhir:Coding.display [ fhir:value "Long-term certification" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.enableWhen.question [ fhir:value "LEGAL_STATUS" ] ; fhir:Questionnaire.item.enableWhen.operator [ fhir:value "=" ] ; fhir:Questionnaire.item.enableWhen.answerCoding [ fhir:Coding.system [ fhir:value "http://bha.colorado.gov/fhir/bha-ig/CodeSystem/bha-legal-status" ] ; fhir:Coding.code [ fhir:value "09" ] ; fhir:Coding.display [ fhir:value "Emergency/Involuntary Alcohol/Drug Commitment" ] ] ] ; fhir:Questionnaire.item.enableBehavior [ fhir:value "any" ] ; fhir:Questionnaire.item.answerValueSet [ fhir:value "http://bha.colorado.gov/fhir/bha-ig/ValueSet/bha-involuntary-commitment-reason-vs" ; fhir:link <http://bha.colorado.gov/fhir/bha-ig/ValueSet/bha-involuntary-commitment-reason-vs> ] ], [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "CRIMINAL_JUSTICE_INVOLVEMENT" ] ; fhir:Questionnaire.item.text [ fhir:value "Criminal Justice Involvement" ] ; fhir:Questionnaire.item.type [ fhir:value "boolean" ] ; fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ] ], [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "EDUCATION_LEVEL" ] ; fhir:Questionnaire.item.text [ fhir:value "Education Level" ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerValueSet [ fhir:value "http://bha.colorado.gov/fhir/bha-ig/ValueSet/bha-education-level-vs" ; fhir:link <http://bha.colorado.gov/fhir/bha-ig/ValueSet/bha-education-level-vs> ] ], [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "SCHOOL_ATTENDANCE_STATUS" ] ; fhir:Questionnaire.item.text [ fhir:value "School Attendance Status (in the previous 3 months)" ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerValueSet [ fhir:value "http://bha.colorado.gov/fhir/bha-ig/ValueSet/bha-school-attendance-status-vs" ; fhir:link <http://bha.colorado.gov/fhir/bha-ig/ValueSet/bha-school-attendance-status-vs> ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/minValue" ] ; fhir:Extension.valueInteger [ fhir:value "0"^^xsd:integer ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/maxValue" ] ; fhir:Extension.valueInteger [ fhir:value "99"^^xsd:integer ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "PSYCHIATRIC_ER_VISIT_6_MONTHS" ] ; fhir:Questionnaire.item.text [ fhir:value "Visit to Psychiatric ER in last 6 months" ] ; fhir:Questionnaire.item.type [ fhir:value "integer" ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ], [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "COMMUNICATION_ACCOMMODATIONS" ] ; fhir:Questionnaire.item.text [ fhir:value "Communication Accommodations" ] ; fhir:Questionnaire.item.type [ fhir:value "boolean" ] ; fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-referenceResource" ] ; fhir:Extension.valueCode [ fhir:value "EpisodeOfCare" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-referenceProfile" ] ; fhir:Extension.valueCanonical [ fhir:value "http://bha.colorado.gov/fhir/bha-ig/StructureDefinition/bha-episodeOfCare" ; fhir:link <http://bha.colorado.gov/fhir/bha-ig/StructureDefinition/bha-episodeOfCare> ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "episodeOfCare" ] ; fhir:Questionnaire.item.text [ fhir:value "Episode of Care Information" ] ; fhir:Questionnaire.item.type [ fhir:value "reference" ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-referenceResource" ] ; fhir:Extension.valueCode [ fhir:value "Condition" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-referenceProfile" ] ; fhir:Extension.valueCanonical [ fhir:value "http://bha.colorado.gov/fhir/bha-ig/StructureDefinition/BHAEpisodeDiagnosis" ; fhir:link <http://bha.colorado.gov/fhir/bha-ig/StructureDefinition/BHAEpisodeDiagnosis> ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "diagnosis" ] ; fhir:Questionnaire.item.text [ fhir:value "Diagnosis Information" ] ; fhir:Questionnaire.item.type [ fhir:value "reference" ] ; fhir:Questionnaire.item.required [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ] . # - ontology header ------------------------------------------------------------ <http://hl7.org/fhir/Questionnaire/BHAAdmissionQuestionnaire.ttl> a owl:Ontology ; owl:imports fhir:fhir.ttl ; owl:versionIRI <http://build.fhir.org/Questionnaire/BHAAdmissionQuestionnaire.ttl> .
IG © 2025+ Colorado Behavioral Health Administration.
Package us.co.bha-ig#0.3.0-current based on FHIR 4.0.1.
Generated
2026-07-06
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QA Report
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