Colorado BHA FHIR Implementation Guide
0.3.0-current - ci-build United States of America flag

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

Example QuestionnaireResponse: Example BHA Admission Questionnaire Responses South

Page standards status: Informative
LinkIDTextDefinitionAnswerdoco
BHAAdmissionQuestionnaireResponseExampleSouthQuestionnaire:BHA Admission Questionnaire
BHAAdmissionQuestionnaireResponseExampleSouth / lastUpdated2025-01-10T09:00:00Z
BHAAdmissionQuestionnaireResponseExampleSouth / SERVICE_IDENTIFIERService IdentifierBHA Service Identifier Codes: 30 (Mental Health Outpatient)
BHAAdmissionQuestionnaireResponseExampleSouth / FIRST_CONTACT_DATEDate of First Contact2025-01-10
BHAAdmissionQuestionnaireResponseExampleSouth / FIRST_APPOINTMENT_OFFERED_DATEDate of First Appointment Offered2025-01-14
BHAAdmissionQuestionnaireResponseExampleSouth / MEDICATION_ASSISTED_THERAPYMedication Assisted Therapyfalse
BHAAdmissionQuestionnaireResponseExampleSouth / REFERRAL_SOURCEReferral SourceBHA Referral Source: 1 (Individual (self, family, friend))
BHAAdmissionQuestionnaireResponseExampleSouth / ARRESTS_PAST_30_DAYSArrests in Past 30 Days0
BHAAdmissionQuestionnaireResponseExampleSouth / EMPLOYMENT_STATUSEmployment StatusBHA Employment Status: 02 (Employed Part Time (<35 hours/week))
BHAAdmissionQuestionnaireResponseExampleSouth / LIVING_SITUATIONLiving SituationBHA Living Situation: 2 (Inpatient)
BHAAdmissionQuestionnaireResponseExampleSouth / MONTHLY_INCOMEMonthly Income1800
BHAAdmissionQuestionnaireResponseExampleSouth / PRIMARY_INCOME_SOURCEPrimary Source of income/support for client (or for client's parent if client >18 years of age)BHA Income Source: 1 (Wages)
BHAAdmissionQuestionnaireResponseExampleSouth / PREGNANCY_STATUSPregnancy Statustrue
BHAAdmissionQuestionnaireResponseExampleSouth / WITHIN_1_YEAR_POSTPARTUM_STATUSWithin 1 Year Postpartum Statusfalse
BHAAdmissionQuestionnaireResponseExampleSouth / SPECIAL_CONNECTIONS_ENROLLMENTEnrollment in Special Connectionstrue
BHAAdmissionQuestionnaireResponseExampleSouth / ACT_ENROLLMENTEnrollment in ACT?false
BHAAdmissionQuestionnaireResponseExampleSouth / ASCENT_ENROLLMENTEnrollment in Ascent (FEP)?false
BHAAdmissionQuestionnaireResponseExampleSouth / NUMBER_DEPENDENT_CHILDRENNumber of Dependent Children0
BHAAdmissionQuestionnaireResponseExampleSouth / SELF_HELP_ATTENDANCESelf Help Attendance (Last 30 days at admission)/ Peer Support Attendance1
BHAAdmissionQuestionnaireResponseExampleSouth / TOTAL_SUBSTANCE_USE_PRIOR_TREATMENTSubstance Use Prior Treatment (Total Lifetime admissions)0
BHAAdmissionQuestionnaireResponseExampleSouth / PSYCHIATRIC_HOSPITAL_ADMISSIONPsychiatric Hospital Admission (Last 30 days)false
BHAAdmissionQuestionnaireResponseExampleSouth / LEGAL_STATUSLegal StatusBHA Legal Status: 02 (Court-directed voluntary)
BHAAdmissionQuestionnaireResponseExampleSouth / CRIMINAL_JUSTICE_INVOLVEMENTCriminal Justice Involvementfalse
BHAAdmissionQuestionnaireResponseExampleSouth / EDUCATION_LEVELEducation LevelBHA Education Level: 14 (Some College)
BHAAdmissionQuestionnaireResponseExampleSouth / SCHOOL_ATTENDANCE_STATUSSchool Attendance Status (in the previous 3 months)BHA School Attendance Status: 03 (Not Applicable)
BHAAdmissionQuestionnaireResponseExampleSouth / PSYCHIATRIC_ER_VISIT_6_MONTHSVisit to Psychiatric ER in last 6 months0
BHAAdmissionQuestionnaireResponseExampleSouth / COMMUNICATION_ACCOMMODATIONSCommunication Accommodationsfalse
BHAAdmissionQuestionnaireResponseExampleSouth / episodeOfCareEpisode of Care InformationEpisodeOfCare: status = finished; type = Mental Health; period = 2025-01-10 --> 2025-12-15
BHAAdmissionQuestionnaireResponseExampleSouth / diagnosisDiagnosis InformationMental disorder, not otherwise specified

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