SDOH Clinical Care
3.0.0-ballot - STU 3 Ballot
SDOH Clinical Care
3.0.0-ballot - STU 3 Ballot
SDOH Clinical Care, published by HL7 International / Patient Care. This guide is not an authorized publication; it is the continuous build for version 3.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-sdoh-clinicalcare/ and changes regularly. See the Directory of published versions
| Page standards status: Informative |
@prefix fhir: <http://hl7.org/fhir/> . @prefix loinc: <http://loinc.org/rdf#> . @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/SDOHCC-QuestionnairePRAPARE> a fhir:Questionnaire ; fhir:nodeRole fhir:treeRoot ; fhir:Resource.id [ fhir:value "SDOHCC-QuestionnairePRAPARE"] ; fhir:Resource.meta [ fhir:Meta.profile [ fhir:value "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-extr-smap" ; fhir:index -1 ; fhir:link <http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-extr-smap> ] ] ; 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 SDOHCC-QuestionnairePRAPARE</b></p><a name=\"SDOHCC-QuestionnairePRAPARE\"> </a><a name=\"hcSDOHCC-QuestionnairePRAPARE\"> </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=\"http://hl7.org/fhir/uv/sdc/STU3/StructureDefinition-sdc-questionnaire-extr-smap.html\">Extractable Questionnaire - StructureMap</a></p></div><b>Structure</b><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\"/> SDOHCCQuestionnairePRAPARE</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\"/><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://hl7.org/fhir/us/sdoh-clinicalcare/Questionnaire/SDOHCC-QuestionnairePRAPARE#3.0.0-ballot</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_bck01.png)\" id=\"item./93025-5\" 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-group.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"group\" class=\"hierarchy\"/> /93025-5</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\">Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]</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-group\">group</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_bck011.png)\" id=\"item./93043-8\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"group\" class=\"hierarchy\"/> /93043-8</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\">Personal characteristics</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-group\">group</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_bck0110.png)\" id=\"item./93043-8/56051-6\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.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\"/> /93043-8/56051-6</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\">Hispanic or Latino</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-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\">Options: <a href=\"#opt-item./93043-8/56051-6\">3 options</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_bck0110.png)\" id=\"item./93043-8/32624-9\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.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\"/> /93043-8/32624-9</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\">Race</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..*</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\">Options: <a href=\"#opt-item./93043-8/32624-9\">8 options</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_bck0110.png)\" id=\"item./93043-8/93035-4\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.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\"/> /93043-8/93035-4</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\">Has season or migrant farm work been your or your family's main source of income at any point in past 2 years?</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-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\">Options: <a href=\"#opt-item./93043-8/93035-4\">3 options</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_bck0110.png)\" id=\"item./93043-8/93034-7\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.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\"/> /93043-8/93034-7</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\">Have you been discharged from the armed forces of the United States?</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\">Options: <a href=\"#opt-item./93043-8/93034-7\">3 options</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_bck0100.png)\" id=\"item./93043-8/54899-0\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.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-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> /93043-8/54899-0</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\">Preferred language</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-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\">Options: <a href=\"#opt-item./93043-8/54899-0\">3 options</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_bck011.png)\" id=\"item./93042-0\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"group\" class=\"hierarchy\"/> /93042-0</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\">Family and home</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-group\">group</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_bck0110.png)\" id=\"item./93042-0/63512-8\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.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\"/> /93042-0/63512-8</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\">How many people are living or staying at this address?</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-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_bck0111.png)\" id=\"item./93042-0/71802-3\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.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\"/> /93042-0/71802-3</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\">Housing 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\">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\">Options: <a href=\"#opt-item./93042-0/71802-3\">3 options</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_bck01100.png)\" id=\"item./93042-0/71802-3-help\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.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-display.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"display\" class=\"hierarchy\"/> /93042-0/71802-3-help</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\">Describes patients living arrangement</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-display\">display</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_bck0110.png)\" id=\"item./93042-0/93033-9\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.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\"/> /93042-0/93033-9</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\">Are you worried about losing your housing?</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\">Options: <a href=\"#opt-item./93042-0/93033-9\">3 options</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_bck0100.png)\" id=\"item./93042-0/56799-0\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.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-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> /93042-0/56799-0</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\">Address</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-string\">string</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_bck011.png)\" id=\"item./93041-2\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"group\" class=\"hierarchy\"/> /93041-2</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\">Money and resources</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-group\">group</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_bck0110.png)\" id=\"item./93041-2/82589-3\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.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\"/> /93041-2/82589-3</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\">Highest level of educ</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-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\">Options: <a href=\"#opt-item./93041-2/82589-3\">4 options</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_bck0110.png)\" id=\"item./93041-2/67875-5\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.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\"/> /93041-2/67875-5</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 current</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\">Options: <a href=\"#opt-item./93041-2/67875-5\">5 options</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_bck0110.png)\" id=\"item./93041-2/76437-3\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.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\"/> /93041-2/76437-3</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 insurance</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-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\">Options: <a href=\"#opt-item./93041-2/76437-3\">7 options</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_bck0110.png)\" id=\"item./93041-2/63586-2\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.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\"/> /93041-2/63586-2</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\">What was your best estimate of the total income of all family members from all sources, before taxes, in last year?</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_bck0110.png)\" id=\"item./93041-2/93031-3\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.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\"/> /93041-2/93031-3</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\">In the past year, have you or any family members you live with been unable to get any of the following when it was really needed?</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..*</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\">Options: <a href=\"#opt-item./93041-2/93031-3\">8 options</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_bck0100.png)\" id=\"item./93041-2/93030-5\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.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-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> /93041-2/93030-5</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\">Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living?</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..*</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\">Options: <a href=\"#opt-item./93041-2/93030-5\">4 options</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_bck011.png)\" id=\"item./93040-4\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"group\" class=\"hierarchy\"/> /93040-4</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\">Social and emotional health</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-group\">group</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_bck0110.png)\" id=\"item./93040-4/93029-7\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.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\"/> /93040-4/93029-7</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\">How often do you see or talk to people that you care about and feel close to (For example: talking to friends on the phone, visiting friends or family, going to church or club meetings)?</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\">Options: <a href=\"#opt-item./93040-4/93029-7\">5 options</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_bck0100.png)\" id=\"item./93040-4/93038-8\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.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-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> /93040-4/93038-8</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\">Stress is when someone feels tense, nervous, anxious or can't sleep at night because their mind is troubled. How stressed are you?</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-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\">Options: <a href=\"#opt-item./93040-4/93038-8\">6 options</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_bck001.png)\" id=\"item./93039-6\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.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-group.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"group\" class=\"hierarchy\"/> /93039-6</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\">Optional additional questions</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-group\">group</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_bck0010.png)\" id=\"item./93039-6/93028-9\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.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\"/> /93039-6/93028-9</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\">In the past year, have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility?</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-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\">Options: <a href=\"#opt-item./93039-6/93028-9\">3 options</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_bck0010.png)\" id=\"item./93039-6/93027-1\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.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\"/> /93039-6/93027-1</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\">Are you a refugee?</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\">Options: <a href=\"#opt-item./93039-6/93027-1\">3 options</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_bck0010.png)\" id=\"item./93039-6/93026-3\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.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\"/> /93039-6/93026-3</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\">Do you feel physically and emotionally safe where you currently live?</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-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\">Options: <a href=\"#opt-item./93039-6/93026-3\">4 options</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_bck0000.png)\" id=\"item./93039-6/76501-6\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.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-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> /93039-6/76501-6</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\">Within the last year, have you been afraid of your partner or ex-partner?</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\">Options: <a href=\"#opt-item./93039-6/76501-6\">2 options</a></td></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><hr/><p><b>Options Sets</b></p><a name=\"opt-item./93043-8/56051-6\"> </a><p><b>Answer options for /93043-8/56051-6 </b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA33-6 (\"Yes\")</li><li style=\"font-size: 11px\">http://loinc.org#LA32-8 (\"No\")</li><li style=\"font-size: 11px\">http://loinc.org#LA30122-8 (\"I choose not to answer this question\")</li></ul><a name=\"opt-item./93043-8/32624-9\"> </a><p><b>Answer options for /93043-8/32624-9 </b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA6156-9 (\"Asian\")</li><li style=\"font-size: 11px\">http://loinc.org#LA14045-1 (\"Native Hawaiian\")</li><li style=\"font-size: 11px\">http://loinc.org#LA30187-1 (\"Pacific Islander\")</li><li style=\"font-size: 11px\">http://loinc.org#LA14042-8 (\"Black/African American\")</li><li style=\"font-size: 11px\">http://loinc.org#LA4457-3 (\"White\")</li><li style=\"font-size: 11px\">http://loinc.org#LA4-4 (\"American Indian/Alaskan Native\")</li><li style=\"font-size: 11px\">http://loinc.org#LA46-8 (\"Other\")</li><li style=\"font-size: 11px\">http://loinc.org#LA30122-8 (\"I choose not to answer this question\")</li></ul><a name=\"opt-item./93043-8/93035-4\"> </a><p><b>Answer options for /93043-8/93035-4 </b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA33-6 (\"Yes\")</li><li style=\"font-size: 11px\">http://loinc.org#LA32-8 (\"No\")</li><li style=\"font-size: 11px\">http://loinc.org#LA30122-8 (\"I choose not to answer this question\")</li></ul><a name=\"opt-item./93043-8/93034-7\"> </a><p><b>Answer options for /93043-8/93034-7 </b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA33-6 (\"Yes\")</li><li style=\"font-size: 11px\">http://loinc.org#LA32-8 (\"No\")</li><li style=\"font-size: 11px\">http://loinc.org#LA30122-8 (\"I choose not to answer this question\")</li></ul><a name=\"opt-item./93043-8/54899-0\"> </a><p><b>Answer options for /93043-8/54899-0 </b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA43-5 (\"English\")</li><li style=\"font-size: 11px\">http://loinc.org#LA30188-9 (\"Language other than English\")</li><li style=\"font-size: 11px\">http://loinc.org#LA30122-8 (\"I choose not to answer this question\")</li></ul><a name=\"opt-item./93042-0/71802-3\"> </a><p><b>Answer options for /93042-0/71802-3 </b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA30189-7 (\"I have housing\")</li><li style=\"font-size: 11px\">http://loinc.org#LA30190-5 (\"I do not have housing (staying with others, in a hotel, in a shelter, living outside on the street, on a beach, in a car, or in a park)\")</li><li style=\"font-size: 11px\">http://loinc.org#LA30122-8 (\"I choose not to answer this question\")</li></ul><a name=\"opt-item./93042-0/93033-9\"> </a><p><b>Answer options for /93042-0/93033-9 </b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA33-6 (\"Yes\")</li><li style=\"font-size: 11px\">http://loinc.org#LA32-8 (\"No\")</li><li style=\"font-size: 11px\">http://loinc.org#LA30122-8 (\"I choose not to answer this question\")</li></ul><a name=\"opt-item./93041-2/82589-3\"> </a><p><b>Answer options for /93041-2/82589-3 </b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA30191-3 (\"Less than high school degree\")</li><li style=\"font-size: 11px\">http://loinc.org#LA30192-1 (\"High school diploma or GED\")</li><li style=\"font-size: 11px\">http://loinc.org#LA30193-9 (\"More than high school\")</li><li style=\"font-size: 11px\">http://loinc.org#LA30122-8 (\"I choose not to answer this question\")</li></ul><a name=\"opt-item./93041-2/67875-5\"> </a><p><b>Answer options for /93041-2/67875-5 </b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA17956-6 (\"Unemployed\")</li><li style=\"font-size: 11px\">http://loinc.org#LA30138-4 (\"Part-time or temporary work\")</li><li style=\"font-size: 11px\">http://loinc.org#LA30136-8 (\"Full-time work\")</li><li style=\"font-size: 11px\">http://loinc.org#LA30137-6 (\"Otherwise unemployed but not seeking work (ex: student, retired, disabled, unpaid primary care giver)\")</li><li style=\"font-size: 11px\">http://loinc.org#LA30122-8 (\"I choose not to answer this question\")</li></ul><a name=\"opt-item./93041-2/76437-3\"> </a><p><b>Answer options for /93041-2/76437-3 </b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA30194-7 (\"None/uninsured\")</li><li style=\"font-size: 11px\">http://loinc.org#LA17849-3 (\"Medicaid\")</li><li style=\"font-size: 11px\">http://loinc.org#LA30195-4 (\"CHIP Medicaid\")</li><li style=\"font-size: 11px\">http://loinc.org#LA15652-3 (\"Medicare\")</li><li style=\"font-size: 11px\">http://loinc.org#LA30196-2 (\"Other public insurance (not CHIP)\")</li><li style=\"font-size: 11px\">http://loinc.org#LA30197-0 (\"Other public insurance (CHIP)\")</li><li style=\"font-size: 11px\">http://loinc.org#LA6350-8 (\"Private insurance\")</li></ul><a name=\"opt-item./93041-2/93031-3\"> </a><p><b>Answer options for /93041-2/93031-3 </b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA30125-1 (\"Food\")</li><li style=\"font-size: 11px\">http://loinc.org#LA30126-9 (\"Clothing\")</li><li style=\"font-size: 11px\">http://loinc.org#LA30124-4 (\"Utilities\")</li><li style=\"font-size: 11px\">http://loinc.org#LA30127-7 (\"Child care\")</li><li style=\"font-size: 11px\">http://loinc.org#LA30128-5 (\"Medicine or Any Health Care (Medical, Dental, Mental Health, Vision)\")</li><li style=\"font-size: 11px\">http://loinc.org#LA30129-3 (\"Phone\")</li><li style=\"font-size: 11px\">http://loinc.org#LA46-8 (\"Other\")</li><li style=\"font-size: 11px\">http://loinc.org#LA30122-8 (\"I choose not to answer this question\")</li></ul><a name=\"opt-item./93041-2/93030-5\"> </a><p><b>Answer options for /93041-2/93030-5 </b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA30133-5 (\"Yes, it has kept me from medical appointments or from getting my medications\")</li><li style=\"font-size: 11px\">http://loinc.org#LA30134-3 (\"Yes, it has kept me from non-medical meetings, appointments, work, or from getting things that I need\")</li><li style=\"font-size: 11px\">http://loinc.org#LA32-8 (\"No\")</li><li style=\"font-size: 11px\">http://loinc.org#LA30257-2 (\"Patient unable to respond\")</li></ul><a name=\"opt-item./93040-4/93029-7\"> </a><p><b>Answer options for /93040-4/93029-7 </b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA27722-0 (\"Less than once a week\")</li><li style=\"font-size: 11px\">http://loinc.org#LA30130-1 (\"1 or 2 times a week\")</li><li style=\"font-size: 11px\">http://loinc.org#LA30131-9 (\"3 to 5 times a week\")</li><li style=\"font-size: 11px\">http://loinc.org#LA30132-7 (\"5 or more times a week\")</li><li style=\"font-size: 11px\">http://loinc.org#LA30122-8 (\"I choose not to answer this question\")</li></ul><a name=\"opt-item./93040-4/93038-8\"> </a><p><b>Answer options for /93040-4/93038-8 </b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA6568-5 (\"Not at all\")</li><li style=\"font-size: 11px\">http://loinc.org#LA13863-8 (\"A little bit\")</li><li style=\"font-size: 11px\">http://loinc.org#LA13909-9 (\"Somewhat\")</li><li style=\"font-size: 11px\">http://loinc.org#LA13902-4 (\"Quite a bit\")</li><li style=\"font-size: 11px\">http://loinc.org#LA13914-9 (\"Very much\")</li><li style=\"font-size: 11px\">http://loinc.org#LA30122-8 (\"I choose not to answer this question\")</li></ul><a name=\"opt-item./93039-6/93028-9\"> </a><p><b>Answer options for /93039-6/93028-9 </b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA33-6 (\"Yes\")</li><li style=\"font-size: 11px\">http://loinc.org#LA32-8 (\"No\")</li><li style=\"font-size: 11px\">http://loinc.org#LA30122-8 (\"I choose not to answer this question\")</li></ul><a name=\"opt-item./93039-6/93027-1\"> </a><p><b>Answer options for /93039-6/93027-1 </b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA33-6 (\"Yes\")</li><li style=\"font-size: 11px\">http://loinc.org#LA32-8 (\"No\")</li><li style=\"font-size: 11px\">http://loinc.org#LA30122-8 (\"I choose not to answer this question\")</li></ul><a name=\"opt-item./93039-6/93026-3\"> </a><p><b>Answer options for /93039-6/93026-3 </b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA33-6 (\"Yes\")</li><li style=\"font-size: 11px\">http://loinc.org#LA32-8 (\"No\")</li><li style=\"font-size: 11px\">http://loinc.org#LA14072-5 (\"Unsure\")</li><li style=\"font-size: 11px\">http://loinc.org#LA30122-8 (\"I choose not to answer this question\")</li></ul><a name=\"opt-item./93039-6/76501-6\"> </a><p><b>Answer options for /93039-6/76501-6 </b></p><ul><li style=\"font-size: 11px\">http://loinc.org#LA33-6 (\"Yes\")</li><li style=\"font-size: 11px\">http://loinc.org#LA32-8 (\"No\")</li></ul></div>" ] ; fhir:DomainResource.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-targetStructureMap" ] ; fhir:Extension.valueCanonical [ fhir:value "http://hl7.org/fhir/us/sdoh-clinicalcare/StructureMap/SDOHCC-StructureMapPRAPARE" ; fhir:link <http://hl7.org/fhir/us/sdoh-clinicalcare/StructureMap/SDOHCC-StructureMapPRAPARE> ] ] ; fhir:Questionnaire.url [ fhir:value "http://hl7.org/fhir/us/sdoh-clinicalcare/Questionnaire/SDOHCC-QuestionnairePRAPARE"] ; fhir:Questionnaire.identifier [ fhir:index -1 ; fhir:Identifier.system [ fhir:value "urn:ietf:rfc:3986" ] ; fhir:Identifier.value [ fhir:value "urn:oid:2.16.840.1.113762.1.4.1247.35.2" ] ] ; fhir:Questionnaire.version [ fhir:value "3.0.0-ballot"] ; fhir:Questionnaire.name [ fhir:value "SDOHCCQuestionnairePRAPARE"] ; fhir:Questionnaire.title [ fhir:value "SDOHCC Questionnaire PRAPARE"] ; fhir:Questionnaire.status [ fhir:value "draft"] ; fhir:Questionnaire.subjectType [ fhir:value "Patient" ; fhir:index -1 ] ; fhir:Questionnaire.date [ fhir:value "2021-04-01T04:01:34+00:00"^^xsd:dateTime] ; fhir:Questionnaire.publisher [ fhir:value "HL7 International / Patient Care"] ; fhir:Questionnaire.contact [ fhir:index -1 ; fhir:ContactDetail.name [ fhir:value "HL7 International / Patient Care" ] ; fhir:ContactDetail.telecom [ fhir:index -1 ; fhir:ContactPoint.system [ fhir:value "url" ] ; fhir:ContactPoint.value [ fhir:value "http://www.hl7.org/Special/committees/patientcare" ] ], [ fhir:index -1 ; fhir:ContactPoint.system [ fhir:value "email" ] ; fhir:ContactPoint.value [ fhir:value "patientcare@lists.hl7.org" ] ] ] ; 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 "US" ] ; fhir:Coding.display [ fhir:value "United States of America" ] ] ] ; fhir:Questionnaire.item [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "/93025-5" ] ; fhir:Questionnaire.item.code [ fhir:index -1 ; a loinc:93025-5 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "93025-5" ] ; fhir:Coding.display [ fhir:value "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]" ] ] ; fhir:Questionnaire.item.text [ fhir:value "Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]" ] ; fhir:Questionnaire.item.type [ fhir:value "group" ] ; fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ] ; fhir:Questionnaire.item.item [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "/93043-8" ] ; fhir:Questionnaire.item.code [ fhir:index -1 ; a loinc:93043-8 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "93043-8" ] ; fhir:Coding.display [ fhir:value "Personal characteristics [PRAPARE]" ] ] ; fhir:Questionnaire.item.text [ fhir:value "Personal characteristics" ] ; fhir:Questionnaire.item.type [ fhir:value "group" ] ; fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ] ; fhir:Questionnaire.item.item [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "drop-down" ] ; fhir:Coding.display [ fhir:value "Drop down" ] ] ; fhir:CodeableConcept.text [ fhir:value "Drop down" ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "/93043-8/56051-6" ] ; fhir:Questionnaire.item.code [ fhir:index -1 ; a loinc:56051-6 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "56051-6" ] ; fhir:Coding.display [ fhir:value "Hispanic or Latino" ] ] ; fhir:Questionnaire.item.text [ fhir:value "Hispanic or Latino" ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA33-6 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA33-6" ] ; fhir:Coding.display [ fhir:value "Yes" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA32-8 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA32-8" ] ; fhir:Coding.display [ fhir:value "No" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA30122-8 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA30122-8" ] ; fhir:Coding.display [ fhir:value "I choose not to answer this question" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "drop-down" ] ; fhir:Coding.display [ fhir:value "Drop down" ] ] ; fhir:CodeableConcept.text [ fhir:value "Drop down" ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "/93043-8/32624-9" ] ; fhir:Questionnaire.item.code [ fhir:index -1 ; a loinc:32624-9 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "32624-9" ] ; fhir:Coding.display [ fhir:value "Race" ] ] ; fhir:Questionnaire.item.text [ fhir:value "Race" ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA6156-9 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA6156-9" ] ; fhir:Coding.display [ fhir:value "Asian" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA14045-1 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA14045-1" ] ; fhir:Coding.display [ fhir:value "Native Hawaiian" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA30187-1 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA30187-1" ] ; fhir:Coding.display [ fhir:value "Pacific Islander" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA14042-8 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA14042-8" ] ; fhir:Coding.display [ fhir:value "Black/African American" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA4457-3 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA4457-3" ] ; fhir:Coding.display [ fhir:value "White" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA4-4 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA4-4" ] ; fhir:Coding.display [ fhir:value "American Indian/Alaskan Native" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA46-8 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA46-8" ] ; fhir:Coding.display [ fhir:value "Other" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA30122-8 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA30122-8" ] ; fhir:Coding.display [ fhir:value "I choose not to answer this question" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "drop-down" ] ; fhir:Coding.display [ fhir:value "Drop down" ] ] ; fhir:CodeableConcept.text [ fhir:value "Drop down" ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "/93043-8/93035-4" ] ; fhir:Questionnaire.item.code [ fhir:index -1 ; a loinc:93035-4 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "93035-4" ] ; fhir:Coding.display [ fhir:value "Has season or migrant farm work been your or your family's main source of income at any point in past 2 years [PRAPARE]" ] ] ; fhir:Questionnaire.item.text [ fhir:value "Has season or migrant farm work been your or your family's main source of income at any point in past 2 years?" ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA33-6 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA33-6" ] ; fhir:Coding.display [ fhir:value "Yes" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA32-8 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA32-8" ] ; fhir:Coding.display [ fhir:value "No" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA30122-8 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA30122-8" ] ; fhir:Coding.display [ fhir:value "I choose not to answer this question" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "drop-down" ] ; fhir:Coding.display [ fhir:value "Drop down" ] ] ; fhir:CodeableConcept.text [ fhir:value "Drop down" ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "/93043-8/93034-7" ] ; fhir:Questionnaire.item.code [ fhir:index -1 ; a loinc:93034-7 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "93034-7" ] ; fhir:Coding.display [ fhir:value "Discharged from the U.S. Armed Forces" ] ] ; fhir:Questionnaire.item.text [ fhir:value "Have you been discharged from the armed forces of the United States?" ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA33-6 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA33-6" ] ; fhir:Coding.display [ fhir:value "Yes" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA32-8 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA32-8" ] ; fhir:Coding.display [ fhir:value "No" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA30122-8 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA30122-8" ] ; fhir:Coding.display [ fhir:value "I choose not to answer this question" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "drop-down" ] ; fhir:Coding.display [ fhir:value "Drop down" ] ] ; fhir:CodeableConcept.text [ fhir:value "Drop down" ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "/93043-8/54899-0" ] ; fhir:Questionnaire.item.code [ fhir:index -1 ; a loinc:54899-0 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "54899-0" ] ; fhir:Coding.display [ fhir:value "Preferred language" ] ] ; fhir:Questionnaire.item.text [ fhir:value "Preferred language" ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA43-5 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA43-5" ] ; fhir:Coding.display [ fhir:value "English" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA30188-9 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA30188-9" ] ; fhir:Coding.display [ fhir:value "Language other than English" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA30122-8 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA30122-8" ] ; fhir:Coding.display [ fhir:value "I choose not to answer this question" ] ] ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "/93042-0" ] ; fhir:Questionnaire.item.code [ fhir:index -1 ; a loinc:93042-0 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "93042-0" ] ; fhir:Coding.display [ fhir:value "Family and home [PRAPARE]" ] ] ; fhir:Questionnaire.item.text [ fhir:value "Family and home" ] ; fhir:Questionnaire.item.type [ fhir:value "group" ] ; fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ] ; fhir:Questionnaire.item.item [ 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 "http://unitsofmeasure.org" ] ; fhir:Coding.code [ fhir:value "{#}" ] ; fhir:Coding.display [ fhir:value "{#}" ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "/93042-0/63512-8" ] ; fhir:Questionnaire.item.code [ fhir:index -1 ; a loinc:63512-8 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "63512-8" ] ; fhir:Coding.display [ fhir:value "How many people are living or staying at this address [#]" ] ] ; fhir:Questionnaire.item.text [ fhir:value "How many people are living or staying at this address?" ] ; fhir:Questionnaire.item.type [ fhir:value "integer" ] ; 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-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "drop-down" ] ; fhir:Coding.display [ fhir:value "Drop down" ] ] ; fhir:CodeableConcept.text [ fhir:value "Drop down" ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "/93042-0/71802-3" ] ; fhir:Questionnaire.item.code [ fhir:index -1 ; a loinc:71802-3 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "71802-3" ] ; fhir:Coding.display [ fhir:value "Housing status" ] ] ; fhir:Questionnaire.item.text [ fhir:value "Housing status" ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA30189-7 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA30189-7" ] ; fhir:Coding.display [ fhir:value "I have housing" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA30190-5 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA30190-5" ] ; fhir:Coding.display [ fhir:value "I do not have housing (staying with others, in a hotel, in a shelter, living outside on the street, on a beach, in a car, or in a park)" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA30122-8 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA30122-8" ] ; fhir:Coding.display [ fhir:value "I choose not to answer this question" ] ] ] ; fhir:Questionnaire.item.item [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "help" ] ; fhir:Coding.display [ fhir:value "Help-Button" ] ] ; fhir:CodeableConcept.text [ fhir:value "Help-Button" ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "/93042-0/71802-3-help" ] ; fhir:Questionnaire.item.text [ fhir:value "Describes patients living arrangement" ] ; fhir:Questionnaire.item.type [ fhir:value "display" ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "drop-down" ] ; fhir:Coding.display [ fhir:value "Drop down" ] ] ; fhir:CodeableConcept.text [ fhir:value "Drop down" ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "/93042-0/93033-9" ] ; fhir:Questionnaire.item.code [ fhir:index -1 ; a loinc:93033-9 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "93033-9" ] ; fhir:Coding.display [ fhir:value "Are you worried about losing your housing [PRAPARE]" ] ] ; fhir:Questionnaire.item.text [ fhir:value "Are you worried about losing your housing?" ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA33-6 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA33-6" ] ; fhir:Coding.display [ fhir:value "Yes" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA32-8 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA32-8" ] ; fhir:Coding.display [ fhir:value "No" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA30122-8 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA30122-8" ] ; fhir:Coding.display [ fhir:value "I choose not to answer this question" ] ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "/93042-0/56799-0" ] ; fhir:Questionnaire.item.code [ fhir:index -1 ; a loinc:56799-0 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "56799-0" ] ; fhir:Coding.display [ fhir:value "Address" ] ] ; fhir:Questionnaire.item.text [ fhir:value "Address" ] ; fhir:Questionnaire.item.type [ fhir:value "string" ] ; fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "/93041-2" ] ; fhir:Questionnaire.item.code [ fhir:index -1 ; a loinc:93041-2 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "93041-2" ] ; fhir:Coding.display [ fhir:value "Money and resources [PRAPARE]" ] ] ; fhir:Questionnaire.item.text [ fhir:value "Money and resources" ] ; fhir:Questionnaire.item.type [ fhir:value "group" ] ; fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ] ; fhir:Questionnaire.item.item [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "drop-down" ] ; fhir:Coding.display [ fhir:value "Drop down" ] ] ; fhir:CodeableConcept.text [ fhir:value "Drop down" ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "/93041-2/82589-3" ] ; fhir:Questionnaire.item.code [ fhir:index -1 ; a loinc:82589-3 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "82589-3" ] ; fhir:Coding.display [ fhir:value "Highest level of educ" ] ] ; fhir:Questionnaire.item.text [ fhir:value "Highest level of educ" ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA30191-3 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA30191-3" ] ; fhir:Coding.display [ fhir:value "Less than high school degree" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA30192-1 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA30192-1" ] ; fhir:Coding.display [ fhir:value "High school diploma or GED" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA30193-9 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA30193-9" ] ; fhir:Coding.display [ fhir:value "More than high school" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA30122-8 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA30122-8" ] ; fhir:Coding.display [ fhir:value "I choose not to answer this question" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "drop-down" ] ; fhir:Coding.display [ fhir:value "Drop down" ] ] ; fhir:CodeableConcept.text [ fhir:value "Drop down" ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "/93041-2/67875-5" ] ; fhir:Questionnaire.item.code [ fhir:index -1 ; a loinc:67875-5 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "67875-5" ] ; fhir:Coding.display [ fhir:value "Employment status current" ] ] ; fhir:Questionnaire.item.text [ fhir:value "Employment status current" ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA17956-6 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA17956-6" ] ; fhir:Coding.display [ fhir:value "Unemployed" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA30138-4 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA30138-4" ] ; fhir:Coding.display [ fhir:value "Part-time or temporary work" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA30136-8 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA30136-8" ] ; fhir:Coding.display [ fhir:value "Full-time work" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA30137-6 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA30137-6" ] ; fhir:Coding.display [ fhir:value "Otherwise unemployed but not seeking work (ex: student, retired, disabled, unpaid primary care giver)" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA30122-8 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA30122-8" ] ; fhir:Coding.display [ fhir:value "I choose not to answer this question" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "drop-down" ] ; fhir:Coding.display [ fhir:value "Drop down" ] ] ; fhir:CodeableConcept.text [ fhir:value "Drop down" ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "/93041-2/76437-3" ] ; fhir:Questionnaire.item.code [ fhir:index -1 ; a loinc:76437-3 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "76437-3" ] ; fhir:Coding.display [ fhir:value "Primary insurance" ] ] ; fhir:Questionnaire.item.text [ fhir:value "Primary insurance" ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA30194-7 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA30194-7" ] ; fhir:Coding.display [ fhir:value "None/uninsured" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA17849-3 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA17849-3" ] ; fhir:Coding.display [ fhir:value "Medicaid" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA30195-4 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA30195-4" ] ; fhir:Coding.display [ fhir:value "CHIP Medicaid" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA15652-3 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA15652-3" ] ; fhir:Coding.display [ fhir:value "Medicare" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA30196-2 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA30196-2" ] ; fhir:Coding.display [ fhir:value "Other public insurance (not CHIP)" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA30197-0 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA30197-0" ] ; fhir:Coding.display [ fhir:value "Other public insurance (CHIP)" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA6350-8 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA6350-8" ] ; fhir:Coding.display [ fhir:value "Private insurance" ] ] ] ], [ 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 "http://unitsofmeasure.org" ] ; fhir:Coding.code [ fhir:value "/a" ] ; fhir:Coding.display [ fhir:value "/a" ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "/93041-2/63586-2" ] ; fhir:Questionnaire.item.code [ fhir:index -1 ; a loinc:63586-2 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "63586-2" ] ; fhir:Coding.display [ fhir:value "What was your best estimate of the total income of all family members from all sources, before taxes, in last year [PhenX]" ] ] ; fhir:Questionnaire.item.text [ fhir:value "What was your best estimate of the total income of all family members from all sources, before taxes, in last year?" ] ; fhir:Questionnaire.item.type [ fhir:value "decimal" ] ; 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-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "drop-down" ] ; fhir:Coding.display [ fhir:value "Drop down" ] ] ; fhir:CodeableConcept.text [ fhir:value "Drop down" ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "/93041-2/93031-3" ] ; fhir:Questionnaire.item.code [ fhir:index -1 ; a loinc:93031-3 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "93031-3" ] ; fhir:Coding.display [ fhir:value "Have you or any family members you live with been unable to get any of the following when it was really needed in past 1 year [PRAPARE]" ] ] ; fhir:Questionnaire.item.text [ fhir:value "In the past year, have you or any family members you live with been unable to get any of the following when it was really needed?" ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA30125-1 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA30125-1" ] ; fhir:Coding.display [ fhir:value "Food" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA30126-9 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA30126-9" ] ; fhir:Coding.display [ fhir:value "Clothing" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA30124-4 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA30124-4" ] ; fhir:Coding.display [ fhir:value "Utilities" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA30127-7 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA30127-7" ] ; fhir:Coding.display [ fhir:value "Child care" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA30128-5 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA30128-5" ] ; fhir:Coding.display [ fhir:value "Medicine or Any Health Care (Medical, Dental, Mental Health, Vision)" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA30129-3 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA30129-3" ] ; fhir:Coding.display [ fhir:value "Phone" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA46-8 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA46-8" ] ; fhir:Coding.display [ fhir:value "Other" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA30122-8 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA30122-8" ] ; fhir:Coding.display [ fhir:value "I choose not to answer this question" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "drop-down" ] ; fhir:Coding.display [ fhir:value "Drop down" ] ] ; fhir:CodeableConcept.text [ fhir:value "Drop down" ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "/93041-2/93030-5" ] ; fhir:Questionnaire.item.code [ fhir:index -1 ; a loinc:93030-5 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "93030-5" ] ; fhir:Coding.display [ fhir:value "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living" ] ] ; fhir:Questionnaire.item.text [ fhir:value "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living?" ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ] ; fhir:Questionnaire.item.repeats [ fhir:value "true"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix" ] ; fhir:Extension.valueString [ fhir:value "A" ] ] ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA30133-5 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA30133-5" ] ; fhir:Coding.display [ fhir:value "Yes, it has kept me from medical appointments or from getting my medications" ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix" ] ; fhir:Extension.valueString [ fhir:value "B" ] ] ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA30134-3 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA30134-3" ] ; fhir:Coding.display [ fhir:value "Yes, it has kept me from non-medical meetings, appointments, work, or from getting things that I need" ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix" ] ; fhir:Extension.valueString [ fhir:value "C" ] ] ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA32-8 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA32-8" ] ; fhir:Coding.display [ fhir:value "No" ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix" ] ; fhir:Extension.valueString [ fhir:value "X" ] ] ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA30257-2 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA30257-2" ] ; fhir:Coding.display [ fhir:value "Patient unable to respond" ] ] ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "/93040-4" ] ; fhir:Questionnaire.item.code [ fhir:index -1 ; a loinc:93040-4 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "93040-4" ] ; fhir:Coding.display [ fhir:value "Social and emotional health [PRAPARE]" ] ] ; fhir:Questionnaire.item.text [ fhir:value "Social and emotional health" ] ; fhir:Questionnaire.item.type [ fhir:value "group" ] ; fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ] ; fhir:Questionnaire.item.item [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "drop-down" ] ; fhir:Coding.display [ fhir:value "Drop down" ] ] ; fhir:CodeableConcept.text [ fhir:value "Drop down" ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "/93040-4/93029-7" ] ; fhir:Questionnaire.item.code [ fhir:index -1 ; a loinc:93029-7 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "93029-7" ] ; fhir:Coding.display [ fhir:value "How often do you see or talk to people that you care about and feel close to [PRAPARE]" ] ] ; fhir:Questionnaire.item.text [ fhir:value "How often do you see or talk to people that you care about and feel close to (For example: talking to friends on the phone, visiting friends or family, going to church or club meetings)?" ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA27722-0 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA27722-0" ] ; fhir:Coding.display [ fhir:value "Less than once a week" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA30130-1 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA30130-1" ] ; fhir:Coding.display [ fhir:value "1 or 2 times a week" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA30131-9 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA30131-9" ] ; fhir:Coding.display [ fhir:value "3 to 5 times a week" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA30132-7 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA30132-7" ] ; fhir:Coding.display [ fhir:value "5 or more times a week" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA30122-8 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA30122-8" ] ; fhir:Coding.display [ fhir:value "I choose not to answer this question" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "drop-down" ] ; fhir:Coding.display [ fhir:value "Drop down" ] ] ; fhir:CodeableConcept.text [ fhir:value "Drop down" ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "/93040-4/93038-8" ] ; fhir:Questionnaire.item.code [ fhir:index -1 ; a loinc:93038-8 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "93038-8" ] ; fhir:Coding.display [ fhir:value "Stress level" ] ] ; fhir:Questionnaire.item.text [ fhir:value "Stress is when someone feels tense, nervous, anxious or can't sleep at night because their mind is troubled. How stressed are you?" ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA6568-5 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA6568-5" ] ; fhir:Coding.display [ fhir:value "Not at all" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA13863-8 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA13863-8" ] ; fhir:Coding.display [ fhir:value "A little bit" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA13909-9 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA13909-9" ] ; fhir:Coding.display [ fhir:value "Somewhat" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA13902-4 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA13902-4" ] ; fhir:Coding.display [ fhir:value "Quite a bit" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA13914-9 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA13914-9" ] ; fhir:Coding.display [ fhir:value "Very much" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA30122-8 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA30122-8" ] ; fhir:Coding.display [ fhir:value "I choose not to answer this question" ] ] ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.linkId [ fhir:value "/93039-6" ] ; fhir:Questionnaire.item.code [ fhir:index -1 ; a loinc:93039-6 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "93039-6" ] ; fhir:Coding.display [ fhir:value "Optional additional questions [PRAPARE]" ] ] ; fhir:Questionnaire.item.text [ fhir:value "Optional additional questions" ] ; fhir:Questionnaire.item.type [ fhir:value "group" ] ; fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ] ; fhir:Questionnaire.item.item [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "drop-down" ] ; fhir:Coding.display [ fhir:value "Drop down" ] ] ; fhir:CodeableConcept.text [ fhir:value "Drop down" ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "/93039-6/93028-9" ] ; fhir:Questionnaire.item.code [ fhir:index -1 ; a loinc:93028-9 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "93028-9" ] ; fhir:Coding.display [ fhir:value "Have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility in past 1 year [PRAPARE]" ] ] ; fhir:Questionnaire.item.text [ fhir:value "In the past year, have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility?" ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA33-6 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA33-6" ] ; fhir:Coding.display [ fhir:value "Yes" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA32-8 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA32-8" ] ; fhir:Coding.display [ fhir:value "No" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA30122-8 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA30122-8" ] ; fhir:Coding.display [ fhir:value "I choose not to answer this question" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "drop-down" ] ; fhir:Coding.display [ fhir:value "Drop down" ] ] ; fhir:CodeableConcept.text [ fhir:value "Drop down" ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "/93039-6/93027-1" ] ; fhir:Questionnaire.item.code [ fhir:index -1 ; a loinc:93027-1 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "93027-1" ] ; fhir:Coding.display [ fhir:value "Are you a refugee" ] ] ; fhir:Questionnaire.item.text [ fhir:value "Are you a refugee?" ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA33-6 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA33-6" ] ; fhir:Coding.display [ fhir:value "Yes" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA32-8 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA32-8" ] ; fhir:Coding.display [ fhir:value "No" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA30122-8 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA30122-8" ] ; fhir:Coding.display [ fhir:value "I choose not to answer this question" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "drop-down" ] ; fhir:Coding.display [ fhir:value "Drop down" ] ] ; fhir:CodeableConcept.text [ fhir:value "Drop down" ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "/93039-6/93026-3" ] ; fhir:Questionnaire.item.code [ fhir:index -1 ; a loinc:93026-3 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "93026-3" ] ; fhir:Coding.display [ fhir:value "Do you feel physically and emotionally safe where you currently live [PRAPARE]" ] ] ; fhir:Questionnaire.item.text [ fhir:value "Do you feel physically and emotionally safe where you currently live?" ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA33-6 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA33-6" ] ; fhir:Coding.display [ fhir:value "Yes" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA32-8 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA32-8" ] ; fhir:Coding.display [ fhir:value "No" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA14072-5 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA14072-5" ] ; fhir:Coding.display [ fhir:value "Unsure" ] ] ], [ fhir:index -1 ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA30122-8 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA30122-8" ] ; fhir:Coding.display [ fhir:value "I choose not to answer this question" ] ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index -1 ; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/questionnaire-item-control" ] ; fhir:Coding.code [ fhir:value "drop-down" ] ; fhir:Coding.display [ fhir:value "Drop down" ] ] ; fhir:CodeableConcept.text [ fhir:value "Drop down" ] ] ] ; fhir:Questionnaire.item.linkId [ fhir:value "/93039-6/76501-6" ] ; fhir:Questionnaire.item.code [ fhir:index -1 ; a loinc:76501-6 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "76501-6" ] ; fhir:Coding.display [ fhir:value "Within the last year, have you been afraid of your partner or ex-partner" ] ] ; fhir:Questionnaire.item.text [ fhir:value "Within the last year, have you been afraid of your partner or ex-partner?" ] ; fhir:Questionnaire.item.type [ fhir:value "choice" ] ; fhir:Questionnaire.item.required [ fhir:value "false"^^xsd:boolean ] ; fhir:Questionnaire.item.answerOption [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix" ] ; fhir:Extension.valueString [ fhir:value "1" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/itemWeight" ] ; fhir:Extension.valueDecimal [ fhir:value "1"^^xsd:decimal ] ] ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA33-6 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA33-6" ] ; fhir:Coding.display [ fhir:value "Yes" ] ] ], [ fhir:index -1 ; fhir:Element.extension [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix" ] ; fhir:Extension.valueString [ fhir:value "0" ] ], [ fhir:index -1 ; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/itemWeight" ] ; fhir:Extension.valueDecimal [ fhir:value "0"^^xsd:decimal ] ] ; fhir:Questionnaire.item.answerOption.valueCoding [ a loinc:LA32-8 ; fhir:Coding.system [ fhir:value "http://loinc.org" ] ; fhir:Coding.code [ fhir:value "LA32-8" ] ; fhir:Coding.display [ fhir:value "No" ] ] ] ] ] ] . # - ontology header ------------------------------------------------------------ <http://hl7.org/fhir/Questionnaire/SDOHCC-QuestionnairePRAPARE.ttl> a owl:Ontology ; owl:imports fhir:fhir.ttl ; owl:versionIRI <http://build.fhir.org/Questionnaire/SDOHCC-QuestionnairePRAPARE.ttl> .
IG © 2021+ HL7 International / Patient Care.
Package hl7.fhir.us.sdoh-clinicalcare#3.0.0-ballot based on FHIR 4.0.1.
Generated
2026-07-10
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