Behavioral Health Administration admission questionnaire for collecting patient demographic, clinical, and administrative information

Behavioral Health Administration client questionnaire for collecting patient demographic, clinical, and administrative information

Behavioral Health Administration diagnosis questionnaire for collecting patient clinical information during a behavioral health episode of care

Behavioral Health Administration discharge questionnaire for collecting patient demographic, clinical, and administrative information during discharge process

Behavioral Health Administration Special Connections baby questionnaire for collecting information about a baby born to a person enrolled in the Special Connections program

Behavioral Health Administration Special Connections Pregnancy/Postpartum Risk Screening questionnaire for collecting information about a pregnant or postpartum person's risk factors

Behavioral Health Administration substance use disorder questionnaire for collecting substance use information from a person receiving behavioral health services

Ths profile specifies the mandatory and must support data elements for capturing demographic information for Colorado BHA clients in order to support the BHA's annual reporting requirements.

Encounter profile for client visits and encounters related to BHA episodes

Diagnosis profile for diagnoses related to Colorado BHA episodes

BHA episode profile for client admissions/services

Provider Organization profile for Colorado BHASO clinics

CCAR action type (admission, update, discharge, evaluation)

The type of diagnosis for a client encounter. Can be either Mental Health or Substance Use Disorder

Race classification per BHA requirements

Type of update for CCAR reporting

ASAM Levels of Care for BHA services/admissions.

Value set for access to other drug/alcohol treatment used in BHA Special Connections

Allowed action type values for BHA CCAR reporting

Value set for children ages living in home used in BHA Special Connections

Allowed client county values for BHA reporting

Types of diagnoses for BHA admissions

Disability codes for BHA admissions

Value set for drug using partner used in BHA Special Connections

Value set for education levels used in BHA episodes

Value set for employment statuses used in BHA episodes

End of Treatment Reasons for BHA services/admissions.

Allowed values for Episode ID types

Episode identifiers for BHA services/admissions

Value set for family substance use disorder used in BHA Special Connections

Value set for family/social support used in BHA Special Connections

Value set for HIV risk used in BHA Special Connections

Value set for home stability and safety used in BHA Special Connections

Value set for income sources used in BHA admission process

Value set for reasons for involuntary commitments used in BHA admission process

Value set for legal statuses used in BHA episodes

Value set for living situations used in BHA episodes

Value set for marital statuses used in BHA admission process

Value set for mental health history used in BHA Special Connections

Value set for personal safety used in BHA Special Connections

Value set for pregnancy / postpartum status used in BHA Special Connections Pregnancy/Postpartum Risk Screening Questionnaire

Value set for pregnancy/postpartum care status used in BHA Special Connections

Substance use codes for primary substance for BHA services/admissions

Value set for prior alcohol/drug treatment used in BHA Special Connections

Value set for prior criminal record used in BHA Special Connections

Allowed race values for BHA reporting

Value set for referral sources used in BHA admission process

SMI / SED Statuses for BHA services/admissions.

Value set for school attendance statuses used in BHA episodes

Substance use codes for secondary and tertiary substance for BHA services/admissions

Substance use routes of administration for BHA services/admissions.

ASAM Levels of Care for BHA services/admissions.

Code system for access to other drug/alcohol treatment used in BHA Special Connections

CCAR action types

Code system for children ages living in home used in BHA Special Connections

County codes used by BHA

Types of diagnoses for BHA admissions.

Types of disabilities for BHA admissions.

Code system for drug using partner used in BHA Special Connections

Code system for education levels used in BHA episodes

Code system for employment statuses used in BHA episodes

End of Treatment Reasons for BHA services/admissions.

Types of Episode IDs

Episode identifiers for BHA services/admissions.

Code system for family substance use disorder used in BHA Special Connections

Code system for family/social support used in BHA Special Connections

Code system for HIV risk used in BHA Special Connections

Code system for home stability and safety used in BHA Special Connections

Code system for income sources used in BHA admission process

Code system for involuntary commitment reasons used in BHA admission process

Code system for legal statuses used in BHA episodes

Code system for living situations used in BHA episodes

Code system for marital statuses used in BHA admission process

Code system for mental health history used in BHA Special Connections

Code system for personal safety used in BHA Special Connections

Code system for pregnancy / postpartum status used in BHA Special Connections Pregnancy/Postpartum Risk Screening Questionnaire

Code system for pregnancy/postpartum care status used in BHA Special Connections

Code system for prior alcohol/drug treatment used in BHA Special Connections

Code system for prior criminal record used in BHA Special Connections

Race codes used by BHA

Code system for referral sources used in BHA admission process

SMI / SED Statuses for BHA services/admissions.

Code system for school attendance statuses used in BHA episodes

Substance use codes for BHA services/admissions.

Substance use routes of administration for BHA services/admissions.

Example Responses to BHA Admission Questionnaire Questions

Example Responses to BHA Client Questionnaire Questions

Example Client

Example Responses to Diagnosis Questionnaire Questions

Example Responses to Discharge Questionnaire Questions

Example Encounter for a BHA Episode.

Example Episode of Care record for a BHA service/admission

Example Organization record for a BHA clinic.

Example Observation Record for pregnancy status

Example Responses to Special Connections Baby Questionnaire Questions

Example Responses to Special Connections Pregnancy and Postpartum Risk Screening Questionnaire Questions

Example Responses to Substance Use Disorder Questionnaire Questions