Colorado BHA FHIR Implementation Guide
0.1.0 - ci-build Unknown region code '840'

Colorado BHA FHIR Implementation Guide, published by Colorado Behavioral Health Administration. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/RatioPBC/bha-test-ig/ and changes regularly. See the Directory of published versions

## : BHA Substance Use Disorder Questionnaire - JSON Representation

Active as of 2025-12-17

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    {
      "resourceType" : "Questionnaire",
      "id" : "BHASubstanceUseDisorderQuestionnaire",
      "meta" : {
        "profile" : [
          🔗 "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire"
        ]
      },
      "text" : {
        "status" : "extensions",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Questionnaire BHASubstanceUseDisorderQuestionnaire</b></p><a name=\"BHASubstanceUseDisorderQuestionnaire\"> </a><a name=\"hcBHASubstanceUseDisorderQuestionnaire\"> </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.html\">SDCBaseQuestionnaire</a></p></div><table border=\"1\" cellpadding=\"0\" cellspacing=\"0\" style=\"border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;\"><tr style=\"border: 2px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top\"><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"The linkID for the item\">LinkID</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Text for the item\">Text</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Minimum and Maximum # of times the item can appear in the instance\">Cardinality</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"The type of the item\">Type</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Additional information about the item\">Description &amp; 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, \" 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\"/> BHASubstanceUseDisorderQuestionnaire</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\">Behavioral Health Administration substance use disorder questionnaire for collecting substance use information from a person receiving behavioral health services</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Questionnaire</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">http://bha.colorado.gov/fhir/bha-test-ig/Questionnaire/BHA-sc-pregnant-postpartum-risk#0.1.0</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.ASAM_LEVEL_OF_CARE\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> ASAM_LEVEL_OF_CARE</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\">ASAM Level of Care</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\">Value Set: <a href=\"ValueSet-bha-asam-level-of-care-vs.html\">BHA ASAM Levels of Care Value Set</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.PRIMARY_SUBSTANCE_USE\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> PRIMARY_SUBSTANCE_USE</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\">Primary Substance Use</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Value Set: <a href=\"ValueSet-bha-substance-use-primary-vs.html\">BHA Primary Substance Use Codes Value Set</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.PRIMARY_LAST_USED_30_DAYS\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-integer.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"integer\" class=\"hierarchy\"/> PRIMARY_LAST_USED_30_DAYS</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Times Used Primary Substance in Last 30 Days</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer\">integer</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.PRIMARY_SUBSTANCE_USE\">PRIMARY_SUBSTANCE_USE</a> != </span></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.PRIMARY_ROUTE_OF_USE\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> PRIMARY_ROUTE_OF_USE</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\">Route of Use of Primary Substances</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.PRIMARY_SUBSTANCE_USE\">PRIMARY_SUBSTANCE_USE</a> != </span><br/>Value Set: <a href=\"ValueSet-bha-substance-use-route-of-administration-vs.html\">BHA Substance Use Routes of Administration Value Set</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.PRIMARY_START_AGE\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-integer.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"integer\" class=\"hierarchy\"/> PRIMARY_START_AGE</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Age of First Use of Primary Substances</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer\">integer</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.PRIMARY_SUBSTANCE_USE\">PRIMARY_SUBSTANCE_USE</a> != </span></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.SECONDARY_SUBSTANCE_USE\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> SECONDARY_SUBSTANCE_USE</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\">Secondary Substance Use</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Value Set: <a href=\"ValueSet-bha-substance-use-secondary-tertiary-vs.html\">BHA Secondary and Tertiary Substance Use Codes Value Set</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.SECONDARY_LAST_USED_30_DAYS\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-integer.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"integer\" class=\"hierarchy\"/> SECONDARY_LAST_USED_30_DAYS</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Times Used Secondary Substance in Last 30 Days</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer\">integer</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.SECONDARY_SUBSTANCE_USE\">SECONDARY_SUBSTANCE_USE</a> != </span></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.SECONDARY_ROUTE_OF_USE\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> SECONDARY_ROUTE_OF_USE</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\">Route of Use of Secondary Substances</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.SECONDARY_SUBSTANCE_USE\">SECONDARY_SUBSTANCE_USE</a> != </span><br/>Value Set: <a href=\"ValueSet-bha-substance-use-route-of-administration-vs.html\">BHA Substance Use Routes of Administration Value Set</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.SECONDARY_START_AGE\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-integer.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"integer\" class=\"hierarchy\"/> SECONDARY_START_AGE</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Age of First Use of Secondary Substances</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer\">integer</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.SECONDARY_SUBSTANCE_USE\">SECONDARY_SUBSTANCE_USE</a> != </span></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.TERTIARY_SUBSTANCE_USE\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> TERTIARY_SUBSTANCE_USE</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\">Tertiary Substance Use</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Value Set: <a href=\"ValueSet-bha-substance-use-secondary-tertiary-vs.html\">BHA Secondary and Tertiary Substance Use Codes Value Set</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.TERTIARY_LAST_USED_30_DAYS\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-integer.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"integer\" class=\"hierarchy\"/> TERTIARY_LAST_USED_30_DAYS</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Times Used Tertiary Substance in Last 30 Days</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer\">integer</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.TERTIARY_SUBSTANCE_USE\">TERTIARY_SUBSTANCE_USE</a> != </span></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.TERTIARY_ROUTE_OF_USE\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> TERTIARY_ROUTE_OF_USE</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\">Route of Use of Tertiary Substance</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.TERTIARY_SUBSTANCE_USE\">TERTIARY_SUBSTANCE_USE</a> != </span><br/>Value Set: <a href=\"ValueSet-bha-substance-use-route-of-administration-vs.html\">BHA Substance Use Routes of Administration Value Set</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)\" id=\"item.TERTIARY_START_AGE\" 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-integer.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"integer\" class=\"hierarchy\"/> TERTIARY_START_AGE</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Age of First Use of Tertiary Substance</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer\">integer</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.TERTIARY_SUBSTANCE_USE\">TERTIARY_SUBSTANCE_USE</a> != </span></td></tr>\r\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, \" alt=\"doco\" style=\"background-color: inherit\"/> Documentation for this format</a></td></tr></table></div>"
      },
      "url" : "http://bha.colorado.gov/fhir/bha-test-ig/Questionnaire/BHA-sc-pregnant-postpartum-risk",
      "version" : "0.1.0",
      "name" : "BHASubstanceUseDisorderQuestionnaire",
      "title" : "BHA Substance Use Disorder Questionnaire",
      "status" : "active",
      "subjectType" : [
        "Patient"
      ],
      "date" : "2025-12-17",
      "publisher" : "Colorado Behavioral Health Administration",
      "contact" : [
        {
          "name" : "Colorado Behavioral Health Administration",
          "telecom" : [
            {
              "system" : "url",
              "value" : "https://bha.colorado.gov"
            },
            {
              "system" : "email",
              "value" : "cdhs_bha_provider_support@state.co.us"
            }
          ]
        }
      ],
      "description" : "Behavioral Health Administration substance use disorder questionnaire for collecting substance use information from a person receiving behavioral health services",
      "jurisdiction" : [
        {
          "coding" : [
            {
              "system" : "http://unstats.un.org/unsd/methods/m49/m49.htm",
              "code" : "840"
            }
          ]
        }
      ],
      "item" : [
        {
          "linkId" : "ASAM_LEVEL_OF_CARE",
          "text" : "ASAM Level of Care",
          "type" : "choice",
          "required" : false,
          "answerValueSet" : "http://bha.colorado.gov/fhir/bha-test-ig/ValueSet/bha-asam-level-of-care-vs"
        },
        {
          "linkId" : "PRIMARY_SUBSTANCE_USE",
          "text" : "Primary Substance Use",
          "type" : "choice",
          "required" : true,
          "answerValueSet" : "http://bha.colorado.gov/fhir/bha-test-ig/ValueSet/bha-substance-use-primary-vs"
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/minValue",
              "valueInteger" : 0
            },
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/maxValue",
              "valueInteger" : 30
            }
          ],
          "linkId" : "PRIMARY_LAST_USED_30_DAYS",
          "text" : "Times Used Primary Substance in Last 30 Days",
          "type" : "integer",
          "enableWhen" : [
            {
              "question" : "PRIMARY_SUBSTANCE_USE",
              "operator" : "!=",
              "answerCoding" : {
                "system" : "http://bha.colorado.gov/fhir/bha-test-ig/CodeSystem/bha-substance-use-cs",
                "code" : "0"
              }
            }
          ],
          "required" : true
        },
        {
          "linkId" : "PRIMARY_ROUTE_OF_USE",
          "text" : "Route of Use of Primary Substances",
          "type" : "choice",
          "enableWhen" : [
            {
              "question" : "PRIMARY_SUBSTANCE_USE",
              "operator" : "!=",
              "answerCoding" : {
                "system" : "http://bha.colorado.gov/fhir/bha-test-ig/CodeSystem/bha-substance-use-cs",
                "code" : "0"
              }
            }
          ],
          "required" : true,
          "answerValueSet" : "http://bha.colorado.gov/fhir/bha-test-ig/ValueSet/bha-substance-use-route-of-administration-vs"
        },
        {
          "linkId" : "PRIMARY_START_AGE",
          "text" : "Age of First Use of Primary Substances",
          "type" : "integer",
          "enableWhen" : [
            {
              "question" : "PRIMARY_SUBSTANCE_USE",
              "operator" : "!=",
              "answerCoding" : {
                "system" : "http://bha.colorado.gov/fhir/bha-test-ig/CodeSystem/bha-substance-use-cs",
                "code" : "0"
              }
            }
          ],
          "required" : true
        },
        {
          "linkId" : "SECONDARY_SUBSTANCE_USE",
          "text" : "Secondary Substance Use",
          "type" : "choice",
          "required" : true,
          "answerValueSet" : "http://bha.colorado.gov/fhir/bha-test-ig/ValueSet/bha-substance-use-secondary-tertiary-vs"
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/minValue",
              "valueInteger" : 0
            },
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/maxValue",
              "valueInteger" : 30
            }
          ],
          "linkId" : "SECONDARY_LAST_USED_30_DAYS",
          "text" : "Times Used Secondary Substance in Last 30 Days",
          "type" : "integer",
          "enableWhen" : [
            {
              "question" : "SECONDARY_SUBSTANCE_USE",
              "operator" : "!=",
              "answerCoding" : {
                "system" : "http://bha.colorado.gov/fhir/bha-test-ig/CodeSystem/bha-substance-use-cs",
                "code" : "0"
              }
            }
          ],
          "required" : true
        },
        {
          "linkId" : "SECONDARY_ROUTE_OF_USE",
          "text" : "Route of Use of Secondary Substances",
          "type" : "choice",
          "enableWhen" : [
            {
              "question" : "SECONDARY_SUBSTANCE_USE",
              "operator" : "!=",
              "answerCoding" : {
                "system" : "http://bha.colorado.gov/fhir/bha-test-ig/CodeSystem/bha-substance-use-cs",
                "code" : "0"
              }
            }
          ],
          "required" : true,
          "answerValueSet" : "http://bha.colorado.gov/fhir/bha-test-ig/ValueSet/bha-substance-use-route-of-administration-vs"
        },
        {
          "linkId" : "SECONDARY_START_AGE",
          "text" : "Age of First Use of Secondary Substances",
          "type" : "integer",
          "enableWhen" : [
            {
              "question" : "SECONDARY_SUBSTANCE_USE",
              "operator" : "!=",
              "answerCoding" : {
                "system" : "http://bha.colorado.gov/fhir/bha-test-ig/CodeSystem/bha-substance-use-cs",
                "code" : "0"
              }
            }
          ],
          "required" : true
        },
        {
          "linkId" : "TERTIARY_SUBSTANCE_USE",
          "text" : "Tertiary Substance Use",
          "type" : "choice",
          "required" : true,
          "answerValueSet" : "http://bha.colorado.gov/fhir/bha-test-ig/ValueSet/bha-substance-use-secondary-tertiary-vs"
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/minValue",
              "valueInteger" : 0
            },
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/maxValue",
              "valueInteger" : 30
            }
          ],
          "linkId" : "TERTIARY_LAST_USED_30_DAYS",
          "text" : "Times Used Tertiary Substance in Last 30 Days",
          "type" : "integer",
          "enableWhen" : [
            {
              "question" : "TERTIARY_SUBSTANCE_USE",
              "operator" : "!=",
              "answerCoding" : {
                "system" : "http://bha.colorado.gov/fhir/bha-test-ig/CodeSystem/bha-substance-use-cs",
                "code" : "0"
              }
            }
          ],
          "required" : true
        },
        {
          "linkId" : "TERTIARY_ROUTE_OF_USE",
          "text" : "Route of Use of Tertiary Substance",
          "type" : "choice",
          "enableWhen" : [
            {
              "question" : "TERTIARY_SUBSTANCE_USE",
              "operator" : "!=",
              "answerCoding" : {
                "system" : "http://bha.colorado.gov/fhir/bha-test-ig/CodeSystem/bha-substance-use-cs",
                "code" : "0"
              }
            }
          ],
          "required" : true,
          "answerValueSet" : "http://bha.colorado.gov/fhir/bha-test-ig/ValueSet/bha-substance-use-route-of-administration-vs"
        },
        {
          "linkId" : "TERTIARY_START_AGE",
          "text" : "Age of First Use of Tertiary Substance",
          "type" : "integer",
          "enableWhen" : [
            {
              "question" : "TERTIARY_SUBSTANCE_USE",
              "operator" : "!=",
              "answerCoding" : {
                "system" : "http://bha.colorado.gov/fhir/bha-test-ig/CodeSystem/bha-substance-use-cs",
                "code" : "0"
              }
            }
          ],
          "required" : true
        }
      ]
    }