FHIR Implementation Guide for NJSAMS
1.0.0 - release
1.0.0 - release
NJSAMS - Local Development build (v1.0.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
| Official URL: https://fhir.njsams.rutgers.edu/NJSAMS-fhir/Questionnaire/DASIEQuestionnaire | Version: 1.0.0 | |||
| Draft as of 2022-08-31 | Computable Name: | |||
Generated Narrative: Questionnaire DASIEQuestionnaire
| LinkID | Text | Cardinality | Type | Description & Constraints |
|---|---|---|---|---|
  | Questionnaire | https://fhir.njsams.rutgers.edu/NJSAMS-fhir/Questionnaire/DASIEQuestionnaire#1.0.0 | ||
  tblClientIncomeDetails | null | 0..1 | group | |
  tblClientIncomeDetails.HouseHoldSize | Household Size | 1..1 | integer | |
| tblClientIncomeDetails.EarnedIncome | Earned Monthly Income | 1..1 | integer | |
| tblClientIncomeDetails.OtherIncome | Other Monthly Income | 1..1 | integer | |
| tblClientIncomeDetails.Payments | Monthly Payments | 1..1 | integer | |
 tblMonthlyHouseIncome.HouseHoldSize | Household Size | 1..1 | integer | |
| tblProgramEligibility | null | 0..1 | group | |
  tblProgramEligibility.DC | Is the client referred from Drug Court? | 1..1 | open-choice | Value Set: https://hl7.org/fhir/R4/valueset-example-yesnodontknow.html |
| tblProgramEligibility.DC_County | County of Referral: | 0..1 | choice | Value Set: NJSAMS Dasie County Of Referral |
| tblProgramEligibility.SPB | Is the client referred by State Parole Board [SPB] for Mutual Agreement Program [MAP]? | 1..1 | open-choice | Value Set: https://hl7.org/fhir/R4/valueset-example-yesnodontknow.html |
| tblProgramEligibility.SPB_Office | SPB District Office: | 0..1 | choice | Value Set: NJSAMS Dasie SPBOffice |
 tblProgramEligibility.SBINumber | SBI Number: | 0..1 | text | |
| tblProgramEligibility.DUII | Is this client a DUI conviction after October 17, 2005? | 1..1 | open-choice | Value Set: https://hl7.org/fhir/R4/valueset-example-yesnodontknow.html |
| tblProgramEligibility.SJI | Is client between ages of 18-30 and a resident of Atlantic, Burlington, Camden, Cape May, Cumberland, Gloucester, Ocean or Salem | 1..1 | choice | Value Set: https://hl7.org/fhir/R4/valueset-example-yesnodontknow.html |
| tblProgramEligibility.SEP | Is this client referred from Harm Reduction Center? | 1..1 | open-choice | Value Set: https://hl7.org/fhir/R4/valueset-example-yesnodontknow.html |
| tblProgramEligibility.SEPLocation | If Yes then select a program | 0..1 | choice | Value Set: NJSAMS Dasie SEPLocation |
| tblProgramEligibility.IVDrug | Is this client an IV drug user? | 1..1 | choice | Value Set: https://hl7.org/fhir/R4/valueset-example-yesnodontknow.html |
| tblProgramEligibility.Opiates | Does this client's drug use include Heroin or Prescription Opiate/Other Opiates? | 1..1 | choice | Value Set: https://hl7.org/fhir/R4/valueset-example-yesnodontknow.html |
| tblProgramEligibility.MatiDetox | Does this client need Inpataient Withdrawal Management? | 0..1 | choice | Value Set: https://hl7.org/fhir/R4/valueset-example-yesnodontknow.html |
| tblProgramEligibility.SHARE | Is this client referred from State Psychiatric Hospital? | 0..1 | choice | Value Set: https://hl7.org/fhir/R4/valueset-example-yesnodontknow.html |
| tblProgramEligibility.Medicaid | Is the client currently enrolled in Medicaid? | 0..1 | open-choice | Value Set: https://hl7.org/fhir/R4/valueset-example-yesnodontknow.html |
| tblProgramEligibility.TANFGA | Is the client receiving TANF [or] GA? | 1..1 | choice | Value Set: https://hl7.org/fhir/R4/valueset-example-yesnodontknow.html |
| tblProgramEligibility.WFNJ | Was the client referred by Work First New Jersey Substance Abuse Initiative - WFNJ SAI? | 1..1 | choice | Value Set: https://hl7.org/fhir/R4/valueset-example-yesnodontknow.html |
| tblProgramEligibility.SAIComments | Note/Comment: | 0..1 | text | |
| tblProgramEligibility.DYFS | Is this client involved in DCP&P or CPSAI referral? | 1..1 | choice | Value Set: https://hl7.org/fhir/R4/valueset-example-yesnodontknow.html |
| tblProgramEligibility.privateinsurance | Does this client have private insurance? | 0..1 | choice | Value Set: https://hl7.org/fhir/R4/valueset-example-yesnodontknow.html |
| Documentation for this format | ||||