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/Dimension6 | Version: 1.0.0 | |||
| Draft as of 2022-08-31 | Computable Name: | |||
Justification for level of care score (see ServiceRequest) in Dimension 1
Generated Narrative: Questionnaire Dimension6
| LinkID | Text | Cardinality | Type | Description & Constraints |
|---|---|---|---|---|
  | Justification for level of care score (see ServiceRequest) in Dimension 1 | Questionnaire | https://fhir.njsams.rutgers.edu/NJSAMS-fhir/Questionnaire/Dimension6#1.0.0 | |
  LOCI3Dimension6 | null | 0..1 | group | |
  Level0_5 | LEVEL 0.5 - EARLY INTERVENTION SERVICES | 0..1 | group | |
  LOCI3Dimension6.Level0_5.D6Level0_5EIa | a. Social support system composed primarily of persons whose substance use or addictive behavior patterns prevent patient from meeting social, work, school, or family obligations; OR | 0..1 | boolean | |
| LOCI3Dimension6.Level0_5.D6Level0_5EIb | b. Family member[s] currently is/are addictively using alcohol or other drugs [or has/have done so in the past], heightening patient’s substance use disorder risk; OR | 0..1 | boolean | |
| LOCI3Dimension6.Level0_5.D6Level0_5EIc | c. Patient’s significant other expresses values concerning addictive behavior and/or alcohol or other drug use that create serious conflict for the individual; OR | 0..1 | boolean | |
| LOCI3Dimension6.Level0_5.D6Level0_5EId | d. Patient’s significant other condones or encourages high-risk addictive behavior and/or use. | 0..1 | boolean | |
| Level1_Services | LEVEL 1 - OUTPATIENT SERVICES | 0..1 | group | |
| LOCI3Dimension6.Level1_Services.D6Level1OPa | a. Psychosocial environment is sufficiently supportive that outpatient treatment is feasible; OR | 0..1 | boolean | |
| LOCI3Dimension6.Level1_Services.D6Level1OPb | b. Does not have an adequate primary or social support system, but has demonstrated motivation and willingness to obtain such a support system; OR | 0..1 | boolean | |
| LOCI3Dimension6.Level1_Services.D6Level1OPc | c. Family, guardian, or significant others are supportive but requires professional interventions to improve patient’s chance of treatment success and recovery. | 0..1 | boolean | |
| Level1_Enhanced | LEVEL 1 - Co-occurring Enhanced | 0..1 | group | |
| LOCI3Dimension6.Level1_Enhanced.D6Level1DDEa | a. Does not have adequate primary or social support system and has mild impairment in ability to obtain a support system; OR | 0..1 | boolean | |
| LOCI3Dimension6.Level1_Enhanced.D6Level1DDEb | b. Family, guardian, or significant others require active family therapy or systems interventions to improve chances of treatment success and recovery; OR | 0..1 | boolean | |
| Level1_Enhanced_c | c. Patient’s status is characterized by all of the following: | 0..1 | group | |
| LOCI3Dimension6.Level1_Enhanced_c.D6Level1DDEc1 | 1. A severe mental disorder or an emotional,behavioral, or cognitive condition; AND | 0..1 | boolean | |
| LOCI3Dimension6.Level1_Enhanced_c.D6Level1DDEc2 | 2. Does not have an adequate family or social support system; AND | 0..1 | boolean | |
| LOCI3Dimension6.Level1_Enhanced_c.D6Level1DDEc3 | 3. Chronically impaired, but not in imminent danger,and has limited ability to establish a supportive recovery environment. Does have access to intensive outreach and case management services that can provide structure and allow patient to work toward stabilizing both the substance use or other addictive disorder and mental disorders. | 0..1 | boolean | |
| Level2_1_Services | LEVEL 2.1 - INTENSIVE OUTPATIENT SERVICES | 0..1 | group | |
| LOCI3Dimension6.Level2_1_Services.D6Level2_1IOPa | a. Continued exposure to current school, work, or living environment will render recovery unlikely. Lacks resources or skills necessary to maintain adequate level of functioning without services of Level 2.1; OR | 0..1 | boolean | |
| LOCI3Dimension6.Level2_1_Services.D6Level2_1IOPb | b. Lacks social contacts, has unsupportive social contacts that jeopardize recovery, or has few friends or peers who do not use alcohol or other drugs. Also lacks resources or skills necessary to maintain adequate level of functioning without Level 2.1 services. | 0..1 | boolean | |
| Level2_1_Enhanced | LEVEL 2.1 - Co-occurring Enhanced | 0..1 | group | |
| LOCI3Dimension6.Level2_1_Enhanced.D6Level2_1DDEa | a. A living, working, social, and/or community environment not supportive of good mental functioning. AND | 0..1 | boolean | |
| LOCI3Dimension6.Level2_1_Enhanced.D6Level2_1DDEb | b. Has insufficient resources and skills to deal with this situation. Support and structure of a Level 2.1 cooccurring enhanced program provide sufficient stability to prevent further deterioration. OR | 0..1 | boolean | |
| LOCI3Dimension6.Level2_1_Enhanced.D6Level2_1DDEc | c. Has such limited resources and skills to deal with this situation that treatment is not succeeding or not feasible. Support and intermittent structure of a Level 2.5 co-occurring enhanced program provide sufficient stability to prevent further deterioration. | 0..1 | boolean | |
| Level2_5_Services | LEVEL 2.5 - PARTIAL HOSPITALIZATION SERVICES | 0..1 | group | |
| LOCI3Dimension6.Level2_5_Services.D6Level2_5PHa | a. Continued exposure to current school, work, or living environment will render recovery unlikely. Lacks resources or skills necessary to maintain adequate level of functioning without services of Level 2.5; OR | 0..1 | boolean | |
| LOCI3Dimension6.Level2_5_Services.D6Level2_5PHb | b. Lacks social contacts, has unsupportive social contacts that jeopardize recovery, or has few friends or peers who do not use alcohol or other drugs. Also lacks resources or skills necessary to maintain adequate level of functioning without Level 2.5 services. | 0..1 | boolean | |
| Level2_5_Enhanced | LEVEL 2.5 – Co-occurring Enhanced | 0..1 | group | |
| LOCI3Dimension6.Level2_5_Enhanced.D6Level2_5DDEa | a. A living, working, social, and/or community environment not supportive of good mental functioning. AND | 0..1 | boolean | |
| LOCI3Dimension6.Level2_5_Enhanced.D6Level2_5DDEb | b. Has insufficient resources and skills to deal with this situation. Support and structure of a Level 2.1 cooccurring enhanced program provide sufficient stability to prevent further deterioration. OR | 0..1 | boolean | |
| LOCI3Dimension6.Level2_5_Enhanced.D6Level2_5DDEc | c. Has such limited resources and skills to deal with this situation that treatment is not succeeding or not feasible. Support and intermittent structure of a Level 2.5 co-occurring enhanced program provide sufficient stability to prevent further deterioration. | 0..1 | boolean | |
| Level3_1_Treatment | LEVEL 3.1 - CLINICALLLY MANAGED LOW-INTENSITY RESIDENTIAL TREATMENT | 0..1 | group | |
| LOCI3Dimension6.Level3_1_Treatment.D6Level3_1HHa | a. Able to cope, for limited periods of time, outside 24-hour structure of a Level 3.1 program in order to pursue clinical, vocational, educational, and community activities AND | 0..1 | boolean | |
| LOCI3Dimension6.Level3_1_Treatment.D6Level3_1HHb | b. Has been living in an environment characterized by a moderately high risk of initiation or repetition of physical, sexual, or emotional abuse, or substance use so endemic that patient is unable to achieve or maintain recovery at a less intensive level of care; OR | 0..1 | boolean | |
| LOCI3Dimension6.Level3_1_Treatment.D6Level3_1HHc | c. Lacks social contacts or has high-risk social contacts that jeopardize recovery, or social network is characterized by significant social isolation and withdrawal. Social network includes many friends who are regular users or regular gamblers, leading recovery goals to be assessed as unachievable outside of a 24-hour supportive setting; OR | 0..1 | boolean | |
| LOCI3Dimension6.Level3_1_Treatment.D6Level3_1HHd | d. Social network involves living in an environment so highly invested in alcohol or other drug use that patient’s recovery goals are unachievable; OR | 0..1 | boolean | |
| LOCI3Dimension6.Level3_1_Treatment.D6Level3_1HHe | e. Continued exposure to school, work, or living environment makes recovery unlikely, and patient has insufficient resources and skills to maintain an adequate level of functioning outside of a 24-hour supportive environment; OR | 0..1 | boolean | |
| LOCI3Dimension6.Level3_1_Treatment.D6Level3_1HHf | f. In danger of victimization by another and thus requires 24-hour supervision. | 0..1 | boolean | |
| Level3_1_Enhanced | LEVEL 3.1 - Co-occurring Enhanced | 0..1 | group | |
| LOCI3Dimension6.Level3_1_Enhanced.D6Level3_1DDEa | a. Severe and chronic mental illness. May be too ill [or too compromised] to benefit from skills training to learn to cope with problems in the recovery environment. Requires planning for assertive community treatment,intensive case management, or other community outreach and support services. AND | 0..1 | boolean | |
| LOCI3Dimension6.Level3_1_Enhanced.D6Level3_1DDEb | b. Living, working, social, and/or community environment not supportive of good mental health functioning. Has insufficient resources and skills to deal with this situation. | 0..1 | boolean | |
| Level3_3_Services | LEVEL 3.3 - CLINICALLY MANAGED POPULATION SPECIFIC HIGH-INTENSITY RESIDENTIAL SERVICES | 0..1 | group | |
| LOCI3Dimension6.Level3_3_Services.D6Level3_3LTRa | a. Has been living in an environment characterized by a moderately high risk of initiation or repetition of physical, sexual, or emotional abuse, or substance use so endemic that patient is unable to achieve or maintain recovery at a less intensive level of care; OR | 0..1 | boolean | |
| LOCI3Dimension6.Level3_3_Services.D6Level3_3LTRb | b. In significant danger of victimization and thus requires 24-hour supervision; OR | 0..1 | boolean | |
| LOCI3Dimension6.Level3_3_Services.D6Level3_3LTRc | c. Social network includes regular users, such that recovery goals are unachievable at a less intensive level of care; OR | 0..1 | boolean | |
| LOCI3Dimension6.Level3_3_Services.D6Level3_3LTRd | d. Social network involves living with a regular user,addicted user, or dealer of alcohol/drugs, or living environment is so highly invested in alcohol/drug use that recovery goals are unachievable; OR | 0..1 | boolean | |
| LOCI3Dimension6.Level3_3_Services.D6Level3_3LTRe | e. Because of cognitive limitations, patient is in danger of victimization by another and thus requires 24-hour supervision; OR | 0..1 | boolean | |
| LOCI3Dimension6.Level3_3_Services.D6Level3_3LTRf | f. Unable to cope, for even limited periods of time,outside the 24-hour structure of a Level 3.3 program.Needs staff monitoring to assure safety and well-being. | 0..1 | boolean | |
| Level3_3_Enhanced | LEVEL 3.3 - Co-occurring Enhanced | 0..1 | group | |
| LOCI3Dimension6.Level3_3_Enhanced.D6Level3_3DDEa | a. Severe and chronic mental illness. May be too ill [or too compromised] to benefit from skills training to learn to cope with problems in the recovery environment. Requires planning for assertive community treatment,intensive case management, or other community outreach and support services. AND | 0..1 | boolean | |
| LOCI3Dimension6.Level3_3_Enhanced.D6Level3_3DDEb | b. Living, working, social, and/or community environment not supportive of good mental health functioning. Has insufficient resources and skills to deal with this situation. | 0..1 | boolean | |
| Level3_5_Services | LEVEL 3.5 - CLINICALLY MANAGED HIGH INTENSITY RESIDENTIAL SERVICES | 0..1 | group | |
| LOCI3Dimension6.Level3_5_Services.D6Level3_5LTRa | a. Has been living in an environment characterized by moderately high risk of neglect; initiation or repetition of physical, sexual, or emotional abuse; or substance use so endemic that patient is unable to achieve or maintain recovery at a less intensive level of care; AND | 0..1 | boolean | |
| LOCI3Dimension6.Level3_5_Services.D6Level3_5LTRb | b. Social network includes regular users of alcohol,tobacco, and/or other drugs, such that recovery goals are unachievable at a less intensive level of care; OR | 0..1 | boolean | |
| LOCI3Dimension6.Level3_5_Services.D6Level3_5LTRc | c. Social network characterized by significant social isolation or withdrawal, such that recovery goals are inconsistently unachievable at a less intensive level of care; OR | 0..1 | boolean | |
| LOCI3Dimension6.Level3_5_Services.D6Level3_5LTRd | d. Social network involves living with a regular user,addicted user or dealer of alcohol/other drugs, or living environment is so highly invested in alcohol/drug use that recovery goals are assessed as unachievable; OR | 0..1 | boolean | |
| LOCI3Dimension6.Level3_5_Services.D6Level3_5LTRe | e. Unable to cope, for even limited periods of time,outside of 24-hour care. Needs staff monitoring to learn to cope with Dimension 6 problems before being transferred safely to a less intensive setting. | 0..1 | boolean | |
| Level3_5_Enhanced | LEVEL 3.5 - Co-occurring Enhanced | 0..1 | group | |
| LOCI3Dimension6.Level3_5_Enhanced.D6Level3_5DDEa | a. Severe and chronic mental illness. May be too ill [or too compromised] to benefit from skills training to learn to cope with problems in the recovery environment. Requires planning for assertive community treatment,intensive case management, or other community outreach and support services. AND | 0..1 | boolean | |
| LOCI3Dimension6.Level3_5_Enhanced.D6Level3_5DDEb | b. Living, working, social, and/or community environment not supportive of good mental health functioning. Has insufficient resources and skills to deal with this situation. | 0..1 | boolean | |
| Level3_7_Services | LEVEL 3.7 - MEDICALLY MONITORED INTENSIVE INPATIENT SERVICES | 0..1 | group | |
| LOCI3Dimension6.Level3_7_Services.D6Level3_7STRa | a. Requires continuous medical monitoring while addressing substance use and/or psychiatric symptoms because current living situation is characterized by high risk of initiation or repetition of physical, sexual, or emotional abuse, or active substance use, such that patient is unable to achieve or maintain recovery at a less intensive level of care; OR | 0..1 | boolean | |
| LOCI3Dimension6.Level3_7_Services.D6Level3_7STRb | b. Family members or significant others living with patient are not supportive of recovery goals and are actively sabotaging treatment, or their behavior jeopardizes recovery efforts. Requires structured treatment services and relief from home environment in order for patient to focus on recovery; OR | 0..1 | boolean | |
| LOCI3Dimension6.Level3_7_Services.D6Level3_7STRc | c. Unable to cope, for even limited periods of time,outside of 24-hour care. Patient needs staff monitoring to learn to cope with Dimension 6 problems before safe transfer to a less intensive setting. | 0..1 | boolean | |
| Level3_7_Enhanced | LEVEL 3.7 - Co-occurring Enhanced | 0..1 | group | |
| LOCI3Dimension6.Level3_7_Enhanced.D6Level3_7DDEa | a. Severe and chronic mental illness. May be too ill [or too compromised] to benefit from skills training to learn to cope with problems in the recovery environment. Requires planning for assertive community treatment,intensive case management, or other community outreach and support services. AND | 0..1 | boolean | |
| LOCI3Dimension6.Level3_7_Enhanced.D6Level3_7DDEb | b. Living, working, social, and/or community environment not supportive of good mental health functioning. Has insufficient resources and skills to deal with this situation. | 0..1 | boolean | |
| Documentation for this format | ||||