CARE REPORTS TO THE FIELD NUMERIC LIST WITH X/PTR RETENTION

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1 Preliminary (P); uarterly (); uarterly/ytd (Y); On Request (R); Semi-Annual (S); Annual (A); X/PTR's current retention period is as GROUP = 182 days ( years) GROUP 7 = 21 days (7 years) HC M Assigned Clients/Alpha HC M Assigned Clients /Numeric HC D Notice of Registration/Asgmt D 2 HC Client Charact Trends Age & Prob SH HC MH Client County Profile Trends SH, HC Principal Psy Diagnoses Trends, HC MH/Sex & Eth(Camp) SH, SH,, HC MH/Sex & Eth(Comm) SH, SH,, HC MH/Sex & Eth(Comm Ctr) HC MR/Sex & Eth(Comm Ctr) HC MR/Sex & Eth(Camp) SS, SS, HC0211. MR/Sex & Eth(Comm)SS, SS, SS, W 4 HC W Reviews Not Approved s, HC M Status By Consumer SS, MRS, Pri. Prov. HC02139.W Reviews Needed SS, s, December 20, 2017 Page 1 M 4 W 4 SS, SH, W 2 HC02123.W Clients W/Change/MR to MH, HC02190.M ADC/Abs Comp/Client Type-Camp SS HC02191.M Avg Daily Census/Abs/MH Comp SH, 1, 9 HC M Avg Daily Census Campus M` 3 M HC M MR Adm/Comm Place/Pop SS, M HC02201.M MR Adm/Comm Place/Census Sch HC M MH Adm/Disch/Pop by Month SH, M HC M New Adm/Disch/Pop by Month SH, 9 HC02202.M MH Adm/Abs/Disch/Census Hos M 4 HC M Client Days Account Unit Hos SH HC M Client Days Account Unit Sch SS HC M Client Days Account Unit St Ctrs HC W Adm/Abs/Disch/Place by LSA HC02213.M Adm/Abs/Disch/Place by LSA HC Client Asgmt Report W 2 HC Follow-up Service for Clients Disch HC02211.W Follow-up Service for Clients Disch W 3 HC0221. Follow-up Service for Closed Assignments HC0221.W Follow-up Service for Closed Assignments W 3 HC02210.W Asgnd to Prog w/o Act Asgmt, W 2 HC02217.M Undup Days By Acct Unit/Hos SH HC M Undup Days By Acct Unit/Sch SS HC02218.M Undup Days by Acct Unit/Ctr HC M Resident Census Ward/Dorm HC M Resident Census Account Unit

2 Preliminary (P); uarterly (); uarterly/ytd (Y); On Request (R); Semi-Annual (S); Annual (A); X/PTR's current retention period is as GROUP = 182 days ( years) GROUP 7 = 21 days (7 years) HC M Sum Camp Asgmt by Loc SH, SS HC M Sum Camp Asgmt by Acct Unit SH, SS HC Recidivism Trends State Hos SH HC Statewide Recidivism Trends HC D Notif: County of Res Chg HC D Additions/Updates to Comp, HC MH Clients Average LOS SH, 9 D 2 HC02227.M CP Transfers to Sch Dist SS HC02227.M CP Transfers from Sch Dist SS HC S CPs by SS Dist & SS S HC Active Clients, SH HC M Readm Within 21 Days of Disch HC M Readm Within 30 Days of Disch SH, 1 & 9 HC Beddays/Served/Avg Dly Pop HC Y Beddays/Served/Avg Dly Pop December 20, 2017 Page 2 HC02230.M Recidivism by, Prim DG & Res Co HC0223.M Readm to SH & St Ctr MH Unit SH, HC M Clients Served by Psy DG/No DG SH, HC D Census by Authority Austin SH 030,040, 00,100, 220,20, 390,430, 40, 77 HC A Disch To ReAdm w/n 90 Days A HC M Disch To ReAdm w/n 90 Days HC Disch To ReAdm w/n 90 Days HC BM MR Physical Characteristics ( th & 20 th of month) SS/ B SS, D 2 HC02240.D ICFMR Data Requirements SH, 9, W 3 HC02240.W Missing Diagnosis 1 HC0224.W Clients w/missing BPRS SH, 9 W 1 HC02200.M Assigned by Position Number HC02240.W Admitted w/o Destination Asgmt W 3 HC0224. Screening of LSA MH Camp Adms trly HC0224.W Screening of LSA MH Camp Adms - Wkly W 3 HC0220.M Case Mgmt Outside or HC D Census by MH Fac/MH Auth SH, 9, 1, D 2 HC M Beddays/MH Fac/, SH M HC02283.D Hos Census by Hospital SH, 9 D 2 HC D Hos Census by D 2 HC02284.BM &M Hospital Allocation Methodology by (can be viewed by SH, 9) B HC02280.BM &M Hospital Allocation Methodology by MH Facility (can be viewed by ) SH, 9 B HC0228.BM &M Hospital Allocation Methodology by YTD(can be viewed by SH,9) BM 7 HC02280.BM &M Hospital Allocation by MH Facility YTD (can be viewed by ) SH, 9 BM 7

3 Preliminary (P); uarterly (); uarterly/ytd (Y); On Request (R); Semi-Annual (S); Annual (A); X/PTR's current retention period is as GROUP = 182 days ( years) GROUP 7 = 21 days (7 years) HC02282.M Hospital Allocation Methodology Census by MH Facility YTD SH M HC02283.BM Hospital Allocation Methodology by Hosp Serv Districts YTD Summary (can be SH,, viewed by SH,, ) BM 7 HC02284.M Hospital Allocation Census by MH Facility SH HC02289.M Hospital Census Monthly SH M HC02289.M Hospital Census YTD SH M HC M Adm to State Sch HC M Adm to State Hos HC M Readm to State Hos HC M Adm to SS (Detail) HC M Adm to SH (Detail) HC M Bed Day Utilization SS M HC M Bed Day Utilization SH HC W SMRF Recommended for Placement by - PI W 2 HC W Clients in SS Recommended for Placement Info. Changes W 2 HC W SS Referral Entry Exception Report SS, W 2 HC02320.W Promoting Independence Exception W HC W LG ICFMR/Wait Waiv Svcs. - PI W 2 HC W ICFMR/Wait Waiver Services Change W 2 HC W SMRF Recommended for Placement by SMRF SS, W 2 HC02321.W SMRF Recommended for Placement/ Changes SS, D 2 HC W Enrollment Activity Tracking W 2 HC M Large ICFMR/Wait by Referral Date HC W Initial Placement Activity W 2 HC W Initial Placement Exception W 2 HC W Promoting Indep Pending Placement W 3 HC W NF Clients on Interest List by Referral Date W 2 HC02322.W Small/Medium ICFMR Interest for Waiver W HC02322.W Waiver Enrollment Activity Report Slot Type W 3 HC M Large ICFMR Interest List Monthly Change HC M Adds/Drops in MR Services Tarrant Co. (200) HC02320.M Clients w/bed Days SS (Detail) HC02321.M Clients w/bed Days SH (Detail) HC02371.BM Need of Place by B HC02372.BM Need of Place by Hos SH B HC02373.BM Need of Place >180 Days by B HC02374.BM Need of Place >180 Days by Hos SH B HC0237.BM Disch from SH Past 0 Days/ B HC0237.BM Disch from SH Past 0 Days/Hos SH B HC02379.BM Disch from SH/ Past 30 Days B HC M Aftercare Pop/ HC MO Aftercare Stat Past 90 Days HC MP Aftercare Stat Past 90 Days December 20, 2017 Page 3

4 Preliminary (P); uarterly (); uarterly/ytd (Y); On Request (R); Semi-Annual (S); Annual (A); X/PTR's current retention period is as GROUP = 182 days ( years) GROUP 7 = 21 days (7 years) HC MO Aftercare Assess Past 90 Days HC MP Aftercare Assess Past 90 Days HC02400.M Persons Added w/n Past 90 Days SH HC M Persons Age + in SH SH HC02407.M Persons Age + Dschg Last 90 Days SH, 9 HC M Persons Age 20 and Under In Residence SH, 9 HC02408.M Persons Age 20 or Less Dschg Last 90 Days SH, 9 HC M Persons w/3 Adms in 180 Days s HC M Counts of Persons w/3 Adms in 180 Days(Only in XPTR; no VPS) s HC M Persons w/2 Adms in 120 Days s HC M Counts of Persons w/2 Adms in 120 Days(Only in XPTR; no VPS) s HC D Three MH Admissions in 180 Days SH HC UA Completed/ HC02200.M Comm Based Persons List 410 HC MH w/multiple Open Asgmt 3 HC MR w/multiple Open Asgmt 3 HC022. MR Perf Review/Axis I SS HC02310.M Dorm Vacancy Report SS HC Prooflist Acct Unit HC Prooflist Acct Unit & Bed Cap HC0230.M Num Active MR Clients by LSA HC023.M Num Active MH Clients by LSA HC Component Description Prooflist, HC023.M Critical Incident Report HC023.R Critical Incident Report HC02700.M All Campus Clients on CARE (microfiche info. now in rpt.format) 77,79, 8,88 HC0271.M Annual Exams Due 4 December 20, 2017 Page 4 M R M 3 HC02719.M Annual Exams Due Sort Axis III SS, HC02720.W ATT d 30 Days Will Expire/Hos SH W 2 HC02722.W ATT d 30 Days Will Expire/Sch SS W 2 HC02740.D Jail Match D 3 HC02741.M& Jail Match Summary M & SS,SH, D 3 HC0288.D Changes to Client Demographics, HC0299. Missing Serv Part Group/Co, SS, HC D MR Needs Exception HC D Commitments to Expire HC02701.W Notice of Commitments to Expire HC W Commitments Due for Follow-Up, HC D Registrations Posted, W 2 W 2

5 Preliminary (P); uarterly (); uarterly/ytd (Y); On Request (R); Semi-Annual (S); Annual (A); X/PTR's current retention period is as GROUP = 182 days ( years) GROUP 7 = 21 days (7 years) HC D Assignments Posted, HC W Transaction Log, W 3 HC D Batch Submission Detail D 2 HC D Batch Submission Summary D 2 HC02710.D Daily Reconciliation SH,, SS, HC0271.BW Cumulative Reconciliation SH,, SS, D 2 BW 2 HC M Transaction & Suspense File Cnts HC02724.M MH Persons Served Report (not mailed) HC MH Persons Served Report (not mailed) HC02720.M MR Persons Served Report (not mailed) M HC MR Persons Served Report (not mailed) R 1 HC R Report of Requested Batch, SS, HC02739.M Claims Absence Days/ICFMR Locs HC D Claims Asgmt Posted HC02749.W Vendor Listing/Alpha MR A W 3 HC02730.M Weekly Bed Detail, SH M HC02730.W Weekly Bed Detail, SH W HC Counts by Sex, Eth, & Servs HC Amt by Age,Fund,Cat & Servs HC Age,Fund,Category & Type HC Open Camp Asgmt >0 Days HC Amts Granted Sex, Eth, & Servs HC M Persons Rec IHFS Servs Monthly HC O Persons Rec IHFS Servs uarterly Official HC P Persons Rec IHFS Servs - uarterly Preliminary HC W Persons Rec IHFS Servs W HC M Beddays/Risperidone HC M Beddays/Olanzapine HC M Beddays/uetiapine HC02774.M Beddays/Generic Clozapine HC02774.M Beddays/Aripiprazole HC M Beddays/Generic Ziprasidone HC0277.W/M Drug UPD for Medicaid Eligible W/M 4 HC02779.W Interest List Contact Date, W 2 HC02771.M Beddays/Clozapine HC02774.M Beddays/Risperdal Consta HC0277.BM Assignments in Drug Prog (1 th SH,, B ) HC0277.M Assignments in Drug Program HC M/ SH,, M & Count of Persons in Drug Program ; HC S Census by ICFMR SS S HC M/ SH,, M & New Gen Drug at Facility by Month/uarter SS December 20, 2017 Page

6 Preliminary (P); uarterly (); uarterly/ytd (Y); On Request (R); Semi-Annual (S); Annual (A); X/PTR's current retention period is as GROUP = 182 days ( years) GROUP 7 = 21 days (7 years) HC M/ s, New Gen Drugs by Month HC02779.M/ M & Detail for NGM to Match HC HC0278.M Persons Disch by Prim DG M & HC W Interest List Alpha by Client, W 2 HC W Statewide Ranking W 2 HC W Summary by Service Area, W 3 HC02787.W Interest List Contacts by Service, W 2 HC W Interest List Contacts by Wait Date, W 3 HC W Interest List Contacts by County, W 2 HC Interest List Clients Requiring Annual Contact, HC W Interest List Clients Requiring Annual Contact, W 3 HC W Interst List R034 Waiting for State School W 2 HC W Waiver Interest List Alpha by Client / W 2 HC M Mthly Interest List Contact Summary / HC trly Interest List Contact Summary / HC M Mthly Interest List Contact Detail / HC trly Interest List Contact Detail / HC W Status for HCS Enrollments by Slot Type W 2 HC R Requested Ad Hoc, HC Utilization Report HC Pentration Rates Report HC Day Follow-Up Report HC0283. Persons W/MMI Receiving ACT HC Person W/MMI Rcvg Sup Housing HC Persons W/MMI RCVG Sup Emplymnt HC Persons W/Schiz/Atyp Meds-Com HC Persons W/Schiz/Atyp Meds-Hosp H HC Emp Rate For Adults Served HC O OS Continuum of CARE HC M SO Continuum of CARE R 1 HC0284.O MH Outcomes FYTD HC0284.P MH Outcomes FYTD HC0284.MY MH Outcomes HC02840.M MH Prio Pop Counts HC02840.O MH Prio Pop Counts HC02842.O Outcome Persons w/readmissions HC02842.P Outcome Persons w/readmissions HC02843.O Persons in IHFS HC02844.MY Outcome Persons w/readmissions HC02848.M MH Prio Pop Counts HC MH Prio Pop Counts HC O MH Hosp Discharge/FYTD December 20, 2017 Page M 3

7 Preliminary (P); uarterly (); uarterly/ytd (Y); On Request (R); Semi-Annual (S); Annual (A); X/PTR's current retention period is as GROUP = 182 days ( years) GROUP 7 = 21 days (7 years) HC O MR Workload Counts HC P MR Workload Counts HC O MR Workload Detail HC P MR Workload Detail HC O MH Workload Counts HC P MH Workload Counts HC02849.O MH Workload Detail HC02849.P MH Workload Detail HC02891.M MR Monthly Workload Counts HC02892.M MR Monthly Workload Detail HC02894.M MH Monthly Workload Counts HC0289.M MH Monthly Workload Detail HC M Comm Psy Pop 200, HC02908.D Referred to Another Comp HC02912.D Aftercare Referrals to Comp D 2 HC Admissions to SH by HC BM Currently in MH Setting/ B HC BM Currently in MH Setting/Hos SH B HC Disch from SH & HC0291. Persons Placed in Comm from SS HC Clients Community Placed by 3 HC Clients Community Placed by School SS 3 HC D Campus Persons/RSH 79 D 2 HC M THCIC UB-92 Clients Discharge SH, 9 HC THCIC UB-92 Clients in Residence SH, 9 HC02920.M/ MR Prio Pop Children/Age/Service M/ HC02920.M Alpha Clients Recommended for Movement SS, HC HO/TC Prio. Population Counts (Does not go VPS/XPTR only) HC M Ref/Trk Monthly Average Days Waiting /SS/ HC Ref/Trk trly Average Days Waiting /SS/ HC Ref/Trk FYTD Average Days Waiting /SS/ HC M Referrals for State School Transfer SS,, HC Referrals for State School Transfer SS,, HC M SMRF Admissions Summary SS,, HC02944.M Inquiries for Admission to State Schools SS,, HC M Community Referral Closures HC02941.M Clients w/mrrc Assessments SS/ HC M Senate Bill Perm Plan Goals HC S Senate Bill Perm Plan Goals S HC S Senate Bill Perm Plan Goals (March & September) S HC M Clients Reported Deceased by DHS SS/ HC02912.W ICFMR Clients Under 22 not on Interest List / W 3 December 20, 2017 Page 7

8 Preliminary (P); uarterly (); uarterly/ytd (Y); On Request (R); Semi-Annual (S); Annual (A); X/PTR's current retention period is as GROUP = 182 days ( years) GROUP 7 = 21 days (7 years) HC02914.W ICFMR Clients Under 22 Added to HCS Interest List W 3 HC0291.W Status Interest List Alpha by Client / W 3 HC02917.W R000 Interest List Alpha by Client / W 3 SH,9, HC0292.M Alleged Offenders at Admission 1 HC02934.W Status 2 Clients Over 0/180 Days / W 2 HC0293.M Admits w/commit Type, HC0293.M Delinquent Provider Char Reviews HC02940.M Incomplete/Autodelete RDM Records (Daily version does not get stored in XPTR only goes VPS) HC02940.W Incomplete/Autodelete RDM Records W 2 HC0299.W PI39 Tracking W HC0290.W Assessment Summary W 2 HC0291.W Assignments w/o Assessments W 2 HC0292.W Expired or Discharged Assessments W 2 HC03220.M OBRA Mandated Population Status HC03420.M Mandated/Non-Mandated Exception HC02320.M Interest List County Change Notification, HC0949.M Parent Involvement by s HC14299.D Srvc Auth/MRRC Assess Change SS, D 2 HC W Living Options File by State School/State Center SS, W 1 HC W Living Options File by Community ICFMR W 1 HC14310.M CLOIP Notification List M HC14310.M CLOIP Notification List M HC M/ CLOIP Notification Worksheet Complete Report M/ HC14311.M/ ClOIP Notification Worksheet Complete 14 Days Report M/ HC M/ CLOIP Contract Participation Report M/ HC M/ CLOIP Contract Participation Report M/ HC17100.D NorthStar Daily Jail Match Danza & D 3 HC19201.D RDM Billing Crosswalk Report D 3 HC D RDM Billing Crosswalk Exception D 3 HC19229.D Drug Claims Processing HC19293.M RDM Billing Monthly Activity Report HC19299.M Part D Member ID Change HC W Medicare Part D Plan All HC W Medicare Part D Plan Missing HC W Medicare Part D Has Plan HC19302.D Claim Response HC M Part D Member ID Change HC D Part D Paid Claims HC D Part D Rejected Claims HC19304.D Part D Process Claims Missing D M W W W D M D D D December 20, 2017 Page 8

9 Preliminary (P); uarterly (); uarterly/ytd (Y); On Request (R); Semi-Annual (S); Annual (A); X/PTR's current retention period is as GROUP = 182 days ( years) GROUP 7 = 21 days (7 years) R HC19304.R Medicare Part D. Paid Claim report HC M Medicare Part D Plan All T HC T Medicare Part D Plan All M December 20, 2017 Page 9

CARE REPORTS TO THE FIELD BY SUBJECT CATEGORY WITH X/PTR RETENTION. Annual.Exams.Due Report Number Report Name Dist Freq

CARE REPORTS TO THE FIELD BY SUBJECT CATEGORY WITH X/PTR RETENTION. Annual.Exams.Due Report Number Report Name Dist Freq WITH RETENTION Preliminary (P); uarterly (); uarterly/ytd (Y); On Request (R); Semi-Annual (S); Annual (A); 's current retention period is as Annual.Exams.Due Number Name Dist Freq HC02715.M Annual Exams

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