FASAMS ITN - Record Data Model Specification Document. Date: 01/26/2017 Version: 1.00

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1 Florida Department of Children and Families Substance Abuse and Mental Health Financial and Services Accountability Management System Phase II Procurement FASAMS ITN - Record Data Model Specification Document Date: 01/26/2017 Version: 1.00 Table of Contents 1 Overview Document Purpose Context Entity Relationship Diagram Legal Authorities... 9

2 2 Acute Care Data Model Diagram Data Model Description Data Table Bed Capacity Data Bed Utilization Data Data Flow Diagram Appendix A: XML Format and Schema for BCD and BUD B: Optional TXT File Layout Template for BUD Submission C: Acute Care Code Table Service Event Data Model Diagram Data Model Description Data Tables Service Event Data Flow Diagram Appendix A: Code Table General B: Covered Services Code Table C: Non-Concurrent Covered Services D: Treatment Service Settings and Covered Services E. SAMH OCA Modifier Codes Provider Directory Data Model Diagram Data Model Description Data Tables I-BHS Facility Information Data Flow Diagram Appendix A: Provider Directory Code Table Waiting List Data Model Diagram FASAMS ITN - Record Data Model Specification Document Page 2

3 5.2 Data Model Description Data Tables Waiting List Data Flow Diagram Appendix A: Wait List Code Table COAD Data Model Diagram Data Model Description Data Tables COAD Admission Record COAD Discharge Record COAD Diagnosis Record Data Flow Diagram Business Process Mapping Diagram Appendix A: COAD Code Table B: Admission Episode versus Treatment Episode Budget Data Model Diagram Data Model Description Data Tables I-BHS Facility Information Data Flow Diagram Appendix A: Budget Code Table Provider Invoice Validation Report Data Model Diagram Data Model Description FASAMS ITN - Record Data Model Specification Document Page 3

4 8.3 Data Tables Invoice Validation Data Flow Diagram Appendix A: Invoice Code Table B: Business Mapping Processes for Invoice Validation Demographic Data Model Diagram Data Model Description Data Tables Demographic File Data Flow Diagram Appendix A: Demographic Code Table Expenditure Data Model Diagram Data Model Description Data Tables Managing Entity Expenditures Report Provider Expenditures Report Data Flow Diagram Appendix A: Code Table General B. Budget and Expenditure OCA Crosswalk Code Table C. Flair Category D. SAMH OCA # E. Expenditure Code Contract Data Model Diagram Data Model Description Data Tables Managing Entity Contract Managing Entity Subcontract FASAMS ITN - Record Data Model Specification Document Page 4

5 11.4 Data Flow Diagram Appendix A: Code Table ACCESS Data Model Diagram Data Model Description Data Tables Demo Match Request File Demo Match Response File Demo Update File Data Flow Diagram Appendix A: Code Table FSFN Data Model Diagram Data Model Description Data Tables FSFN File Data Flow Diagram Appendix A: FSFN Code Table Overview 1.1 Document Purpose The purpose of the data model specification documents is to support the definition of business requirements for the Financial and Services Accountability Management System (FASAMS) by defining the data needed and created by Department of Children and Families (DCF, Department) Substance Abuse and Mental Health (SAMH) business processes, and to define the interactions between users and the system and data. This document also includes sections, which outline the data structure, and data flows. FASAMS ITN - Record Data Model Specification Document Page 5

6 The information provided in this document is a representation of the minimum requirements for data sharing between systems for the FASAMS solution. The data models are not comprehensive. Therefore, the Department welcomes and strongly encourages the vendor s input on industry best practices and alternative solutions with the goal of realizing system efficiencies, improved data quality and integrity, and more robust reporting and analytics capabilities. 1.2 Context The Florida Legislature, through Specific Appropriation 302A, has funded and authorized the Department to develop and implement a Financial and Services Accountability Management System (FASAMS) with integrated data analytics and reporting capabilities that answer the question Who receives what services from whom at what cost for what outcomes? The FASAMS business intelligence and data warehouse (BI/DW) solution will support at least six major management functions, including service budgeting, service contracting, service needs assessment, service delivery, service payment, and service outcomes, and satisfy the following statutory data requirements: A uniform management information system and fiscal accounting system for use by providers of community substance abuse and mental health services; A uniform reporting system with uniform definitions and reporting categories; and A uniform system with automated interfaces to the Department s child welfare information system and the Agency for Health Care Administration s Medicaid Management Information System. In addition, and through the authority of Section (3)(h) Florida Statutes, the creation of a unique identifier for clients receiving behavioural health services through the Managing Entities (MEs) to coordinate care. SAMH in collaboration with the Department s Office of Information Technology Services (OITS) has launched the FASAMS project as a part of the Fiscal Year priority of effort (POE) initiatives and completed the following milestones to date: Established the SAMH Information Management Team (SIMT). The SIMT established the guiding principles and core business functions for FASAMS. Secured legislative funding through Specific Appropriation 302A for Fiscal Year and Fiscal Year for the implementation of FASAMS. Completed the development of FASAMS business and technical requirements and a fully-loaded evidence-based information technology framework. These data model specification documents will be included in the FASAMS Procurement Library and will assist the Department in the acquisition of a FASAMS solution. The information provided in the data model specification records support the FASAMS business requirements specifying standardization of record formats. The data models represent the minimum requirements for information sharing between FASAMs, Department systems, MEs and Agency partners. The information presented in this document for various data model specifications only reflects the Department s business and technical requirements based on its current systems, policies and procedures. This document is very limited in scope and only provides information minimally required for the procurement of the new data system. Therefore, the Department welcomes and strongly encourages the vendor s input on industry best practices and alternative solutions and approaches to data structure, collection and management. FASAMS ITN - Record Data Model Specification Document Page 6

7 1.3 Entity Relationship Diagram At the minimum, the FASAMS solution will consist of several data modules as illustrated in the following Exhibit-1: FASAMS Entity Relationship Diagram. The data model specifications for these modules are detailed in Section 3 through Section 14 of this document. FASAMS ITN - Record Data Model Specification Document Page 7

8 FASAMS ENTITY RELATIONSHIP DIAGRAM Exhibit 1 - FASAMS Entity Relationship Diagram FASAMS ITN - Record Data Model Specification Document Page 8

9 1.4 Legal Authorities The Florida Legislature, through Specific Appropriation 302A, requires the Department to develop and implement the Financial and Services Accountability Management System (FASAMS) in accordance with s , Florida Statutes. Section (10), Florida Statutes (Senate Bill 12), requires the Department to develop a state wide database and standards, which will allow a managing entity to collect and submit acute care data from all public receiving facilities and all detoxification and addictions receiving facilities under contract with the managing entity. Section 505(a) of the Public Health Service Act (42 US 290aa-4) directs the Administrator of the Substance Abuse and Mental Health Services Administration (SAMHSA) to collect data on public and private behavioral health treatment programs and individuals seeking treatment through such programs. As part of the Block Grant data requirements, the SAMHSA Center for Behavioral Health Statistics and Quality requires each U.S. State and Territory to collect and submit the Combined Substance Abuse and Mental Health Treatment Episode Data Set (TEDS), which includes most of the COAD data elements. Federal Regulations, 45 CFR (c), require each State receiving funding from federal grant to establish a waiting list management program which provides systematic reporting of treatment demand. This regulation requires the waiting list to include a unique patient identifier for each injecting drug abuser seeking treatment including those receiving interim services, while awaiting admission to such treatment. Federal Regulations, 45 CFR (a)(6), requires each State to submit to the Secretary 1 documentation describing the results of the State's management information system pertaining to capacity and waiting lists, as well as a summary of such information for admissions and discharges. Section (3)(e), Florida Statutes, is a provision requiring DCF contracted entities to submit client demographic, service, and outcome information to the department s data system by a date specified in the contract. This provision also indicates that the department may not pay the service provider unless the required information has been submitted by the specified date. Section (6)(f), Florida Statutes, requires managing entities to collect and submit data to the department regarding persons served, outcomes of persons served, and the costs of services provided through the department s contract. As a Pass-Through-Entity (PTE), the Department contracts federal funding as a sub-award to subrecipients to carry out part of a federal program. As such, per the Uniform Grant Guidance (UGG), requirements and , the Department is required by federal law to ensure that subrecipients are compliant with the applicable federal grant requirements. Specifically, the Department must perform risk assessments and perform ongoing monitoring for all sub-recipients. 1 Secretary is the Secretary of the United States Department of Health and Human Services or the Secretary's designee FASAMS ITN - Record Data Model Specification Document Page 9

10 2 Acute Care 2.1 Data Model Diagram There are two data sets to be submitted by the managing entity into the department database as part of the acute care data requirements: Bed Capacity Data (BCD) and Bed Utilization Data (BUD). These two data sets are linkable based on primary key (PK) fields, which uniquely identify each record in each file, as illustrated in the diagram below. As also shown in the diagram, the BUD record is a child of BCD record and BCD is a child of SubContract record. Therefore, a BCD record should have a corresponding record with matching key field(s) in Subcontract table, and a BUD record should have a corresponding record with matching key field(s) in BCD table. The files containing BCD and BUD records will be processed in the order they are uploaded into FASAMS, and the records within each file will be processed in the order the managing entity wrote them. When FASAMS processes any of these files, it will first process BCD records sequentially from the top of the file (updates and deletes); then, it will process BUD records sequentially (updates and deletes). Therefore, it is the managing entity s responsibility to ensure the files and records within each file are ordered correctly. 2.2 Data Model Description Data Model ID: <ID> Data Model Name: Acute Care Record Description The managing entities collect and analyse data pertaining to bed capacity and bed utilization for real time assessment of the number of acute care beds being utilized daily, 24/7, in all public receiving FASAMS ITN - Record Data Model Specification Document Page 10

11 facilities and all detoxification and addictions receiving facilities under contract with the Managing Entity (ME). At the state level, the purpose for BCD submission is to record the total number of licensed beds and the number of these beds purchased by the Department. The purpose for BUD submission is to record the total number of operational licensed beds that are unoccupied and occupied (utilized), as well as the number of indigent clients admitted and discharged. Purpose The purpose for BCD submission is to record the total number of licensed beds and the number of these beds purchased by the Department. The purpose for BUD submission is to record the total number of operational licensed beds that are unoccupied and occupied (utilized), as well as the number of indigent clients admitted and discharged. Data Sources Managing Entities must require each Provider under a contract with the ME to submit acute care data captured and input by Provider staff at the receiving facility in their individual systems (e.g., Electronic Health Record Systems) to the ME. Managing Entities will validate and submit the data from each Provider to DCF. Timing / Frequency of Data Providers collect and submit required acute care data in real time or at least daily to the Managing Entity. Real-time data submission of bed availability (e.g., licensed beds that are unoccupied) is necessary to ensure more timely information needed for care coordination purposes. MEs must reconcile the acute care data from each Provider to make sure the data is valid and consistent, and corrections are made to ensure accuracy. Daily data reconciliation is highly recommended to ease the burden of reviewing very large data files and to allow for more timely detection and resolution of data problems. MEs submit reconciled data received from Providers to the department not later than the date specified in the ME contract. Data Submission Process Unless otherwise specified, FASAMS will use a Secured File Transfer Protocol (SFTP) site to process the Acute Care data and to provide data submission reports to both DCF staff and Managing Entity staff. The Extensible Markup Language (XML) is the department s standard file format for submission and validation of BCD and BUD records. Appendix A provides the required XML file format and schema, which the ME will use to validate and submit BCD and BUD records into FASAMS. Additional Information Data Model ID: <ID> Data Model Name: Acute Care Record An optional TXT file layout template is included in Appendix B; Providers may use the optional TXT file to submit BUD records to MEs. FASAMS ITN - Record Data Model Specification Document Page 11

12 2.3 Data Table Bed Capacity Data ID Field Name Field Type Field Definition Validation ContractorId (Primary Key) ProviderId (Primary Key) FacilityType (Primary Key) CHAR(10) CHAR(10) CHAR(1) 10-digit code in XX-XXXXXXX format describing the Federal Employer Identification Number (FEIN) of the entity that either holds a contract with DCF to provide SAMH services in community or in state treatment facility or is owned and operated by DCF (e.g., state treatment facility). 10-digit code in XX-XXXXXXX format describing the Federal Employer Identification Number (FEIN) of the entity that provides SAMH services either in state treatment facility operated by or under contract with DCF or in community under DCF contract or ME subcontract. Enter 1-digit numeric code describing the type of facility where the client is receiving acute care service. See Code Table in Appendix C. Valid entry must be the Contractor ID that is registered in FASAMS Provider Directory. Valid entry must be the Provider ID that is registered in FASAMS Provider Directory. Valid values must be in the code table for FacilityType as specified in 3.5 Appendix C AgeGroup CHAR (1) Enter 1-digit numeric code describing the Valid entry must be in the (Primary Key) age group designated for the licensed bed code table for AgeGroup as occupied by the client receiving the acute specified in 3.5 Appendix C care services: See Code Table in Appendix C. There are no acute care beds for children in STF. Hence, if FacilityType code value is 4, then AgeGroup code value cannot be 2 or 3; else reject. According to 65E , F.A.C., AgeGroup code value of 3 only applies to PRF beds. Therefore, if FacilityType code value is not 1, then AgeGroup code value cannot be 3; else, reject. FASAMS ITN - Record Data Model Specification Document Page 12

13 ID Field Name Field Type Field Definition EffectiveDate (Primary Key) DATE(8) Enter 8-digit for the date in YYYYMMDD format showing when the managing entity contract with each provider became effective to reflect the total number of licensed beds and the number of these purchased by the department. Validation Valid entry must be a valid calendar date; else, reject. LicensedBeds DECIMAL(6) Enter 6-digit decimal number in Valid entry must be a format showing the total number of decimal number that is operational licensed beds that are greater than zero; else, currently available for this Contractor ID, reject. Provider ID, Facility Type and Age Group. DCFBeds TransactionType DECIMAL(6) Enter 6-digit decimal number in format showing the total number of licensed beds purchased by DCF that are currently operational and available for this Contractor ID, Provider ID, Facility Type, and Age Group. CHAR(1) Enter 1-digit numeric code describing the record transaction type. See Code Table in Appendix C. Valid entry must be a decimal number that is greater than zero and is less than or equal to LicensedBeds; else, reject. Valid entry must be in the code table for TransactionType as specified in 3.5 Appendix C Code value of U is used to add a new record if there is no existing record with matching primary keys or to replace an existing record with matching primary keys. Code value of D is used to delete an existing record with matching primary keys ID Business Rule 1 All fields in each BCD record must have valid values as specified in the BCD Data Table. Otherwise, the BCD record will be rejected with a message describing the error(s). 2 Both ContractorId and ProviderId must be registered in the contract between the Managing Entity and each Provider. Otherwise, the BCD record will be rejected with a message describing the error(s). 3 The total number of licensed beds (LicensedBeds) and the number of these beds purchased by the department (DCFBeds) must be documented in the contract between the Managing Entity and each Provider. The contract must also specify the number of these beds designated by the Department for each age group (AgeGroup) within each facility (FacilityType). The effective date (EffectiveDate) is the date the contract between the ME and each Provider became effective. 4 BCD records submitted to the Department should remain consistent (invariable) unless there is a contract amendment with a new EffectiveDate to reflect changes in the number of LicensedBeds or FASAMS ITN - Record Data Model Specification Document Page 13

14 ID DCFBeds. When this change occurs, the managing entity must submit a new BCD record to the Department. Business Rule 5 The number of beds purchased by the Department (DCFBeds) cannot exceed the total number of operational licensed beds (LicensedBeds). In other words, the number of DCFBeds must be less than or equal to the number of LicensedBeds. Otherwise, the system should reject the BCD record with a message describing the error(s). 6 State Treatment Facilities (STF) do not have acute care beds designated for children. Hence, if the FacilityType code value is 4 (STF), then the AgeGroup code value cannot be 2 (Children) or 3 (Both). Otherwise, the system should reject the BCD record with a message describing the error(s). 7 According to the Financial Rule 65E , F.A.C., the AgeGroup code value of 3 (Both) only applies to CSU beds in a Public Receiving Facility (PRF). Therefore, if the FacilityType code value is not 1 (Adult), then the AgeGroup code value cannot be 3 (Both). Otherwise, the system should reject the BCD record with a message describing the error(s). 8 Leading zeros are not allowed for BCD fields that are defined and formatted as decimal numbers (e.g., ) or integer numbers (e.g., 999). Examples of allowable entries are as follows: 0.5 or 0.50 instead of or 5.50 instead of and 55 instead of 005 and 055 Otherwise, the system should reject the BCD record with a message describing the error(s) Bed Utilization Data ID Field Name Field Type Field Definition Validation ContractorId CHAR(10) Enter 10-digit in XX-XXXXXXX format describing the Federal Employer Identification Number (FEIN) of the managing entity that holds a contract with DCF or the state treatment facility that is operated by or under contract with DCF. Valid entry must match ContractorId reported in the corresponding BCD record; else, reject. ProviderId CHAR(10) Enter 10-digit in XX-XXXXXXX format describing the Federal Employer Identification Number of the facility that provides acute care services in community under contract with the managing entity or in state treatment facility. FacilityType CHAR(1) Enter 1-digit numeric code describing the type of facility where the client is receiving acute care service. See Code Table in Appendix C. Valid entry must match ProviderId reported in the corresponding BCD record with matching ContractorId; else, reject. AgeGroup CHAR (1) Enter 1 Valid entry must be in the code table for FacilityType as specified in 3.5 Appendix C. Must exist in the corresponding BCD record with matching ContractorId and ProviderId; else, reject. FASAMS ITN - Record Data Model Specification Document Page 14

15 ID Field Name Field Type Field Definition Validation digit numeric code describing the - age group designated for the licensed bed occupied by the client receiving the acute care services. See Code Table in Appendix C. Valid entry must be in the code table for AgeGroup as specified in 3.5 Appendix C. Must exist in the corresponding BCD record with matching ContractorId, ProviderId, and FacilityType; else, reject. There are no acute care beds for children in STF. Hence, if FacilityType code value is 4, then AgeGroup code value cannot be 2 or 3; else reject. According to 65E , F.A.C., AgeGroup code value of 3 only applies to PRF beds. Therefore, if FacilityType code value is not 1, then AgeGroup code value cannot be 3; else, reject. CensusDate DATE(8) Enter 8-digit for the date in YYYYMMDD format showing when the provider (facility) collected and submitted the acute care census data to the managing entity. Valid entry must be a valid date that is greater than or equal to the most recent effective date (EffectiveDate) that already exists in the corresponding BCD record with matching ContractorId, ProviderId, FacilityType and AgeGroup; else, reject. Unoccupied DECIMAL(6) Enter 6-digit decimal number in Enter 0 (zero) if there are no format showing the total number of vacant licensed beds at the licensed beds that are not occupied by time of the midnight census. any clients at the time of the midnight census for this Contractor ID, Provider ID, Facility Type, and Age Group. DCF DECIMAL(6) Enter 6-digit decimal number in format showing the total number of licensed beds that are physically occupied by clients whose acute care services are billable to the Department of Children and Families (DCF) at the time of the midnight census for this Contractor ID, Provider ID, Facility Type, and Age Group. Enter 0 (zero) if there are no licensed beds occupied by clients whose acute care services are billable to DCF at the time of the midnight census. If the number of beds occupied and billable to DCF exceeds the number of licensed beds purchased by DCF, the system will report the number in excess as uncompensated care. FASAMS ITN - Record Data Model Specification Document Page 15

16 ID Field Name Field Type Field Definition Validation - LocalMatch DECIMAL(6) Enter 6 digit decimal number in format showing the total number of licensed beds that are physically occupied by clients whose acute care services are billable to local match at the time of the midnight census for this Contractor ID, Provider ID, Facility Type, Medicaid DECIMAL(6) Enter 6-digit decimal number in format showing the total number of licensed beds that are physically occupied by clients whose acute care services are billable to Medicaid at the time of the midnight census for this Contractor ID, Provider ID, Facility Type, and Age Group. and Age Group. MedicaidHMO DECIMAL(6) Enter 6- digit decimal number in format showing the total number of licensed beds that are physically occupied by clients whose acute care services are billable to Medicaid Health Maintenance Organization at the time of the midnight census for this Contractor ID, Provider Medicare DECIMAL(6) Enter 6-digit decimal number in format showing the total number of licensed beds that are physically occupied by clients whose acute care services are billable to Medicare at the time of the midnight census for this Contractor ID, Provider ID, Facility Type, and Age Group. ID, Facility Type, and Age Group. MedicareHMO DECIMAL(6) Enter 6- digit decimal number in format showing the total number of licensed beds that are physically occupied by clients whose acute care services are billable to Medicare Health Maintenance Organization at the time of the midnight OtherGovernment DECIMAL(6) Enter 6-digit decimal number in format showing the total number of licensed beds that are physically occupied by clients whose acute care services are billable to other government programs at the time of the midnight census for this Contractor ID, Provider ID, Facility Type, and Age Group. Enter 0 (zero) if there are no licensed beds occupied by clients whose acute care services are billable to Local Match at the time of the midnight census. Enter 0 (zero) if there are no licensed beds occupied by clients whose acute care services are billable to Medicaid at the time of the midnight census. Enter 0 (zero) if there are no licensed beds occupied by clients whose acute care services are billable to Medicaid HMO at the time of the midnight census. Enter 0 (zero) if there are no licensed beds occupied by clients whose acute care services are billable to Medicare at the time of the midnight census. Enter 0 (zero) if there are no licensed beds occupied by clients whose acute care services are billable to Other Government Programs at the time of the midnight census. c e n s u s f o FASAMS ITN - Record Data Model Specification Document Page 16

17 ID Field Name Field Type Field Definition Validation - r this Contractor ID, Provider ID, Facility Type, and Age Group. Enter 0 (zero) if there are no licensed beds occupied by clients whose acute care services are billable to Medicare HMO at the time of the midnight census. PrivateHMO DECIMAL(6) Enter 6 digit decimal number in format showing the total number of licensed beds that are physically occupied by clients whose acute care services are billable to Private-Pay HMO at the time of the midnight census for this Contractor ID, Provider ID, Facility Type, Enter 0 (zero) if there are no licensed beds occupied by clients whose acute care services are billable to Private-Pay HMO at the time of the midnight census. PrivatePPO DECIMAL(6) Enter 6-digit decimal number in format showing the total number of licensed beds that are physically occupied by clients whose acute care services are billable to Private PPO at the time of the midnight census for this Contractor ID, Provider ID, Facility Type, and Age Group. and Age Group. PrivateInsurance DECIMAL(6) Enter 6- digit decimal number in format showing the total number of licensed beds that are physically occupied by clients whose acute care services are billable to Private-Pay Health Insurance at the time of the midnight census for this Contractor ID, Enter 0 (zero) if there are no licensed beds occupied by clients whose acute care services are billable to Private PPO at the time of the midnight census. Enter 0 (zero) if there are no licensed beds occupied by clients whose acute care services are billable to Private-Pay Health Insurance at the time of the midnight census. SelfPay DECIMAL(6) Enter 6-digit decimal number in format showing the total number of licensed beds that are physically occupied by clients whose acute care services are billable to Self-Pay Patient at the time of the midnight census for this Contractor ID, Provider ID, Facility Type, and Age Group. Provider ID, Facility Type, and Age Group. BeginningCensus INTEGER(6) Enter 6- digit integer number (no decimal) showing the distinct count of indigent clients admitted prior to the census date and occupying any licensed beds during the census date between 12:00 am and 11:59 pm, for this Contractor ID, Provider ID, Facility Type, and Age Group, regardless of the payers. Enter 0 (zero) if there are no licensed beds occupied by clients whose acute care services are billable to SelfPay at the time of the midnight census. FASAMS ITN - Record Data Model Specification Document Page 17

18 ID Field Name NewAdmissions Field Type Field Definition INTEGER(6) Enter 6-digit integer number (no decimal) Validation showing the distinct count of indigent clients admitted and occupying any licensed beds during the census date between 12:00 am and 11:59 pm, for this Contractor ID, Provider ID, Facility Type, and Age Group, regardless of the payers. For clients served in public receiving facilities, this number includes individuals, who qualify as indigent as defined in s , F.S. For clients served in If a client is admitted more than once on the date of the census, that client should be counted only once. If a client is in the beginning census and he/she is discharged and readmitted during the date of the census, that client should not be counted as new admission. If a client is discharged more than once on the date detoxification and addiction receiving facilities, this number includes individuals admitted pursuant to Parts IV and V of Chapter 397, who qualify as indigent as defined in s , F.S. Discharges INTEGER(6) Enter 6-digit integer number (no decimal) showing the distinct count of indigent clients, who were discharged from any licensed beds during the census date between 12:00 am and 11:59 pm, for this Contractor ID, Provider ID, Facility Type, and Age Group, regardless of the payers. TransactionType CHAR(1) Enter 1-digit numeric code describing the record transaction type. See Code Table in Appendix C. of the census, that client should be counted only once. If a client is transferred outside the facility and the bed is kept open for that client pending his/her return to the facility, that client should not be counted as a discharge. Valid entry must be in the code table for TransactionType as specified in 3.5 Appendix C. Code value of U is used to add a new record if there is no existing record with matching primary keys or to replace an existing record with matching primary keys. Code value of D is used to mark an existing record with matching primary keys as deleted. ID Business Rule FASAMS ITN - Record Data Model Specification Document Page 18

19 ID Field Name Field Type Field Definition Validation - 1 All fields in each BUD record must have valid values as specified in the BUD Data Table. Otherwise, the system will reject the BUD record with a message describing the error(s). 2 The total number of BUD records reported for each month and for each combination of ContractorId, ProviderId, FacilityType, AgeGroup, and CensusDate must equal the number of days in the reporting month. For example, the number of records per month should be 31 for July, and 30 for September. Otherwise, the system will reject the BUD record with a message describing the error(s). 3 The CensusDate in the BUD record must be a valid date for the reporting month. For instance, the CensusDate must be greater than or equal to Begin, and less than or equal to End; where Begin is FASA MS ITN - Recor d Data Model Specifi cation Docu ment Page 19

20 ID Business Rule the beginning date of the reporting month and End is the ending date of the reporting month. Otherwise, the system will reject the BUD record with a message describing the error(s). 4 The CensusDate for each combination of ContractorId, ProviderId, FacilityType, and AgeGroup must be a subsequent day. Otherwise, the system will reject the BUD record with a message describing the error(s). 5 Each BUD record must have a corresponding BCD record with matching ContractorId, ProviderId, FacilityType, and AgeGroup values; and the CensusDate in the BUD record is greater than or equal to the most recent EffectiveDate in the BCD record. Otherwise, the system will reject the BUD record with a message describing the error(s). 6 Leading zeros are not allowed for BUD fields that are defined and formatted as decimal numbers (e.g., ) or integer number (e.g., 999). Examples of allowable entries are as follows: 0.5 or 0.50 instead of or 5.50 instead of and 55 instead of 005 and 055. Otherwise, the system will reject the BUD record with a message describing the error(s). 7 A count of licensed beds that are not utilized (occupied) by any clients at the time of the midnight census must be reported as unoccupied. Note: If a bed is not occupied at the time of the midnight census because the client occupying the bed has been transferred outside the facility and the bed is kept open for that client pending his/her return to the facility, that bed should not be counted as unoccupied. Instead, that bed should be reported as occupied under the payer class that would be billable for the bed days when the client returns. 8 A count of licensed beds that are occupied by indigent and non-indigent clients at the time of the midnight census must be reported as occupied. These beds must be reported by payer class as specified in the BUD Data Table. The following are statutes and rules containing special requirements for reporting occupied beds: a. The Financial Rule 65E (3), which defines the standards for covered services measured in bed day, requires these data to be collected as part of the midnight census of individuals who are physically present in each bed before midnight, including the day the individual is admitted and excluding the day the individual is discharged. Occupied beds are reported per payer class that would be billable for those bed days. b. According to s (9), F.S., occupied beds in crisis stabilization units (CSU) may not exceed their licensed capacity by more than 10 percent, or for more than 3 consecutive working days, or for more than 7 days in one month. It is the responsibility of the Managing Entity to be in full compliance with this statutory requirement. The system will accept the BUD record and will produce an error report showing any CSU bed utilization violations per Managing Entity and Provider. This information will be part of the annual legislative report. c. Providers and managing entities are not required to submit the number of occupied beds that are billable to charity care 2. This number will be calculated automatically by the system as the difference between the total number of occupied beds billable to the department 2 Section (3), F.S., provides the definition of charity care FASAMS ITN - Record Data Model Specification Document Page 20

21 (DCF) as reported in BUD record and the total number of licensed beds purchased by the department (DCFBeds) as reported in BCD record. ID Business Rule Note: If DCF minus DCFBeds is greater than zero, the system will accept the BUD record with a warning message indicating that DCF exceeds DCFBeds and the Delta will be reported as uncompensated care. This information will be part of the annual legislative report. 9 A count of indigent clients who are admitted and receiving acute care services in a public receiving facility, addictions receiving facility, and/or detoxification facility is required for reporting client admissions. The following are policy guidelines for collecting and submitting new admissions (NewAdmissions) and a beginning census (BeginningCensus) in a BUD record: Note: a. BeginningCensus includes the distinct count of indigent clients, who are admitted prior to the census date and occupy any licensed beds during the census date between 12:00 am and 11:59 pm. b. NewAdmissions includes the distinct count of indigent clients, who are admitted and occupy any licensed beds during the census date between 12:00 am and 11:59 pm. a. If a client is in the beginning census and he/she is discharged and readmitted during the date of the census, that client should not be counted as new admission. b. If a client is admitted more than once on the date of the census, that client should only be counted once. 10 A count of indigent clients who are discharged from a public receiving facility, addictions receiving facility, and/or detoxification facility on the census date at any time between 12:00 am and 11:59 pm is required for reporting client discharges. Note: If a client is discharged more than once on the date of the census, that client should be counted only once. If a client is transferred outside the facility and the bed is kept open for that client pending his/her return to the facility, that client should not be counted as a discharge. FASAMS ITN - Record Data Model Specification Document Page 21

22 11 Providers and Managing Entities are not required to report EndingCensus in the BUD record. The system will automatically calculate the EndingCensus using the following formula: EndingCensus = (BeginningCensus + NewAdmissions) Discharges Note: EndingCensus in the BUD record for any census date (CensusDate), and for each combination of ContractorId, ProviderId, FacilityType, and AgeGroup must equal BeginningCensus of the next consecutive census date. Otherwise, the system will reject the BUD record with a message describing the error(s). The sum of beds occupied by all payer classes (OCCUPBEDS) for each combination of ContractorId, ProviderId, FacilityType, AgeGroup, and CensusDate, must include the number of licensed beds occupied by indigent and non-indigent clients. The EndingCensus must only include clients who qualify as indigent. Therefore, the sum of beds occupied by all payer classes (OCCUPBEDS) must be greater than or equal to the ending census (EndingCensus). Otherwise, the system will reject the BUD record with a message describing the error(s). 2.4 Data Flow Diagram The diagram below describes how the acute care data from the Managing Entity will be processed using SFTP to provide data submission reports to DCF. FASAMS Data FASAMS Data Service Providers Results Managing Entities Results FASAMS --- OR --- FASAMS Data Service Providers Results FASAMS FASAMS ITN - Record Data Model Specification Document Page 22

23 2.5 Appendix A: XML Format and Schema for BCD and BUD Appendix A: XML Format and Schema for BCD and BUD Submission FASAMS ITN - Record Data Model Specification Document Page 23

24 6.1. XML Schema <?xml version="1.0" encoding="utf-8"?> <xs:schema version="1.0" attributeformdefault="unqualified" elementformdefault="qualified" xmlns:xs=" targetnamespace=" xmlns:ac=" <xs:element name="acutecare"> <xs:complextype> <xs:sequence> <xs:annotation> <xs:appinfo>acute Care Schema</xs:appinfo> <xs:documentation> This file is used to validate XML files that contain Acute Care data. "BedCapacity" elemments contain information pertaining to the number beds that are licensed and purchaces by DCF on a particular date. "BedUtilization" elemments contain information pertaining to the number of beds in use at midnight and how the beds are being funded. NOTE: BedCapacity elements, if included, must preceed any BedUtilization elements within the submitted XML file. </xs:documentation> </xs:annotation> <xs:element minoccurs="0" maxoccurs="unbounded" name="bedcapacity"> <xs:complextype> <xs:all> <xs:element name="contractorid" type="ac:provideridtype" /> <xs:element name="providerid" type="ac:provideridtype" /> <xs:element name="facilitytype" type="ac:facilitytype" /> <xs:element name="agegroup" type="ac:agetype" /> <xs:element name="effectivedate" type="xs:date" /> <xs:element name="licensedbeds" type="xs:decimal" /> <xs:element name="dcfbeds" type="xs:decimal" /> <xs:element name="transactiontype" type="ac:actiontype" /> </xs:all> </xs:complextype> </xs:element> <xs:element minoccurs="0" maxoccurs="unbounded" name="bedutilization"> <xs:complextype> <xs:all> <xs:element name="contractorid" type="ac:provideridtype" /> <xs:element name="providerid" type="ac:provideridtype" /> <xs:element name="facilitytype" type="ac:facilitytype" /> <xs:element name="agegroup" type="ac:agetype" /> <xs:element name="censusdate" type="xs:date" /> YYYY-MM-DD FASAMS ITN - Record Data Model Specification Document Page 24

25 Appendix A: XML Format and Schema for BCD and BUD Submission FASAMS ITN - Record Data Model Specification Document Page 25

26 <xs:element name="unoccupied" type="xs:decimal" /> <xs:element name="dcf" type="xs:decimal" /> <xs:element name="localmatch" type="xs:decimal" /> <xs:element name="medicaid" type="xs:decimal" /> <xs:element name="medicaidhmo" type="xs:decimal" /> <xs:element name="medicare" type="xs:decimal" /> <xs:element name="medicarehmo" type="xs:decimal" /> <xs:element name="othergovernment" type="xs:decimal" /> <xs:element name="privatehmo" type="xs:decimal" /> <xs:element name="privateppo" type="xs:decimal" /> <xs:element name="privateinsurance" type="xs:decimal" /> <xs:element name="selfpay" type="xs:decimal" /> <xs:element name="beginningcensus" type="xs:integer" /> <xs:element name="newadmissions" type="xs:integer" /> <xs:element name="discharges" type="xs:integer" /> <xs:element name="transactiontype" type="ac:actiontype" /> </xs:all> </xs:complextype> </xs:element> </xs:sequence> <xs:attribute name="version" type="xs:decimal" use="required" /> </xs:complextype> </xs:element> <xs:simpletype name="provideridtype"> <xs:restriction base="xs:string"> <xs:pattern value="[0-9]{2}-[0-9]{7}"/> </xs:restriction> </xs:simpletype> <xs:simpletype name="facilitytype"> <xs:restriction base="xs:string"> <xs:maxlength value="1"/> <xs:pattern value=" "/> </xs:restriction> </xs:simpletype> <xs:simpletype name="agetype"> <xs:restriction base="xs:string"> <xs:maxlength value="1"/> <xs:pattern value="1 2 3"/> </xs:restriction> </xs:simpletype> <xs:simpletype name="actiontype"> <xs:restriction base="xs:string"> <xs:maxlength value="1"/> <xs:pattern value="u D"/> </xs:restriction> </xs:simpletype> </xs:schema> FASAMS ITN - Record Data Model Specification Document Page 26

27 6.2. Example XML Document FASAMS ITN - Record Data Model Specification Document Page 27

28 Appendix A: XML Format and Schema for BCD and BUD Submission <?xml version="1.0" encoding="utf-8"?> <AcuteCare Version="1.0" xmlns="http//myflfamilies.com/acutecare"> <BedCapacity> <ContractorId> </ContractorId> <ProviderId> </ProviderId> <FacilityType>1</FacilityType> <AgeGroup>2</AgeGroup> <EffectiveDate> </EffectiveDate> <LicensedBeds>999.99</LicensedBeds> <DCFBeds>999.99</DCFBeds> <TransactionType>U</TransactionType> </BedCapacity> <BedUtilization> <ContractorId> </ContractorId> <ProviderId> </ProviderId> <FacilityType>1</FacilityType> <AgeGroup>1</AgeGroup> <CensusDate> </CensusDate> <Unoccupied>999.99</Unoccupied> <DCF>999.99</DCF> <LocalMatch>999.99</LocalMatch> <Medicaid>999.99</Medicaid> <MedicaidHMO>999.99</MedicaidHMO> <Medicare>999.99</Medicare> <MedicareHMO>999.99</MedicareHMO> <OtherGovernment>999.99</OtherGovernment> <PrivateHMO>999.99</PrivateHMO> <PrivatePPO>999.99</PrivatePPO> <PrivateInsurance>999.99</PrivateInsurance> <SelfPay>999.99</SelfPay> <BeginningCensus>999</BeginningCensus> <NewAdmissions>999</NewAdmissions> <Discharges>999</Discharges> <TransactionType>U</TransactionType> </BedUtilization> </AcuteCare> B: Optional TXT File Layout Template for BUD Submission Optional TXT File Layout for BUD Submission from Provider to ME FASAMS ITN - Record Data Model Specification Document Page 28

29 Field Name Field Type(Size) Field Position Start End ContractorId CHAR(10) 1 10 ProviderId CHAR(10) FacilityType CHAR(1) AgeGroup CHAR(1) CensusDate DATE(10) Unoccupied DECIMAL(6) DCF DECIMAL(6) LocalMatch DECIMAL(6) Medicaid DECIMAL(6) MedicaidHMO DECIMAL(6) Medicare DECIMAL(6) MedicareHMO DECIMAL(6) OtherGovernment DECIMAL(6) PrivateHMO DECIMAL(6) PrivatePPO DECIMAL(6) PrivateInsurance DECIMAL(6) SelfPay DECIMAL(6) BeginningCensus INTEGER(6) NewAdmissions INTEGER(6) Discharges INTEGER(6) TransactionType CHAR(1) FASAMS ITN - Record Data Model Specification Document Page 29

30 C: Acute Care Code Table Field Name Code Description FacilityType 1 Public Receiving Facility (PRF) 2 Detoxification Residential Facility (DRF) 3 Addiction Receiving Facility (ARF) 4 State Treatment Facility (STF) AgeGroup 1 Adult (bed designated for adult only in any facility) TransactionType U Update 2 Children (bed designated for children only in any facility) 3 Both (adult bed designated for children aged in PRF) D Delete FASAMS ITN - Record Data Model Specification Document Page 30

31 3 Service Event 3.1 Data Model Diagram A Service Event record must have a corresponding record in the Subcontract data table and in the CoOccurring Admission and Discharge (COAD) data table. Clients, who are receiving interim services while on Waiting List, must have a demographic record with unique client identifier. Service event records, in combination with the corresponding subcontract records, provider information needed to generate the Provider Invoice Validation Report. FASAMS ITN - Record Data Model Specification Document Page 31

32 3.2 Data Model Description Data Model ID: <ID> Data Model Name: Service Event Record Description The Service Event data set is used at the state level to collect and report the types and amounts of services provided in state-contracted community substance abuse and mental health programs to individuals and non-specific individuals. At a minimum, entities contracted with the Department are required to report each service event for persons who meets the eligibility criteria for state substance abuse and mental health target populations, and whose services are funded, in whole or in part, by DCF funds. Activities provided to a group of individuals for whom individual client records are not maintained, or as part of an activity where client contact is maintained through an activity log as opposed to an individual client record, must also be collected and submitted. Purpose Service Event data set is a critical component for tracking client-specific and non-client-specific service encounter data, including recipients, providers, procedures, dates and times, service units, and other service event data elements as needed for billing and payment purposes, and linking to outcomes. Data Sources Any entity that has a state contract to provide client-specific services in community mental health or substance abuse programs is required to submit client specific service event data on each person served. Any provider with a Substance Abuse and Mental Health contract for which non-client-specific services are contracted are also required to report the services. Managing Entities must require each Provider that has a contract with the ME to submit Service Event data captured locally by Provider staff in their individual systems (e.g., Electronic Health Record Systems) to the ME. Managing Entities will validate and submit the data from each Provider to DCF. Timing / Frequency of Data MEs submit reconciled service event data received from Providers to the Department not later than the date specified in the ME contract. Data Submission Process Service Event data will be submitted and processed using a Secured File Transfer Protocol (SFTP) site to provide data submission reports to both DCF staff and managing entity staff. The Extensible Markup Language (XML) is the department s standard file format for submission and validation of records. Additional Information N/A FASAMS ITN - Record Data Model Specification Document Page 32

33 3.3 Data Tables Service Event Data ID Field Name Field Type Field Definition Validation EventType XXXXXXXXXX UniqueClientId CHAR(10) 10-digit code in (Primary Key) Valid entry must be if EventType=2 ContractorId (Primary Key) CHAR(10) format describing the client s unique identifier within DCF. 10-digit code in XX-XXXXXXX format describing the Federal Employer Identification Number (FEIN) of the entity that holds a contract with DCF or the state treatment facility that is operated by or under contract with DCF. Must be registered in the Demographic table if EventType=1. Must have COAD record with matching UniqueClientId if EventType=1 Valid entry must be the ContractorId that is registered in the Subcontract table. ContractNumber CHAR(5) 5-digit contract number under Must be a valid SAMH (Primary Key) which services are provided. contract number that is registered in the Subcontract table. ProviderId (Primary Key) CHAR(10) 10-digit code in XX-XXXXXXX format describing the Federal Employer Identification Number (FEIN) of the entity that provides SAMH services Valid entry must be the Provider ID that is registered in the Subcontract table. SubContractNumber CHAR(5) 5-digit contract number the Must be a subcontract (Primary Key) service provider has with the number registered in Managing Entity to provide the Subcontract table. services. ProgramArea (Primary Key) CHAR(1) CHAR(1) 1-digit code indicating whether the service event is clientspecific or non-client-specific. See Code Table in Appendix A. 1-digit code that indicates the program area in which the service is being provided. Valid entry must be a value in the code table for EventType. Valid entry must be a value in the code table for ProgramArea as specified in 4.5 Appendix A. Must be registered in Subcontract table FASAMS ITN - Record Data Model Specification Document Page 33

34 TxServiceSetting CHAR(2) Indicate the treatment service setting for substance abuse program or mental health program as defined in the TEDS manual. Valid entry must be a value in code table for TxServiceSetting and CoveredService as specified in 4.5 Appendix D. FASAMS ITN - Record Data Model Specification Document Page 34

35 Must have a COAD record with matching ID Field Name Field Type Field Definition Validation CoveredService CHAR(2) 2-digit code that indicates Valid entry must be a (Primary Key) the general category of value in the Code services provided to the Table for client. See Covered Service Code Table in Pamphlet CoveredService and ProgramArea as specified in 4.5 Appendix B. Must be registered in Subcontract table. ProcedureCode (Primary Key) ServiceDate (Primary Key) BeginTime (Primary Key) ExpenditureCode CHAR(5) CHAR(8) CHAR(4) CHAR(5) 5-digit Current Procedural Terminology (CPT) code that identifies the service. See Procedure Codes and Units Table in Pamphlet digit for the date in YYYYMMDD format for when the service was provided. Time the service actually began in HHMM (24 hour) format. Indicate the OCA code used by the ME in the Provider Expenditure Report to track the funding and expenditures related to this Covered Service event. Valid entry must be a value in the Code Table for ProcedureCode as specified in the DCF Pamphlet Appendix 4. Must be <= SystemDate and >= AdmissionDate in the corresponding COAD record. If the covered service is not measured in hours and minutes, default to Valid entry must be a value in the code table for ExpenditureCode as specified in 11.5 Appendix E. FASAMS ITN - Record Data Model Specification Document Page 35

36 SamhOca CHAR(5) Indicate the OCA code used by the ME in the Provider Expenditure Report to track the funding and expenditures related to this covered Service event. Valid entry must be a value in the code table for SAMHOCA as specified in 11.5 Appendix D. SamhOcaModifier CHAR(2) Indicate the code used as the modifier of SamhOca to track the funding and expenditures related to this covered Service event. Valid entry must be a value in the code table for SAMH OCA Modifier as specified in 4.5 Appendix F. FASAMS ITN - Record Data Model Specification Document Page 36

37 ID Field Name Field Type Field Definition Validation SiteId CHAR(2) 2-digit code describing the physical location of the provider where services will be provided. ClientId CHAR(10) Client identification number for local use by Provider. ContractorNpi ProviderNpi CHAR(10) CHAR(10) National Provider Identification number associated with the contracted entity that is reporting the service event. National Provider Identification number associated with the service provider that is reporting the service event. ServiceSetting if EventType = 1 Valid entry must be registered in the Provider Directory table. Leave blank if EventType = 2 Cannot be blank Cannot be blank CountyOfService CHAR(2) 2-digit code indicating the Must be between 01 Florida county in which the client and 67. received services. See Florida County Codes Table in Pamphlet ServiceUnits INTEGER(4) Number of service units provided during the service event. The number of units cannot exceed the maximum allowed per service event for each Covered Service as specified in 4.5 Appendix B. Fund CHAR(1) 1-digit code that indicates the Must be a valid value appropriate fund code for the in Code Table for current service the client is Fund as specified in receiving through DCF Funds. 4.5 Appendix A. See Code Table in Appendix A. InvoiceStatus CHAR(5) Indicate whether this service event was used by the Provider for Invoice Validation of service units billed to ME for payment as part of the Provider Expenditure Report. FASAMS ITN - Record Data Model Specification Document Page 37

38 BillingStatus CHAR(1) See Code Table in Appendix A. 1-digit indicating whether this service event was paid or unpaid by the ME as part of the Provider Expenditure Report. See Code Table in Appendix A. Must be a valid value in Code Table for BillingStatus as specified in 4.5 Appendix A. Must be a valid value in Code Table for InvoiceStatus as specified in 4.5 Appendix A. ID Field Name Field Type Field Definition Validation PaymentRate DECIMAL(10) Indicate in XXXXXXX.XX format the contracted dollar amount between the ME and the Provider agency as the payment per unit of the covered service. Cannot be blank Business Rules ID Business Rule 1 Clients, who are receiving interim services while on Waiting List, must have a demographic record with unique client identifier, which will allow the system to accept the interim service event record. 2 If EventType = 1 for Client-Specific, then: A COAD parent record must exist with matching UniqueClientId, ContractorId, ProviderId, and Service Setting and ServiceDate >= EvaluationDate.. Also, a Subcontract parent record must exist with matching ContractorId, ContractNumber, ProviderId, SubContractNumber, ProgramArea, CoveredService, and ServiceDate is within FiscalYear of the Subcontract. 3 If EventType = 2 for Non-Client-Specific, then: A Subcontract parent record must exist with matching ContractorId, ContractNumber, ProviderId, SubContractNumber, ProgramArea, CoveredService, and ServiceDate is within FiscalYear of the Subcontract. 4 Service units that are measured and reported in dollar amount must be rounded to the nearest dollar (e.g. $9.25 should be reported as $9 and $ should be reported as $951). 5 The number of units reported per service event cannot exceed the maximum number of units specified for each Unit of Measure as indicated in Covered Services Code Table (see Code Table in Appendix B) 6 Covered Services must be reported under valid Program Areas and Valid Event Types as indicated in Covered Services Code Table (See Code Table in Appendix B). 7 Covered Services must be reported under valid Treatment Service Settings and valid Levels of Care (See Crosswalk Table in Appendix D). 8 For client-specific events, which are measured in Direct Staff Hours and which involve more than one client and/or more than one staff, the total number of minutes spent by the staff should be divided by the number of clients involved to get the number of units per client per event. For example, if two staff members spent 3 hours in day care involving 5 children, then the total number of minutes for both staff would be 3 hours x 2 staff members x 60 minutes = 360 service units. The number of service units per service event for each of the five children would be 360/5 = 72 minutes. FASAMS ITN - Record Data Model Specification Document Page 38

39 9 For client-specific events, which are measured in days, the system should not allow any of these events to be concurrent, overlapping, or asynchronous for the same client as indicated in Appendix C. For example, if a client is discharged from one residential service setting and admitted into another on the same day, then only the service event for the admission day should be reported. This also applies to client admitted and discharged the same day in the same residential service setting. 10 For client-specific events, which are measured in hours, the system should not allow any of these service event records to be concurrent or overlapping for the same client. 11 If a contracted covered service is paid based on Availability and if that service is not provided to a specific client during the reporting period, then that service must be reported as a non-client-specific event. 3.4 Data Flow Diagram The diagram below describes how the Services Event data from the Providers will be collected and submitted to FASAMS. FASAMS Data FASAMS Data Service Providers Results Managing Entities Results FASAMS --- OR --- FASAMS Data Service Providers Results FASAMS 3.5 Appendix A: Code Table General FASAMS ITN - Record Data Model Specification Document Page 39

40 Field Name Code Description EventType 1 Client-Specific 2 Non-Client-Specific ProgramArea 1 Adult Mental Health 2 Adult Substance Abuse 3 Children Mental Health 4 Children Substance Abuse Fund 2 SAMH 3 TANF 5 Local Match Only B Title 21 InvoiceStatus 1 Yes, Service Event Was Used for Invoice Verification 2 No, Service Event Was Not Used for Invoice Verification BillingStatus 1 Paid 2 Unpaid B: Covered Services Code Table Covered Services Valid Service Units per Event Valid Program Area and Event Type 3 Code Description Unit of Measure Reported Units Program Area Event Type 01 Assessment Direct Staff Hour Minutes (Max = 1440) 1=AMH, 2=ASA, 3=CMH, 4=CSA 02 Case management Direct Staff Hour Minutes (Max = 1440) 1=AMH, 2=ASA, 3=CMH, 4=CSA 1=SERV 1=SERV 03 Crisis Stabilization Day Day (Max = 1) 1=AMH, 3=CMH 1=SERV 04 Crisis Support / Emergency Direct Staff Hour Minutes (Max = 1440) 1=AMH, 2=ASA, 3=CMH, 4=CSA 1=SERV, 2=EVNT 05 Day Care Services Direct Staff Hour Minutes (Max = 240) 1=AMH, 2=ASA 1=SERV 06 Day Treatment Direct Staff Hour Minutes (Max = 240) 1=AMH, 2=ASA, 3=CMH, 4=CSA 07 Drop In / Self Help Centers Non Direct Staff Hour 1=SERV Minutes (Max = 1440) 1=AMH 2=EVNT 08 In-Home/ On-Site Services Direct Staff Hour Minutes (Max = 1440) 1=AMH, 2=ASA, 3=CMH, 4=CSA 1=SERV 09 Inpatient Day Day (Max = 1) 1=AMH, 3=CMH 1=SERV 10 Intensive Case Management Direct Staff Hour Minutes (Max = 1440) 1=AMH, 3=CMH 1=SERV FASAMS ITN - Record Data Model Specification Document Page 40

41 11 Intervention-Individual Direct Staff Hour Minutes (Max = 1440) 1=AMH, 2=ASA, 3=CMH, 4=CSA 12 Medical Services Direct Staff Hour Minutes (Max = 1440) 1=AMH, 2=ASA, 3=CMH, 4=CSA 1=SERV 1=SERV 13 Medication Assisted Treatment Dosage Dose (Max =1) 2=ASA, 4=CSA 1=SERV 14 Outpatient Individual Direct Staff Hour Minutes (Max = 1440) 1=AMH, 2=ASA, 3=CMH, 4=CSA 15 Outreach Non Direct Staff Hour Minutes (Max = 1440) 1=AMH, 2=ASA, 3=CMH, 4=CSA 18 Residential Level 1 Day Day (Max = 1) 1=AMH, 2=ASA, 3=CMH, 4=CSA 19 Residential Level 2 Day Day (Max = 1) 1=AMH, 2=ASA, 3=CMH, 4=CSA 20 Residential Level 3 Day Day (Max = 1) 1=AMH, 2=ASA, 3=CMH, 4=CSA 21 Residential Level 4 Day Day (Max = 1) 1=AMH, 2=ASA, 3=CMH, 4=CSA 22 Respite Services Direct Staff Hour Minutes (Max = 1440) 1=AMH, 2=ASA, 3=CMH, 4=CSA 1=SERV 2=EVNT 1=SERV 1=SERV 1=SERV 1=SERV 1=SERV 24 Substance Abuse Detoxification Day Day (Max = 1) 2=ASA, 4=CSA 1=SERV 25 Supported Employment Direct Staff Hour Minutes (Max = 1440) 1=AMH, 2=ASA, 3=CMH, 4=CSA 26 Supported Housing/Living Direct Staff Hour Minutes (Max = 1440) 1=AMH, 2=ASA, 3=CMH, 4=CSA 1=SERV 1=SERV 3 1 = SERV = Client-Specific Event; 2 = EVNT = Non-Client-Specific Event Covered Services Valid Service Units per Event Valid Program Area and Event Type 3 Code Description Unit of Measure Reported Units Program Area Event Type 27 TASC 3 Direct Staff Hour Minutes (Max = 1440) 2=ASA, 4=CSA 1=SERV 28 Incidental Expenses 4 Dollar Amount Dollars (Max = 9999) 1=AMH, 2=ASA, 3=CMH, 4=CSA 29 Aftercare/Follow-up Individual Direct Staff Hour Minutes (Max = 1440) 1=AMH, 2=ASA, 3=CMH, 4=CSA 30 Information and Referral Direct Staff Hour Minutes (Max = 1440) 1=AMH, 2=ASA, 3=CMH, 4=CSA 1=SERV 2=EVNT 1=SERV 2=EVNT 32 Outpatient Detoxification Direct Staff Hour Minutes (Max = 240) 2=ASA, 4=CSA 1=SERV 35 Outpatient Group Direct Staff Hour Minutes (Max = 1440) 1=AMH, 2=ASA, 3=CMH, 4=CSA 36 Room & Board with Supervision, L1 37 Room & Board with Supervision, L2 Day Day (Max = 1) 1=AMH, 2=ASA, 3=CMH, 4=CSA Day Day (Max = 1) 1=AMH, 2=ASA, 3=CMH, 4=CSA 1=SERV 1=SERV 1=SERV 3 TASC is an acronym for Treatment Alternatives for Safer Communities 4 Incidental Expenses are for Client-Specific Event only, except for incidental expenses related to IDP bulk purchases which are Non- ClientSpecific Event. FASAMS ITN - Record Data Model Specification Document Page 41

42 38 Room & Board with Supervision, L3 39 Short-term Residential Treatment Day Day (Max = 1) 1=AMH, 2=ASA, 3=CMH, 4=CSA 1=SERV Day Day (Max = 1) 1=AMH 1=SERV 40 Mental Health Clubhouse Direct Staff Hour Minutes (Max = 1440) 1=AMH 2=EVNT 42 Intervention Group Direct Staff Hour Minutes (Max = 1440) 1=AMH, 2=ASA, 3=CMH, 4=CSA 43 Aftercare Group Direct Staff Hour Minutes (Max = 1440) 1=AMH, 2=ASA, 3=CMH, 4=CSA 44 CCST 5 Individual Direct Staff Hour Minutes (Max = 1440) 1=AMH, 2=ASA, 3=CMH, 4=CSA 45 CCST Group Direct Staff Hour Minutes (Max = 1440) 1=AMH, 2=ASA, 3=CMH, 4=CSA 46 Recovery Support Individual Direct Staff Hour Minutes (Max = 1440) 1=AMH, 2=ASA, 3=CMH, 4=CSA 47 Recovery Support Group Direct Staff Hour Minutes (Max = 1440) 1=AMH, 2=ASA, 3=CMH, 4=CSA 48 Indicated Prevention Direct Staff Hour Minutes (Max = 480) 1=AMH, 2=ASA, 3=CMH, 4=CSA 49 Selective Prevention Non-Direct Staff Hour 50 Universal Direct Prevention Non-Direct Staff Hour 51 Universal Indirect Prevention Non-Direct Staff Hour Minutes (Max = 1440) Minutes (Max = 1440) Minutes (Max = 1440) 1=AMH, 2=ASA, 3=CMH, 4=CSA 1=AMH, 2=ASA, 3=CMH, 4=CSA 1=AMH, 2=ASA, 3=CMH, 4=CSA 1=SERV 1=SERV 1=SERV 2=EVNT 1=SERV 2=EVNT 1=SERV 1=SERV 1=SERV 2=EVNT 2=EVNT 2=EVNT 5 CCST is an acronym for Comprehensive Community Service Team FASAMS ITN - Record Data Model Specification Document Page 42

43 C: Non-Concurrent Covered Services D: Treatment Service Settings and Covered Services TEDS Treatment Service Settings Covered Services Code Description Code Description 02 Detoxification, 24-hour 24 Substance Abuse Inpatient Detoxification service, Free- Standing Residential 08 Ambulatory - Detoxification 32 Substance Abuse Outpatient Detoxification 03 Rehabilitation/Residential - Hospital (other than Detoxification) 04 Rehabilitation/Residential -Short term (30 days or fewer) 05 Rehabilitation/Residential -Long term (more than 30 days) 09 Inpatient 03 Crisis Stabilization 39 Short-term Residential Treatment (30 days of fewer) 18 Residential Level I 19 Residential Level II 20 Residential Level III 21 Residential Level IV 36 Room and Board with Supervision Level I FASAMS ITN - Record Data Model Specification Document Page 43

44 37 Room and Board with Supervision Level II 38 Room and Board with Supervision Level III TEDS Treatment Service Settings Covered Services Code Description Code Description 39 Short-term Residential Treatment (more than 30 days) 06 Ambulatory Intensive outpatient 04 Crisis Support/Emergency 07 Ambulatory Non-Intensive outpatient 06 Day Treatment 08 In-Home and On-Site 10 Intensive Case Management 34 Florida Assertive Community Treatment Team (FACT) 01 Assessment 02 Case Management 11 Intervention (Individual) 12 Medical Services 13 Medication Assisted Treatment 14 Outpatient (Individual) 25 Supported Employment 26 Supported Housing/Living 27 Treatment Alternative for Safer Community 29 Aftercare (Individual) 35 Outpatient (Group) 40 Mental Health Clubhouse Services 42 Intervention (Group) 43 Aftercare (Group) 44 Comprehensive Community Service Team (Individual) 45 Comprehensive Community Service Team (Group) 46 Recovery Support (Individual) 47 Recovery Support (Group) 96 Non-TEDS Tx Service Settings 05 Day Care Services 07 Drop-In/Self-Help Centers FASAMS ITN - Record Data Model Specification Document Page 44

45 15 Outreach 22 Respite 28 Incidental Expenses 30 Information and Referral TEDS Treatment Service Settings Covered Services Code Description Code Description 48 Prevention - Indicated 49 Prevention - Selective 50 Prevention Universal Direct 51 Prevention Universal Indirect 96 Co-dependent/Collateral Client or Immediate Discharge E. SAMH OCA Modifier Codes Appendix F: SamhOca Modifier Codes and Descriptions Status A=Active I=Inactive A Modifier Code Short Description Definition B0 MHA01 - Adult Mental Health 24hr To designate allowable expenditures for 24 Hour Residential Services residential services (non-hospitalization). A B1 MHA09 - Adult Mental Health Non- To designate allowable expenditures for Residential Services nonresidential services. A B2 MHA18 Adult Mental Health Crisis Services To designate allowable expenditures for crisis services. A B3 MHA25 - Adult Mental Health Prevention Services To designate allowable expenditures for prevention services. I B4 MHA70 - Adult Mental Health Projects A B5 MHA72 Community Forensic Beds To designate allowable expenditures for Adult Mental Health Projects To designate allowable expenditures for Adult Community Forensic Beds To designate allowable expenditures for the salaries A B6 and expenses of the FACT team. MHA73 Adult Mental Health FACT Counted as state s Medicaid Admin match. Administrative Services FASAMS ITN - Record Data Model Specification Document Page 45

46 I B7 MHA74 Adult Mental Health FACT - Expenses To designate allowable expenditures for the expenses of the FACT team A I B8 B9 MHA76 Indigent Psychiatric Medication Program MHAJD Grants Jail Diversion and Trauma Recovery To designate allowable expenditures for the Indigent Psychiatric Medication Program To designate allowable expenditures for the Grants Jail Diversion and Trauma Recovery Appendix F: SamhOca Modifier Codes and Descriptions Status A=Active I=Inactive Modifier Code Short Description Definition A BA MHAPG Grants PATH To designate allowable expenditures for the Grants PATH A BB MHATB - Adult Mental Health TANF Eligible To designate the allowable expenditures for TANF eligible participants. Priority for CWI families. MHC01 - Children Mental Health 24hr To designate the allowable expenditures for 24 Hour A BC Residential Services residential services (non-hospitalization). A BD MHC09 - Children Non-Residential Services To designate the allowable expenditures for nonresidential services. A BE MHC18 - Children Crisis Services A BF MHC25 Children Prevention Services To designate the allowable expenditures for children s crisis services. To designate the allowable expenditures for children s prevention services I BG MHC70 Children Mental Health Projects To designate the allowable expenditures for Children Mental Health Projects MHC71 Residential Treatment for Purchase of Residential Treatment services for A BH Emotionally Disturbed Children/Youth Emotionally Disturbed children and youth A BI MHCBN Title XXI Children s Health Insurance Program (Behavioral Health Network) A BJ MHCMD Miami Wrap Around Grant A BK MHCFA FACES Miami To designate the allowable expenditures for the Title XXI Children s Health Insurance Program To designate the allowable expenditures for the Miami-Dade County Wrap Around Grant To designate the allowable expenditures for the Miami-Dade County Wrap Around FACES Grant FASAMS ITN - Record Data Model Specification Document Page 46

47 To designate the allowable expenditures for 24 Hour A BL MSA03 - Adult 24hr Residential Servicesresidential services (non-hospitalization) To designate the allowable expenditures for non- A BM MSA11 - Adult Non-Residential Services residential services. To designate the allowable expenditures for A BN MSA21 - Adult Detoxification Services detoxification services. A BO MSA23 Adult HIV Services A BP MSA25 - Adult Prevention Services To designate the allowable expenditures for adult HIV services To designate the allowable expenditures for prevention services. Appendix F: SamhOca Modifier Codes and Descriptions Status A=Active I=Inactive A Modifier Code Short Description Definition BQ MSA27 SAPTBG Set-Aside for Pregnant Women and Children To designate the allowable expenditures for the SAPTBG Set-Aside for Pregnant Women I BR MSA70 Adult Substance Abuse Projects MSA81 Expansion of Services for A BS Pregnant Women and their Families A BT MSATB - Adult TANF Eligible To designate the allowable expenditures for Adult Substance Abuse Projects To designate the allowable expenditures for the expansion services for Pregnant Women To designate the allowable expenditures for adult TANF eligible participants A BU MSC03 - Children 24hr Residential Services To designate the allowable expenditures for 24 Hour residential services (non-hospitalization) A BV MSC11 - Children Non-Residential Services To designate the allowable expenditures for nonresidential services A BW MSC21 - Children Detoxification Services A BX MSC23 Children s HIV Services A BY MSC25 - Children Prevention Services To designate the allowable expenditures for children s detoxification services To designate the allowable expenditures for children s HIV services To designate the allowable expenditures for children s prevention services FASAMS ITN - Record Data Model Specification Document Page 47

48 A CA MSCTB - Children TANF Eligible To designate the allowable expenditures for children TANF eligible participants A CB MSCPP Partners for Prevention Grant To designate the allowable expenditures for the Partners for Prevention Grant A CC MSC80 Informed Families To designate the allowable expenditures for Informed Families A CD MHA88 - Guidance Care Center Key West SFBHN A CE MHA93 Camillus Health Network SFBHN A CF MHA94 Citrus Health Network SFBHN A CG MSA91 Family Intensive Treatment (FIT) Appendix F: SamhOca Modifier Codes and Descriptions Status A=Active I=Inactive Modifier Code Short Description Definition I CH MSA85 Strengthen Our Communities A CI MHC87 Baycare Behavioral Health Children CFBHN A CJ MHA90 Northside Mental Health Center CFBHN A CK MHA89 Clay Behavioral Health Center CFBHN A CL MSC95 DACCO CFBHN A CM MHA86 Baycare Behavioral Health Vets MHA97 Crisis Center of Tampa Bay A CN - Adult CFBHN CFBHN FASAMS ITN - Record Data Model Specification Document Page 48

49 A CO MHA26 EI for SMI and Psych Disorder Early Intervention for SMI and Psych Disorder A CP MHS51 Circles of Care Cedar Village A A CQ CR MHS52 Circles of Care Crisis Stabilization MHA79 Clay Crisis Behavioral Prevention Team A CS MH010 Miami-Dade Homeless Trust SFBHN CT CU MHA88 Guidance Care Center Key West MHA89 Clay Behavioral Health Center A CV CW MHA90 Northside Mental Health Center MHA92 Palm Beach MH SA Treatment Appendix F: SamhOca Modifier Codes and Descriptions Status A=Active I=Inactive A Modifier Code Short Description Definition CX MHA93 Camillus Health Network Homeless A CY MHA94 Citrus Health Network A A A CZ DA DB MHA96 Jerome Golden Center for Behavioral Health MHATA FL Youth Transitions to Adulthood MHC77- Child At Risk Emotionally Disturbed FASAMS ITN - Record Data Model Specification Document Page 49

50 A DC MHC87 - Baycare Behavioral Health Child A DD MSC95 - SA Dacco CFBHN A DE MHC98 ME Salus Care Center - Children CFBHN A DF MH819 Gracepoint Center - Adult CFBHN A DG MHRM5 Renaissance Center - Adult CFBHN A DH MS903 Adult SA Proviso Allocation for Here s Help SFBHN A DI MHS50 Lifestream - Adult LSF A DJ MHSMB Meridian - Adult LSF A DK MS902 First Step of Sarasota Drug Free Babies CFBHN A DL MHS55 Circles of Care Geropsychiatric Care Adult MH CFCHS Appendix F: SamhOca Modifier Codes and Descriptions Status A=Active I=Inactive Modifier Code Short Description Definition A DM MHTRV - ME Transition Vouchers - MH A DN MH011 - Stewart Marchman Behavioral Healthcare CFBHN A DO MH0CN - ME Care Coordination - MH A DP MH031 - David Lawrence Center Behavioral Health Services CFBHN FASAMS ITN - Record Data Model Specification Document Page 50

51 A DQ MH032 - Baycare Behavioral Health Veterans Intervention Program CFBHN A DR MH037 - Fort Myers Salvation Army Behavioral Health Services CFBHN A DS MSTRV Transition Vouchers - SA A DT MH047- Lakeview Center MH & SA Adult BBCBC 4 Provider Directory 4.1 Data Model Diagram Providers in the ProviderDirectory must be licensed either by DCF for substance abuse services or by AHCA for mental health services. The Provider Directory is the parent of the DCF Contract as shown in the diagram below. Thus, the FEIN for ContractorId in the DCF Contract table should have a matching FEIN for ProviderId in the ProviderDirectory. FASAMS ITN - Record Data Model Specification Document Page 51

52 4.2 Data Model Description Data Model ID: Data Model Name: Provider Directory Record Description The Provider Directory data set contains the provider agency s demographic information including, but not limited to, provider and provider site identification numbers, names, addresses, and phone numbers, as well as information Purpose At the federal level, the Provider Directory data are collected as part of the Block Grant requirements for Inventory of Behavioral Health Services (I-BHS), including the National Survey of Substance Abuse Treatment Services (N-SSATS) and the National Survey of Mental Health Services (N-SMHS). At the state level, the Provider Directory record is used to improve the financial and service accountability by linking all the other records in FASAMS, i.e., Contract, Budget, Expenditure, Invoice, Service Event, Admission, Discharge and Transfer, and so on. Data Sources Provider Directory data is required from all agencies that have contract with the Department for community mental health or substance abuse services and all state treatment facilities that are operated by or have contract with the Department. Additionally, all providers licensed by DCF for substance abuse services or by AHCA for mental health services should also submit this information. Managing Entities must require each Provider, which has a contract with the ME to submit Provider Directory data to the ME. Managing Entities will validate and submit the data from each subcontracted Provider to DCF. Providers that have direct DCF contract are required to submit ProviderDirectory data to DCF. Timing / Frequency of Data Data Submission Process Provider Directory data will be submitted and processed using a Secured File Transfer Protocol (SFTP) site to provide data submission reports to both DCF staff and Managing Entity staff. The Extensible Markup Language (XML) is the department s standard file format for submission and validation of BCD records. Appendix A provides the required XML file format and schema, which the ME will use to validate and submit BCD and BUD records into FASAMS. Additional Information N/A FASAMS ITN - Record Data Model Specification Document Page 52

53 4.3 Data Tables I-BHS Facility Information ID Field Name Field Type Field Definition Validation ProviderId (Primary Key) CHAR(10) Enter 10-digit in XX-XXXXXXX format describing the Federal Employer Identification Number of the facility that provides acute care services in community under contract with the managing entity or in state treatment facility. SiteId (Primary Key) CHAR(2) Enter 2 digit of the provider site under which provider provides services Status CHAR(1) This is the site s status at the one digit code indicating if the site is open or closed. Valid entry must be the Provider ID that is registered in FASAMS Provider Directory. Must be a value between 00 and 99. Else, issue error message for invalid value 1 = Open 2 = Closed StatusDate DATE(8) Enter 8-digit for the date in Valid entry must be a YYYYMMDD format showing the date valid calendar date; else, when the site was opened for issue error message for operations. invalid value FacilityType (Primary Key) CHAR(1) Enter 1-digit numeric code describing the type of facility where the client is receiving acute care service. See Code Table in Appendix C. Valid entry must be a value in code table for FacilityType as specified in 5.5 Appendix A. Else, issue message showing error number and description Facility Name CHAR(50) Line 1 should include the corporate or Cannot be blank or more highest level name of the facility. Line than 50 characters. Else, 2 should include a unit or program issue message showing name that uniquely identifies the error number and facility. description FacilityAddress CHAR(38) FacilityCity FacilityState Street address for facility where services are provided; Address can be 1 to 38 characters. Do not enter a P.O. box number. Cannot be blank or more than 38 characters. Else, issue message showing error number and description CHAR(30) City in which facility is located. Cannot be blank or more than 30 characters. Else, issue message showing error number and description CHAR(2) State in which the Facility is located. Valid entry is FL. Filled in automatically by application (Read Only). FASAMS ITN - Record Data Model Specification Document Page 53

54 ID Field Name Field Type Field Definition Validation FacilityZip CHAR(10) Zip code for facility s location. Enter 10-digit in XXXXX-XXXX format, with a dash in 5 th position, e.g., Cannot be blank or more than 10 characters Florida Department of Children and F amilies CountyCode CHAR(2) Enter 2 digit code of the Florida county in which the site is located. See Florida County Codes Table in Pamphlet WebAddress CHAR(100) URL of website home page for this facility. MailingAddress CHAR(38) Street address for facility s mailing address; can be a P.O. box number. MailingCity CHAR(30) City for facility s mailing address; can be in a different state. Valid entry is must be a valid county code; else, issue message showing error number and description. Can be blank, but cannot exceed 100 characters Leave blank if same as physical facility address Can be blank, but cannot exceed 30 characters MailingState CHAR(2) State for facility s mailing address; can be a different state. Can be blank or FL. Else, issue message with error number and description MailingZip CHAR(10) Zip code for facility s mailing address. Can be blank, but cannot exceed 10 characters FacilityPhone CHAR(12) Telephone number for facility providing services. Can be blank, but cannot exceed 12 characters FacilityFax CHAR(12) Fax number for facility providing Can be blank, but services. cannot exceed 12 characters. FacilityService CHAR(2) This includes services with Substance Abuse and Mental Health. Valid entry must be a value in code table for FacilityService. Else, issue message with error number and description. DirectorPrefix CHAR(2) Self-explanatory (e.g., Dr., Ms.) Can be blank, but cannot exceed 2 characters DirectorFirstName CHAR(25) Self-explanatory. Can be blank, but cannot exceed 25 characters DirectorMI CHAR(1) Self-explanatory. Can be blank, but cannot exceed 1 character DirectorLastName CHAR(25) Self-explanatory. FASAMS ITN - Record Data Model Specification Document Page 54

55 Florida Department of Children and F amilies FASAMS ITN - Record Data Model Specification Document Page 55

56 ID Field Name Field Type Field Definition Validation DirectorPhone CHAR(12) Should be entered even if identical to facility phone. NationalProviderID CHAR(15) Assigned by HHS to health care providers. Cannot be blank and cannot exceed 12 characters. Else, issue message with error number and description Up to 15 characters. ID Business Rule 1 For substance abuse provider, the FEIN for ProviderID must exist in DCF licensure information system 2 For mental health provider, the FEIN for ProviderId must exist in AHCA licensure database. FASAMS ITN - Record Data Model Specification Document Page 56

57 4.4 Data Flow Diagram The diagram below describes not only how providers will use the SFTP process to submit the Provider Directory data directly into FASAMS or indirectly via the Managing Entities, but also how FASAMS will provide data submission reports to DCF and system users. 4.5 Appendix A: Provider Directory Code Table Field Name Code Description FacilityService 01 Substance Abuse - Administrative Services Only: Facility provides administrative services only. FASAMS ITN - Record Data Model Specification Document Page 57

58 02 Substance Abuse - Treatment/Detoxification Services: Facility provides services that focus on initiating and maintaining an individual s recovery from substance abuse and the management of acute intoxication and withdrawal. 03 Substance Abuse - Non-treatment Halfway House. 04 Substance Abuse - Other Non-treatment Services: Facility provides ONLY services such as intake, assessment, referral, sobering-up stations, and collateral services. 05 Mental Health - Mental Health Services Treatment: Facility provides services that focus on treating mental health issues. 06 Mental Health - Non-Treatment (Intake, Assessment, referral, etc.): Facility provides services such as intake, assessment, referral, and collateral services. 07 Mental Health - Administrative Only: Facility provides administrative services only. FASAMS ITN - Record Data Model Specification Document Page 58

59 5 Waiting List 5.1 Data Model Diagram The waiting list record is a child of the Demographic record and the ME Subcontract record. Hence, the waiting list record should have corresponding records with matching key field(s) in the Me Subcontract table and Demographic table. It should be noted that if a client is placed on waiting list and if that client receives any interim service that is reported in Service Event record, then that client must have a UniqueClientId in the corresponding Demographic record. SubContract Demographic FASAMS ITN - Record Data Model Specification Document Page 59

60 5.2 Data Model Description Data Model ID: Data Model Name: Wait List Description The waiting list module collects client-level data regarding the dates the client was placed and removed from the waiting list, the recommended and actual treatment service setting in which the client was placed, and other relevant data fields as specified below in the Data Table. Purpose The waiting list data module is designed to comply with federal regulations, which require the State to do the following: (a) improve the process for referring individuals to treatment facility that is most appropriate for their individual needs, (b) establish a waiting list management program which provides systematic reporting of treatment demand, and (c) develop and implement a Care Coordination Policy that specifies the methods used to reduce, manage, and eliminate waitlists for services. Ultimately, the waiting list data are necessary to document unmet needs and the extent to which current resources are insufficient to meet the need for services. Data Sources Waiting list records are collected locally by the entity, which provides SAMH services to clients. The entity, which has DCF contract to provide SAMHIS services, is required to receive and validate waiting list records from SAMH service providers and to upload these records into the department s data system (e.g., FASAMS). Timing / Frequency of Data The waiting list records are uploaded into the department s data system by a date and frequency specified in the DCF contract. Any individual who has not had a face-to-face, telephone or other documented contact in the last 30 days should be removed from the waiting list. Data Submission Process Wait list data will be submitted and processed using a Secured File Transfer Protocol (SFTP) site to provide data submission reports to both DCF staff and managing entity staff. The Extensible Markup Language (XML) is the department s standard file format for submission and validation of records, including waiting lists. Additional Information NA FASAMS ITN - Record Data Model Specification Document Page 60

61 ID Field Name Field Type Field Definition Validation 5.3 Data Tables Waiting List ID Field Name Field Type Field Definition Validation UniqueClientId CHAR(10) This field is used to uniquely identify the person receiving treatment If this field is blank, contains an invalid value, or is all zeros, the record will be rejected and not processed. A fatal error will be displayed in the processing report. ContractorId CHAR (10) The Federal Employer Identification Number (FEIN) of the entity that either holds a contract with DCF to provide SAMH services, or the entity that is owned and operated by DCF (e.g., state treatment facility). ProviderId CHAR (10) The Federal Employer Identification Number (FEIN) of the entity responsible for placing the client on waiting list and providing the required interim services. Must match CONTRACTORID in the corresponding ME Subcontract record Must match ProviderId in the corresponding ME Subcontract record. ProgramArea CHAR(1) Indicate the program in Must be a valid value in the which the client is being code table for ProgramArea as placed on the Waiting List. specified in 6.5 Appendix A. FASAMS ITN - Record Data Model Specification Document Page 61

62 LevelOfCare CHAR (2) Indicate the level of care for which the client is being placed on the waiting list. AssessmentType CHAR(1) The type of clinical instrument, i.e., ASAM or LOCUS, used for assessing the client s level of care and determining the appropriate treatment service/setting in which the client needs to be admitted (placed). AssessmentDate DATE (8) Indicate the date when the assessment was made to determine the level of care the client is waiting for. Must be a valid value in the code table for LevelOfCare as specified in 6.5 Appendix A. Code 01 thru 06 are valid only if AssessmentType = 2 for LOCUS Code 07 thru 19 are valid if AssessmentType = 1 for ASAM Must be a valid value in the code table for AssessmentType as specified in 6.5 Appendix A Format: YYYYMMDD Must be <= PlacementDate Florida Department of Children and Families PlacementDate CHAR (8) Indicate the date the client Format: YYYYMMDD was actually placed on the Waiting List. PlacementReason CHAR (1) Indicate the reason the client was placed on the Waiting List. Must be >= AssessmentDate Must be a valid value in the code table for PlacementReason as specified in 6.5 Appendix A SiteId CHAR (2) The physical location of the Format: XX right justified/zero provider site where filled. Must be registered in the FASAMS ITN - Record Data Model Specification Document Page 62

63 ID Field Name Field Type Field Definition Validation CountyOfService CHAR (2) Indicate the county in which the provider site, which is placing the client on the Waiting and providing interim services, is located. Must be a valid county code in Florida, i.e., 1 thru 67 ClientId CHAR (10) Contractor use only. Left justified/space filled. SSN CHAR(9) Enter the 9-digit social security number (SSN). If SSN is unknown or is not available use the pseudossn.. Field used to create UniqueClientId Valid entry is the client s SSN must be in format: XXXXXXXXX and the SSN cannot start with 000 or 9. FASAMS ITN - Record Data Model Specification Document Page 63

64 services will be provided the client is waiting on. Provider Directory for the that PROVIDERID. Pregnant CHAR (1) Indicate the client s pregnancy status at the time he/she is placed on waiting. Not Applicable can only be used for males. Must be a valid value in the code table for Pregnant as specified in 6.5 Appendix A. IvDrugUse CHAR (1) Indicate whether or not the Must be a valid value in the client on waiting is an code table for IvDrugUse as SuDS8 Homeless CHAR (1) Identifies whether the client is homeless, a dependent (living with parents or in a supervised setting), or living independently on his or her own. intravenous drug user. specified in 6.5 Appendix A. Must be a valid value in the code table for Homeless as specified in 6.5 Appendix A. If this field is blank or contains an invalid value, the value will be changed to 99 Invalid data and a warning error will be generated. FASAMS ITN - Record Data Model Specification Document Page 64

65 ID Field Name Field Type Field Definition Validation DOB CHAR( 8) This field identifies the client s date of birth. If this field is blank, uses the wrong date format, or contains an invalid value, the value record will not be processed. A fatal error will be displayed in the processing report. Race CHAR(1) This field identifies the Must be a valid value in the client s race. code table for Race as specified in 6.5 Appendix A. If this field is blank or contains an invalid value, the value will be changed to 99 Invalid data and a warning error will be generated. Gender Last First Middle CHAR(1) CHAR(35) CHAR(35) CHAR(14) This field identifies the client s gender. Enter Client s last name. Field used to create UniqueClientId Enter client s first name. Field used to create UniqueClientId Enter the client s middle name. If a middle name can absolutely not be obtained, then use the letter X. Field used to create UniqueClientId Must be a valid value in the code table for Gender as specified in 6.5 Appendix A. If this field is blank or contains an invalid value, the value will be changed to 9 Invalid data and a warning error will be generated. Valid entry is the client s last name must be left justified/space filled. Valid entry is the client s first name must be left justified/space filled. Valid entry is the client s middle name must be left justified/space filled. Suffix CHAR(10) Enter the client s suffix (e.g. Jr., II, etc.). Field used to create UniqueClientId Valid entry is the client s suffix must be left justified/space filled. Counselor CHAR (35) Indicate the last name of Left justified/space filled. LName Counselor FName CHAR (35) the counselor who determined that the client needs to be placed on the Waiting List. Indicate the first name of the counselor who determined that the client needs to be placed on the Waiting List. Left justified/space filled. Counselor MName CHAR (14) Indicate the middle name of the counselor who determined that the client Left justified/space filled. FASAMS ITN - Record Data Model Specification Document Page 65

66 ReferProviderId CHAR (10) The Federal Employer Identification Number of the entity from which the client is receiving the referral needs to be placed on the Waiting List. Format: XX-XXXXXXX Provider must be registered in SAMHIS. Must match ProviderID in DEMO record. Will be Blank until Removal Record is submitted (Automatically populated from Removal Record) Florida Department of Children and F amilies RemoveReason CHAR (1) Indicate the reason for which the client is being removed from the Waiting List. RemoveDate CHAR (8) Indicate the date that the client is removed from the waiting list. Based on the reason to be removed, enter the appropriate date. Must be a valid value in the code table for RemoveReason as specified in 6.5 Appendix A. Will be Blank until Removal SDS1 SystemTransaction CHAR (1) This field identifies the appropriate action that needs to be undertaken, that is, whether the record is added to the database, changes (by replacement) an existing record in the database, or deletes an existing record from the database. Record is submitted (Automatically populated from Removal Record) Format: YYYYMMDD Will be Blank until Removal Record is submitted (Automatically populated from Removal Record) Must be a valid value in the code table for SystemTransaction as specified in 6.5 Appendix A If this field is blank or contains an invalid entry, the file will be rejected and not processed. A fatal error will be displayed in the processing report. Business Rules ID Business Rule FASAMS ITN - Record Data Model Specification Document Page 66

67 Field Name Field Type Field Definition Validation 1 If a client is placed on waiting list and if that client receives any interim service that is reported in Service Event record, then that client must have a UniqueClientId in the corresponding demographic record. 2 A client placed on waiting list for intravenous drug abuse treatment service/setting must be admitted to that treatment service/setting not later than 14 days after the request. 3 A client, who cannot be placed in the requested treatment service/setting within 14 days, must be enrolled in interim services not later than 48 hours after such request, and those who remain active on a waiting list, must be admitted to a treatment service/setting within 120 days. 4 If a person cannot be located for admission into treatment or, if a person refuses treatment, such persons may be taken off the waiting list within 120 days. 5 The transaction code value of U is used to add a new record if there is no existing record with matching primary keys or to replace an existing record with matching primary keys. Transaction code value of D is used to delete an existing record with matching primary keys 5.4 Data Flow Diagram FASAMS Data FASAMS Data Service Providers Results Managing Entities Results FASAMS --- OR --- FASAMS Data Service Providers Results FASAMS rida Department of Children and Families SAMS ITN - Record Data Model Specification Document Page 67

68 5.5 Appendix A: Wait List Code Table Field Name Code Description LevelOfCare 01 LOCUS Level 1: Recovery Maintenance and Health Management 02 LOCUS Level II: Low Intensity Community Based Outpatient Services 03 LOCUS Level III: High Intensity Community Based Outpatient Services 04 LOCUS Level IV: Medically Monitored Non-Residential Services 05 LOCUS Level V: Medically Monitored Residential Services 06 LOCUS Level VI: Medically Managed Residential Services 07 ASAM Level ASAM Level 1: Outpatient 09 ASAM Level II: Intensive Outpatient/Partial Hospitalization 10 ASAM Level III-1: Clinically Managed Low Intensity Residential Services 11 ASAM Level III-3: Clinically Managed Medium intensity Residential Services 12 ASAM Level III-5: Clinically Managed High Intensity Residential Services 13 ASAM Level III-7: Medically Monitored Intensive Inpatient Treatment 14 ASAM Level IV: Medically Managed Inpatient Treatment 15 ASAM Level I-D: Withdrawal Management (Ambulatory Detox without extended on-site monitoring) 16 ASAM Level II-D: Withdrawal Management (Ambulatory Detox with extended on-site monitoring) 17 ASAM Level III-2D: Withdrawal Management (Clinically Managed Residential Detox) FASAMS ITN - Record Data Model Specification Document Page 68

69 Field Name Code Description 18 ASAM Level III-7D: Withdrawal Management (Medically Monitored Inpatient Treatment) 19 ASAM Level IV-D: Withdrawal Management (Medically Managed Intensive Inpatient Detox) ProgramArea 1 Adult Mental Health 2 Adult Substance Abuse 3 Children Mental Health 4 Children Substance Abuse AssessmentType 1 American Society for Addiction Medicine (ASAM) 2 Level of Care Utilization Services (LOCUS) PlacementReason 1 Service is not available/not offered 2 Service needed is at capacity 3 Other Pregnant 1 Pregnant 2 Not Pregnant IvDrugUse 1 Yes 3 Not Applicable (Male) 2 No Homeless 1 Yes 2 No RemoveReason 1 Receiving Referred Services 2 Moved out of State 3 Moved out of Circuit 4 Declined 5 Died PseudoSSN Position 1 First Initial 6 Service no Longer Appropriate 7 Receiving referred services at another provider. 8 Incarceration. Position 2 Position 3 Positions 4-5 Middle Initial (X if no middle name) Last Initial Month of Birth [01-12] FASAMS ITN - Record Data Model Specification Document Page 69

70 Field Name Code Description Positions 6-7 Positions 8-9 Day of Birth [01-31 or if the pseudo SSN is already in use, alter the two digits of the Birth Day to a number greater than 31.] Year of Birth [00-99] Race 01 ALASKA NATIVE (Aleut, Eskimo) A person having origins in any of the original peoples of Alaska. This category may be reported if available. 02 AMERICAN INDIAN/ALASKA NATIVE A person having origins in any of the original peoples of North America and South America (including Central America and the original peoples of Alaska) and who maintains tribal affiliation or community attachment. States collecting Alaska Native should use this category for all other American Indians. 03 ASIAN OR PACIFIC ISLANDER A person having origins in any of the original peoples of the Far East, the Indian subcontinent, Southeast Asia, or the Pacific Islands. This category may be used only if a state does not collect Asian and Native Hawaiian or Other Pacific Islander separately. 04 BLACK OR AFRICAN AMERICAN A person having origins in any of the black racial groups of Africa. 05 WHITE A person having origins in any of the original peoples of Europe, the Middle East, or North Africa. 13 ASIAN A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam. FASAMS ITN - Record Data Model Specification Document Page 70

71 Field Name Code Description 20 OTHER SINGLE RACE Use this category for instances in which the client is not identified in any category above or whose origin group, because of area custom, is regarded as a racial class distinct from the above categories. 21 TWO OR MORE RACES Use this code when the state data system allows multiple race selection and more than one race is indicated. 23 NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands. Gender 1 Male 2 Female SystemTransaction A Add a new record to the database C D Change (by replacement) an existing record in the database Delete an existing record from the database FASAMS ITN - Record Data Model Specification Document Page 71

72 6 COAD 6.1 Data Model Diagram There are three data sets to be submitted by the managing entity into the department database as part of the COAD data requirements: Admission data, Discharge data, and Diagnosis data. These three data sets are linkable based on primary key (PK) fields, which uniquely identify each record in each file. A COAD Admission record is a child of two records: the Subcontract record and the Demographic record and, therefore, it should have a corresponding record with matching key field(s) in these two parent records. The Discharge record is a unique child of the COAD Admission record, i.e., there can be only one discharge record per admission record. The Diagnosis record is a child of both Admission record and Discharge record, as there can be more than one diagnosis record per client at the time of admission and discharge. SubContract Event Discharge Demographic FASAMS ITN - Record Data Model Specification Document Page 72

73 6.2 Data Model Description Data Model ID: <ID> Data Model Name: <Record name> Description The three COAD data sets (Admission, Discharge and Diagnosis) capture data for treatment episodes from the time the client is initially admitted into a provider agency to the time the client is finally discharged from that provider agency. The following are the COAD data sets and circumstances under which these data are collected and reported. COAD Admission Record: Initial Admission to Provider Agency This record includes admission data for clients requiring initial admission in a provider agency for treatment services in substance abuse and/or mental health programs. In this record, ClientTransaction code value must be 1. Transfer Admission to Treatment Service/Setting within Provider Agency This record includes admission data for clients who change treatment service/setting after the initial admission into the provider agency. In this record, ClientTransaction code value must be 2. Periodic Update within Provider Agency This record includes admission data for clients initially admitted into a provider agency and continuously receive services in the same treatment service/setting within the same provider agency for six months. In this record, ClientTransaction code must be 3. Furthermore, this record must have a corresponding record with ClientTransaction code of 1 for Initial Admission or 2 for Transfer Admission. COAD Discharge Record: Immediate Discharge from Provider Agency This record includes discharge data for clients who, after an initial assessment/evaluation, do not require an admission for treatment services in substance abuse and/or mental health programs and are immediately discharged from the provider agency. In this record, ClientTransaction code must be 6. Discharge from Provider Agency This record includes discharge data for clients, who no longer require treatment services in substance abuse and/or mental health programs within the provider agency and, who are discharged from that provider agency for various reasons. In this record, ClientTransaction code must be 4. Furthermore, this record must have a corresponding record with ClientTransaction code of 1 for Initial Admission. Transfer Discharge from Treatment Service/Setting within Provider Agency This record includes discharge data for clients, who no longer require services in one treatment service/setting and are transferred to another treatment service/setting within the provider agency. In this record, ClientTransaction code must be 5. Furthermore, this record must have a corresponding record with ClientTransaction code of 2 for Transfer Admission. Note: Section 7.4 provides the Data Flow Diagram (DFD) describing the processes for collecting and submitting the COAD record for each client transaction type. Appendix 7.5 B is a diagram that illustrates when the COAD data should be reported not only when a client begins and ends an admission episode within a provider agency, but also during an admission episode when the client begins and ends each treatment episode in that provider agency. FASAMS ITN - Record Data Model Specification Document Page 73

74 Data Model ID: <ID> Data Model Name: <Record name> Purpose This document provides the business requirements for collecting and reporting the co-occurring admission and discharge (COAD) data to meet state and federal data reporting needs. At the federal level, COAD data are collected mainly as part of the Block Grant requirements for Treatment Episode Data Sets (TEDS) that include: (a) the National Outcome Measures, (b) the Uniform Reporting System (URS) data tables, and (c) the Basic Client Information (BCI). At the State level, COAD data provide information for performance outcome measures required by: (a) the Legislature as part of the General Appropriation Act (GAA), and (b) the Department as part of the program planning and budgeting, contract monitoring, and various other priority of efforts (POE) initiatives for quality assurance and quality improvement Data Sources The Department of Children and Families (department) collects and reports COAD data from publicly funded substance abuse and/or mental health programs in community. Timing / Frequency of Data A COAD record is uploaded into the department s data system by a date and frequency specified in the DCF contract with ME. Data Submission Process COAD data will be submitted and processed using a Secured File Transfer Protocol (SFTP) site to provide data submission reports to both DCF staff and Managing Entity staff. The Extensible Markup Language (XML) is the department s standard file format for submission and validation of BCD records. Additional Information N/A 6.3 Data Tables COAD Admission Record Note: The column labelled Applicable Program shows data fields that are applicable to substance abuse (SA) admission or to mental health (MH) admission or to both (SA&MH). The column labelled Field Source reflects data fields currently required either in the DCF Pamphlet (PAM 155-2) or by TEDS as part of the system data set (SDS), (b) minimum data set (MDS or MHA), or supplemental data set (SUDS). This column also indicates which data fields are currently used for reporting the National Outcome Measures (NOM), as well as the FASAMS ITN - Record Data Model Specification Document Page 74

75 performance outcome measures required by the Legislature as part of the General Appropriation act (GAA). The column labelled Field Name shows Key fields, which are used to uniquely identify each admission record. FASAMS ITN - Record Data Model Specification Document Page 75

76 COAD Admission Table Applicable Program Field Source Field Name Field Field Definition Type(Size) Field Validation SA&MH TEDS SDS 1 SystemTransaction (KEY) (CHAR(1) System Transaction Type - This field identifies the appropriate action that needs to be undertaken, that is, whether the record is added to the database, changes (by replacement) an existing record in the database, or deletes an existing record from the database Must have a valid value in the Code Table for SystemTransaction as specified in 7.5 Appendix A SA&MH TEDS MDS4 ClientTransaction (KEY) CHAR(1) Client Transaction Type (Purpose) at Admission Indicates whether a record represents one of the following purposes for submitting the COAD admission record: (1) Initial Admission, (2) Transfer Admission, (3) Periodic Update. This field must have a valid value in the Code Table for ClientTransaction as specified in 7.5 Appendix A. Refer to MDS4 data field in TEDS Manual for detailed Validation Edits and Guidelines. SA&MH SA&MH SA&MH PAM GAA TEDS MDS1 TEDS MDS2 ContractorId (KEY) ProviderId (KEY) UniqueClientId (KEY) CHAR(10) CHAR(10) CHAR(10) Contractor ID Indicates the Federal Employer Identification Number (FEIN) of the entity that either holds a contract with DCF to provide Must exist in SubContract table SAMH services in community or in state treatment facility or is owned and operated by DCF (e.g., state treatment facility). Provider ID Indicates the Federal Employer Identification Number (FEIN) of the entity that either holds a contract with DCF to provide Must exist in SubContract table SAMH services in community or in state treatment facility or is owned and operated by DCF (e.g., state treatment facility). Unique Client Identifier Specifies the unique client Identifier of the person receiving treatment as reported in the demographic record. Must exist in Demographic table. FASAMS ITN - Record Data Model Specification Document Page 76

77 SA&MH PAM GAA ProgramArea (KEY) CHAR(1) Program Area indicates the program area in which the client is being admitted. Valid entry must be a valid value in the Code Table for ProgramArea as specified in 7.5 Appendix A. Must exist in SubContract table. Applicable Program SA&MH SA&MH SA&MH SA&MH SA&MH SA&MH Field Source TEDS MDS5 TEDS MDS5 TEDS MDS18 PAM GAA PAM GAA TEDS SUDS5 NOM Field Name AdmissionDate (KEY) TxBeginDate KEY TxServiceSetting (KEY) ContractNumber SubContractNumber COAD Admission Table Field Field Definition Type(Size) DATE(10) DATE(10) CHAR(2) CHAR(5) CHAR(5) CoOccurring CHAR (1) Date of Admission Indicate the date when the client was initially admitted into the provider agency to receive the first direct treatment or service. Treatment Beginning Date Indicate the date when the client actually started receiving services in the treatment service setting after admission into provider agency Type of Treatment Service/Setting This field describes the type of treatment service or treatment setting in which the client is placed at the time of admission or transfer. Contract Number Indicates the number of the contract between the Department and the contracting entity, e.g., Managing Entity. Subcontract Number Indicates the number of the subcontract between the service provider and the Managing Entity to provide services. Co-occurring Substance Abuse and Mental Health Problems This field indicates whether the client has co-occurring substance abuse and mental health problems. Field Validation Admission Date must be within Fiscal Year in the Subcontract table. Refer to MDS5 data field in TEDS Manual for detailed Validation Edits Must be >= AdmissionDate This field must have a valid value in the Code Table for TxServiceSetting as specified in 4.5 Appendix D. Refer to MDS18 data field in TEDS Manual for detailed Validation Edits and Guidelines This field must have a valid number in Subcontract table. Note: this field must be valid for ContractorId or ProviderId. This field must have a valid number in Subcontract table. Note: this field must be valid for ProviderId. This field must have a valid value in Code Table for CoOccurring. Refer to SUDS5 data field in TEDS Manual for detailed Validation Edits and Guidelines. Note: This field is used to identify data elements required for clients with MH problem only, SA problem only, or both. FASAMS ITN - Record Data Model Specification Document Page 77

78 SA&MH TEDS MDS3 Codependent CHAR(1) Codependent/Collateral- Indicates whether treatment is for a primary substance abuse problem or arises from the client s relationship with someone with a substance abuse problem. For mental health client, use code value for Client. This field must have a valid value in Code Table for Codependent. Refer to MDS3 data field in TEDS Manual for detailed Validation Edits and Guidelines Note: This field is part of the KEY fields in the submission of TEDS records. COAD Admission Table Applicable Program Field Source Field Name Field Field Definition Type(Size) Field Validation SA&MH Related to MDS18 GAA AssessmentType CHAR(1) Level of Care Assessment Type Indicates the type of clinical instrument, i.e., ASAM or LOCUS, used for assessing the client s level of care and determining the appropriate treatment service/setting in which the client needs to be admitted or transferred This field must have a valid value in Code Table for AssessmentType. SA&MH Related to MDS18 GAA AssessmentDate CHAR(10) Level of Care Assessment Date Indicates the date when the assessment was This field must have a valid made to determine the level of calendar date. care for the client being admitted or transferred to treatment. SA&MH Related to MDS18 GAA LevelOfCare CHAR(2) Level of Care Indicates the level of care in which the client is being placed at the time of admission or transfer. This field must have a valid value in the Code Table for LevelOfCare as specified in in 6.5 Appendix A. SA&MH TEDS MDS7 ReferralSource CHAR(2) Referral Source This field describes the person or agency referring the client to treatment This field must have a valid value in Code Table for ReferralSource as specified in in 7.5 Appendix A. Refer to MDS7 data field in TEDS Manual for detailed Validation Edits and Guidelines SA&MH TEDS SUDS13 CrimJustReferral CHAR(2) Detailed Criminal Justice Referral This field provides more detailed information about those clients who are coded as 07 Criminal justice referral in Referral Source. This field must have a valid value in Code Table for CrimJustReferral as specified in in 7.5 Appendix A. Refer to SUDS13 data field in TEDS Manual for detailed Validation Edits and Guidelines FASAMS ITN - Record Data Model Specification Document Page 78

79 SA&MH TEDS MDS12 NOM Education CHAR(2) Education This field specifies either the highest school grade completed for adults or children not attending school or the current school grade for school-age children (3-17 years old) attending school. This field must have a valid value in Code Table for Education as specified in in 7.5 Appendix A. Refer to MDS12 data field in TEDS Manual for detailed Validation Edits and Guidelines SA&MH TEDS MHA3 SchoolAttendance CHAR (1) School Attendance Status This field specifies the school attendance status of schoolage children and adolescents (3-17 years old), including young adults (18-21 years old) who are protected under the Individuals with Disabilities Education Act (IDEA), receiving mental This field must have a valid value in Code Table for SchoolAttendance as specified in in 7.5 Appendix A. Refer to MHA3 data field in TEDS Manual for detailed Validation Edits and Guidelines COAD Admission Table Applicable Program Field Source Field Name Field Field Definition Type(Size) Field Validation health services. MH MH SA&MH SA&MH PAM GAA PAM GAA TEDS MDS13 NOM TEDS SUDS12 NOM SchoolDaysAvailable SchoolDaysAttended EmploymentStatus LaborForceDetails CHAR (2) CHAR (2) CHAR(2) CHAR(2) School Days Available Indicate the number of school days available within the last 90 days The valid value is 0 through 90 if SchoolAttendance is 1 for Yes. Enter 99 for Not Applicable (SA) The valid value is 0 through 90 if School Days Attended SchoolAttendance is 1 for Yes Indicate the number of school and SchoolDaysAvailable is 0 days attended within the last thru 30. Enter 99 for Not 90 days Applicable (SA) Employment Status Indicate the client s employment status. This field must have a valid value in Code Table for EmploymentStatus as specified in TEDS manual. Refer to MDS13 data field in TEDS Manual for codes and descriptions and for detailed Validation Edits and Guidelines This field must have a valid value in Code Table for Detailed for Not Being In LaborForceDetails as specified Labor Force Provides more TEDS manual. detailed information about those clients who are coded as Refer to SUDS12 data field in 04 Not in labor force in TEDS Manual for codes and Employment Status. descriptions and for detailed Validation Edits and Guidelines FASAMS ITN - Record Data Model Specification Document Page 79

80 SA&MH MH SA&MH PAM GAA PAM GAA TEDS SUDS9 DaysWorked DaysInCommunity IncomeSource CHAR(2) CHAR(2) CHAR(2) Days Worked Indicate the number of days the client worked for pay, including paid leave, within the last 30 days. Days in Community Indicate the number of days the client spent in the community within the last 30 days Primary Source of Income/Support This field identifies the client s principal source of financial support Valid Values must be 0 through 30 and if Employment Status is not 04 (not in labor force) Valid value is 0 thru 30 or 96 for Not Applicable (SA) This field must have a valid value in Code Table for IncomeSource as specified in in 7.5 Appendix A. Refer to SUDS9 data field in TEDS Manual for detailed Validation Edits and Guidelines SA&MH PAM PersonalIncome CHAR(2) Personal Income This field indicates the annual personal income (in thousands) rounded to nearest thousand. This field must have a valid income value from 00 through 99, where 00 is for No income, 98 is for Income over 98,000. SA&MH PAM FamilyIncome CHAR(2) FamilyIncome This field indicates the annual family This field must have a valid value in Code Table for FamilyIncome Applicable Program SA & MH SA&MH Field Source Field Name FamilySize PAM TEDS SUDS11 PaymentSource COAD Admission Table Field Field Definition Type(Size) Field CHAR(2) CHAR(2) (gross) income (in thousands) rounded to nearest thousands of the client s household. If there is no known income from other family members, enter what is reported for PersonalIncome Family Size Indicate the number of persons living in the household. Primary Payment Source This field identifies the expected or actual primary source of payment for this treatment episode anticipated at the time of admission Validation as specified in in 7.5 Appendix A Cannot be blank. Valid values range from 1 to 99 This field must have a valid value in Code Table for PaymentSource as specified in in 7.5 Appendix A. Refer to SUDS11 data field in TEDS Manual for detailed Validation Edits and Guidelines MH PAM GAA DisabilityIncome CHAR(1) Disability Income Status Indicate whether or not the client is receiving disability income for a psychiatric condition This field must have a valid value in Code Table for DisabilityIncome as specified in in 7.5 Appendix A. FASAMS ITN - Record Data Model Specification Document Page 80

81 SA&MH SA&MH TEDS SUDS8 NOM PAM GAA LivingArrangement CountyOfResidence SA & MH PAM ZipResidence SA&MH TEDS SUDS7 VeteranStatus CHAR(2) CHAR(2) Char(5) CHAR (1) Living Arrangements Identifies whether the client is homeless, a dependent (living with parents or in a supervised setting), or living independently on his or her own This field must have a valid value in Code Table for LivingArrangement as specified in TEDS manual. Refer to SUDS8 data field in TEDS Manual for codes and descriptions and for detailed Validation Edits and Guidelines County of Residence Indicates the Florida county in Valid entry must be a valid which the client resides at the Florida county code, i.e., 01 thru time of admission. If unknown, 67. enter the county of the provider site where the client is being admitted Residence Zip Code Indicate the client s home/residence US Postal Office Zip code. Cannot be blank. If unknown, enter the county of the provider site where the client is being admitted. Veteran Status This field indicates whether the client has served in the uniformed services (Army, Navy, Air Force, Marine Corps, Coast Guard, Public Health Service Commissioned Corps, Coast This field must have a valid value in Code Table for VeteranStatus as specified in in 7.5 Appendix A. Refer to SUDS7 data field in TEDS Manual for detailed Validation Edits and Guidelines COAD Admission Table Applicable Program Field Source Field Name Field Field Definition Type(Size) Field Validation and Geodetic Survey, etc.). SA&MH SA&MH PAM TEDS SUDS14 AdaStatus MaritalStatus CHAR(1) CHAR(2) Americans with Disabilities Act Status Indicate whether or not the client meets the This field must have a valid value definition of disabled under in Code Table for AdaStatus as the Americans with Disabilities specified in in 7.5 Appendix A. Act (ADA), e.g., developmentally disabled, physically disabled, visually impaired, hearing impaired, non-ambulatory, or English Language impaired. Marital Status This field describes the client s marital status codes that are compatible with categories used in the U.S. Census. This field must have a valid value in Code Table for MaritalStatus as specified in in 7.5 Appendix A. Refer to SUDS14 data field in TEDS Manual for detailed Validation Edits and Guidelines FASAMS ITN - Record Data Model Specification Document Page 81

82 SA&MH TEDS SUDS10 HealthInsurance CHAR(2) Health Insurance This field specifies the client s health insurance at admission. The insurance may or may not cover behavioral health treatment. This field must have a valid value in Code Table for HealthInsurance as specified in in 7.5 Appendix A. Refer to SUDS10 data field in TEDS Manual for detailed Validation Edits and Guidelines SA&MH SA&MH SA&MH TEDS SUDS17 NOM TEDS MDS6 SelfHelpAttendance PreviousSaTx TEDS SUDS15 DaysWaiting CHAR(2) CHAR(1) CHAR(3) Attendance at SA Self-Help Groups in Past 30 Days Indicates the frequency of attendance at a substance abuse self-help group in the 30 days prior to the date of admission. It includes attendance at Alcoholics Anonymous (AA), Narcotics Anonymous (NA), and other self- help/mutual support groups focused on recovery from substance abuse and dependence Previous SA Treatment Episodes (Optional for MH) This field indicates the number of previous treatment episodes the client has received in any substance abuse treatment program Days Waiting to Enter SA Treatment Indicates the number of days from the first contact or request for a substance abuse treatment service until the client was This field must have a valid value in Code Table for SelfHelpAttendance as specified in in 7.5 Appendix A. Refer to SUDS17 data field in TEDS Manual for detailed Validation Edits and Guidelines This field must have a valid value in Code Table for PreviousSATx as specified in in 7.5 Appendix A Refer to MDS6 data field in TEDS Manual for detailed Validation Edits and Guidelines Valid entry for DaysWaiting must be values from 000 to 996 or 997 for Unknown or 999 for Not Applicable COAD Admission Table Applicable Program Field Source Field Name Field Field Definition Type(Size) Field Validation admitted and the first clinical substance abuse service was provided. Applicable only for SA clients or MH client with co-occurring SA problem Refer to SUDS15 data field in TEDS Manual for detailed Validation Edits and Guidelines SA TEDS SUDS6 Pregnant CHAR (1) Pregnant at Admission This field indicates whether a female client was pregnant at time of admission. This field must have a valid value in Code Table for Pregnant as specified in in 7.5 Appendix A. Gender must be 2 for Female. Refer to SUDS6 data field in TEDS Manual for detailed FASAMS ITN - Record Data Model Specification Document Page 82

83 Validation Edits and Guidelines SA SA TEDS MDS14a ProblemPrimary TEDS MDS15a AdminRoutePrimary CHAR(2) CHAR(2) Substance Abuse Problem, Primary This field identifies the client s primary substance abuse problem ranked in the order of use. Route of Administration, Primary This field identifies the usual route of administration of the corresponding primary substance identified in Substance Abuse Problem (Primary, Secondary, Tertiary). This field must have a valid value in Code Table for Problem (Primary, Secondary, Tertiary) as specified in TEDS manual. Refer to MDS14a data field in TEDS Manual for valid codes and descriptions and for detailed Validation Edits and Guidelines Must have a valid value in code table for AdminRoute as specified in 7.5 Appendix A Refer to MDS15a data field in TEDS Manual for detailed Validation Edits and Guidelines SA SA SA SA TEDS MDS16a NOM TEDS MDS17a TEDS MDS14b NOM TEDS FrequencyUsePrimary AgeFirstUsePrimary ProblemSecondary AdminRouteSecondary CHAR(2) CHAR(2) CHAR(2) CHAR(2) Frequency of Use, Primary Specifies the frequency of use of the corresponding primary substance identified in Substance Abuse Problem (Primary, Secondary, Tertiary). Age at First Use, Primary For substances other than alcohol, this field identifies the age at which the client first used the substance corresponding to the Primary Substance Abuse Problem. For alcohol, this field records the age at the first intoxication. Substance Abuse Problem, Secondary See ProblemPrimary above Route of Administration, Must have valid value in code table for SaFrequencyUse, as specified in 7.5 Appendix A Refer to MDS16a data field in TEDS Manual for detailed Validation Edits and Guidelines Must have valid value in code table for AgeFirstUse as specified in 7.5 Appendix A Refer to MDS17a data field in TEDS Manual for detailed Validation Edits and Guidelines Same as ProblemPrimary above Refer to MDS14b data field in TEDS Manual for detailed Validation Edits and Guidelines Must have a valid value in code table for AdminRoute as specified COAD Admission Table Applicable Program Field Source Field Name Field Field Definition Type(Size) Field Validation FASAMS ITN - Record Data Model Specification Document Page 83

84 SA SA SA SA SA SA SA MDS15b TEDS MDS16b NOM TEDS MDS17b TEDS MDS14c NOM TEDS MDS15c TEDS MDS16c NOM FrequencyUseSecondary AgeFirstUseSecondary ProblemTertiary AdminRouteTertiary FrequencyUseTertiary TEDS MDS17c AgeFirstUseTertiary TEDS MDS19 OpioidTherapy CHAR(2) CHAR(2) CHAR(2) CHAR(2) CHAR(2) CHAR(2) CHAR (1) Secondary- See ProblemPrimary above). Frequency of Use, Secondary See ProblemPrimary above). Age at First Use, Secondary See ProblemPrimary above). Substance Abuse Problem, Tertiary See ProblemPrimary above Route of Administration, Tertiary- See ProblemPrimary above). Frequency of Use, Tertiary See ProblemPrimary above). Age at First Use, Tertiary See ProblemPrimary above). Medication-Assisted Opioid Therapy This field identifies whether the use of opioid medications such as methadone or buprenorphine is part of the client s treatment plan. in 7.5 Appendix A Refer to MDS15b data field in TEDS Manual for detailed Validation Edits and Guidelines Must have valid value in code table for SaFrequencyUse, as specified in 7.5 Appendix A Refer to MDS16b data field in TEDS Manual for detailed Validation Edits and Guidelines Must have valid value in code table for AgeFirstUse as specified in 7.5 Appendix A Refer to MDS17b data field in TEDS Manual for detailed Validation Edits and Guidelines Same as ProblemPrimary above. Refer to MDS14c data field in TEDS Manual for detailed Validation Edits and Guidelines Must have a valid value in code table for AdminRoute as specified in 7.5 Appendix A Refer to MDS15c data field in TEDS Manual for detailed Validation Edits and Guidelines Must have valid value in code table for SaFrequencyUse, as specified in 7.5 Appendix A Refer to MDS16c data field in TEDS Manual for detailed Validation Edits and Guidelines Must have valid value in code table for AgeFirstUse as specified in 7.5 Appendix A Refer to MDS17c data field in TEDS Manual for detailed Validation Edits and Guidelines This field must have a valid value in Code Table for OpioidTherapy as specified in 7.5 Appendix A. Refer to MDS19 data field in TEDS Manual for detailed Validation Edits and Guidelines FASAMS ITN - Record Data Model Specification Document Page 84

85 SA TEDS SUDS1 DrugPrimary CHAR(4) Detailed Drug Code, Primary Identifies in greater detail the drug problem recorded in This field must have a valid value in Code Table for DetailedDrugProblem as specified in TEDS manual. COAD Admission Table Applicable Program Field Source Field Name Field Type(Size) Field Definition Field Validation SA TEDS SUDS2 DrugSecondary CHAR(4) Substance Abuse Problem (Primary). Detailed drug codes enable distinction between substances in cases where a client uses two or more drugs that are assigned the same Substance Abuse Problem code. Detailed Drug Code, Secondary See DrugPrimary above Refer to SUDS1 data field in TEDS Manual for codes and descriptions and for detailed Validation Edits and Guidelines See DrugPrimary above Refer to SUDS2 data field in TEDS Manual for codes and descriptions and for detailed Validation Edits and Guidelines SA TEDS SUDS3 DrugTertiary CHAR(4) See DrugPrimary above Detailed Drug Code, Refer to SUDS3 data field in TertiarySee DrugPrimary TEDS Manual for codes and above. descriptions and for detailed Validation Edits and Guidelines SA&MH SA TEDS SUDS18 TEDS SUDS19 DiagnosisCodeId SaDiagnosis CHAR (1) CHAR(8) This field must have a valid value Diagnostic Code Set in Code Table for Identifier This field indicates DiagnosisCodeId as specified in the diagnostic code set(s) used 7.5 Appendix A. to report the Substance Abuse Diagnosis and/or Mental Health Diagnoses Refer to SUDS18 data field in (One, Two, Three) for a client. TEDS Manual for detailed Validation Edits and Guidelines Substance Abuse Diagnosis This field must have a valid value in Code Table for DiagnosisCode Enter the substance abuse as specified in the DCF Pamphlet diagnosis code for the client Appendix 8. using the code from the Refer to SUDS19 data field International Classification of in TEDS Manual for detailed Diseases (e.g., ICD-10-CM o r later version specified above Validation Edits and DiagnosisCodeId) Guidelines i FASAMS ITN - Record Data Model Specification Document Page 85

86 MH TEDS MHA1a MhDiagnosisOne CHAR(8) Mental Health Diagnosis h One Enter the mental healt Th diagnosis code for the client in is field must have a valid value using the code from the as Code Table for DiagnosisCode International Classification of 15 specified in the DCF Pamphlet 5-2 Appendix 8. Diseases (ICD-10-CM or late r fer to MHA1a data field in version specified above in Re TEDS DiagnosisIdCode). anual for detailed Validation an Edits d Guidelines MH TEDS MHA1b MhDiagnosisTwo CHAR(8) Mental Health Diagnosis Two Same as MhDiagnosisOne above. This field must have a valid value in Code Table for DiagnosisCode as specified in the DCF Pamphlet Appendix 8. Refer to MHA1b data field in TEDS Manual for detailed Validation Edits and Guidelines FASAMS ITN - Record Data Model Specification Document Page 86

87 COAD Admission Table Applicable Field Field Field Definition Program Source Field Name Type(Size) Field Substance Abuse and Mental Health Application Support MH MH MH MH MH MH TEDS MHA1c TEDS MHA2 TEDS MHA5 PAM GAA MhDiagnosisThree SmiSedStatus CgasScore Prognosis MhProblemRisk PAM GAA PAM GAA RiskFactor CHAR(8) CHAR (1) CHAR(3) CHAR(1) CHAR(1) Mental Health Diagnosis Three Same as MhDiagnosisOne above. SMI/SED Status This field indicates whether the client has serious mental illness (SMI) or serious emotional disturbance (SED) based on state s definition for these target populations Validation This field must have a valid value in Code Table for DiagnosisCode as specified in the DCF Pamphlet Appendix 8. Refer to MHA1c data field in TEDS Manual for detailed Validation Edits and Guidelines This field must have a valid value in Code Table for SmiSedStatus as specified in 7.5 Appendix A. Refer to MHA2 data field in TEDS Manual for detailed Validation Edits and Guidelines CGAS Score Specifies the Children Global Assessment The valid values for this field mus Scale (CGAS) score for be 0 through 100, or 997 for Not children and adolescents. This Applicable. field is part of the data elements used to determine Refer to MHA5 data field in TEDS whether a child has serious or Manual for detailed Validation nonserious emotional Edits and Guidelines disturbance. Prognosis Indicate if the This field must have a valid value client received services for the in Code Table for Prognosis as current mental health problem specified in 7.5 Appendix A. within the past 12 months or if the mental health problem is expected to persist for at least another 12 months Mental Health Problem Indicate if the client shows evidence of stress and/or mental health problems. This field is used as part of the algorithm to determine the state target population. Risk Factor Indicate if the child has risk factors for Emotional Disturbance (referred to Emotion Health program in conjunction with IDEA, homelessness, family history of mental illness, abuse or neglect, exposure to domestic violence, substance abuse, chronic or serious physical illness, or multiple outof-home placements). This field is used as part of the algorithm to determine the state target population. This field must have a valid value in Code Table for MhProblemRisk as specified in 7.5 Appendix A. This field must have a valid value in Code Table for RiskFactor as specified in 7.5 Appendix A. t FASAMS ITN - Record Data Model Specification Document Page 87

88 COAD Admission Table Applicable Program SA&MH SA&MH SA&MH SA&MH SA&MH SA & MH Field Source TEDS SUDS16 TEDS MHA4 PAM PAM PAM PAM Field Name Arrests LegalStatus LegalGuardian DependencyStatus CompetencyStatus DailyLivingActivity Field Field Definition Type(Size) Field CHAR(2) CHAR(2) CHAR(2) CHAR(2) CHAR(1) Arrests in Past 30 Days Indicates the number of arrests for any cause in the 30 days prior to date of admission. Legal Status at time of Admission This field identifies the client s legal status at the time of initial admission to any treatment service setting in community provider agency as well as in state psychiatric hospital. Legal Guardian - Indicate the type of legal guardianship for the child (Parent, other relative, state, etc.) Children Dependency and/or Delinquency Status Indicates the status of children who are adjudicated or nonadjudicated as dependent and/or delinquent at the time of admission into treatment. Competency Status Competent indicates the status of an individual who, at the time of admission to treatment, has not been deemed incompetent by courtorder. Incompetent indicates the status of an individual who, at the time of admission to treatment, has been deemed incompetent to proceed in a criminal proceeding, adjudicated incapacitated, or deemed incompetent by courtorder. Activities of Daily Living Functioning (ADLFC) - Indicate if the client is unable to perform independently. Validation The valid values for this field must be 00 through 96 or 97 for Unknown. Refer to SUDS16 data field in TEDS Manual for detailed Validation Edits and Guidelines This field must have a valid value in Code Table for LegalStatus as specified in 7.5 Appendix A. Refer to MHA4 data field in TEDS Manual for detailed Validation Edits and Guidelines Valid values must be in the Code Table for LegalGuardian as specified in 7.5 Appendix A. This field must have a valid value in Code Table for DependencyStatus as specified in 7.5 Appendix A. This field must have a valid value in Code Table for CompetencyStatus as specified in 7.5 Appendix A. This field must have a valid value in Code Table for DailyLivingActivity as specified in 7.5 Appendix A FASAMS ITN - Record Data Model Specification Document Page 88

89 SA&MH PAM DJJCommitment CHAR(1) Department of Juvenile Justice Commitment Indicate if the child was committed or recommitted to the Department of Juvenile Justice This field must have a valid value in Code Table for DJJCommitment COAD Admission Table Applicable Program Field Source Field Name Field Field Definition Type(Size) Field Validation SA MarchmanAct CHAR(1) PAM MH BakerAct CHAR(1) PAM MH PAM IdpPrescription CHAR(1) MH PapPrescription CHAR(1) PAM MH AntipsychoticMed CHAR(1) PAM SA&MH HealthStatus CHAR(1) PAM SA PAM DrugCourtOrder CHAR(1) SA DrugsHarmful PAM Marchman Act Status - This field must have a valid value Indicate the type of Marchman in Code Table for MarchmanAct Act admission. as specified in 7.5 Appendix A. Baker Act Status - Indicate (Yes, No) if the client meets the criteria for admission to a Baker Act receiving facility. IDP Prescription Indicate (Yes or No) if the client received medication through Indigent Drug Program (IDP) within the last 90 days. PAP Prescription - Indicate (Yes or No) if the client received atypical antipsychotic medication through the Patient Assistance Program (PAP) Antipsychotic Medication - Indicate if the client has been taking any atypical antipsychotic medication Health Status Indicate the health status of the client at the time of admission (e.g., agitated, depressed, disoriented, etc.) Must have a valid value in Code Table for BakerAct as specified in 7.5 Appendix A. Must have a valid value in Code Table for IdpPrescription as specified in 7.5 Appendix A. Must have a valid value in Code Table for PapPrescription as specified in 7.5 Appendix A. Must have a valid value in Code Table for AntipsychoticMed as specified in 7.5 Appendix A This field must have a valid value in Code Table for HealthStatus as specified in 7.5 Appendix A Drug Court - Indicate (Yes, Must have a valid value in Code No, Unknown) if the client was Table for DrugCourtOrder as Drug Court ordered to attend specified in 7.5 Appendix A SA treatment Perceive Drugs as Harmful - Indicate if the client perceives drugs as being harmful to their overall health. Must have a valid value in Code Table for DrugsHarmful as specified in 7.5 Appendix A FASAMS ITN - Record Data Model Specification Document Page 89

90 SA AlcoholHarmful PAM CHAR(1) Perceive Alcohol as Harmful - Indicate if client perceives alcohol as being harmful to their overall health Must have a valid value in Code Table for AlcoholHarmful as specified in 7.5 Appendix A SA TobaccoHarmful PAM CHAR(1) Tobacco Harmful - Indicate if client perceives tobacco as being harmful to their overall health Must have a valid value in Code Table for TobaccoHarmful as specified in 7.5 Appendix A SA TobaccoUse PAM CHAR(1) Tobacco Use - Indicate if the client uses tobacco products Must have a valid value in Code Table for TobaccoUse as specified in 7.5 Appendix A SA PostPartum PAM CHAR(1) Post-Partum Status Indicate if the client is PostPartum Must have a valid value in Code Table for PostPartum as specified in 7.5 Appendix A C OAD Admission Table Applicable Program Field Source Field Name Field Field Definition Type(Size) Field Validation SA IvHistory PAM CHAR(1) IV History Indicate if the client has a history of intravenous substance use Must have a valid value in Code Table for IvHistory as specified in 7.5 Appendix A SA PregancyTrimester PAM CHAR(1) Value Values must in the Code Pregnancy Trimester - Table for PregancyTrimester as Indicate the client s pregnancy specified in 7.5 Appendix A status at admission. Business Rules 1. TEDS Guidelines for Defining Admission to Treatment 1.1. An admission into a provider agency is the formal acceptance of a client into substance abuse and/or mental health treatment service settings. An admission has occurred if, and only if, the client begins treatment in a provider agency Service events such as initial screening, referral and placement on wait-listing, usually take place before the initial admission to treatment to determine if the client needs to be admitted into treatment or be immediately discharged. 2. Guidelines for Data Definition and Submission Frequency Unless specified otherwise, the following TEDS guidelines will be used as the standards for COAD data collection and submission 2.1. TEDS data dictionary should be used for field definitions and code values, especially for data elements that are required for TEDS reporting purposes as part of the NOMs and other Block Grants data requirements. Otherwise, PAM field definitions and code values should be used COAD data should be reported not only when a client is admitted to and discharge from a provider agency, but also periodically during this admission episode when a client changes services from one treatment service setting to another or when the client remains in the same treatment service setting for more than six months. FASAMS ITN - Record Data Model Specification Document Page 90

91 3. Guidelines for Rejecting and Accepting COAD Admission Record All fields in the COAD record are mandatory, i.e., cannot be left blank. As a result, each field in the COAD record should have the optional values to report data that are Not Available at the time of the submission or are Not Applicable to certain clients, e.g., male pregnant. The Periodic Admission Update Record should be used to capture this information when and if information is available The key fields in the COAD record, which are used by the system to uniquely identify each record must have valid values, i.e., cannot be blank or contains an invalid value. Otherwise, the record should be rejected and not processed. A fatal error message should be generated and displayed in the processing report for further correction and resubmission The non-key fields in the COAD record also cannot contain invalid values. However, if any of these non-key field is blank or contains an invalid value, the record should be processed and appended to the database. A warning error message should be generated and displayed in the processing report and the erroneous value of the data field should be replaced by the system-defined Invalid Data Code unless specified otherwise. This business rule will provide the capability to account not only for all records submitted with and without errors, but also for erroneous records that were and were not corrected and resubmitted At the minimum, the processing report should include summary data showing: (1) the number of records submitted, accepted, and rejected; (2) the number of records rejected with fatal errors, (3) the number of non-fatal errors processed and appended to the database with warning messages, and (4) the number of discharge records with missing the corresponding admission records. 4. Guidelines for Adding, Changing and Deleting COAD Records 4.1. The COAD record should have a key field for System Transaction Type code to Delete, Add, and Change records If the key fields of an Add record match the key fields of an existing record, the Add record should be rejected as a duplicate and a warning error will be generated in the processing report The key fields of Change or Delete record must match the key fields of an existing record; otherwise, the record should be rejected and not processed and a warning error will be generated in the processing report COAD records should be processed sequentially starting with Delete records by removing existing records from the database; then the Add records, which contains valid values for all data fields, should be appended to the database and, finally, the Change record should be processed to replace existing records with matching key fields. 5. Minimum Data Set for COAD Admission Record All fields in the admission records should be reported regardless of the client transaction type (purpose). However, the field values to be reported largely depend on Applicable Program and whether or not the client has Co-Occurring substance abuse or mental health problem as follows. If CoOccurring = 1 (Yes), then the client s admission record must include the required data fields for MH program and for SA program. FASAMS ITN - Record Data Model Specification Document Page 91

92 If CoOccurring = 2 (No) and ProgramArea = 1 or 3 (AMH or CMH), then the client s admission record must include the required data fields for MH program only. In this case, all SA fields should be coded as Not Applicable. If CoOccurring = 2 (No) and ProgramArea = 2 or 4 (ASA or CSA), then the client s admission record must include the required data fields for SA program only. In this case, all MH fields should be coded as Not Applicable COAD Discharge Record Note: The column labelled Applicable Program shows data fields that are applicable to SA admission record or MH admission record or both. The column labelled Field Source reflects data fields currently required either in PAM (DCF Pamphlet 155-2) or by TEDS as part of the minimum data set (DIS or MHD) for substance abuse and mental health discharge record. This column also indicates which data fields are currently used for reporting the National Outcome Measures (NOM), as well as the performance outcome measures required by the Legislature as part of the General Appropriation act (GAA). The column labelled Field Name shows Key fields, which are used to uniquely identify each discharge record. COAD Discharge Record Applicable Program Field Source Field Name Field Type(Size) Field Definition Field Validation SA&MH SA&MH TEDS DIS1 TEDS DIS14 SystemTransaction (KEY) ClientTransaction (KEY) CHAR(1) System Transaction Type - This field identifies the appropriate action that needs to be undertaken, that is, whether the record is added to the database, changes (by replacement) an existing record in the database, or deletes an existing record from the database Client Transaction Type (Purpose) at Discharge Indicates whether a record represents one of the following purposes for submitting the COAD discharge record: (4) Discharge from Provider Agency, (5) Transfer Discharge from Treatment Setting, 6) Immediate Discharge from Provider Agency Must have a valid value in the Code Table for SystemTransaction. Refer to DIS1 data field in TEDS Manual for detailed Validation Edits and Guidelines. This field must have a valid value in the Code Table for ClientTransaction. Refer to DIS14 data field in TEDS Manual for detailed Validation Edits and Guidelines. FASAMS ITN - Record Data Model Specification Document Page 92

93 SA&MH SA&MH PAM ContractorId (KEY) TEDS DIS4 ProviderId (KEY) CHAR(10) CHAR(10) Contractor ID Indicates the Federal Employer Identification Must exist in COAD Admission Number (FEIN) of the entity Record that either holds a contract with DCF to provide SAMH services in community or in state treatment facility or is owned and operated by DCF (e.g., state treatment facility). Provider ID Indicates the Federal Employer Identification Number (FEIN) of the entity that either holds a contract with DCF to provide SAMH services in community or in state treatment facility or is owned and operated by DCF (e.g., state treatment facility). Must exist in COAD Admission Record SA&MH TEDS DIS5 UniqueClientId (KEY) CHAR(10) Unique Client Identifier Specifies the unique client Identifier of the person receiving treatment as reported in the demographic record. Must exist in COAD Admission Record Refer to DIS5 data field in TEDS Manual for detailed Validation Edits and Guidelines SA&MH PAM GAA ProgramArea (KEY) CHAR(1) Program Area - indicates the program area in which the client is being admitted. Must exist in COAD Admission Record This field must have a valid value in the Code Table for ProgramArea as COAD Discharge Record Applicable Program Field Source Field Name Field Type(Size) Field Definition Field Validation specified in 7.5 Appendix A and must exist in SubContract table. FASAMS ITN - Record Data Model Specification Document Page 93

94 If TransactionType = 4 or 5, AdmissionDate must exist in the corresponding Initial Admission Record SA&MH TEDS DIS15 AdmissionDate (KEY) DATE(10) Admission Date Indicate the date when the client was initially admitted into the provider agency for treatment or when the client was assessed/evaluated to determine the immediate discharge from the provider agency. If TransactionType = 6, AdmissionDate must be the date when the client was assessed/evaluated to determine the immediate discharge from the provider agency Admission Date must be within Fiscal Year in the Subcontract table. Refer to DIS15 data field in TEDS Manual for detailed Validation Edits and Guidelines SA&MH SA&MH SA&MH TEDS MDS5 TxBeginDate KEY TEDS DIS7 TxServiceSetting (KEY) TEDS MDS5 TxEndDate KEY DATE(10) CHAR(2) DATE(10) Treatment Beginning Date Indicate the date when the client actually started receiving services in the treatment service setting, either as par after admission into provider agency Type of Treatment Service/Setting - This field describes the type of treatment service or treatment setting in which the client is placed at the time of discharge. Treatment End Date Indicate the date when the client actually ended receiving services in the treatment service setting If TransactionType = 4 or 5, TxBeginDate must exist in the corresponding Admission Record If TransactionType = 6, TxBeginDate must be the date when the client was assessed/evaluated to determine the immediate discharge from the provider agency If TransactionType = 4 or 5, TxServiceSetting must exist in the corresponding Admission Record If TransactionType = 6, TxServiceSetting must be the setting in which the client was assessed/evaluated to determine the immediate discharge from the provider agency. This field must have a valid value in the Code Table for TxServiceSetting as specified in 4.5 Appendix D. Must be >= AdmissionDate SA&MH DischargeDate TEDS DIS9 (KEY) DATE(10) Date of Discharge Indicate the date when the client was discharged from the provider agency of from a treatment service setting. If ClientTransaction = 4, then this is the date when the client Must be a valid calendar date that is >= AdmissionDate Refer to DIS9 data field in TEDS Manual for detailed Validation Edits and Guidelines COAD Discharge Record FASAMS ITN - Record Data Model Specification Document Page 94

95 Applicable Program SA&MH Field Source Field Name TEDS DIS6 Codependent Field Type(Size) CHAR(1) Field Definition was discharged from the provider agency. If ClientTransaction = 5, then this is the date when the client was discharged from a treatment service setting and transferred to another within the provider agency. If ClientTransaction = 6, then this is the date when the client was immediately discharged from the provider agency. Codependent/Collateral- Indicates whether treatment is for a primary substance abuse problem or arises from the client s relationship with someone with a substance abuse problem. For mental health client, use code value for Client. Field Validation This field must have a valid value in Code Table for Codependent as specified in 7.5 Appendix A. Refer to DIS6 data field in TEDS Manual for detailed Validation Edits and Guidelines Note: This field is part of the KEY fields in the submission of TEDS records. SA&MH SA&MH TEDS DIS8 LastContactDate DATE(10) TEDS DIS10 DischargeReason CHAR(2) Date of Last Contact or Data Update. Indicate (a) the date of a client s last treatment service, or (b) the most recent date when a client's record was updated, depending on the type of record submitted. If a discharge record, this field is interpreted as Date of Last Contact. If a Periodic Update record, this field is interpreted as Date of Data Update. Reason for Discharge, Transfer, or Discontinuance of Treatment - This field indicates the outcome of the treatment episode/event or the reason for transfer or discontinuance of treatment. Must be a valid calendar date that is <= DischargeDate Refer to DIS8 data field in TEDS Manual for detailed Validation Edits and Guidelines This field is used as the key for submission of TEDS discharge record Must be a valid code value in the Code Table for DischargeReason as specified in 7.5 Appendix A Refer to DIS10 data field in TEDS Manual for detailed Validation Edits and Guidelines SA&MH Related to DIS7 GAA AssessmentType CHAR(1) Level of Care Assessment Type Indicates the type of clinical instrument, i.e., ASAM or LOCUS, used for assessing the client s level of care at the time of discharge. This field must have a valid value in Code Table for AssessmentType as specified in 7.5 Appendix A. FASAMS ITN - Record Data Model Specification Document Page 95

96 SA&MH Related to DIS7 GAA AssessmentDate CHAR(10) Level of Care Assessment Date Indicates the date when the last assessment was made to determine the level of care for the client being discharged. This field must have a valid calendar date that is <= DischargeDate Applicable Program SA&MH SA&MH SA&MH MH MH SA&MH Field Source Related to DIS7 GAA TEDS MHD5 NOM TEDS MHD4 NOM PAM GAA PAM GAA TEDS DIS24 NOM Field Name LevelOfCare Education SchoolAttendance SchoolDaysAvailable SchoolDaysAttended EmploymentStatus COAD Discharge Record Field Type(Size) CHAR(2) CHAR(2) CHAR (1) CHAR (2) CHAR (2) CHAR(2) Field Definition Field Level of Care Indicates the level of care from which the client is being discharged. Education - This field specifies either the highest school grade completed for adults or children not attending school or the current school grade for schoolage children (3-17 years old) attending school. School Attendance Status (at discharge) - This field specifies the school attendance status of school age children and adolescents (3-17 years old), including young adults (18-21 years old) who are protected under the Individuals with Disabilities Education Act (IDEA), receiving mental health services. Validation This field must have a valid value in the Code Table for LevelOfCare as specified in 6.5 Appendix A. This field must have a valid value in Code Table for Education as specified in 7.5 Appendix A. Refer to MHD5 data field in TEDS Manual for detailed Validation Edits and Guidelines This field must have a valid value in Code Table for SchoolAttendance as specified in 7.5 Appendix A. Refer to MHD4 data field in TEDS Manual for detailed Validation Edits and Guidelines School Days Available (at discharge) - Indicate the The valid value is 0 through 90 if number of school days SchoolAttendance is 1 for Yes. available within the last 90 days Enter 99 for Not Applicable (SA) of discharge School Days Attended (at discharge) - Indicate the number of school days attended within the last 90 days Employment Status at Discharge Indicates the employment status of the client at the time of discharge from provider agency or as part of the discharge transfer from treatment service setting and admission into another The valid value is 0 through 90 if SchoolAttendance is 1 for Yes and SchoolDaysAvailable is 0 thru 30. Enter 99 for Not Applicable (SA) This field must have a valid value in Code Table for EmploymentStatus as specified in TEDS manual. Refer to DIS24 data field in TEDS Manual for codes and descriptions and for detailed Validation Edits and Guidelines FASAMS ITN - Record Data Model Specification Document Page 96

97 SA&MH TEDS DIS25 NOM LaborForceDetails CHAR(2) Detailed for Not Being In Labor Force at Discharge - Provides more detailed information about those clients who are coded as 04 Not in labor force in Employment Status. This field must have a valid value in Code Table for LaborForceDetails. Refer to DIS25 data field in TEDS Manual for detailed Validation Edits and Guidelines MH PAM GAA DaysWorked CHAR(2) Days Worked (at discharge) - Indicate the number of days the client worked for pay, including paid leave, within the last 30 days. Valid Values must be 0 through 30 and if Employment Status is not 04 (not in labor force) MH PAM GAA DaysInCommunity CHAR(2) Days in Community (at discharge) - Indicate the number of days the client spent Valid value is 0 thru 30 or 96 for Not Applicable (SA) COAD Discharge Record Applicable Program Field Source Field Name Field Type(Size) Field Definition Field Validation in the community within the last 30 days MH PAM GAA DisabilityIncome CHAR(1) Disability Income Status (at This field must have a valid value in discharge) - Indicate whether or Code Table for DisabilityIncome as not the client is receiving specified in 7.5 Appendix A. disability income for a psychiatric condition SA&MH TEDS DIS23 NOM LivingArrangement CHAR(2) Living Arrangements at Discharge- Identifies whether the client is homeless, a dependent (living with parents or in a supervised setting), or living independently on his or her own This field must have a valid value in Code Table for LivingArrangement as specified in TEDS manual. Refer to DIS23 data field in TEDS Manual for codes and descriptions and for detailed Validation Edits and Guidelines SA&MH PAM GAA CountyOfResidence CHAR(2) County of Residence at Discharge- Indicates the Florida county in which the client resides at the time of Valid entry must be a Florida discharge. If unknown, enter county code, i.e., 01 thru 67 the county of the provider site where the client is being admitted FASAMS ITN - Record Data Model Specification Document Page 97

98 SA&MH SA SA TEDS DIS27 NOM TEDS DIS21a NOM TEDS DIS22a NOM SelfHelpAttendance ProblemPrimary FrequencyUsePrimary CHAR(2) CHAR(2) CHAR(2) Attendance at SA Self-Help Groups in Past 30 Days Discharge - Indicates the frequency of attendance at a substance abuse self-help group in the 30 days prior to the date of admission. It includes attendance at Alcoholics Anonymous (AA), Narcotics Anonymous (NA), and other self- help/mutual support groups focused on recovery from substance abuse and dependence Substance Abuse Problem at Discharge Primary - This field identifies the client s primary substance abuse problem ranked in the order of use. Frequency of Use at Discharge Primary - Specifies the frequency of use of the corresponding primary substance identified in Substance Abuse Problem (Primary, Secondary, Tertiary). This field must have a valid value in Code Table for SelfHelpAttendance as specified in 7.5 Appendix A Refer to DIS27 data field in TEDS Manual for detailed Validation Edits and Guidelines This field must have a valid value in Code Table for SubtanceProblem (Primary, Secondary, Tertiary) as specified in TEDS manual. Refer to DIS21a data field in TEDS Manual for codes and descriptions and for detailed Validation Edits and Guidelines Must have valid value in code table for SaFrequencyUse, as specified in 7.5 Appendix A Refer to DIS22a data field in TEDS Manual for detailed Validation Edits and Guidelines COAD Discharge Record Applicable Program Field Source Field Name Field Type(Size) Field Definition Field Validation SA SA PAM PAM AdminRoutePrimary AgeFirstUsePrimary CHAR(2) Route of Administration at discharge, Primary This field identifies the usual route of administration of the corresponding primary substance identified in Substance Abuse Problem (Primary, Secondary, Tertiary). CHAR(2) Age at First Use, Primary For substances other than alcohol, this field identifies the age at which the client first used the substance corresponding to the Primary Substance Abuse Problem. For alcohol, this field records the age at the first intoxication. Must have a valid value in code table for AdminRoute as specified in 7.5 Appendix A Must have valid value in code table for AgeFirstUse as specified in 7.5 Appendix A FASAMS ITN - Record Data Model Specification Document Page 98

99 SA SA TEDS DIS21b NOM TEDS DIS22b NOM SA PAM SA SA SA ProblemSecondary FrequencyUseSecond AdminRouteSecond PAM AgeFirstUseSecond TEDS DIS21c NOM TEDS DIS22c NOM ProblemTertiary FrequencyUseTertiary CHAR(2) CHAR(2) CHAR(2) CHAR(2) CHAR(2) CHAR(2) Substance Abuse Problem at Discharge Secondary See ProblemPrimary above Frequency of Use at Discharge Secondary - See ProblemPrimary above Route of Administration, Secondary- See ProblemPrimary above Same as ProblemPrimary above Refer to DIS21b data field in TEDS Manual for detailed Validation Edits and Guidelines Must have valid value in code table for SaFrequencyUse, as specified in 7.5 Appendix A Refer to DIS22b data field in TEDS Manual for detailed Validation Edits and Guidelines Must have a valid value in code table for AdminRoute as specified in 7.5 Appendix A Must have valid value in code table Age at First Use, Secondary for AgeFirstUse as specified in 7.5 See ProblemPrimary above Appendix A Substance Abuse Problem at Discharge Tertiary - See ProblemPrimary above Frequency of Use at Discharge Tertiary - See ProblemPrimary above Same as ProblemPrimary above. Refer to DIS21c data field in TEDS Manual for detailed Validation Edits and Guidelines Must have valid value in code table for SaFrequencyUse, as specified in 7.5 Appendix A Refer to DIS22c data field in TEDS Manual for detailed Validation Edits and Guidelines SA PAM AdminRouteTertiary CHAR(2) Route of Administration, Tertiary- See ProblemPrimary Must have a valid value in code table for AdminRoute as specified in COAD Discharge Record Applicable Program Field Source Field Name Field Type(Size) Field Definition Field Validation above 7.5 Appendix A SA PAM AgeFirstUseTertiary CHAR(2) Age at First Use, Tertiary See ProblemPrimary above Must have valid value in code table for AgeFirstUse as specified in 7.5 Appendix A FASAMS ITN - Record Data Model Specification Document Page 99

100 SA&MH SA MH MH TEDS MHD1 PAM GAA TEDS MHD2a GAA TEDS MHD2b GAA DiagnosisId SaDiagnosis MhDiagnosisOne MhDiagnosisTwo CHAR (1) CHAR(8) CHAR(8) CHAR(8) Diagnostic Code Set Identifier - This field indicates the diagnostic code set(s) used to report the Substance Abuse Diagnosis and/or Mental Health Diagnoses (One, Two, Three) for a client. Substance Abuse Diagnosis Enter the substance abuse diagnosis code for the client using the code from the International Classification of Diseases (e.g., ICD-10-CM or later version specified above in DiagnosisIdCode) While a three-character code with no decimal or following digits will be accepted, more complete diagnoses have at least one digit to the right of the decimal. Mental Health Diagnosis One - Enter the mental health diagnosis code for the client using the code from the International Classification of Diseases (ICD-10-CM or later version specified above in DiagnosisIdCode). While a three-character code with no decimal or following digits will be accepted, more complete diagnoses have at least one digit to the right of the decimal. Mental Health Diagnosis Two Same as MhDiagnosisOne above. This field must have a valid value in Code Table for DiagnosisIdCode Refer to MHD1 data field in TEDS Manual for detailed Validation Edits and Guidelines This field must have a valid value in Code Table for DiagnosisCode (e.g., Refer to Appendix 8 in PAM 155-2). Refer to SUDS19 data field in TEDS Manual for detailed Validation Edits and Guidelines This field must have a valid value in Code Table for DiagnosisCode (e.g., Refer to Appendix 8 in PAM 155-2). Refer to MHD2a data field in TEDS Manual for detailed Validation Edits and Guidelines Same as MhDiagnosisOne above. Refer to MHD2b data field in TEDS Manual for detailed Validation Edits and Guidelines MH TEDS MHD2c GAA MhDiagnosisThree CHAR(8) Mental Health Diagnosis Three - Same as MhDiagnosisOne above. Same as MhDiagnosisOne above. Refer to MHD2c data field in TEDS Manual for detailed Validation Edits and Guidelines MH SmiSedStatus CHAR (1) SMI/SED Status - This field indicates whether the client has This field must have a valid value in Code Table for SmiSedStatus as COAD Discharge Record FASAMS ITN - Record Data Model Specification Document Page 100

101 Applicable Program Field Source Field Name Field Type(Size) Field Definition Field Validation TEDS MHD3 GAA serious mental illness (SMI) or serious emotional disturbance (SED) using the state s definition for these target populations specified in 7.5 Appendix A Refer to MHD3 data field in TEDS Manual for detailed Validation Edits and Guidelines MH MH MH MH TEDS MHD6 GAA CgasScore PAM MHPrognosis GAA PAM GAA MhProblemRisk PAM GAA TEDS DIS26 NOM RiskFactor Arrests CHAR(3) CHAR(1) CHAR(1) CHAR(2) CGAS Score - Specifies the The valid values for this field must Children Global Assessment be 0 through 100, or 997 for Not Scale (CGAS) score for children Applicable. and adolescents. This field is Refer to MHD6 data field in TEDS part of the data elements used Manual for detailed Validation Edits to determine whether a child has and Guidelines serious or non-serious emotional disturbance. Prognosis - Indicate if the client received services for the current mental health problem within the past 12 months or if the mental health problem is expected to persist for at least another 12 months Mental Health Problem - Indicate if the client shows evidence of stress and/or mental health problems Risk Factor - Indicate if the child has risk factors for Emotional Disturbance (referred to Emotion Health program in conjunction with IDEA, homelessness, family history of mental illness, abuse or neglect, exposure to domestic violence, substance abuse, chronic or serious physical illness, or multiple outof-home placements). Arrests in Past 30 Days at Discharge Indicates the number of arrests for any cause in the 30 days prior to date of admission. This field must have a valid value in Code Table for MHPrognosis as specified in 7.5 Appendix A This field must have a valid value in Code Table for MhProblemRisk as specified in 7.5 Appendix A This field must have a valid value in Code Table for RiskFactor as specified in 7.5 Appendix A The valid values for this field must be 00 through 96 or 97 for Unknown. Refer to DIS26 data field in TEDS Manual for detailed Validation Edits and Guidelines SA&MH FASAMS ITN - Record Data Model Specification Document Page 101

102 SA SA Pregnancy Trimester at Value Values must in the Code PregancyTrimester CHAR(1) Discharge - Indicate the client s Table for PregancyTrimester as pregnancy status at the time of specified in 7.5 Appendix A discharge. PAM BirthOutcome PAM CHAR(1) Pregnancy Outcome at Valid values must be in the code Applicable Program SA SA SA Field Source PAM PAM PAM Field Name DrugFreeStatus DrugsHarmful AlcoholHarmful COAD Discharge Record Field Type(Size) CHAR(1) CHAR(1) SA PAM TobaccoHarmful CHAR(1) Field Definition Field Discharge - Indicate the birth outcome for a client that was pregnant within the admission and discharge dates Drug Free Status at Discharge Indicate whether the client was drug free at time of delivery if the client was pregnant at any time during the episode of care Perceive Drugs as Harmful at discharge - Indicate if the client perceives drugs as being harmful to their overall health. Perceive Alcohol as Harmful at discharge - Indicate if client perceives alcohol as being harmful to their overall health Perceive Tobacco as Harmful at discharge - Indicate if client perceives tobacco as being harmful to their overall health Validation table for BirthOutcome as specified in 7.5 Appendix A Valid values must be in the code table for DrugFreeStatus as specified in 7.5 Appendix A Valid values must be in the code table for DrugsHarmful as specified in 7.5 Appendix A Valid values must be in the code table for AlcoholHarmful as specified in 7.5 Appendix A Valid values must be in the code table for TobaccoHarmful as specified in 7.5 Appendix A SA TobaccoUse PAM FutureDrugsUse SA PAM FriendsUseDrugs SA PAM HealthStatus SA&MH PAM CHAR(1) CHAR(1) Tobacco Use - Indicate if the client uses tobacco products Future Usage of Drug and Alcohol- Indicate if the client s intention is to use drugs or alcohol in the future. CHAR(1) Friend Usage of Substance - Indicate if the client s friends engage in underage drinking or use of drugs or tobacco. CHAR(1) Health Status at Discharge Indicate the health status of the client at the time of admission (e.g., agitated, depressed, disoriented, etc.) Must have a valid value in Code Table for TobaccoUse as specified in 7.5 Appendix A Must have a valid value in Code Table for FutureDrugsUse as specified in 7.5 Appendix A Must have a valid value in Code Table for FriendsUseDrugs as specified in 7.5 Appendix A This field must have a valid value in Code Table for HealthStatus as specified in 7.5 Appendix A FASAMS ITN - Record Data Model Specification Document Page 102

103 Business Rules 1. Guidelines for Data Definition and Submission Frequency Same as Coad Admission Record 2. Guidelines for Rejecting and Accepting COAD Discharge Record. Same as Coad Admission Record 3. Guidelines for Adding, Changing and Deleting COAD Records Same as Coad Admission Record 4. Minimum Data Set for COAD Discharge Record If TransactionType = 6 (Immediate Discharge), then only the Key fields should be reported. If TransactionType = 4 or 5, then all the fields in the discharge records should be reported. However, the field values to be reported largely depend on Applicable Program and whether or not the client has Co-Occurring substance abuse or mental health problem as follows. o If CoOccurring = 1 (Yes), then the client s discharge record must include the required data fields for MH program and for SA program. o If CoOccurring = 2 (No) and ProgramArea = 1 or 3 (AMH or CMH), then the client s discharge record must include the required data fields for MH program only. In this case, all SA fields should be coded as Not Applicable. o If CoOccurring = 2 (No) and ProgramArea = 2 or 4 (ASA or CSA), then the client s discharge record must include the required data fields for SA program only. In this case, all MH fields should be coded as Not Applicable FASAMS ITN - Record Data Model Specification Document Page 103

104 6.3.3 COAD Diagnosis Record COAD Diagnosis Table Applicabl e Program Field Source Field Name Field Type(Size) Field Definition Field Validation SA&MH TEDS SDS 1 SystemTransaction (KEY) (CHAR(1) System Transaction Type - This field identifies the appropriate action that needs to be undertaken, that is, whether the record is added to the database, changes (by replacement) an existing record in the database, or deletes an existing record from the database Must have a valid value in the Code Table for SystemTransaction SA&MH TEDS MDS4 ClientTransaction (KEY) CHAR(1) Client Transaction Type (Purpose) Indicates whether a record represents one of the following purposes for submitting the COAD diagnosis record: (1) Initial Admission, (2) Transfer Admission, (3) Periodic Update, (4) Discharge from Provider Agency, (5) Transfer Discharge, and (6) Immediate Discharge. This field must have a valid value in the Code Table for ClientTransaction. Refer to MDS4 data field in TEDS Manual for detailed Validation Edits and Guidelines. SA&MH SA&MH PAM ContractorId (KEY) TEDS MDS1 ProviderId (KEY) CHAR(10) CHAR(10) Contractor ID Indicates the Federal Employer Identification Number (FEIN) Must exist in COAD of the entity that either holds a contract Admission record or with DCF to provide SAMH services in COAD Discharge record community or in state treatment facility or is owned and operated by DCF (e.g., state treatment facility). Provider ID Indicates the Federal Employer Identification Number (FEIN) Must exist in COAD of the entity that either holds a contract Admission record or with DCF to provide SAMH services in COAD Discharge record community or in state treatment facility or is owned and operated by DCF (e.g., state treatment facility). SA&MH TEDS MDS2 UniqueClientId (KEY) CHAR(10) Unique Client Identifier Specifies the unique client Identifier of the person receiving treatment as reported in the demographic record. Must exist in COAD Admission record or COAD Discharge record SA&MH PAM GAA ProgramArea (KEY) CHAR(1) Program Area indicates the program area in which the client is being admitted. Must exist in COAD Admission record or COAD Discharge record FASAMS ITN - Record Data Model Specification Document Page 104

105 SA&MH TEDS MDS5 AdmissionDate (KEY) DATE(10) Date of Admission Indicates the date when the client was initially admitted into the provider agency. Must exist in COAD Admission record or COAD Discharge record Applicabl e Program SA&MH Field Source TEDS MDS18 Field Name TxServiceSetting (KEY) COAD Diagnosis Table Field Type(Size) Field Definition CHAR(2) If ClientTransaction = 6, this is the date when the client was initially assessed/evaluated by the provider to determine if the client needs to be admitted into treatment or be immediately discharged. Type of Treatment Service/Setting This field describes the type of treatment service or treatment setting in which the client was assessed/evaluated is placed at the time of admission or transfer. Field Validation This field must have a valid value in the Code Table for TxServiceSetting. Must exist in COAD Admission record or COAD Discharge record If TransactionType = 1 or 2 or 3, TxBeginDate must exist in the corresponding Admission Record SA&MH SA&MH SA&MH TEDS MDS5 PAM GAA PAM GAA TxBeginDate KEY ContractNumber SubContractNumber DATE(10) CHAR(5) CHAR(5) If TransactionType = 4 or 5 Treatment Beginning Date Indicate TxBeginDate must exist in the date when the client actually started the corresponding Discharge receiving services in the Record treatment service setting, either as par after admission into provider agency If TransactionType = 6, TxBeginDate must be the date when the client was assessed/evaluated to determine the immediate discharge from the provider agency Contract Number Indicates the number of the contract between the Department and the contracting entity, e.g., Managing Entity. Subcontract Number Indicates the number of the subcontract between the service provider and the Managing Entity to provide services. Must exist in COAD Admission record or COAD Discharge record Must exist in COAD Admission record or COAD Discharge record Note: this field must be valid for ProviderId. FASAMS ITN - Record Data Model Specification Document Page 105

106 SA&MH SA&MH TEDS SUDS18 TEDS SUDS19 MHA1a DiagnosisId DiagnosisCode CHAR (1) CHAR(8) This field must have a valid Diagnostic Code Set Identifier This value in Code Table for field indicates the diagnostic code set(s) DiagnosisIdCode used to report the Substance Abuse Refer to SUDS18 data field in Diagnosis and/or Mental Health TEDS Manual for detailed Diagnoses for a client. Validation Edits and Guidelines Diagnosis Code Indicate the diagnosis code for the client using the This field must have a valid value in Code Table for DiagnosisCode (e.g., Refer to Appendix 8 in PAM 155-2). Applicabl Field e Program Source SA&MH SA&MH PAM PAM Field Name COAD Diagnosis Table Field Type(Size) DiagnosisBeginDate DATE(10) DiagnosisEndDate DATE(10) Field Definition Field code from the International Classification of Diseases (e.g., ICD10- CM or later version specified above in DiagnosisId. If ProgramArea = 1 or 3 (MH), enter a MH diagnosis. If ProgramArea = 2 or 4 (SA), enter Sa Diagnosis. While a three-character code with no decimal or following digits will be accepted, more complete diagnoses have at least one digit to the right of the decimal. Diagnosis Beginning Date Indicate the date when it was determined that the client had the diagnosis Diagnosis End Date Indicate the date when it was determined that the client no longer had the diagnosis Validation Refer to SUDS19, MHA1a, data field in TEDS Manual for detailed Validation Edits and Guidelines Must be a valid calendar date Must be a valid calendar date or blank 6.4 Data Flow Diagram FASAMS Data FASAMS Data Service Providers Results Managing Entities Results FASAMS FASAMS ITN - Record Data Model Specification Document Page 106

107 --- OR --- FASAMS Data Service Providers Results FASAMS 6.5 Business Process Mapping Diagram This diagram describes the processes based on TEDS guidelines for collecting and submitting the COAD records when the client enters a provider agency and one of the following happens: (a) the client is immediately discharged from the provider agency; (b) the client is initially admitted to treatment service settings within the provider agency; (c) after the initial admission, the client changes services and is transferred to and discharged from other treatment service settings; (d) the client continues to receive services in the same treatment services/settings for more than six months and the COAD data need to be updated; and (e) the client is finally discharged from the provider agency. FASAMS ITN - Record Data Model Specification Document Page 107

108 6.5 Appendix A: COAD Code Table COAD Code Table Field Name Code Description MarchManAct 1 Involuntary Assessment 2 Involuntary Treatment 3 Involuntary Assessment and Treatment 6 Not applicable 7 Unknown BakerAct 1 Yes, Involuntary Examinations thru Court 2 Yes, Involuntary Examinations thru Law Enforcement FASAMS ITN - Record Data Model Specification Document Page 108

109 3 Yes, Involuntary Examinations thru MH Professionals 6 Not applicable 7 Unknown AntipsychoticMed 0 No 1 Yes 6 Not applicable 7 Unknown ClientTransaction 1 Initial Admission to Provider Agency 2 Transfer Admission to Treatment Service Setting 3 Periodic Data Update 4 Discharge from Provider Agency 5 Transfer Discharge from Treatment Setting 6 Immediate Discharge from Provider Agency CoOccurring 1 YES Client has co-occurring substance abuse and mental health problems 2 No Client does not have co-occurring substance abuse and mental health problems DischargeReason 01 Treatment completed 02 Dropped out of treatment (lost contact, administrative discharge, left against medical advice, eloped, failed to return from leave, and client choice) 03 Terminated by facility 04 Transferred to another treatment program or facility 14 Transferred to another treatment program but client is no show 05 Incarcerated or released by or to courts 06 Death COAD Code Table Field Name Code Description 07 Other (includes aging out of the children's MH system, extended placement (conditional release), immediate discharge, and all other reasons) 24 Transferred to another treatment program or facility that is not in the SSA or SMHA reporting system 34 Discharged temporarily to an acute medical facility for medical services (MH only) 96 Not applicable FASAMS ITN - Record Data Model Specification Document Page 109

110 97 Unknown LegalStatus 01 Voluntary-self 02 Voluntary-others (parents, guardians, etc) 03 Involuntary-civil 04 Involuntary-criminal 05 Involuntary-juvenile justice 06 Involuntary-civil, sexual 96 Not applicable 97 Unknown SystemTransaction A Add a new record to the database SelfHelpAttendance 01 No attendance DisabilityIncome 1 Yes C D Change (by replacement) an existing record in the database Delete an existing record from the database 02 Less than once a week - 1 to 3 times in the past 30 days 03 About once a week - 4 to 7 times in the past 30 days 04 2 to 3 times per week times in the past 30 days 05 At least 4 times a week 16 to 30 times in past 30 days 06 Some attendance Number of times and frequency is unknown 97 Unknown 99 Not Applicable (MH) 2 No 6 Not Applicable FamilyIncome 00 No Income Income from 01 thru Income Over $95, Unknown Income COAD Code Table Field Name Code Description 99 Not Applicable MhProblemRisk 0 None FASAMS ITN - Record Data Model Specification Document Page 110

111 1 Shows evidence of recent severe stressful event and problems with coping; 2 Displays symptomatology placing person at risk of more restrictive intervention if untreated; 3 Both 1 and 2 6 Not Applicable 7 Unknown SchoolAttendance 1 Yes, client has attended school at any time in the past 3 months 2 No, client has not attended school at any time in the past 3 months 6 Not applicable 7 Unknown LegalGuardian 1 Parent 2 Other Relative 3 Non-relative DJJCommitment 0 No 4 Emancipated minor 5 State or public agency 6 Not Applicable 1 Yes DrugsHarmful 0 No Yes 3 Unknown AlcoholHarmful 0 No 6 Not Applicable (MH) 1 Yes 3 Unknown TobaccoHarmful 0 No 6 Not Applicable (MH) 1 Yes 3 Unknown TobaccoUse 0 No 6 Not Applicable (MH) FASAMS ITN - Record Data Model Specification Document Page 111

112 COAD Code Table Field Name Code Description 1 Yes 3 Unknown FriendsUseDrugs 0 No 6 Not Applicable (MH) 1 Yes 3 Unknown 6 Not Applicable (MH) FutureDrugsUse 1 No past experimentation or use and no future intent 2 No past experimentation or use but expresses future use 3 Past experimentation or use but no further intent 4 Past experimentation or use and expresses future intent 5 Currently experiments or uses substance 6 Not Applicable (MH) VeteranStatus 1 Veteran 2 Not a Veteran 7 Unknown 01 State/Federal Court CrimJustReferral 02 Other Court (Other than state or federal) 03 Probation/Parole 04 Other Recognized Legal Entity, e.g., local law enforcement agency, correction agency, youth services, review board/agency 05 Diversionary Program, e.g., TASC 06 Prison 07 DUI/DWI 08 Other 96 Not Applicable use this code if Referral Source is not Unknown Dependency 01 Children Adjudicated as Delinquent, in physical custody - A delinquent youth in the physical custody of the Department of Juvenile Justice, who is either committed to a Juvenile Justice facility, e.g., training school, group treatment home, halfway FASAMS ITN - Record Data Model Specification Document Page 112

113 02 Children Adjudicated as Delinquent, not in physical custody - A delinquent youth placed on community control or in a Juvenile Justice non-residential commitment program, e.g., Special Intensive Group (SIG), day treatment or Juvenile Alternatives Services COAD Code Table Field Name Code Description Programs (JASP) 03 Children Adjudicated as Dependent, in physical custody - A dependent child in the physical custody of the Department of Children and Families; including children in foster care, temporary placement in an emergency shelter or residing in a CSU. 04 Children Adjudicated as Dependent, not in physical custody - A dependent child is a person that remains in his/her home, and who is under protective services supervision. 05 Children Adjudicated as Dependent & Delinquent, in physical custody - The child meets the conditions of codes 01 and 03 above 06 Children Adjudicated as Dependent & Delinquent, not in physical custody - The child meets the conditions of codes 02 and 04 above 07 Children Adjudicated as Children in Need of Services (CINS), not in physical custody - A child is in need of services and there is no pending departmental investigation into an allegation of suspicion of abuse, neglect or delinquent, or no current supervision by the department for adjudication for dependency or delinquency. The child must also be found by the court to be a persistent runaway, habitual truant, or to have persistently disobeyed the reasonable and lawful demands of parent or legal guardians, pursuant to Chapter 39, F.S. 08 Non-Adjudicated Children under other DCF Program Status 09 Non-Adjudicated Children under custody & supervision of family relatives or guardian 96 Not Applicable 97 Unknown CompetencyStatus The client is not under the jurisdiction of the court and is not involved in criminal justice system FASAMS ITN - Record Data Model Specification Document Page 113

114 The client is deemed by the court to be competent to proceed in criminal offenses and is not adjudicated "Not Guilty by Reason of Insanity" The client is adjudicated by the court as incompetent to proceed (ITP) at a material stage of a criminal proceeding The client is adjudicated by the court as "Not Guilty by Reason of Insanity" on criminal charges Other (None of the above) Unknown MHPrognosis 0 No (if both conditions are not met) COAD Code Table Field Name Code Description 1 Yes (if either or both conditions are met) 6 Not Applicable (SA) 7 Unknown DrugCourtOrder 0 No 1 Yes 6 Not Applicable (MH) 7 Unknown AdminRoute 1 Oral 2 Smoking 3 Inhalation 4 Injection (IV or Intra-muscular) 5 Other Route 6 Not Applicable (MH) 7 Unknown SaFrequencyUse 1 No Past Month Use Times in Past Month Times per Week Times per Week 5 Daily FASAMS ITN - Record Data Model Specification Document Page 114

115 7 Unknown 5 Daily 6 Not Applicable (MH) 7 Unknown AgeFirstUse 00 Newborn with Substance Dependency Problem Age At First Use (in years) 96 Not applicable 97 Unknown 98 Not collected OpioidTherapy 0 No 1 Yes 3 Unknown 6 Not Applicable (MH) IvHistory 0 No 1 Yes FASAMS ITN - Record Data Model Specification Document Page 115

116 COAD Code Table Field Name Code Description 3 Unknown 6 Not Applicable (MH) PregancyTrimester 1 1st trimester 2 2nd trimester 3 3rd trimester 4 Not pregnant or male 5 Unknown PostPartum 0 No 6 Not Applicable 1 Yes 3 Unknown 6 Not Applicable BirthOutcome 1 Live birth (drug presence in newborn) 2 Live birth (no drug presence in newborn) 3 Still birth 4 Miscarriage 5 Pregnancy terminated 6 Not yet delivered (transfers only) 7 Unknown Birth Outcome (an option only if whereabouts of client is unknown) 8 Not Applicable 0 No DrugFreeStatus 1 Yes 3 Unknown (use only if whereabouts of client is unknown) 4 Not Applicable DaysWaiting to Number of days waiting 997 Unknown 999 Not Applicable (MH) DiagnosisCodeId 1 DSM-IV FASAMS ITN - Record Data Model Specification Document Page 116

117 2 ICD-9 3 ICD-10 4 DSM-5 COAD Code Table Field Name Code Description 5 DSM-IIIR DailyLivingActivity 0 No 1 Yes 6 Not Applicable 7 Unknown IdpPrescription 0 NO 1 Yes 6 Not Applicable 7 Unknown PapPrescription 0 NO 1 Yes 6 Not Applicable 7 Unknown HealthStatus 01 Agitated 02 Comatose 03 Disoriented 04 Depressed 05 Forgetful 06 Lethargic FASAMS ITN - Record Data Model Specification Document Page 117

118 SmiSedStatus 1 SMI 07 Oriented 08 Other (None of the above) 96 Not Applicable 97 Unknown 2 SED 3 At risk for SED (optional) COAD Code Table Field Name Code Description 4 Not SMI/SED 7 Unknown FASAMS ITN - Record Data Model Specification Document Page 118

119 B: Admission Episode versus Treatment Episode 7 Budget 7.1 Data Model Diagram FASAMS ITN - Record Data Model Specification Document Page 119

120 DCF Contract FASAMS ITN - Record Data Model Specification Document Page 120

121 7.2 Data Model Description Data Model ID: <ID> Data Model Name: Budget Record Description IDS is the parent record of the ME Budget record which contains DCF budget and funding allocation to the entity that holds the DCF contract (i.e., sub-recipient). Purpose The Budget data set is required for MEs to support contracted services, and operational costs. Data Sources The Budget Ledger populates a data warehouse known as IDS, which is the main source of information for the ME budget. Timing / Frequency of Data A budget record is uploaded into the department s data system on a daily basis. Data Submission Process The ME budget, extracted from IDS, is derived from the Budget Ledger. The Budget Ledger comes from the DFS central accounting system, which receives information from DFS FLAIR system and LAS/PBS Additional Information N/A 7.3 Data Tables I-BHS Facility Information ID Field Name Field Type Field Definition Validation StateFiscalYear (Primary Key) CHAR(4) State Fiscal Year denotes the ending year of the State of Florida s fiscal year a 12 month period from July 1 st through June 30 th. Must equal a calendar year. Format must be YYYY. MEContract (Primary Key) CHAR(5) Managing Entity Contract Number. Must exist in IDS Title view. MEContractTitle CHAR(60) Name for Managing Entity Provider. N/A. Extracted from IDS Title view. FASAMS ITN - Record Data Model Specification Document Page 121

122 BudgetPart CHAR(1) Budget Part identifies the type of budget. Must equal 1,2, or 3. BudgetPartTitle CHAR(2) Name of the Budget Part. N/A. Extracted from IDS Title view. BudgetEntity (Primary Key) CHAR(8) Budget Entity represents the unit or program which funds are specifically appropriated in the General Appropriations Act (GAA) and the major classification of expenditures. Budget Entity is also referenced as BE. BETitleShort CHAR(10) Abbreviated name of the Budget Entity. Must exist in IDS Title view. N/A. Extracted from IDS Title view. SPGM CHAR(16) State Program Component is an aggregation of generally related objectives related to workloads and can logically be considered an entity purposed for the organization of management, accounting, reporting and budgeting. SPGMStateStd CHAR(10) The State Standard Program component is defined by FLAIR. A standardized classification of activities. SPGMTitle CHAR(60) Name of the State Program Component. Category (Primary Key) CHAR(6) Appropriation Category sub-defines the appropriation made to a budget entity or defines a revenue source. Must exist in IDS Title view. Must exist in IDS Title view. N/A. Extracted from IDS Title view. Must exist in IDS Title view. CATTitleLong CHAR(60) Name of the Category. N/A. Extracted from IDS Title view. FASAMS ITN - Record Data Model Specification Document Page 122

123 Florida Department of Children and F amilies BETitleLong CHAR(60) Name of the Budget Entity. N/A. Extracted from IDS Title view. ID Field Name Field Type Field Definition Validation GF_SF_FID (Primary Key) CHAR(11) Combination of GAAFR Fund, State Fund and Fund ID (dash between each component). GAAFR_FUND CHAR(2) GAAFR_FUND is the classification of funds according to the Governmental Accounting Auditing & Financial Reporting. N/A. System generated concatenation of GAAFR Fund, State Fund and Fund ID. Must exist in the FLAIR Table. GFTitleLong CHAR(60) Name of the GAAFR Fund. N/A. Extracted from IDS Title view. StateFund CHAR(1) State Fund identifies the type of fund based on the classification of section , Florida Statues; 1=General Revenue fund; 2=Trust fund. Must exist in IDS Title view. SFTitleLong CHAR(60) Name of the State Fund. N/A. Extracted from IDS Title view. FundID CHAR(6) Fund Identifier differentiates between funds of the same state fund type. Fund ID is also referred to as FID. Must exist in IDS Title view. FIDTitleLong CHAR(60) Name of the fund identifier. N/A. Extracted from IDS FundSource (Primary Key) CHAR(10) Fund Source Code links an activity (OCA) to the specific funding sources which support the activity and it identifies how the Department uses particular fund sources. Must be 6 characters; last 4 characters are not used. FSCTitle CHAR(50) Name of the Fund Source Code. Must exist in IDS Title view. OCA (Primary Key) CHAR(5) The Other Cost Accumulator is used to track agency unique costs that have not been otherwise classified; codes are provided by FLAIR. Must exist in IDS Title view. OCATitleLong CHAR(60) Name of the Other Cost Accumulator. N/A. Extracted from IDS Title view. Authority CHAR(6) Authority code is the authorizing source of the budgetary action. FASAMS ITN - Record Data Model Specification Document Page 123

124 Florida Department of Children and F amilies OrgLevel2 CHAR(2) Organization Level 2 is position 3 & 4 of the 11 character FLAIR organization code; it designates the Department s operating structure by regions & treatment facilities. Title view. Must exist in IDS Title view. OrgL2TitleLong CHAR(60) Name of the Organization Level 2. N/A. Extracted from IDS Title view. FASAMS ITN - Record Data Model Specification Document Page 124

125 ID Field Name Field Type Field Definition Validation TransactionDate (Primary key) CHAR(8) Date the budgetary action was approved. RecurringIndicator CHAR(1) The Recurring Indicator denotes if a budgetary change to the approved operating budget should be made permanent in the next fiscal year. Must equal a calendar date between the fiscal year start and fiscal year end. Format must be MMDDYYYY. Must equal Y or N where Y equals yes and N equals no. Description CHAR(640) Description of the budgetary action. N/A ACStatutoryAuth CHAR(15) Account Code Statutory Authorization reflects the line item (specific number) and year of the appropriation within General Appropriations Act (GAA). N/A AccountCode-29 CHAR(29) The 29 digit FLAIR Account Code. Must exist in IDS Title view. ACStatus CHAR(1) Status of the account code; U=available for use, I=inactive, D=deleted. Appropriation CHAR(14) The dollar amount is the expenditure budget provided by the Legislature for a specific purpose. EOGReserve CHAR(14) The dollar amount segregated from appropriations and held as reserved or unreleased appropriations. The Executive Office of the Governor (EOG) identifies any portion of appropriation that will be reserved. ApprovedBudget CHAR(14) The dollar balance is a sum of Must equal U, I or D. Account code status must be U for payroll transactions. FASAMS ITN - Record Data Model Specification Document Page 125

126 MachineGenDate CHAR(8) Machine Generated Date identifies date & time the budgetary transaction as added; will always equal a calendar date between the fiscal year N/A. System generated date. FASAMS ITN - Record Data Model Specification Document Page 126

127 start and fiscal year end; format is MMDDYYYY. appropriation from the General Appropriations Act (GAA), any supplemental appropriations, and any additional, less any reserves or adjustments. Releases CHAR(14) The dollar balance of budgeted funds available for expenditures; amount is usually released quarterly in the case of general revenue, or annually for trust funds and special categories. UnreleasedBalance CHAR(14) The dollar balance of the budgeted funds unavailable for expenditures. ID Business Rule 1 The ME Budget cannot be modified. File sent as read only. 2 ME budget information must come from IDS. 3 The sum of child record allocation cannot exceed the sum of parent record allocation. 4 ME must add any initial or subsequent budget allocations to sub-contracted providers. FASAMS ITN - Record Data Model Specification Document Page 127

128 7.4 Data Flow Diagram The diagram below describes how the acute care data from the Managing Entity will be processed using SFTP to provide data submission reports to DCF. LAS / PBS Gov / Leg Central Accounting System DFS FLAIR DFS Budget Ledger DCF FASAMS ME Budget Year to Date IDS DCF Provider Invoices FACTS DFS CARS DCF ME Contract Service Event 7.5 Appendix A: Budget Code Table Field Name Code Description BudgetPart 1 Operating Budget. 2 Fixed Capital Outlay. 3 NonOperating Budget. StateFund 1 General Revenue fund. 2 Trust fund. RecurringIndicator Y Yes. N No. ACStatus U Available for use. I D Inactive. Deleted. FASAMS ITN - Record Data Model Specification Document Page 128

129 FASAMS ITN - Record Data Model Specification Document Page 129

130 8 Provider Invoice Validation Report 8.1 Data Model Diagram The Provider Invoice Validation (PIV) data table is a child of the Subcontract table and Service Event table. Hence, each record in PIV table must have a corresponding record with matching key fields in each of these two parent tables. FASAMS ITN - Record Data Model Specification Document Page 130

131 8.2 Data Model Description Data Model ID: <ID> Data Model Name: Budget Record Description The Provider Invoice Validation (PIV) report includes: (a) year-to-date dollar amount and service units actually earned (YtdAmountEarned and YtdUnitsEarned) based on actual service events reported to managing entity by each provider agency, and (b) year-to-date dollar amounts and service units prorated (YtdAmountProrated and YtdUnitsProrated) based on subcontracted prorated amounts and payment rates. This report also provides a comparative analysis of these data to validate the extent to which YtdAmountEarned and YtdUnitsEarned are commensurate with YtdAmountProrated and YtdUnitsProrated to determine the dollar amount and service units payable (YtdAmountPayable and YtdUnitsPayable). Purpose The purpose of this report is to validate the extent to which the dollar values of the service units, which are actually reported to managing by the provider agency, are commensurate not only with prorated year-to-date contract dollar amounts available for these services, but also with the dollar amounts invoiced by the provider and paid by the managing entity as documented in the Year-to-Date Monthly Provider Expenditures. Data Sources Providers submit service event data and subcontract data to managing entities. The system will automatically generate the Provider Invoice Validation Report based on data from these two tables. Timing / Frequency of Data MEs submit service event data and subcontract data to the Department not later than the date specified in the ME contract. The system will generate the Provider Invoice Validation Report as soon as service events data and subcontract data are uploaded and processed. Data Submission Process Service event data and subcontract data will be submitted and processed using a Secured File Transfer Protocol (SFTP). The Extensible Markup Language (XML) is the department s standard file format for submission and validation of records. Additional Information FASAMS ITN - Record Data Model Specification Document Page 131

132 8.3 Data Tables Invoice Validation ID Field Name Field Field Definition Validation Type StateFiscalYear (Primary Key) CHAR(4) State Fiscal Year denotes the ending year of the State of Florida s fiscal year a 12 month period from July 1 st through June 30 th. Must equal a calendar year. Format must be YYYY. ContractorID CHAR(10) 10-digit code in XX- (Primary Key) XXXXXXX format describing the Federal Employer Identification Number (FEIN) of the entity that either holds a contract with DCF to provide SAMH services in community or in state treatment facility or is owned and operated by DCF (e.g., state treatment facility). Valid entry must be the FEIN for ContractorId that is registered in the ME Subcontract table ContractNumber (Primary Key) CHAR(5) 5-digit contract number between the entity and the Department under which services were provided. Must be a valid SAMH contract number that is in the Florida Accountability Contract Tracking System (FACTS). Must be registered in the ME Contract table ProviderId (Primary Key) SubContractNumber (Primary Key) ProgramArea (Primary Key) CHAR(10) CHAR(5) CHAR(1) 10-digit code in XX- XXXXXXX format describing the Federal Employer Identification Number (FEIN) of the entity that provides SAMH services either in state treatment facility operated by or under contract with DCF or in community under DCF contract or ME subcontract. 5-digit contract number the service provider has with the Managing Entity to provide services. 1-digit code that indicates the program area in which SAMH services are provided., See Code Table in Appendix A. Valid entry must be the FEIN for ProviderId that is registered in the ME Subcontract table. Must be registered in the ME Subcontract table. Valid entry must be a value in code table for ProgramArea as specified in 4.5 Appendix A FASAMS ITN - Record Data Model Specification Document Page 132

133 ID Field Name Field Field Definition Validation Type SamhOca (Primary Key) CHAR(5) Indicate the code used to track the funding and expenditures related to SAMH OCA. See SAMH OCA Codes in Pamphlet 155-2, Tables 10 and 11. SamhOcaModifier CHAR(2) Indicate the code used as the modifier of the SAMH OCA. CoveredService (Primary Key) CHAR(2) See SAMH OCA modifier code in Pamphlet 155-2, Tables 10 and digit code that indicates the general category of services provided to the client. See Covered Service Code Table in Pamphlet Must be a valid code registered in the SAMH OCA Code table as specified in 11.5 Appendix D Must be a valid code registered in SamhOcaModifier table as specified in 4.5 Appendix E Must be a valid twodigit code from the CoveredService code table as specified in 4.5 Appendix B. Must be registered in the ME Subcontract table. ProcedureCode CHAR(5) 5-digit Current Procedural Must be a valid CPT (Primary Key) Terminology (CPT) code that or HIPAA code AS identifies the service. specified in the DCF See Procedure Codes and Pamphlet Units Table in Pamphlet 155- Appendix 4. EventCount INTEGER(5) Up to 5 numeric digit number indicating the total count of service event records involved in the production of YtdUnitsEarned 2. Cannot be blank. The value is calculated as indicated in Business Rules PaymentType CHAR(1) 1-digit code that indicates the Must be valid value in measurement standard for code table for each covered service as PaymentType as defined in Financial Rule specified in E (3). Appendix A PaymentRate DECIMAL(10) See Code Table in Appendix A. Indicate in XXXXXXX.XX format the contracted dollar amount between the ME and the Provider agency as the payment per unit of the covered service provided. Must be a valid value in Subcontract FASAMS ITN - Record Data Model Specification Document Page 133

134 ID Field Name Field Type Field Definition Validation YtdUnitsEarned INTEGER(12) Indicate the total YTD service units earned per covered service for the OCA. Cannot be blank. Must be calculated as indicated in Appendix 9.5 B YtdAmountEarned DECIMAL(10) Indicate in XXXXXXX.XX format the total YTD dollar amounts earned per covered service for the OCA. Cannot be blank. Must be calculated as indicated in Appendix 9.5 B YtdUnitsProrated Indicate the total YTD Cannot be blank. INTEGER(12) prorated service units Must be calculated as contracted per covered indicated in Appendix service for the OCA. 9.5 B YtdAmountProrated Indicate in XXXXXXX.XX DECIMAL(10) format the total YTD prorated dollar amounts contracted Cannot be blank. Must be calculated as indicated in Appendix per covered service for the 9.5 B OCA YtdUnitsPayable Indicate the total YTD Cannot be blank. INTEGER(12) service units payable per Must be calculated as covered service for the OCA. indicated in Appendix 9.5 B YtdAmountPayable Indicate in XXXXXXX.XX DECIMAL(10) format the total YTD dollar amounts payable per covered service for the OCA. Cannot be blank. Must be calculated as indicated in Appendix 9.5 B ID Business Rule 1 Rule 65E (3) requires all covered services to be paid on the basis of utilization, except for the following, which are paid on the basis availability: Crisis Support/Emergency; Information and Referral; Substance Abuse Outpatient Detoxification; Drop-in/Self Help Centers; Crisis Stabilization; Short-term Residential Treatment; and Substance Abuse Inpatient Detoxification. 2 For covered services paid on the basis of availability, the year-to-date total service units payable should reflect the prorated service units contracted by dividing prorated contracted amount by the payment rate. 3 For covered services paid on the basis of utilization, the year-to-date total service units payable should reflect the year-to-date service units actually earned that is less than or equal to the prorated service units contracted. 4 Multiply the Payment Rate by Total YTD Units Payable to get Total YTD Amount Payable. Payment rates are documented in Exhibit G of the provider agency's Subcontract with the ME FASAMS ITN - Record Data Model Specification Document Page 134

135 5 DCF is the payor of last resort for services provided to DCF eligible clients. Only covered services that have a funding source paid by the Subcontract between ME and provider and have been validated by the ME as error-free are used in the invoice. ID Business Rule 6 The clients, whose services are being invoiced, must have enrollment into program covering the effective date(s) of service and the service being rendered must be valid for its corresponding program and SamhOca. 8.4 Data Flow Diagram The diagram below describes how the acute care data from the Managing Entity will be processed using SFTP to provide data submission reports to DCF. FASAMS Data FASAMS Data Service Providers Results Managing Entities Results FASAMS --- OR --- FASAMS Data Service Providers Results FASAMS 8.5 Appendix A: Invoice Code Table Invoice codes and descriptions are already defined in other data models as indicated above in Field Name Code Description FASAMS ITN - Record Data Model Specification Document Page 135

136 B: Business Mapping Processes for Invoice Validation 1. Validation of FASAMS Data Managing Entities (MEs) must ensure that records entered in DCF database meet DCF standard formats and validation edits for client-specific and non-client-specific service events. 2. Validation of Client/Service Eligibility for DCF Funding MEs must check the following to see if DCF is the payor of last resort for services provided to DCF eligible clients: 2.1. Does the client have Medicare/Medicaid or private/other funding source available to him/her? If yes, DCF is not the payor of last resort! 2.2. Are there self-pay or co-payment considerations for the covered service? If yes, DCF is not the payor of last resort! 2.3. Has the client exhausted "other" funding type pool? If no, DCF is not the payor of last resort! 2.4. Is the service rendered qualify for DCF funding, i.e., SAMH, TANF, BNet or Local Match)? If no, DCF is not the payor of last resort 2.5. Does the service being rendered require a prior authorization (e.g. Acute Services), certification (TANF), approved enrollment (e.g. BNET) and has it been approved and are there still available units to be ran down? If no, DCF is not the payor of last resort 3. Validation of Provider Invoiced Services MEs must check the following to validate invoiced services from providers: 3.1. Check if the client has enrollment into program covering the effective date(s) of service and that the service being rendered is valid for its corresponding program and eligibility. If the client s enrollment is not valid and the covered service is not valid for the program, then the service cannot be invoiced Validate OCA related to service event information that includes the combination of ContractorId + ContractNumber + ProviderId + SubContractNumber + Funding + CoveredService + ProcedureCode If OCA is not valid, then the covered service cannot be invoiced Confirm that the service(s) rendered are contracted services by the ME If the covered service is not contracted, then the service cannot be invoiced. 4. Validation of Billable Service Units 4.1. Calculate year-to-date service units earned (YtdUnitsEarned) and year-to-date dollar amount earned (YtdAmountEarned) as follows. For each combination of ContractorId + ContractNumber + ProviderId + SubContractNumber + ExpenditureCode + SamhOca + ProgramArea + CoveredService + ProcedureCode in Service Event, calculate the SUM of year-to-date ServiceUnits to obtain total service units earned (YtdEarnedUnits) by the provider and billable to MEs for payment based on service FASAMS ITN - Record Data Model Specification Document Page 136

137 units actually delivered. Multiply YtdEarnedUnits by the corresponding PaymentRate to obtain YtdAmountEarned based on covered services actually delivered Calculate year-to-date prorated service units (YtdUnitsProrated) and year-to-date prorated dollar amount (YtdAmountProrated) as follows. For each combination of ContractorId + ContractNumber + ProviderId + SubContractNumber + ExpenditureCode + SamhOca + ProgramArea + CoveredService + ProcedureCode in Subcontract, calculate year-to-date prorated contracted dollar amount (YtdAmountProrated). Divide YtdAmountProrated by the corresponding PaymentRate to obtain the prorated service units (YtdUnitsProrated) based on funds currently available Calculate year-to-date service units payable (YtdUnitsPayable) and year-to-date dollar amount payable (YtdAmountPayable) as follows If PaymentType = 1 (i.e., services units are paid based on Utilization) and if YtdUnitsEarned is greater than or equal to YtdUnitsProrated, then YtdUnitsPayable = YtdUnitsProrated and YtdAmountPayable = YtdAmountProrated. Else, YtdUnitsPayable = YtdUnitsEarned and YtdAmountPayable = YtdAmountEarned Note: The corresponding service event records, which are used to produce the YtdUnitsPayable, must be identified and coded in Service Event record as having been invoiced (InvoiceStatus = 1) and paid by the ME (BillingStatus =1) before these records are submitted into DCF database If PaymentType = 2 (i.e., services units are paid based on Availability), then YtdUnitsPayable = YtdUnitsProrated and YtdAmountPayable = YtdAmountProrated, regardless of YtdUnitsEarned and YtdAmountEarned. Note: The corresponding service event records, which are used to produce the YtdUnitsEarned for both client-specific and non-client-specific service events, must be identified and coded in Service Event record as having been invoiced (InvoiceStatus = 1) and paid by the ME (BillingStatus =1) before these records are submitted into DCF database. 9 Demographic 9.1 Data Model Diagram The Demographics record doesn t have a parent record in the FASAMS database. However, the FASAMS database has interface with two databases: the ACCESS database and the FSFN database. The former provides the client s eligibility information including the person identification number, which is used in the FASAMS database as the client unique identifier, and the later provides the history of the client s involvement in the child welfare system. FASAMS ITN - Record Data Model Specification Document Page 137

138 ACCESS ACCESS FASAMS ITN - Record Data Model Specification Document Page 138

139 9.2 Data Model Description Data Model ID: <ID> Data Model Name: Demographic Record Description The Demographic record has no parent record. It contains data elements that are used by the Department to uniquely identify each client served in substance abuse and mental health programs. One of these data elements is a unique client identifier that links the demographic record to all the other client records in FASAMS, e.g., co-occurring admission and discharge record (COAD), service event record, waiting list. Purpose Entities that are under contract with DCF to provide SAMH services are required to submit demographic records into the state database system in compliance with s (3)(e), Florida Statutes. Data Sources Demographic records are collected locally by the entity, which provides services to clients. The entity, which has DCF contract to provide SAMHIS services, is required to receive and validate demographic records from service providers and to upload these records into the department s data system (e.g., FASAMS). Timing / Frequency of Data A demographic record is uploaded into the department s data system by a date and frequency specified in the DCF contract. Data Submission Process Demographic records must be submitted into the department s data system prior to submission of any other child records associated with the demographic record. Additional Information 9.3 Data Tables Demographic Data FASAMS ITN - Record Data Model Specification Document Page 139

140 ID Field Name Field Type Field Definition Validation MDS2 UniqueClientId (Primary Key) CHAR(10) This field is used to identify the person receiving treatment. If this field is blank, contains an invalid value, or is all zeros, the record will be rejected and not processed. A fatal error will be displayed in the processing report. Refer to MDS 2 Code Table in TEDS manual. SSN CHAR(9) Enter the 9-digit social security Valid entry is the client s MDS8 number (SSN). If SSN is unknown or LastName FirstName MiddleName SSN or pseudo-ssn as not available, use the pseudo SSN. specified in 10.5 Appendix A.. Cannot be blank or start with 000 or 9. CHAR(35) Enter Client s last name. Valid entry is the client s last name; must be left justified/space filled. CHAR(35) Enter client s first name. Valid entry is the client s first name; must be left justified/space filled. CHAR(14) Enter the client s middle name. If a Valid entry is the client s middle name can absolutely not be middle name; must be left obtained, then use the letter X. justified/space filled. Suffix CHAR(10) Enter the client s suffix (e.g. Jr., II, Valid entry is the client s etc.). suffix; must be left justified/space filled. BirthDate CHAR( 8) This field identifies the client s date of birth. If this field is blank, uses the wrong date format, or contains an invalid value, the value record will not be processed. A fatal error will be displayed in the processing report. Refer to MDS 8 Code Table in TEDS manual. MDS9 Gender CHAR(1) This field identifies the client s If this field is blank or gender. contains an invalid value, the value will be changed to 9 Invalid data and a warning error will be generated. If Gender is 1 Male, then Pregnant at Admission must be 6 Not applicable. Refer to MDS 9 Code Table in TEDS manual. FASAMS ITN - Record Data Model Specification Document Page 140

141 ID Field Name Field Type Field Definition Validation MDS10 Race CHAR(1) This field identifies the client s race. If this field is blank or contains an invalid value, the value will be changed to 99 Invalid data and a warning error will be generated. Refer to MDS 10 Code Table in TEDS manual. MDS11 Ethnicity CHAR(1) This field identifies client s specific If this field is blank or Hispanic or Latino origin, if contains an invalid value, applicable. the value will be changed to 99 Invalid data and a warning error will be generated. Refer to MDS 11 Code Table in TEDS manual. ID Business Rule 1 Client demographic data must be submitted for all individuals receiving substance abuse and/or mental health services whose cost of care is funded, in whole or in part, by DCF funds, e.g., SAMH, TANF, Local Match, Title 21. (Refer to Table 7. Funding Codes in Appendix 5 Data Code Tables for list of valid funding sources.) 2 Records that fail edits and validations of key fields will be rejected. Records that fail edits and validations of non-key fields, the value will be changed to code for Invalid data and a warning error will be generated 3 Whenever the information contained in a client s demographic record changes, then the demographic record must be updated and uploaded into the department s data system. 4 If the provider agency maintains electronic client documentation, a paper copy of the demographic form is not required to be in the client s medical record, but the provider must furnish the electronic information when requested for monitoring or audit purposes. 9.4 Data Flow Diagram The diagram below describes how the demographic data from the Managing Entity or from providers with direct contract with DCF will be processed using SFTP to provide data submission reports to DCF. FASAMS ITN - Record Data Model Specification Document Page 141

142 F A S A M S D a t a F A S A M S D a t a Service Providers R e s u lt s Managing Entities R e s u lt s FASAMS --- OR --- FASAMS Data Service Providers Results FASAMS 9.5 Appendix A: Demographic Code Table Field Name Code Description Pseudo-SSN Position 1 First Initial Position 2 Middle Initial (X if no middle name) Position 3 Last Initial Positions 45 Month of Birth [01-12] Positions 67 Day of Birth [01-31 or if the pseudo SSN is already in use, alter the two digits of the Birth Day to a number greater than 31.] Positions 89 Year of Birth [00-99] Race 01 ALASKA NATIVE (Aleut, Eskimo) A person having origins in any of the original peoples of Alaska. This category may be reported if available. 02 AMERICAN INDIAN/ALASKA NATIVE A person having origins in any of the original peoples of North America and South America (including Central America and the original peoples of Alaska) and who maintains tribal affiliation or community attachment. States collecting Alaska Native should use this category for all other American Indians. 03 ASIAN OR PACIFIC ISLANDER A person having origins in any of the original peoples of the Far East, the Indian subcontinent, Southeast Asia, or the Pacific Islands. This category may be used only if a state does not collect Asian and Native Hawaiian or Other Pacific Islander separately. FASAMS ITN - Record Data Model Specification Document Page 142

143 Ethnicity 04 BLACK OR AFRICAN AMERICAN A person having origins in any of the black racial groups of Africa. 05 WHITE A person having origins in any of the original peoples of Europe, the Middle East, or North Africa. 13 ASIAN A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam. 20 OTHER SINGLE RACE Use this category for instances in which the client is not identified in any category above or whose origin group, because of area custom, is regarded as a racial class distinct from the above categories. 21 TWO OR MORE RACES Use this code when the state data system allows multiple race selection and more than one race is indicated. 23 NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands. 01 PUERTO RICAN Of Puerto Rican origin regardless of race 02 MEXICAN Of Mexican origin regardless of race 03 CUBAN Of Cuban origin regardless of race 04 OTHER SPECIFIC HISPANIC OR LATINO Of known Central or South American or any other Spanish culture or origin (including Spain), other than Puerto Rican, Mexican, or Cuban, regardless of race 05 NOT OF HISPANIC OR LATINO ORIGIN Field Name Code Description Gender 06 HISPANIC OR LATINO SPECIFIC ORIGIN NOT SPECIFIED Of Hispanic or Latino origin, but origin not known or not specified 1 Male 2 Female 10 Expenditure 10.1 Data Model Diagram The Expenditure data model comprises two records: the Managing Entity Expenditures Report and the Provider Expenditures Report. Each record in the Provider Expenditure Report must have a corresponding record in Managing Entity Expenditure Report with matching key fields. FASAMS ITN - Record Data Model Specification Document Page 143

144 ME Budget Expenditures SubContract Expenditures Service Event FASAMS ITN - Record Data Model Specification Document Page 144

145 10.2 Data Model Description Data Model ID: <ID> Data Model Name: Expenditure Record Description The Expenditure data set is used at the state level to collect and report actual expenditures of DCF funds by program area and OCA at the Managing Entity and Provider levels. Purpose The Expenditure data set is a critical component for tracking actual expenditures against what was budgeted and contracted as needed for billing and payment purposes, and linking to outcomes. Data Sources Any entity that has a state contract to provide services in community mental health or substance abuse programs is required to submit expenditure data. Managing Entities must require each Provider which has a contract with the ME to submit actual expenditures to the ME. Managing Entities will validate and submit the data from each Provider to DCF. Timing / Frequency of Data Providers must work with the ME to reconcile expenditure data submitted to make sure they are accurate and consistent, and error corrections are made as needed. MEs must reconcile the data from each Provider to make sure it is valid and consistent, and corrections are made to ensure accuracy. Daily data reconciliation is highly recommended to ease the burden of reviewing very large data files and to allow for more timely detection and resolution of data problems. MEs submit reconciled data received from Providers monthly to the Department not later than the date specified in the ME contract. Data Submission Process Expenditure data will be submitted and processed using a Secured File Transfer Protocol (SFTP) site to provide data submission reports to both DCF staff and Managing Entity staff. The Extensible Markup Language (XML) is the department s standard file format for submission and validation of records. Additional Information N/A 10.3 Data Tables Managing Entity Expenditures Report FASAMS ITN - Record Data Model Specification Document Page 145

146 ID Field Name Field Type Field Definition Validation ContractorId (Primary Key) CHAR(10) 10-digit code in XX-XXXXXXX format describing the Federal Employer Identification Number (FEIN) of the entity that holds direct contracts with the department or state treatment facility. Valid entry must be the FEIN for ContractorId that is registered in the ME Contract table. ContractNumber CHAR(5) 5-digit contract number between Must be a valid SAMH (Primary Key) the entity and the Department contract number that is under which services were in the Florida provided. Accountability Contract Tracking System (FACTS). Must be registered in the ME Contract table MonthYear CHAR(6) Month and Year of the Expenditure Must be a valid date in MMYYYY format ExpenseType CHAR(1) 1-digit code that indicates the type Valid entry is valid value (Primary Key) of expenditure for the services, in code table for i.e., Operational,, Mental Health or ExpenseType as Substance Abuse. specified in Appendix A. BudgetOca CHAR(5) Indicate the code used in Budget Ledger to track the funding and expenditures related to this OCA. Must be a valid code registered for ExpenseType in the Budget and Expenditure OCA configuration code table as specified in 11.5 Appendix B. ExpenditureCode CHAR(5) Indicate the code used to track the Must be a valid code funding and expenditures related to this Expenditure OCA. FlairCategory CHAR(6) Indicate the code used in FLAIR to track the funding and expenditures related to this category. ID Field Name Field Type Field Definition Validation registered for the BudgetOca in the Budget and Expenditure OCA configuration code table as specified in 11.5 Appendix E Must be a valid code registered for the combination of BudgetOca and ExpenditureCode in the Budget and Expenditure OCA configuration code table as specified in 11.5 Appendix C FASAMS ITN - Record Data Model Specification Document Page 146

147 YtdExpendituresPrior DECIMAL(10) Indicate in XXXXXXX.XX format the total YTD expenditures from the prior month. Cannot be blank YtdExpendituresCurrent DECIMAL(10) Indicate in XXXXXXX.XX format the total YTD expenditures for the current month. Cannot be blank FlairAmounts DECIMAL(10) Indicate in XXXXXXX.XX format the total expenditure amount to be entered in FLAIR. Cannot be blank ID Business Rule 1 The BudgetOca must be valid for ExpenseType as specified in the Budget and Expenditure OCA configuration code table 2 The ExpenditureCode must be valid for BudgetOca as specified in the Budget and Expenditure OCA configuration code table 3 FlairCategory must be valid for the combination of BudgetOca and ExpenditureCode as specified in the Budget and Expenditure OCA configuration code table 4 YtdExpendituresCurrent must be >= YtdExpendituresPrior 5 FlairAmounts = YtdExpendituresCurrent - YtdExpendituresPrior ContractNumber (Primary Key) CHAR(5) 5-digit contract number between the entity and the Department under which services were provided. Must be a valid SAMH contract number that is in the Florida Accountability Contract Tracking System (FACTS). Must be registered in the ME Contract table FASAMS ITN - Record Data Model Specification Document Page 147

148 Provider Expenditures Report ID Field Name Field Type Field Definition Validation ContractorID (Primary Key) CHAR(10) 10-digit code in XX- XXXXXXX format describing the Federal Employer Identification Number (FEIN) of the entity that either holds a contract with DCF to provide SAMH services in community or in state treatment facility or is owned and operated by DCF (e.g., state treatment facility). Valid entry must be the FEIN for ContractorId that is registered in the ME Subcontract table FASAMS ITN - Record Data Model Specification Document Page 148

149 ID Field Name Field Type Field Definition Validation ProviderId (Primary Key) CHAR(10) 10-digit code in XX- XXXXXXX format describing the Federal Employer Identification Number (FEIN) of the entity that provides SAMH services either in state treatment facility operated by or under contract with DCF or in community under DCF contract or ME subcontract. SubContractNumber (Primary Key) ExpenditureCode (Primary Key) CHAR(5) 5-digit contract number the service provider has with the Managing Entity to provide services. Indicate the code used to track the funding and expenditures related to this Expenditure OCA. Valid entry must be the FEIN for ProviderId that is registered in the ME Subcontract table. Must be registered in the ME Subcontract table. Must be a valid code registered in the Expenditure Code table. SamhOca Indicate the code used to Must be a valid code (Primary Key) track the funding and registered in the expenditures related to this SAMHIS OCA Code SAMH OCA table. CoveredService (Primary Key) CHAR(2) 2-digit code that indicates the general category of services provided to the client. See Covered Service Code Table in Pamphlet Must be a valid twodigit code from the Covered Service Code Table. Must be registered in the ME Subcontract table. PaymentMethod CHAR(1) 1-digit code that indicates the Must be valid value in method of payment for code table for services as defined in PaymentMethod Financial Rule 65E PaymentType BundledRate CHAR(1) CHAR(1) See Code Table in Appendix A. 1-digit code that indicates the measurement standard for each covered service as defined in Financial Rule 65E (3). See Code Table in Appendix A. 1-digit code that indicates whether the covered service can be reported with a bundled rate. See Code Table in Appendix A. Must be valid value in code table for PaymentType Must be valid value in code table for BundledRate FASAMS ITN - Record Data Model Specification Document Page 149

150 ID Field Name Field Type Field Definition Validation PaymentRate Indicate in XXXXXXX.XX Cannot be blank DECIMAL(10) format the contracted dollar amount between the ME and the Provider agency as the payment per unit of the covered service provided. YtdUnitsPayable INTEGER(12) Indicate in the total YTD Cannot be blank service units payable per covered service for the OCA. YtdAmountPayable Indicate in XXXXXXX.XX Cannot be blank DECIMAL(10) format the total YTD amount payable. ID Business Rule 1 Rule 65E (3) specifies the measurement standard (e.g., direct staff hour, non-direct staff hour, day, or dosage) for each covered service. The rule requirements for PaymentType are as follows: a) All covered services measured in "direct staff hour" must be reported on the basis of utilization, except for the following three covered services, which are paid on the basis of availability: Crisis Support/Emergency; Information and Referral; and Substance Abuse Outpatient Detoxification. b) All covered services measured in "Non-Direct Staff Hour" must be reported on the basis of utilization, except for Drop-in/Self Help Centers, which must be reported on the basis of availability. c) All covered services measured in "Day" must be reported on the basis of utilization, except for the following three covered services, which are paid on the basis of availability: Crisis Stabilization; Short-term Residential Treatment; and Substance Abuse Inpatient Detoxification (d) All covered services measured in "Dosage" must be reported on the basis of utilization. 2 For covered services paid on the basis of availability, the total should reflect the prorated service units contracted by dividing prorated contracted amount by the payment rate 3 For covered services paid on the basis of utilization, the total should reflect the year-to-date service units actually earned that is less than or equal to the prorated service units contracted. 4 Multiply the Payment Rate by Total YTD Units Payable to get Total YTD Amount Payable Data Flow Diagram The diagram below describes how the Expenditure data from the Providers will be collected and submitted to FASAMS. FASAMS ITN - Record Data Model Specification Document Page 150

151 FASAMS Data FASAMS Data Service Providers Results Managing Entities Results FASAMS --- OR --- FASAMS Data Service Providers Results FASAMS 10.5 Appendix A: Code Table General Field Name Code Description 1 Operational Cost ExpenseType 2 Mental Health Services 3 Substance Abuse Services PaymentMethod 1 Fee For Service 2 Case Rate 3 Capitation Rate 4 Cost Reimbursement PaymentType 1 Utilization 2 Availability BundledRate 1 Yes 2 No FASAMS ITN - Record Data Model Specification Document Page 151

152 B. Budget and Expenditure OCA Crosswalk Code Table Budget and Expenditure OCA Configuration Code Table Field Name Budget Expenditure Description FLAIR Effective Effective Code Code Category Begin Date End Date Operational MHS00 MHS00 Managing Entity Cost Administrative Costs. MS092 MS092 ME Data Management Support. MH0CS MH0CS ME Acute Care Utilization Database MH0SK MH0SK ME Mental Health System of Care. Mental Health MH000 ME Services & Supports Provider Activity - Mental Health. MH000 MH Hour Care (NonHospitalization) Residential. MH000 MH009 Ambulatory/Community Non-24 Hour Care. MH000 MH018 CSU, Baker Act, Inpatient Crisis Services. MH000 MH025 Prevention Services MH000 MH0CN Care Coordination (Mental Health) MH026 MH026 ME Early Intervention Services for SMI & Psych Disorder. MH071 MH071 Purchase of Residential Treatment Services for Emotionally Disturbed Children and Youth. MH072 MH072 Community Forensic Beds MH073 MH073 Florida Assertive Community Treatment (FACT). MH076 MH076 Indigent Psychiatric Medication Program. MH089 MH089 Clay Behavioral Health Center Crisis Prevention MH093 MH093 Camillus House Mental Health/ Substance Abuse Treatment- Homeless. MH094 MH094 Citrus Health Network MHO96 MHO96 Jerome Golden Center FASAMS ITN - Record Data Model Specification Document Page 152

153 MHO97 MHO97 Crisis Center of Tampa Bay Budget and Expenditure OCA Configuration Code Table Field Name Budget Expenditure Description FLAIR Effective Effective Code Code Category Begin Date End Date MHO98 MHO98 ME Saluscare Center Substance Abuse MH819 MH819 Gracepoint Center MHS50 MHS50 Lifestream Center MSHMB MSHMB Meridian Behavioral Healthcare. MHRM5 MHRM5 Renaissance Center MHS51 MHS51 Circles of Care - Cedar Village. MHS52 MHS52 Circles of Care - Crisis Stabilization. MH0PG MH0PG Grants PATH MH0TA MH0TA Florida Youth Transition to Adulthood. MH0TB MH0TB Temporary Assistance for Needy Families (TANF). MH0BN MH0BN Title XXI Children's Health Insurance Program (Behavioral Health Network). MH0FA MH0FA Grant Miami-Dade Wraparound FACES MH0MD MH0MD Grants Miami-Dade County Wraparound. MH0PL MH0PL Grants Project Launch MS000 ME Services & Supports Provider Activity - Substance Abuse. MS000 MS Hour Care (NonHospitalization) Residential. MS000 MS011 Ambulatory/Community Non-24 Hour Care A/C. MS000 MS021 Detoxification Services MS000 MS0CN Care Coordination (Substance Abuse) MS023 MS023 HIV Services MS025 MS025 Prevention Services MS081 MS081 Projects Expansion of Substance Abuse FASAMS ITN - Record Data Model Specification Document Page 153

154 Services for Pregnant Women and their affected families. MS091 MS091 Family Intensive Treatment (FIT) Budget and Expenditure OCA Configuration Code Table Field Name Budget Expenditure Description FLAIR Effective Effective Code Code Category Begin Date End Date MS0TB MS0TB Temporary Assistance for Needy Families (TANF). MS095 MS095 Drug Abuse Comprehensive Coordinating Treatment (DACCO). MS902 MS902 First Step of Sarasota MS903 MS903 Here's Help MS0PP MS0PP Prevention Partnership Grant (PPG) C. Flair Category Field Name Code Description Operational Cost Contracted SVC-SA/MH Admin G/A-Contracted Services Contracted Services G/A-Central Rec Facilities. Mental Health G/A-Comm Mental Hlth Svs G/A-Baker Act Services G/A-Prts Emo Dis Chi/Youth G/A-Indigent Psych Med Prg. Substance Abuse G/A-Com Sub Abuse Svcs. D. SAMH OCA # Field Name SAMH SAMH OCA Description Effective Effective OCA Child Begin Date End Date Adult Direct Expenditure MHA01 MHC01 24 Hour Care (Non- Hospitalization) Residential FASAMS ITN - Record Data Model Specification Document Page 154

155 MHA09 MHC09 Ambulatory/Community Non-24 Hour Care MHA18 MHC18 CSU, Baker Act, Inpatient Crisis Services MHA25 MHC25 Prevention Services MH0CN MH0CN Care Coordination (Mental Health) MH010 MH010 Miami-Dade Homeless Trust Field Name SAMH SAMH OCA Description Effective Effective OCA Child Begin Date End Date Adult MHA11 N/A Stewart-Marchman Behavioral Healthcare MHA26 N/A ME Early Intervention Svc - Psychotic Disorders MH027 MH027 Directions for Living MH031 MH031 David Lawrence Center- Behavioral Health Services MH032 MH032 ME Veterans and Families Pilot Program MH037 MH037 Fort Myers Salvation Army- Behavioral Health Services MH046 MH046 Centerstone Florida MH047 MH047 Lakeview Center MH050 MH050 Specialized Treatment, Education and Prevention Services MH060 MH060 Veterans Alternative Retreat Program MH061 MH061 Northside Mental Health Center N/A MHC71 Purchase of Residential Treatment Services for Emotionally Disturbed Children and Youth MHA72 N/A Community Forensic Beds MHA73 N/A Florida Assertive Community Treatment (FACT) MHA76 N/A Indigent Psychiatric Medication Program MHA89 N/A Clay Behavioral Health Center - Crisis Prevention MHA93 N/A Camillus House Mental Health/ Substance Abuse Treatment- Homeless MHA94 N/A Citrus Health Network MHA96 N/A Jerome Golden Center FASAMS ITN - Record Data Model Specification Document Page 155

156 N/A MHCBN Title XXI Children's Health Insurance Program (Behavioral Health Network) MH0FA MH0FA Grant Miami-Dade Wraparound FACES MH0FH MH0FH Community Forensic Multidisciplinary Teams for Hospital Diversion MHAPG N/A Grants PATH N/A MHCPL Grants Project Launch MHATA N/A Florida Youth Transition to Adulthood MHATB N/A Temporary Assistance for Needy Families (TANF) Field Name SAMH SAMH OCA Description Effective Effective OCA Child Begin Date End Date Adult MH819 MH819 Gracepoint Center MHDRF MHDRF ME-Disability Rights Florida Mental Health MHRM5 MHRM5 Renaissance Center MHS50 MHS50 Lifestream Center MHS51 MHS51 Circles of Care - Cedar Village MHS52 MHS52 Circles of Care - Crisis Stabilization MHS55 MHS55 Circles of Care - Geropsychiatric Care Center Services MHSCR MHSCR ME Centralized Receiving Facilities MHSMB MHSMB Meridian Behavioral Healthcare MHTRV MHTRV ME-Transition Vouchers Mental Health MSA03 MSC03 24 Hour Care (Non- Hospitalization) Residential MSA11 MSC11 Ambulatory/Community Non-24 Hour Care A/C MSA21 MSC21 Detoxification Services MSA27 N/A Federal Pregnant Women and Women with Dependent Children MS0CN MS0CN Care Coordination (Substance Abuse) MSA23 MSC23 HIV Services MSA25 MSC25 Prevention Services FASAMS ITN - Record Data Model Specification Document Page 156

157 E. Expenditure Code MSA81 N/A Projects Expansion of Substance Abuse Services for Pregnant Women and their affected families MSA91 N/A Family Intensive Treatment (FIT) N/A MSC95 Drug Abuse Comprehensive Coordinating Treatment (DACCO) MS0JG MS0JG ME Special Services for Jerome Golden Center N/A MSCPP Prevention Partnership Grant (PPG) MSATB MSCTB Temporary Assistance for Needy Families (TANF) MS902 MS902 First Step of Sarasota MS903 MS903 Here's Help MSTRV MSTRV ME-Transition Vouchers Substance Abuse Field Name Code Description Operational Cost MHS00 Managing Entity Administrative Costs. MS092 ME Data Management Support. MH0CS ME Crisis Stabilization Services. MH0SK ME Mental Health System of Care. Mental Health MH000 ME Services & Supports Provider Activity - Mental Health. MH001 MH009 MH018 MH025 MH026 MH071 MH072 MH073 MH076 MH089 MH093 MH094 MHO96 MHO97 MHO98 Expenditure Code Table 24 Hour Care (Non-Hospitalization) Residential. Ambulatory/Community Non-24 Hour Care. CSU, Baker Act, Inpatient Crisis Services. Prevention Services. ME Early Intervention Services for SMI & Psych Disorder. Purchase of Residential Treatment Services for Emotionally Disturbed Children and Youth. Community Forensic Beds. Florida Assertive Community Treatment (FACT). Indigent Psychiatric Medication Program. Clay Behavioral Health Center. Camillus House Mental Health/ Substance Abuse Treatment- Homeless. Citrus Health Network. Jerome Golden Center. Crisis Center of Tampa Bay. ME Saluscare Center. FASAMS ITN - Record Data Model Specification Document Page 157

158 MH819 MHS50 MSHMB MHRM5 MHS51 MHS52 MH0PG MH0TA MH0TB Gracepoint Center. Lifestream Center. Meridian Behavioral Healthcare. Renaissance Center. Circles of Care - Cedar Village. Circles of Care - Crisis Stabilization. Grants PATH. Florida Youth Transition to Adulthood. Temporary Assistance for Needy Families (TANF). MH0BN MH0FA MH0MD MH0PL Title XXI Children's Health Insurance Program (Behavioral Health Network). Grant Miami-Dade Wraparound FACES. Grants Miami-Dade County Wraparound. Grants Project Launch. Substance Abuse MS000 ME Services & Supports Provider Activity - Substance Abuse. MS003 MS Hour Care (Non-Hospitalization) Residential. Ambulatory/Community Non-24 Hour Care A/C. Field Name Code Description MS021 Detoxification Services. MS023 MS025 MS081 MS091 HIV Services. Prevention Services. Projects Expansion of Substance Abuse Services for Pregnant Women and their affected families. Family Intensive Treatment (FIT). MS0TB Temporary Assistance for Needy Families (TANF). MS095 MS902 MS903 Expenditure Code Table Drug Abuse Comprehensive Coordinating Treatment (DACCO). First Step of Sarasota. Here's Help. MS0PP Prevention Partnership Grant (PPG). FASAMS ITN - Record Data Model Specification Document Page 158

159 11 Contract 11.1 Data Model Diagram The Contract data model comprises two data tables: the data table for the Contract between the department and any entity responsible for SAMH services delivery (e.g., Managing Entity), and the data table for the Subcontract between the department s contracted entity and an entity that actually provides SAMH services (e.g., provider agency). Records in the Contract data table should be downloaded from the department s Contract Accountability Reporting System (CARS). For referential integrity purposes, each record in the Contract data table must have a corresponding record in the contractor s Budget data table as well as in the Provider Directory data table. Records in the Subcontract data table are uploaded by the contractor into the department s data system. For referential integrity purposes, each record in the Subcontract data table must have a corresponding record in Contract data table, Budget data table, and Provider Directory table. DCF Contract DCF Licensure FASAMS ITN - Record Data Model Specification Document Page 159

160 11.2 Data Model Description Data Model ID: <ID> Data Model Name: Expenditure Record Description The Contract data set is used at the state level to validate actual expenditures of DCF funds by program area and OCA at the Managing Entity and Provider levels against what was budgeted and contracted. The Subcontract data set is used at the state level to validate actual services purchased by the DCFcontracted entity (e.g., managing entity) from each provider agency, including the total contracted amount and payment rate for each covered service. Purpose The Contract and subcontract data set are a critical component for tracking actual expenditures against what was budgeted as needed for billing and payment purposes, and linking to outcomes and actual services provided. Data Sources Any entity that has a state contract or sub-contract to provide services in community mental health or substance abuse programs is required to submit contract and subcontract data. Managing Entities that sub-contract with Providers must validate and submit contract data from each Provider to DCF. Timing / Frequency of Data Contract data are entered by the DCF-contracted entity into the department s Contract Accountability Reporting System (CARS). Contract data required for FASAMS should be downloaded from CARS as timely and frequently as specified in the procurement of the COTS solution for FASAMS. MEs submit Subcontract data to the Department no later than the date specified in the ME contract. Data Submission Process Contract data will be downloaded from CARS and processed as specified in the procurement of the COTS solution for FASAMS Subcontract data will be submitted and processed using a Secured File Transfer Protocol (SFTP) site to provide data submission reports to both DCF staff and Managing Entity staff. The Extensible Markup Language (XML) is the department s standard file format for submission and validation of records. Additional Information The Contract Accountability Reporting System is the data source for DCF contract with any entity responsible for providing SAMH services. CARS Home page is available at Examples of data elements per ME contract are available at FASAMS ITN - Record Data Model Specification Document Page 160

161 11.3 Data Tables Managing Entity Contract ID Field Name Field Type Field Definition Validation FiscalYear CHAR(5) Date in YYYY/MM/DD showing the ending of the current state fiscal year for the contract (e.g., 2016/06/30) ContractorId (Primary Key) ContractNumber (Primary Key) CHAR(10) CHAR(5) 10-digit code in XX-XXXXXXX format describing the Federal Employer Identification Number (FEIN) of the entity that holds direct contracts with the department or an entity that is a state treatment facility. 5-digit contract number between the Department and the contracting entity, e.g., Managing Entity. Must be a valid date as reported in CARS Valid entry must be the FEIN for ContractorId that is registered in the Contract Accountability Reporting System (CARS) Must be a valid contract number that is registered in CARS. BeginDate DATE(10) Date in YYYY/MM/DD format Must be a valid date (Primary Key) indicating the beginning date of the reported in CARS for the contract between the Department ContractNumber and the contracting entity e.g., Managing Entity. EndDate DATE(10) Date in YYYY/MM/DD format Must be a valid date indicating the original end date of the reported in CARS for the contract between the Department ContractNumber and the contracting entity, e.g., Managing Entity. OriginalAmount DECIMAL(10) Original contracted amount Must be the dollar amount reported in CARS for the ContractNumber AmendmentId (Primary Key) CHAR(5) Amendment Identification Number Must be a number registered in CARS for the ContractNumber AmendmentType (Primary Key) CHAR(2) Indicate Amendment Type Must be a type registered in CARS AmendmentAmount DECIMAL(10) Amendment Amount Must be dollar amount registered in CARS EffectiveDate (Primary Key) DATE(10) Date in YYYY/MM/DD format indicating when the amendment became effective ExecutedDate DATE(10) Date in YYYY/MM/DD format indicating when the amendment was executed Must be a valid date registered in CARS Must be a valid date registered in CARS FASAMS ITN - Record Data Model Specification Document Page 161

162 ID Field Name Field Type Field Definition Validation NewEndDate DATE(10) Date in YYYY/MM/DD format indicating the new end date of the contract between the Department and the contracting entity, e.g., Managing Entity AmendedContractAmount DECIMAL(10) YTD contracted amount based on contract amendments CurrentFyAmount DECIMAL(10) Amount contracted for current Fiscal Year CfdaNumber CHAR(6) 5-digit code in XX.XXX format assigned to grants awarded and funded by the Federal government. Must be a valid date registered in CARS Must be dollar amount on CARS Main tab Must be dollar amount reported in CARS. Cannot be blank Managing Entity Subcontract ID Field Name Field Type Field Definition Validation FiscalYear DATE(10) Date in YYYY/MM/DD showing the end of the state fiscal year for the subcontract (e.g., 2016/06/30) Must be a valid date ContractorId CHAR(10) 10-digit code in XX-XXXXXXX format describing the Federal Employer Identification Number (FEIN) of the entity that holds direct contract with the department or an entity that is a state treatment facility. Valid entry must be the FEIN for ContractorId that is registered in the Contract Accountability Reporting System (CARS) ContractNumber CHAR(5) 5-digit contract number between Must be a valid (Primary Key) the Department and the contract number that is contracting entity, e.g., Managing registered in CARS. Entity. ProviderId CHAR(10) 10-digit code in XX-XXXXXXX Valid entry must be the (Primary Key) format describing the Federal FEIN for ProviderId that Employer Identification Number is registered in the (FEIN) of the entity that provides Provider Directory table. SAMH services either in state treatment facility operated by or under contract with DCF or in community under DCF contract or ME subcontract. SubContractNumber CHAR(5) 5-digit contract number the Cannot be blank (Primary Key) service provider has with the Managing Entity to provide services. FASAMS ITN - Record Data Model Specification Document Page 162

163 FASAMS ITN - Record Data Model Specification Document Page 163

164 ID Field Name Field Type Field Definition Validation ProgramArea (Primary Key) CoveredService (Primary Key) ContractedAmount CHAR(1) CHAR(2) DECIMAL(10) 1-digit code that indicates the program area in which SAMH services are provided., See Code Table in Appendix A. 2-digit code that indicates the general category of SAMH Covered Services as prescribed in Department Rule 65E , F.A.C. as prescribed See Covered Service Code Table in Pamphlet Indicate in XXXXXXX.XX format the amounts contracted for each covered service within each program area. Valid entry must be a value in code table for ProgramArea as specified in 12.5 Appendix A Valid entry must be a valid value in the Code Table for CoveredService and ProgramArea as specified in 4.5 Appendix B. Covered Service code must correspond to ProgramArea The total of these program amounts should equal the total contracted amount for the provider listed. PaymentRate CHAR(10) Indicate in XXXXXXX.XX format Cannot be blank the contracted dollar amount between the ME and the Provider agency as the payment per unit of the covered service provided. UnitofMeasure CHAR(1) Indicate the standard unit of measure of the Covered Service as prescribed in Department Rule 65E , F.A.C. Must be valid value in the code table UnitofMeasure as specified in 12.5 Appendix A PaymentMethod CHAR(1) Indicate the method used for Must be a valid value in payment of the covered service the code table for PaymentMethod as specified in 12.5 Appendix A PaymentType CHAR(1) Indicate the type of payment used for the covered service Must be a valid value in the code table for Payment Type as specified in 12.5 Appendix A Bundled CHAR(1) Indicate whether or not the Must be a valid value in covered service is bundled the code table for Bundled as specified in FASAMS ITN - Record Data Model Specification Document Page 164

165 12.5 Appendix A ID Field Name Field Type Field Definition Validation TotalCapacity CHAR(4) For covered services measured in days, indicate the total Cannot be null See Business Rule number of licensed beds. For covered services, which are not measured in days, i.e., unit of measure is direct staff hours, or non-direct staff hours, or dosages, indicate the total site caseload. DCFFundedCapacity CHAR(4) For covered services measured Cannot be null in days, indicate the total number of licensed beds funded by DCF. For covered services, which are not measured in days, i.e., direct staff hours or non-direct staff hours or dosages, indicate the total caseload funded by DCF. MedicaidProvider CHAR(1) Indicate whether the Provider is an enrolled Medicaid Provider. See Code Table in Appendix A. See Business Rule Must be a valid value in code table for MedicaidProvider as specified in 12.5 Appendix A BillHealthInsurance CHAR(1) Indicate whether the Provider is Must be a valid value in able to bill any non-medicaid code table for third party health insurance. BillHealthInsurance See Code Table in Appendix A. as specified in 12.5 Appendix A Business Rules ID Business Rule 1 The sum of contracted amounts for all covered services across provider agencies within each managing entity, cannot exceed the total budgeted amount for that managing entity. 2 The number of units purchased per covered services should be calculated automatically by the system by dividing the contracted amounts per covered service by the Payment Rate negotiated for that service. FASAMS ITN - Record Data Model Specification Document Page 165

166 11.4 Data Flow Diagram The diagram below describes how data for the Contract and Subcontract data model will be collected and submitted to FASAMS Appendix A: Code Table Field Name Code Description UnitOfMeasure 1 Direct Staff Hour 2 Non-Direct Staff Hour 3 Day 4 Dosage PaymentMethod 1 Fee For Service 2 Case Rate FASAMS ITN - Record Data Model Specification Document Page 166

167 3 Capitation Rate 4 Cost Reimbursement PaymentType 1 Utilization 2 Availability ProgramArea 1 Adult Mental Health (AMH) Bundled 1 Yes 2 Children s Mental Health (CMH) 3 Adult Substance Abuse (ASA) 4 Children s Substance Abuse (CSA) 1 Bed day or 24-hour care 2 Not a bed day or 24-hour care (group) 3 Not a bed day or 24-hour care (individual) 4 Non-client-specific services 2 No MedicaidProvider 1 Yes 2 No BillHealthInsurance 1 Yes 12 ACCESS 2 No 12.1 Data Model Diagram The interface between FASAMS and ACCESS FLORIDA will match incoming FASAMS client demographic records against the corresponding records in ACCESS FLORIDA recipient database to produce matching results that include three files as follows. For totally matched records, the ACCESS FLORIDA database will return each matching demographic record with the existing person identification number (PIN), as well as the person eligibility information. For unmatched records, the ACCESS FLORIDA database will use FASAMS demographic data to register the individual, create a new PIN, and return each demographic record with the new PIN as well as the person eligibility information. For partially matched records, the ACCESS FLORIDA database will return the exceptions records, which a trained SAMH staff member will use for online authentication and creation of a new PIN. FASAMS ITN - Record Data Model Specification Document Page 167

168 ACCESS ACCESS FASAMS ITN - Record Data Model Specification Document Page 168

169 12.2 Data Model Description Data Model ID: <ID> Data Model Name: ACCESS Record Description A vast majority of the individuals receiving SAMH services are also receiving Medicaid and/or other Public Assistance benefits, such as TANF, SNAP, Food Stamps, and so on. Currently, the ACCESS FLORIDA system assigns a 10-digit recipient number (PIN) that serves as a unique identifier for each individual eligible for any of these benefits. The interface between FASAMS and ACCESS FLORIDA will match incoming FASAMS client demographic records against ACCESS FLORIDA recipient database. For totally matched records, the ACCESS database will return each matching demographic record with the existing person identification number (PIN), as well as the person eligibility information. For unmatched records, the ACCESS database will register the individual, create a new PIN, and return each demographic record with the new PIN as well as the person eligibility information. For partially matched records, the ACCESS database will return the exceptions records, which trained SAMH staff will use for online authentication and creation of a new PIN. Furthermore, the ACCESS FLORIDA system will use the interface data module to update the FASAMS demographic records automatically when changes occur in client demographic statuses and/or client benefit indicators. Purpose The ACCESS data set is a critical component for creating and assigning person identification numbers (PIN) for clients, who are eligible for Medicaid, TANF cash assistance, and SNAP. For financial and services accountability purposes, the PIN will allow the Department to uniquely identify and track clients, who are eligible for receiving DCF funded services and to ensure services covered by Medicaid and other payers are not billed to the Department, or billed concurrently to both the Department and other payers. The Medicaid, TANF, SNAP and other client benefit data will be returned in batch to FASAMS as part of the Unique Identifier (UID) process. Data Sources The ACCESS data set will be provided via an interface with the ACCESS FLORIDA system. Timing / Frequency of Data Frequency will be monthly or any time based on the receipt of information from the MEs and Providers. Data Submission Process ACCESS data will be requested and returned via batch process using a Secured File Transfer Protocol (SFTP) between in-house servers. The Extensible Markup Language (XML) is the department s standard file format for submission and validation of records. Additional Information N/A FASAMS ITN - Record Data Model Specification Document Page 169

170 12.3 Data Tables Demo Match Request File ID Field Name Field Type Field Definition Validation SSN (Mandatory Key) FirstName MiddleInitial LastName CHAR(9) Enter the 9-digit social security number (SSN). If SSN is unknown or not available, use the pseudo SSN. Valid entry is the client s SSN or pseudo-ssn as specified in 10.5 Appendix A. Cannot be blank or start with 000 or 9. CHAR(35) Enter client s first name. Valid entry is the client s first name must be left justified/space filled. CHAR(14) Enter the client s middle initial. Valid entry is the client s If a middle name cannot be obtained, middle initial must be left then use the letter X. justified/space filled. CHAR(35) Enter Client s last name. Valid entry is the client s last name must be left justified/space filled. Suffix CHAR(10) Enter the client s suffix (e.g. Jr., II, etc.). Valid entry is the client s suffix must be left justified/space filled. BirthDate Gender Race Address (Optional) CHAR( 8) Enter the client s date of birth. Valid entry is the client s date of birth must be in format: YYYYMMDD and the client s date of birth must be > and <= system date. CHAR(1) Indicate the client s gender. Must be a valid value in code table for Gender as specified in 10.5 Appendix A CHAR(1) Indicate the client s race. Note: Two new codes: 4 Other and 5Alaskan Native effective as of July 1, A default address will be used Must be a valid value in code table for Race as specified in 10.5 Appendix A If unknown, leave blank Demo Match Response File Field Name Field Type Field Definition Data Source SSN Same as above Same as above FASAMS Request File FASAMS ITN - Record Data Model Specification Document Page 170

171 Field Name Field Type Field Definition Data Source Gender Same as above Same as above FASAMS Request File FirstName Same as above Same as above FASAMS Request File MiddleInitial Same as above Same as above FASAMS Request File LastName Same as above Same as above FASAMS Request File Suffix Same as above Same as above FASAMS Request File BirthDate Same as above Same as above FASAMS Request File Florida Department of C hildren and Families Race Same as above Same as above FASAMS Request File RecordType CHAR(TBD) Indicate the code used in ACCESS Response File ACCESS FLORIDA regarding the type of output file (e.g., matched record, exception record, update record) as defined in 13.6 Appendix A PIN CHAR(10) Indicate the Person Identification ACCESS Response File Number created by ACCESS FLORIDA and used by FASAMS as the Unique Client Identifier. FirstName Same as above Same as above ACCESS Response File MiddleInitial Same as above Same as above ACCESS Response File LastName Same as above Same as above ACCESS Response File Suffix Same as above Same as above ACCESS Response File BirthDate Same as above Same as above ACCESS Response File Gender Same as above Same as above ACCESS Response File Race Same as above Same as above ACCESS Response File SSN Same as above Same as above ACCESS Response File TanfEligibility CHAR(TBD) Indicate the code used in ACCESS FLORIDA as the indicator of the client s eligibility for TANF benefits as defined in 13.6 Appendix A ACCESS Response File MedicaidEligibility CHAR(TBD) Indicate the code used in ACCESS Response File ACCESS FLORIDA as the indicator of the client s eligibility for Medicaid benefits as defined in 13.6 Appendix A. SnapEligibility CHAR(TBD) Indicate the code used in ACCESS Response File ACCESS FLORIDA as the indicator of the client s eligibility for SNAP benefits as defined in 13.6 Appendix A. MatchType CHAR(TBD) Indicate the code used in ACCESS Response File ACCESS FLORIDA to indicate the type of record matching, e.g., FASAMS ITN - Record Data Model Specification Document Page 171

172 current PIN or New PIN through Florida client registration as defined in 13.6 Appendix A FASAMS ITN - Record Data Model Specification Document Page 172

173 Demo Update File Field Name Field Type Field Definition Data Source RecordType CHAR(TBD) Indicate the code used in ACCESS FLORIDA regarding the type of output file (e.g., matched record, exception record, update record) as defined in 13.6 Appendix A ACCESS Update File Pin CHAR(10) Indicate the Person Identification ACCESS Update File Number created by ACCESS FLORIDA and used by FASAMS as the unique Client Identifier. FirstName Same as above Same as above ACCESS Update File MiddleInitial Same as above Same as above ACCESS Update File LastName Same as above Same as above ACCESS Update File Suffix Same as above Same as above ACCESS Update File BirthDate Same as above Same as above ACCESS Update File Gender Same as above Same as above ACCESS Update File Race Same as above Same as above ACCESS Update File SSN Same as above Same as above ACCESS Update File TanfEligibility CHAR(TBD) Indicate the value used in ACCESS FLORIDA as the indicator of the client s eligibility for TANF benefits as defined in 13.6 Appendix A ACCESS Update File MedicaidEligibility CHAR(TBD) Indicate the value used in ACCESS Update File ACCESS FLORIDA as the indicator of the client s eligibility for Medicaid benefits as defined in 13.6 Appendix A. SnapEligibility CHAR(TBD) Indicate the value used in ACCESS Update File ACCESS FLORIDA as the indicator of the client s eligibility for SNAP benefits as defined in 13.6 Appendix A. NameChange CHAR(TBD) Indicate the value used in ACCESS Update File ACCESS FLORIDA as the indicator of the client s name change as defined in 13.6 Appendix A. DobChange CHAR(TBD) Indicate the value used in ACCESS ACCESS Update File FLORIDA as the indicator of the client s date of birth change as defined in 13.6 Appendix A. GenderChange CHAR(TBD) Indicate the value used in ACCESS FLORIDA as the ACCESS Update File FASAMS ITN - Record Data Model Specification Document Page 173

174 Field Name Field Type Field Definition Data Source indicator of the client s gender change as defined in 13.6 Appendix A. RaceChange CHAR(TBD) Indicate the value used in ACCESS Update File ACCESS FLORIDA as the indicator of the client s race change as defined in 13.6 Appendix A. SSNChange CHAR(TBD) Indicate the value used in ACCESS Update File ACCESS FLORIDA as the indicator of the client s SSN change as defined in 13.6 Appendix A. Business Rules ID Business Rule 1 ACCESS will receive batch file from FASAMS and will match by SSN. If no match on SSN, then use the fields First Name, Middle Name, Last Name, DOB and Gender as a combination key. 2 For totally matched records, ACCESS will return the FASAMS demographic records with the existing PIN and client eligibility information 3 For unmatched records, ACCESS will create a new PIN and return the FASAMS demographic records with the new PIN and client eligibility information 4 For partially matched records, ACCESS will return exception records showing the FASAMS demographic record along with existing information on each individual who partially match the FASAMS demographic record. SAMH trained staff will use the information in the exception records for online PIN authentication and/or creation of new PIN. 5 It is either 100% match or not a match at all. If there is more than one return on a match, it is a partial match Data Flow Diagram The diagram below describes high-level business mapping processes for matching FASAMS demographic records against the corresponding records in ACCESS FLORIDA and returning the matching results to FASAMS, including Output Files of Florida Demographic Data with PIN, Updated Files of Florida Demographic Data and Benefit Indicators, and Exception Files of Florida Demographic Data without PIN. These exception files will be used by SAMH trained staff for online client registration and creation of new PIN in ACCESS FLORIDA. FASAMS ITN - Record Data Model Specification Document Page 174

175 The table below provides brief descriptions of the ACCESS FLORIDA processes displayed in the above diagram. High-Level Processes Needed for Interface between FASAMS and ACCESS FLORIDA Process Name Process Description FASAMS ITN - Record Data Model Specification Document Page 175

176 1. Demographic Match This process will match input demographic records from FASAM with corresponding records in the ACCESS FLORIDA RS01 (Individual/Recipient Database). If SSN match is found, the record will be considered as a match. Additional criterial for matching other demographic data may be defined for 100% match (e.g., names, DOB, gender, and race) and to return the PIN. If SSN match is not found, additional criteria will be defined to match the rest of the demographic data and return the PIN or to create exception records. Additional criteria may be defined to consider no match situations and to send the record to the Automated Client Registration Process The current matching criteria used by ACCESS automated processes will be leveraged 2. Match Decision This decision will check on full match and partial match of FASAM record with ACCESS Florida data based on the criteria used in Process #1 above This process will initiate and complete the Client Registration process in the FLORIDA 3. Perform system using a driver specifically created for SAMH clients. FLORIDA The system will use the current individual clearance match criteria for Client Client Registration. Additional criteria may be defined to clear individuals as new individuals Registration when demographic information is partially matched or to write exception The system will withdraw RFAs created for the SAMH process 4. New PIN Created This decision will testing the results of Process #3 by checking if a new PIN has been created Decision 5. Write PIN and FLORIDA Demographic Data This process will write the output record based on Decisions #2 and #4 If Decision #2 finds a full match (criteria to be defined), the PIN number and demographic data from ACCESS FLORIDA will be written to the output file. If Decision #4 finds that a new PIN is created, then the PIN and demographic data from FLORIDA will be written to the output file This process is executed when Decision #4 finds that a new PIN cannot be created automatically. 6. Write This takes place when partial/multiple or full matches (criteria to be defined) of the Exception and demographic data is found but there is a mismatch of the SSN (or an SSN is missing in FLORIDA the FASAMS record or in FLORIDA data). Demographic The record will include an exception reason and the ACCESS FLORIDA data that resulted Data in partial/multiple matches including the PIN number of the partially-matching individual record. 7. FLORIDA Demographic and Benefit Type Indicator Data Updates This is a standalone process that will identify updates made to individual demographic data and write out records that will be shared with FASAMS This process will also send updates to the benefit indicators (TANF, SNAP, Medicaid) when individuals are added to other benefit programs or their current benefits are dropped 8. ACCESS to FASAMS File Process This process will transmit the files produced in Processes #5, #6 and #7 to FASAMS. The file will include a record type indicator that will let FASAMS identify the type of record being transmitted, e.g., Matched Records, Exception Records, or Update Records Appendix FASAMS ITN - Record Data Model Specification Document Page 176

177 A: Code Table Field Name Code Description RecordType TBD Matched Record Response MedicaidEligibility TBD TBD TBD Match Response Exception Record Update TBD TanfEligibility SnapEligibility MatchType TBD TBD TBD TBD TBD TBD New Pin thru Matching Record New PIN thru FLORIDA Client Registration FASAMS ITN - Record Data Model Specification Document Page 177

178 13 FSFN 13.1 Data Model Diagram The Child Welfare Involvement (CWI) data module includes historical information on substance abuse and mental health clients, who are involved in the child welfare system of care. The CWI record is a child of the FASAMS Demographic record, which has a matching record in the Florida Safe Family Network (FSFN) DataMart. A FASAMS Demographic record can have many records in the CWI data module. Demographic FASAMS ITN - Record Data Model Specification Document Page 178

179 13.2 Data Model Description Data Model ID: <ID> Data Model Name: Demographic Record Description Incoming FASAMS client demographic records are matched to FSFN DataMart records in a left outer join providing all of the rows originally submitted with matching FSFN cases having additional requested fields in the returned row, as described in the Data Table Purpose Provide up to date information on SAMH clients, who are involved in the Child Welfare System of care. Data Sources FSFN DataMart Timing / Frequency of Data Frequency will be monthly or any time based on the receipt of information from the MEs and Providers. Data Submission Process File will be delivered to SFTP between in-house servers in a batch process. The FASAMS system will need to process the files any time it receives them. FSFN can provide a fuzzy logic on the matching for take a person to confirm the match, in order for FSFN to return. File format is XML. Additional Information N/A 13.3 Data Tables FSFN File ID Field Name Field Type(Size) Field Definition CaseId Integer(9) FSFN Unique ID at the case level Validation FASAMS ITN - Record Data Model Specification Document Page 179

180 PersonId Integer(9) FSFN Unique ID at the person level IntakeNumber Varchar(10) FSFN Intake ID StartDateInterAction* DATE(10) Timestamp in YYYY-MM-DD format indicating the date when the person started interaction with the child welfare system of care - One of several fields may fill* LastDateInteraction* DATE(10) Timestamp in YYYY-MM-DD format indicating the last date when the person interacted with the child welfare system of care- One of several fields may fill* CaseType CHAR(2) Defines the type of interaction with the child welfare system of care *See business rules below ID Business Rule Incoming file from FASAMS FSFN will match by SSN; If no match on SSN, then use the fields First Name, Middle Name, Last Name, DOB and Gender as a combination key. File outbound to FASAMS will return only one row for a PersonID based on the last date of interaction with FSFN StartDateInterAction field returned to FASAMS will be the earliest date of interaction with FSFN system for the PersonID with regard to the case type first created LastDateInterAction field returned to FASAMS will be the latest date of interaction with FSFN system for the PersonID with regard to the case type last updated It is either a one-person match or not a match at all. If there is more than one return on a match, it is not a match. FASAMS ITN - Record Data Model Specification Document Page 180

181 13.4 Data Flow Diagram 13.5 Appendix A: FSFN Code Table Field Name Code Description FASAMS ITN - Record Data Model Specification Document Page 181