Generated Narrative: Questionnaire SHINNYAdministrativeQuestionnaire

LinkID	Text	Cardinality	Type	Description & Constraints
			Questionnaire	http://shinny.org/us/ny/hrsn/Questionnaire/SHINNYAdministrativeQuestionnaire#1.5.3
administrative-questionnaire	Administrative questions that capture information about the patient's population categorization, specific services needed and/or medical necessities.	0..1	group
administrative-questions	Administrative quesitons that verify information about the patient.	0..1	group
enhanced-population-check	Check populated by entity, conducting the assessment. Captures patient response during the HRSN assessment, resulting in SCN request to update covered population categorization with MCO.	0..1	choice	Options: 8 options
service-duplication-check	Check populated by entity, conducting the assessment. Captures patient response during the HRSN assessment, identifying if patient currently receives services that would inhibit ability to deliver any or all NYHER services.	0..1	choice	Options: 11 options
clinical-criteria-check	Check populated by entity, conducting the assessment. Captures patient response during the HRSN assessment, identifying if patient has the required medical necessity that would satisfy requirement to deliver NYHER service.	0..1	choice	Options: 7 options
Documentation for this format

Options Sets

Answer options for enhanced-population-check

• http://shinny.org/us/ny/hrsn/CodeSystem/SHINNYQuestionnaires#medicaid-high-utilizer ("Medicaid High Utilizer")
• http://shinny.org/us/ny/hrsn/CodeSystem/SHINNYQuestionnaires#nys-health-home ("Individuals Enrolled in a NYS Health Home")
• http://shinny.org/us/ny/hrsn/CodeSystem/SHINNYQuestionnaires#pregnant-postpartum ("Pregnant and Postpartum Persons")
• http://shinny.org/us/ny/hrsn/CodeSystem/SHINNYQuestionnaires#children-high-risk ("High-Risk Children Under 18 Years Old")
• http://shinny.org/us/ny/hrsn/CodeSystem/SHINNYQuestionnaires#released-chronic-condition ("Individuals with a Chronic Condition Released from Incarceration in the Past 90 Days")
• http://shinny.org/us/ny/hrsn/CodeSystem/SHINNYQuestionnaires#other-eligible-population ("Other Eligible Population")
• http://shinny.org/us/ny/hrsn/CodeSystem/SHINNYQuestionnaires#high-risk-nutrition ("High Risk Children Under 18 Nutrition Only")
• http://loinc.org#LA9-3 ("None of the above")

Answer options for service-duplication-check

• http://shinny.org/us/ny/hrsn/CodeSystem/SHINNYQuestionnaires#healthy-homes ("Healthy Homes")
• http://shinny.org/us/ny/hrsn/CodeSystem/SHINNYQuestionnaires#nutritional-counseling ("Nutritional Counseling")
• http://shinny.org/us/ny/hrsn/CodeSystem/SHINNYQuestionnaires#medical-tailored-meals ("Medically Tailored Meals (MTM) In-lieu of Services (ILOS)")
• http://shinny.org/us/ny/hrsn/CodeSystem/SHINNYQuestionnaires#health-home-enrollment ("Health Home Enrollment (under Enhanced Populations)")
• http://shinny.org/us/ny/hrsn/CodeSystem/SHINNYQuestionnaires#opwdd-waiver ("Office for Persons with Developmental Disabilities (OPWDD) Waiver")
• http://shinny.org/us/ny/hrsn/CodeSystem/SHINNYQuestionnaires#tbi-waiver ("Traumatic Brain Injury (TBI) Waiver")
• http://shinny.org/us/ny/hrsn/CodeSystem/SHINNYQuestionnaires#nhtd-waiver ("Nursing Home Transition Diversion (NHTD) Waiver")
• http://shinny.org/us/ny/hrsn/CodeSystem/SHINNYQuestionnaires#childrens-waiver ("Childrens Waiver")
• http://shinny.org/us/ny/hrsn/CodeSystem/SHINNYQuestionnaires#medicaid-advantage-program ("Medicaid Advantage Program (MAP)")
• http://shinny.org/us/ny/hrsn/CodeSystem/SHINNYQuestionnaires#mltcp ("Partial Capitation Managed Long-Term Care (MLTCP)")
• http://loinc.org#LA9-3 ("None of the above")

Answer options for clinical-criteria-check

• http://shinny.org/us/ny/hrsn/CodeSystem/SHINNYQuestionnaires#chronic-condition ("Chronic Condition")
• http://shinny.org/us/ny/hrsn/CodeSystem/SHINNYQuestionnaires#uncontrolled-asthma ("Uncontrolled Asthma")
• http://shinny.org/us/ny/hrsn/CodeSystem/SHINNYQuestionnaires#nutrition-therapy ("Enteral or Parenteral Nutrition Therapy")
• http://shinny.org/us/ny/hrsn/CodeSystem/SHINNYQuestionnaires#heat-related-illness ("Heat-Related Illness Requiring an ER or UC Visit")
• http://shinny.org/us/ny/hrsn/CodeSystem/SHINNYQuestionnaires#cold-related-illness ("Cold-Related Illness Requiring an ER or UC Visit")
• http://shinny.org/us/ny/hrsn/CodeSystem/SHINNYQuestionnaires#thermoregulation-interference ("Conditions and Medications Interfering with Thermoregulation")
• http://loinc.org#LA9-3 ("None of the above")