RequiredotherA1
Tier not determined
No rule matched this measure, so no tier is guessed.
- Instrument
- SUPRT-A
- Target
- No target rule stated
Source document, 3RequiredotherA2
Narrative response
A prompt for a description, a selection or a short answer.
- Instrument
- SUPRT-A
- Target
- No target rule stated
Source document, 3RequiredotherA3
Narrative response
A prompt for a description, a selection or a short answer.
Answer categories: Baseline | Reassessment (for clients in care at 3 or 6 months) | Annual (for clients in care for more than 12 months) | Record closeout
- Instrument
- SUPRT-A
- Target
- No target rule stated
Source document, 3RequiredotherA4
Tier not determined
No rule matched this measure, so no tier is guessed.
- Instrument
- SUPRT-A
- Target
- No target rule stated
Source document, 3RequiredotherA5
Tier not determined
No rule matched this measure, so no tier is guessed.
- Instrument
- SUPRT-A
- Target
- No target rule stated
Source document, 3RequiredotherA6
Tier not determined
No rule matched this measure, so no tier is guessed.
Answer categories: Completed the program | No contact | Withdrew from/Refused treatment | Referred out | Transferred to a different grant program | Incarceration | Moved | Death | Other
- Instrument
- SUPRT-A
- Target
- No target rule stated
Source document, 3RequiredotherA6a
Tier not determined
No rule matched this measure, so no tier is guessed.
Answer categories: Suicide | Overdose | Other behavioral health cause | Other cause | Not documented in record
- Instrument
- SUPRT-A
- Target
- No target rule stated
Source document, 4RequiredotherB1
Narrative response
A prompt for a description, a selection or a short answer.
Answer categories: SELECT ALL THAT APPLY | Medicare | Medicaid | Private Insurance or Employer Provided | TRICARE, CHAMPUS, CHAMPVA or other veteran or military health care | Indian Health Service Tribal Health Care | An assistance program [for example, a medication assistance program] | Any other type of health insurance or health coverage plan | None | Not documented in records or not documented in records using…
- Instrument
- SUPRT-A
- Target
- No target rule stated
Source document, 5RequiredotherB2
Tier not determined
No rule matched this measure, so no tier is guessed.
Answer categories: Yes – Behavioral health reasons, for example mental health or substance use disorder | Yes – other health reasons, for example injury or illness | No | Not documented in records or not documented in records using this standard
- Instrument
- SUPRT-A
- Target
- No target rule stated
Source document, 5RequiredotherB3
Tier not determined
No rule matched this measure, so no tier is guessed.
Answer categories: Yes – Behavioral health reasons, for example mental health or substance use disorder | Yes – other health reasons, for example injury or illness | No | Not documented in records or not documented in records using this standard
- Instrument
- SUPRT-A
- Target
- No target rule stated
Source document, 5RequiredotherB4
Tier not determined
No rule matched this measure, so no tier is guessed.
Answer categories: Yes | No | Not documented in records or not documented in records using this standard
- Instrument
- SUPRT-A
- Target
- No target rule stated
Source document, 5RequiredotherB4a
Tier not determined
No rule matched this measure, so no tier is guessed.
Answer categories: Suicide risk | Other risk of harm to self or others (e.g. NSSI, homicidal thoughts) | Mental health | Substance use other than overdose | Overdose | Other | Not documented in records or not documented in records using this standard
- Instrument
- SUPRT-A
- Target
- No target rule stated
Source document, 5RequiredotherB5
Tier not determined
No rule matched this measure, so no tier is guessed.
Answer categories: Yes | No | Not documented in records or not documented in records using this standard
- Instrument
- SUPRT-A
- Target
- No target rule stated
Source document, 6RequiredotherB6
Tier not determined
No rule matched this measure, so no tier is guessed.
Answer categories: Yes | No | Not applicable | Not documented in records or not documented in records using this standard
- Instrument
- SUPRT-A
- Target
- No target rule stated
Source document, 6RequiredotherB7
Tier not determined
No rule matched this measure, so no tier is guessed.
Answer categories: Yes | No | Not applicable | Not documented in records or not documented in records using this standard
- Instrument
- SUPRT-A
- Target
- No target rule stated
Source document, 6RequiredotherB8
Tier not determined
No rule matched this measure, so no tier is guessed.
Answer categories: Yes | No | Not applicable | Not documented in records or not documented in records using this standard
- Instrument
- SUPRT-A
- Target
- No target rule stated
Source document, 6RequiredotherC1
Implementation question, answered from program records
A yes/no question about your own program. You answer it from program records, so there is no data to collect.
Answer categories: Yes – Screening result was negative (no or low risk) | Yes – Screening result was positive (at risk) | No, not screened or assessed | Not documented in records or not documented in records using this standard
- Instrument
- SUPRT-A
- Target
- No target rule stated
Source document, 7RequiredotherC2
Implementation question, answered from program records
A yes/no question about your own program. You answer it from program records, so there is no data to collect.
Answer categories: Yes – Screening result was negative (no or low risk for substance use disorder (SUD)) | Yes – Screening result was positive (at risk for SUD) | No, not screened or assessed | Not documented in records or not documented in records using this standard
- Instrument
- SUPRT-A
- Target
- No target rule stated
Source document, 7RequiredotherC3
Tier not determined
No rule matched this measure, so no tier is guessed.
Item text continues: b. Opioids ... c. Cannabis ... d. Sedative, hypnotic, or anxiolytics ... e. Cocaine ... f. Methamphetamine ... g. Other stimulants ...…
- Instrument
- SUPRT-A
- Target
- No target rule stated
Source document, 7RequiredotherC4
Implementation question, answered from program records
A yes/no question about your own program. You answer it from program records, so there is no data to collect.
Item text continues: Anxiety disorders ... c. Bipolar disorders ... d. Psychosis, psychotic disorders ... e. Trauma disorders, including PTSD ... f. [IF CLIENT < 18 YEARS] Answer categories: Developmental, neurologic disorders ... | g. [IF CLIENT < 18 YEARS] | Behavioral and emotio…
- Instrument
- SUPRT-A
- Target
- No target rule stated
Source document, 8RequiredotherD1
Tier not determined
No rule matched this measure, so no tier is guessed.
Answer categories: No diagnosis
- Instrument
- SUPRT-A
- Target
- No target rule stated
Source document, 9RequiredotherD2
Tier not determined
No rule matched this measure, so no tier is guessed.
Answer categories: No diagnosis
- Instrument
- SUPRT-A
- Target
- No target rule stated
Source document, 9RequiredotherD3
Tier not determined
No rule matched this measure, so no tier is guessed.
Item text continues: | | Answer categories: No diagnosis | OTHER HEALTH STATUS QUESTIONS | Please indicate additional health status information as applicable and as documented in a clinical record.
- Instrument
- SUPRT-A
- Target
- No target rule stated
Source document, 9RequiredotherD4
Tier not determined
No rule matched this measure, so no tier is guessed.
Answer categories: Yes | No | Not applicable | Not documented in records or not documented in records using this standard
- Instrument
- SUPRT-A
- Target
- No target rule stated
Source document, 9RequiredotherD5
Tier not determined
No rule matched this measure, so no tier is guessed.
Answer categories: Yes | No | Not documented in records or not documented in records using this standard
- Instrument
- SUPRT-A
- Target
- No target rule stated
Source document, 9RequiredotherD6
Tier not determined
No rule matched this measure, so no tier is guessed.
Answer categories: Yes | No | Not applicable | Not documented in records or not documented in records using this standard
- Instrument
- SUPRT-A
- Target
- No target rule stated
Source document, 10RequiredotherD6a
Tier not determined
No rule matched this measure, so no tier is guessed.
Answer categories: SELECT ALL THAT APPLY | Naloxone (Narcan) or other opioid overdose reversal medication | Care in an emergency department | Care from a primary care provider | Admission to a hospital | Supervision by someone else | Other | Not applicable | Not documented in records or not documented in records using this standard
- Instrument
- SUPRT-A
- Target
- No target rule stated
Source document, 10RequiredotherD7
Tier not determined
No rule matched this measure, so no tier is guessed.
Answer categories: Yes, HIV-positive | No, HIV-negative | Not documented in records or not documented in records using this standard
- Instrument
- SUPRT-A
- Target
- No target rule stated
Source document, 10RequiredotherD7a
Tier not determined
No rule matched this measure, so no tier is guessed.
Answer categories: Yes, currently taking ART | No, not currently taking ART | Not documented in records or not documented in records using this standard
- Instrument
- SUPRT-A
- Target
- No target rule stated
Source document, 10RequiredotherD7b
Tier not determined
No rule matched this measure, so no tier is guessed.
Answer categories: Yes, currently on PrEP | No, not currently on PrEP | Not documented in records or not documented in records using this standard
- Instrument
- SUPRT-A
- Target
- No target rule stated
Source document, 10RequiredotherD8
Implementation question, answered from program records
A yes/no question about your own program. You answer it from program records, so there is no data to collect.
Answer categories: Yes, active or previous Hepatitis C infection | No, never had Hepatitis C | Not documented in records or not documented in records using this standard
- Instrument
- SUPRT-A
- Target
- No target rule stated
Source document, 10RequiredotherD8a
Tier not determined
No rule matched this measure, so no tier is guessed.
Answer categories: Yes, currently taking viral Hepatitis C treatment | No, took treatment and cured | No, Hepatitis C infection naturally cleared without need for treatment | No, not currently taking treatment | Not documented in records or not documented in records using this standard
- Instrument
- SUPRT-A
- Target
- No target rule stated
Source document, 11RequiredotherE1
Implementation question, answered from program records
A yes/no question about your own program. You answer it from program records, so there is no data to collect.
Answer categories: Yes | No | Not documented in records
- Instrument
- SUPRT-A
- Target
- No target rule stated
Source document, 12RequiredotherE1a
Narrative response
A prompt for a description, a selection or a short answer.
Item text continues: Substance use psychoeducation ... d. Mental health psychoeducation ... e. Mental health therapy ... f. Co-occurring therapy (substance use & mental health) g. Group counseling ... h. Indi…
- Instrument
- SUPRT-A
- Target
- No target rule stated
Source document, 12RequiredotherE2
Tier not determined
No rule matched this measure, so no tier is guessed.
Item text continues: Extended-release Naltrexone ... c. Disulfiram ... d. Acamprosate ... e. Methadone ...…
- Instrument
- SUPRT-A
- Target
- No target rule stated
Source document, 13RequiredotherE3
Implementation question, answered from program records
A yes/no question about your own program. You answer it from program records, so there is no data to collect.
Answer categories: Yes | No | Not documented in records
- Instrument
- SUPRT-A
- Target
- No target rule stated
Source document, 13RequiredotherE3a
Narrative response
A prompt for a description, a selection or a short answer.
Item text continues: Crisis stabilization ... d. Crisis follow-up ... RECOVERY AND SUPPORT SERVICES
- Instrument
- SUPRT-A
- Target
- No target rule stated
Source document, 13RequiredotherE4
Implementation question, answered from program records
A yes/no question about your own program. You answer it from program records, so there is no data to collect.
Answer categories: Yes | No | Not documented in records
- Instrument
- SUPRT-A
- Target
- No target rule stated
Source document, 14RequiredotherE4a
Narrative response
A prompt for a description, a selection or a short answer.
Answer categories: support ... | c. Childcare ... | d. Transportation ... | e. Education support... | f. Housing support ... | g.…
- Instrument
- SUPRT-A
- Target
- No target rule stated
Source document, 14RequiredotherE5
Implementation question, answered from program records
A yes/no question about your own program. You answer it from program records, so there is no data to collect.
Answer categories: Yes | No | Not documented in records
- Instrument
- SUPRT-A
- Target
- No target rule stated
Source document, 15RequiredotherE5a
Narrative response
A prompt for a description, a selection or a short answer.
Item text continues: HIV testing ... d. Viral hepatitis testing ... e. HIV treatment ... f. HIV pre-exposure prophylaxis (PrEP) ... g. Viral hepatitis treatment ... h. Other STI testing or tre…
- Instrument
- SUPRT-A
- Target
- No target rule stated
Source document, 15RequiredotherF1
Narrative response
A prompt for a description, a selection or a short answer.
Answer categories: White – Provide details below. | German | Irish | English | Italian | Polish | French | Enter, for example, Scottish, Norwegian, Dutch, etc. ____ | Hispanic or Latino – Provide details below. | Mexican or Mexican American | Puerto Rican | Cuban | Salvadoran | Dominican | Colombian | Enter, for example, Guatemalan, Spaniard, Ecuadorian, etc. ____ |…
- Instrument
- SUPRT-A
- Target
- No target rule stated
Source document, 16RequiredotherF2
Narrative response
A prompt for a description, a selection or a short answer.
Answer categories: Female | Male
- Instrument
- SUPRT-A
- Target
- No target rule stated
Source document, 17