Removed Contract Name, Removed dates and description from active risk codes. Renamed ProviderStaffName to AssignedStaffName, ProviderStaffPhoneNumber to AssignedStaffPhoneNumber. Added OfferDate. ServiceReferralUpdate: Removed ContractName, RoomNumber. Added CMReassessmentDate, ProviderEndDate,OfferDate, AssignedStaffName, AssignedStaffPhoneNumber, School and ActiveRiskCodes. 2.10 June 12, 2009 Remove Service Referral Update, Service and Offer Response Combined Service Referral Update with Service Referral PreferredName and Health Card elements to the Client elelment Mary Lou Smith Ion Moraru 2.11 Sep 1, 2009 Update to following after QA Testing: 2.1 CcacCode, Referral Type, Request Type 2.2 ServiceTypeCode, ServiceDeliveryType, UnitOfService, ServiceDeliveryLocationCode Appendix B ‘Home Care’ change to ‘Home’ Ellen Hsu 2.12 Sep. 22, 2009 Changed the data type for NumberOfHoursPerVisit and QuantityOfService Ion Moraru 2.13 Oct 6, 2009 Add <Salutation>, <Phone> and <WorkPhone> to <PersonalContacts> Ellen Hsu 2.14 December 9, 2009 Add Sender and Destination elements that describe the participants in the message exchange. Arthur Bydon 2.15 March 26, 2010 Added Allergies, SafetyIssues, BillingCodes Arthur Bydon 2.15 March 29, 2010 Add Description to Frequency Day of the Week selection, Number of Hours per Visit, Recurrence Number and Recurrence Period. Hsu
Purchased Service Referral Brief Description Once it is determined that a Client to receive a Purchased Service, the CCAC may issue a Service Offer to the chosen Service Provider for them to Accept or Reject. Once the Offer is accepted, a Service Referral is sent to that Provider to more fully describe the details and the context of the service that is required. Should the need occur to change the Service frequency, the CCAC will send another Service Referral (for Frequency Update) to the Provider with a set of Frequency elements containing the appropriate changes. This document specifies the information and associated format of Service Referral. High Level Structure of the Service Referral The Service Referral and Service Referral Update are XML documents that share the following high level element structure: Figure Service Referral As the diagram above depicts, a ServiceReferral and ServiceReferralUpdate element contain one Service element, one ServiceRecipient element and possibly one ServicePlanSummary element. The Service element itself contains one to many Frequency and/or Outcome-Based Pathway elements and the ServiceRecipient element contains a single Client element. These are the principal elements that make up a Service Referral and there is a section below to more fully specify each of them.
DischargeDisposition 100 Alpha / num No The description of the reason for discharging [Discharge_Dispositions].[Description] Based on: DischargeComment 250 Alpha / num No Comments associated with the Discharge LastUpdateDate No Date and time of the last update for the Pathway Assignment No Unique identifier of the Outcome-Based Pathway Assignment [ICC_Care_Path_Assignments].[RowGuid] 10 Alpha / num No Code of the current Outcome-Based Pathway assignment status 50 Alpha / num No Name of the current Outcome-Based Pathway assignment status No A collection of Milestones for the Pathway Assignment – Service Referral and Frequency changes only No Code 50 Alpha / num No Milestone code [ICC_Care_Path_Events].[Event_Code]
ServiceDeliveryType 50 / num No Name of the Service Delivery Type 20 Alpha / num No Code of the Service Delivery Type ExternalSystemId 50 Alpha / num No Identification of the external system ServiceRecipient element detail The role of the ServiceRecipient element is to specify the entity that will be receiving the Service. Initially this element will only contain a single Client element, Code and Description. In the future it is envisioned that different types of recipients will need to be supported. For example, allow for the specification of groups of people to be served by a single service (e.g. people located in a specific building, service that is targeted towards serving the fluctuating needs of a community within a retirement home etc). Although not strictly required today, the ServiceRecipient element is being included in the specification to avoid having to make basic changes to the format in the future once multiple recipient types are supported. Name Field Length (chars) Type Mandatory? Description Code 10 Alpha/Num No The MIS Standards code pertaining to the service recipient Description 250 No The descriptive name of the code
ProcedureDate 10 Date Yes Date when client underwent the procedure (yyyy-mm-dd) Allergies - Element No Collection of client allergies Allergy - Element No Category 100 Alpha / num No The category of allergy, i.e. one of 'Animal', 'Drug', 'Environmental', 'Food', 'Unknown' or 'Unable to Assess' AllergyDescription 250 / num No The detailed description of the allergy, for example, 'Animal dander', 'Animal hair', 'Bee pollen', etc. StartDate 10 Date No The known date when the allergy started EndDate 10 Date No The known date when the allergy ended, if applicable AdditionalInformation 500 Alpha / num No Any additional information pertaining to this allergy SafetyIssues - Element No Collection of safety issue that the provider needs to be aware of SafetyIssue - Element No IssueDescription 250 Alpha / num No The description of the active safety issue, for example StartDate 10 Date No The date when the safety issue becomes relevant EndDate 10 Date No The date when the safety issue stops being relevant AdditionalInformation 500 / num No Any additional information pertaining to this safety issue
6 decimal No Number of hours per visit. 10 Alpha Yes The submitted frequency period cancel reason code in the original provider report. 100 Alpha Yes The name of the submitted frequency period cancel reason code in the original provider report. 250 Alpha / Num No Additional provider comments pertaining to visit cancellation Frequency element See Frequency element detail Yes The full details of the requested frequency. 50 Alpha Yes Name of the change request status, representing Approved or Denied 10 Alpha Yes Code of the change request status, representing Approved or Denied 50 Alpha Yes Description of the change request type ChangedFrequency element No Representing the submitted “Change Frequency” request in the original provider report EndDate 10 Date Yes The requested frequency end date in the original request
ER Hourly Children's Enhanced Respite home care Hour Home GER Visit Psychogeriatric Resource Coordination home care Visit Home HOM Hourly Homemaking - Caregiver Respite home care Homemaking – Caregiver Respite Hour Home HOM Hourly Homemaking - Combined personal support & housekeeping home care Combined Personal Support and Housekeeping Hour Home HOM Hourly Homemaking - Housekeeping home care Homemaking - Housekeeping Hour Home HOM Hourly Personal Support Home Care Homemaking - Personal Support Hour Home HOM Hourly Personal Support Residential Hospice Homemaking - Personal Support Hour Residential Hospice HOM Visit Homemaking - Combined home care Combined Personal Support and Housekeeping Visit Home HOM Visit Homemaking - Housekeeping home care Homemaking - Housekeeping Visit Home HOM Visit Homemaking - Respite home care Homemaking - Caregiver Respite Visit Home HOM Visit Personal Support home care Homemaking - Personal Support Visit Home LAB Visit Lab home care Visit Home MOW Meals on Wheels CCAC Home NP Hourly Nurse Practitioner home care Hour Home NP Visit Nurse Practitioner home care Home NUR Hourly nursing home care Hour Home NUR Shift nursing combined therapy & nursing day clinic Hour Combined Day Clinic NUR Shift nursing combined therapy & nursing day/night clinic Hour Combined Day/Night Clinic NUR Shift nursing home care Hour Home NUR Shift nursing nursing only day clinic Hour Nursing Day Clinic
OT Visit OT combined nursing & therapy day/night clinic Visit Combined Day/Night Clinic OT OT home care Visit Home OT OT home care hourly Hour Home OT OT Residential Hospice Visit Residential Hospice OT OT therapy only day clinic Visit Therapy Day Clinic PAS Visit Pastoral Care home care Visit Home PHA Hourly Pharmacy Consultation home care Hour Home PHA Visit Pharmacy Consultation home care Visit Home PHY Physician home care Visit Home PHY Visit Physician Palliative Home Care Palliative Visit Home PM Visit paramedical Home PSM Pain & Sympton Mgmt call Visit PSM Visit Pain & Sympton Mgmt home care Visit Home PSY Visit Psychologist home care Visit Home PT Hourly PT home care Hour Home PT Visit PT combined nursing & therapy day clinic Visit Combined Day Clinic PT Visit PT combined nursing, therapy day/night clinic Visit Combined Day/Night Clinic PT Visit PT home care Visit Home PT Visit PT phone call Visit Phone PT Visit PT Pulmonary Rehab Home Care PT - Pulmonary Rehab Visit Home PT PT Residential Hospice Visit Residential Hospice PT Visit PT therapy only day clinic Visit Therapy Day Clinic RT Hourly RT home care Hour Home RT RT combined nursing, therapy day clinic Visit Combined Day Clinic RT Visit RT combined nursing, therapy day/night clinic Visit Combined Day/Night Clinic RT Visit RT home care Visit Home
RT Visit RT Residential Hospice Visit Residential Hospice RT Visit RT therapy only day clinic Visit Therapy Day Clinic SH Supportive Housing Visit Home SP Hourly speech home care Hour Home SP Hourly speech therapy clinic Hour Therapy Day Clinic SP Visit Communicate Device Assistant Home Care Speech - Communicative Device Assistant Home SP Visit speech augmentative communication home care Speech - Augmentative Communication Home SP Visit speech combined nursing, therapy day clinic Visit Combined Day Clinic SP Visit speech combined nursing, therapy day/night clinic Visit Combined Day/Night Clinic SP Visit speech home care Visit Home SP speech phone call Visit Phone SP Visit speech Residential Hospice Visit Residential Hospice SP Visit speech therapy only day clinic Visit Therapy Day Clinic SW Hourly social work home care Hour Home SW Visit social work combined nursing, therapy day clinic Visit Combined Day Clinic SW social work combined nursing, therapy day/night clinic Visit Combined Clinic SW Visit social work home care Visit Home SW Visit social work phone call Visit Phone SW Visit social work Residential Hospice Visit Residential Hospice SW social work therapy clinic Visit Therapy Day Clinic TRANS Transportation home care Visit Home School Referrals ENT Visit ENT private/home school Visit Private/Home School HOM Hourly Personal Support Private/ Homemaking - Personal Support Hour Private/Home School
NUR Hourly nursing private/home school Hour Private/Home School NUR Hourly nursing public school Hour Publicly Funded School NUR Shift nursing private/home school Hour Private/Home School NUR Shift nursing public school Hour Publicly Funded School NUR Visit nursing private/home school Visit Private/Home School NUR nursing public school Visit Publicly Funded School NUT Hourly dietician private/home school Hour Private/Home School NUT Hourly dietician public school Hour Publicly Funded School NUT Visit dietician private/home school Visit Private/Home School NUT Visit dietician public school Visit Publicly Funded School OT Hourly OT private/home school Hour Private/Home School OT Hourly OT public school Hour Publicly Funded School OT Visit OT private/home school Visit Private/Home School OT Visit OT public school Publicly Funded School PT Hourly PT private/home school Hour Private/Home School PT Hourly PT public school Hour Publicly Funded School PT Visit PT private/home school Visit Private/Home School PT Visit PT public school Visit Publicly Funded School SP Hourly speech private/home school Hour Private/Home School SP Hourly speech public school Hour Publicly Funded School SP Visit speech private/home school Visit Private/Home School