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					                            Health Services & Services Tracking ECP




                             Tennessee
                   Department of Children‟s Services
                                Office of Information Systems
                                      500 Deaderick Street
                                      Nashville, TN 37243




                           Functional Requirements Document


        Project Title:

                      Health Services & Services Tracking ECP
                                     (Project # CS099)




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        1.        Project Scope:
                  The scope of this project is to,
              (1) Expand the existing TNKIDS “Medical” module and introduce “Health Services &
                  Services Tracking” module, shall replaced TNKIDS “Medical” module.
              (2) Develop and deliver the new functionality into “Health Services & Services Tracking”
                  module. Allow users to collect / capture client‟s medical information for today‟s DCS
                  needs in this “Health Services” application.
              (3) New “Health Services” application will allow capturing all clients‟ health information and
                  make available existing TNKIDS medical data from “Health Services” application.
              (4) The new “Health Services” application will provide the users with the ability to capture and
                  track psychotropic medications, client special dietary needs, and client allergies. It will
                  also allow the association of a health service to a primary health service as a „follow-up‟, in
                  addition to the existing TNKIDS “Medical” module functionality.
              (5) “Health Services” application shall maintain “Health Service Providers” and allow the
                  provider information to be re-used instead of users being forced to re-enter each time a
                  specific provider is recorded.
              (6) “Health Services” application shall replace the PMAD application and data conversion of
                  PMAD data into Health Services application shall be out of scope.

        2.        Benefits to Business:
                  DCS commitment to custodial and non-custodial clients is to provide quality health care
                  while the clients are in DCS care. In order to provide quality health care for clients, case
                  managers and medical personnel need to know the client‟s full medical history. TNKIDS
                  should provide DCS Case Managers & appropriate health/medical personnel the ability to
                  perform better documentation of medical health records. Providers often complain that
                  they are not provided with important information when the client is taken for EPSDT
                  examinations. While some of these problems are unavoidable due to DCS‟ inability to gain
                  parental cooperation, DCS must get better at providing all information that we currently
                  have to the health care provider.

                  In addition to this ethical obligation, coordination of care and tracking of EPSDT
                  components are large issues in the John B. lawsuit. Brian A requires tracking of
                  psychotropic medications and the authorizations for those medications being administered
                  to DCS clients. The current system and usage of the system does meet these court ordered
                  mandates.



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                    3.             Assumptions:
                               a. Child Immunization information update from DOH (Department of Health) shall be
                                  out of scope for this project.
                               b. Full download and maintaining of Medication from FDA shall be out of scope for this
                                  project.

                    4.             Constraints:
                              Redesign note: “MCO” and “BHO” Services will henceforth be known as “Medical”,
                               “Behavioral Health”, “Dental”, “COE”, “Hospitalization” and “Health Unit” Services.
                              Redesign note: each of the 7 EPSDT components must have separate and independent
                               fields denoting date of resolution.
                              Redesign note: “Health Services” and “Services Tracking is one application and
                               henceforth will be known as “Health Services”. No information will need to be “derived
                               / displayed” from “Health Services” to “Services Tracking”.

                              Redesign note: the term “Service(s)” is defined as a completed appointment.


                    5.             Revision History:
Revision     Revision        Revised                                               Reason
   #          Date             By
   1.      03/22/2004        G. Alwis   Initial Document
   2.      06/15/2004        G. Alwis   Evaluation Types was replaced by SAT services.
   3.      04/25/2005        G. Alwis   Rename “MCO” and “BHO” Service Categories to “Medical”, “Behavioral Health”, and
                                        “Dental”, “COE”, “Hospitalization” and “Health Unit” Services.
   4.      05/11/2005        G. Alwis   Proving the new security (TNKIDS Health Service Administrative Group access) to all FSA. If
                                        record is ended providing the Medical Admin access to change.
   5.      03/10/2007        G. Alwis   Update with the new security requirement for the Health Services document.
   6.      03/27/2007        G.Alwis    BR03 & 06 –PG03; BR04–PG05; BR12/13– PG06; BR05– PG07; FR04–PG08; BR42/43– PG12;
                                        BR53– PG13. All highlighted are the updates to this document.
   7.      06/19/2007        G.Alwis    Date of Notice of Adverse Action (Central Office Notice) was added to the appointment section.
   8.      06/28/2007        G.Alwis    Change FR02- BR02, FR03-BR03, FR04, FR04-BR06,BR24,BR45, Delete FR04-BR46,BR64
                                        Addition BR104 Change FR05-BR03 Delete FR05-BR08 Addition Header FR06, Addition FR08-
                                        BR01,BR02,BR03 Delete FR08-BR05 Change BR13,BR17 Addition FR10-BR33,BR35,BR38
                                        #4,BR57,BR64, FR11-BR07.BR12,BR17,BR20, Delete BR30,
                                        Addition FR12- BR02 under “Creating Clinically Diagnosed with disability records when creating
                                        a new DSM Diagnosis record Addition, Change FR12-BR18, FR12 Associating a Related
                                        Medication for DSM Diagnosis Record BR04, FR12-BR01 “Required removed from rule”, FR12
                                        Heading Change Creating an electronic mail with DSM record is not created” Change FR13-
                                        BR03,BR04,BR26, Change “Sort Order Appendix A,B,C,D,E,F,G,




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9.       07/09/2007    G.Alwis        Page 08; BR 15 – was updated for clarity.
                                      Page 13; BR 35 – no longer valid.
                                      Page 16; BR 64 – was updated (missing NOT).
                                      Page 30; BR 10 – was updated for clarity.
                                      Page 32; BR 25 – no longer valid.
                                      Page 33; BR 30 – no longer valid.
                                      Page 34; BR 35 – was updated for clarity.
                                      Page 34; BR 38 – was updated from 11 years to 10 years.
                                      Page 38; BR 64 – was updated for clarity.
                                      Page 53; BR 18 – was updated for clarity.
                                      Page 62; BR 02 – was updated for clarity.
                                      Page 66; FR 18 – was updated for clarity.
                                      Psychotropic Medication list
                                      Page 79; line 68 – Paxil CR "Daily Dose Limit" changes from 50mg to 40mg
                                      Page 79; line 72 – Prozac Weekly/ fluoxetine "Daily Dose Limit" changes from
                                      90mg to 60mg.
                                      Page 80; line 88 – Symbyax/ fluoxetine-olanzapine "Daily Dose Limit" changes
                                      from 18/75 to none.
10.      07/10/2007    G.Alwis        Page 09; BR 17 ~ 19 – was added.
                                      Page 37; BR 55 – was updated.
                                      Page 38; BR 56 – was updated.
                                      Page 38; BR 57 – was updated.
11.      07/19/2007    G.Alwis        Page 09; BR 02 – was updated.
                                      Page 46; BR 34 – was updated.
                                      Page 51: BR 01 & 02 – was updated.
                                      Strike the duplicate “Therapy/Counseling – Other” in Behavioral in page 75
                                      Page 73 – all rules on Page 73 were added




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            6.          Health Services Module
        FR 01 –        DCS development shall provide a module in which user can record and track medical
           and mental health information for a client established in the system. This module shall replace
           the existing „Child Medical‟ module and shall be labeled “Health Services”. New module shall
           serve not only as a tracking mechanism for health services provided to a client while in the
           custody or care of DCS, but will also serve as the child‟s electronic health record, displaying
           both historical and current health information about the child.

        BR 01 –        This new Child Medical module in DCS development shall be known as “Health
              Services”.

        BR 02 –         Health Services module will have its own icon and its link to access the health
              services module from DCS development navigation. The Health Services icon shall be
              available for ALL TNKIDS clients, regardless of their intake types. Therefore system shall
              allow recording Health Service records for client‟s who are released or their cases are closed
              from existing cases.

        BR 03 –        Security – (Read) TNKIDS users with TNKIDS Data Read/Write security rights can
              access the Health Services module to read (view) client health information. No updates
              allowed. Current TNKIDS users (before this H/S implementation) who possess the
              “Read/Write” and “Read” access to TNKIDS will automatically have the “Read” security
              access for TNKIDS Health Services module.

        BR 04 –         Security – (Read & Write) these securities access users are the only users from this
              point on time shall have the ability to create/edit health services records in TNKIDS. Users
              who belong to TNKIDS Health Service Administrative Group; Regional Health Nurses;
              Regional HAR; Regional SAT and Regional Psychologist shall have the “Read/Write”
              security access for TNKIDS Health Services module.

        BR 05 –        Security – (Delete) these security access users are the only users from this point on
              time shall have the ability to delete health services records in TNKIDS. Users who belong to
              TNKIDS Health Service Administrative Group shall have the “Delete” security access for
              TNKIDS Health Services module.

        BR 06 –        Security – (Admin) security access users shall have the ability to update & modify a
              completed health services records in TNKIDS H/S icon. Users who belong to Admin security
              group shall be “TNKIDS Health Service Administrative Group” in Health Services module.




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        BR 07 –      Security – (Maintenance) these security access users are the only users from this
           point on time shall have the ability to maintain health services security in TNKIDS. Users
           who belong to TNKIDS Health Service Administrative Group and FSA shall have the
           “Maintenance” security access for TNKIDS Health Services module.
        TNKIDS Health Service Administrative Group users are:
                           Tricia Lea                   Tricia.Lea@state.tn.us
                           Lynn Pollard                 Lynn.Pollard@state.tn.us
                           Patricia Slade               Patricia.Slade@state.tn.us
                           Deborah Gatlin               Deborah.Gatlin@state.tn.us
                           Jane Crawford                Jane.Crawford@state.tn.us
                           Patricia Preston             Patricia.Preston@state.tn.us
                           Betty A. Miller              Betty.A.Miller@state.tn.us
                           Diana Yelton                 Diana.Yelton@state.tn.us
                           Mary Beth Franklyn           Mary.Beth.Franklyn@state.tn.us
                           Shay Jones                   Shay.Jones@state.tn.us

        Note: System shall allow these users to add new users as they wish. Users who belong to TNKIDS
              Health Service Administrative Group shall have the “Maintenance” security access for
              TNKIDS Health Services module.

        BR 08 –        System shall provide the users to access to the “maintenance” table only if the users
              possess the Maintenance access right.

        BR 09 –         Users having access rights with “TNKIDS Health Service Administrative Group ”
              shall have the ability to grant another TNKIDS user (who already has access to TNKIDS data
              with TNKIDS read/write access) the same “TNKIDS Health Service Administrative Group ”
              access rights.

                        DCS Medical and Behavioral Services Unit email account

        BR 10 –          DCS – IS shall create a „DCS Medical and Behavioral Services Unit‟ GroupWise
              email account and DCS Medical and Behavioral Services Unit shall maintain who will belong
              to this list.

        BR 11 –       Initial electronic mail sent to DCS Medical and Behavioral Services Unit shall
              disseminate to:
                             Tricia Lea                  Tricia.Lea@state.tn.us
                             Lynn Pollard                Lynn.Pollard@state.tn.us
                             Patricia Slade              Patricia.Slade@state.tn.us
                             Deborah Gatlin              Deborah.Gatlin@state.tn.us
                         Note: System shall allow these users to add new users as they wish.


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            7.          Creating an Appointment Record
        System shall provide the ability to record and track health services appointments in TNKIDS from
        this “Health Service ECP” implementation. Client‟s health services appointments can initiate from a
        client‟s permanence plan or client EPSDT Screening or some other client‟s health need thus system
        shall provide the users to record client‟s future appointments in the system. System shall maintain
        these appointments until the DCS health services staff fulfill or complete the appointment in a
        reasonable manner. In such time the appointment shall display as an appointment in TNKIDS
        however if fulfilled then become a client health service record and shall not be visible from as an
        appointment. System also should provide the ability to update the appointments in TNKIDS and
        users possess the Read/Write access to TNKIDS Health Services icon shall have the ability to
        updated the appointments in TNKIDS.

        If an appointment cannot be fulfilled or pass the due date system shall provide the users to do one of
        two things
          1. Users who posses the „Read/Write‟ access to TNKIDS Health Services icon shall have the
              ability to update the existing appointment record.

          2. Users who posses the „Delete‟ access to TNKIDS Health Services icon shall have the ability to
             delete the appointment record.

        Users need to be able to enter multiple appointments for any active client that exists in TNKIDS.
        System shall only require enter the Service Category and Service Type when creating appointment
        for each single appointment. System shall then have the ability to record the appointment date,
        Provider detail for each newly created appointment.

        FR 02 –        System shall allows the users who possess the Read/Write access to Health Services
           Icon in TNKIDS to create new one to many appointment records for client‟s who have any active
           or inactive intake type in the system.

            BR 01 –      System shall provide the ability to create multiple appointment/s record for TNKIDS
                 client who have at least one active or inactive intake in the system.

            BR 02 –    When creating appointment/s system shall require the user to record „Service
                 Category‟ and „Service Type‟ for each single appointment in TNKIDS.
                       Note: The “Service Type” shall be sorted by ascending order
            BR 03 –     System shall provide the ability to record the „Appointment Date‟ for each
                 appointment that is recorded in TNKIDS.

            BR 04 –      „Appointment Date‟ shall be greater than or equal to System Date and shall not be
                 greater or equal to one year from the system date.


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            BR 05 –      If the appointment shall be an ongoing appointment then, system shall provide the
                ability to record the „Frequency‟ for the appointment (See Appendix I for Ongoing
                Services).

            BR 06 –     Valid Frequency for the appointments are

                      Sort Order               Frequency of Appointments:
                          10                             Daily
                          20                            Weekly
                          30                          Bi-Weekly
                          40                           Monthly
                          50                          Bi-Monthly
                          60                           Quarterly
                          70                         Twice Yearly
                          80                           Annually
                          90                            OTHER

            BR 07 –     System shall require the user to record the „Other Frequency‟ if „OTHER‟ was
                selected for Frequency of Appointments. „Other Frequency‟ shall be a text field and shall
                not be greater than 100 alphanumeric characters.

            BR 08 –    System shall provide the ability to record the „Provider Professional Title‟ for each
                appointment that is recorded in the system. System shall provide the ability to select the
                „Provider Professional Title‟ from a list of values.

            BR 09 –    System shall provide the ability to record the „Provider Name‟ by performing a
                Provider search for each of the recorded appointments. If the provider does not exist then
                system shall provider the ability to create a new provider detail records for users who have
                the Read/Write access to TNKIDS Health Services Icon.

            BR 10 –    System shall auto populate the „Completion Date‟ for the appointment when the
                appointment been fulfilled by the healthcare provider. This action shall be carryout by the
                system when the user associates the appointment record to a „Health Services Record‟ at such
                time system shall auto populate the appointment „Completion Date‟ by using the H/S Begin
                Date.

            BR 11 –    Completed Appointment then be comes a Health Services Record and shall not be
                displayed in the Appointment section.

            BR 12 –   System shall provide the ability to associate multiple appointments resulted with
                „Good Cause Exception‟ records to a single Health Services record.

            BR 13 –     System shall provide the ability to associate maximum of one appointment to a single
                health services record (appointment should not resulted with „Good Cause Exception‟).
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        Date of Notice of Adverse Action (Central Office Notice)
            BR 14 –    System shall allow the user with H/S Read/Write security access to record the “Date
                of Notice of Adverse Action” staff received the termination of treatment notice.

            BR 15 –     This date can only be entered in conjunction with an appointment service. The “Date
                of Notice of Adverse Action” must be less than or equal to the current system date and
                greater than or equal to the appointment date. (If appointment date is null then “Date of
                Notice of Adverse Action” must be less than or equal to the current system date and greater
                than or equal to the client‟s DOB).

            BR 16 –      “Date of Notice of Adverse Action” must conform to TNKIDS date standards.

            BR 17 –    System shall allow the user to record and track if there was an appeal has filed to the
                Notice of Adverse Action, if an appeal has recorded then user shall record “An Appeal
                Recorded” with a valid values („Yes‟ / „No‟ / „ ‟ Null). “An Appeal Recorded” is not a
                required field.

            BR 18 –     If „Yes‟ was recorded then “Appeal Date” shall be required. Appeal Date is less or
                equal to system date and greater or equal to „Date of Notice of Adverse Action‟.

            BR 19 –   If „No‟ was recorded then “Reason” for a not an appeal was record will be required.
                The “Reason” shall be no more then 4K alphanumeric fields.



                           Good Cause Exception for Appointment Record

        FR 03 –        System shall allow the users who are identified as TNKIDS Health Service
           Administrative Group to create a „Good Cause Exception‟ if the appoint was not been able to
           service for any reason. The appointment shall capture „Good Cause Exception Date‟ and shall
           remain in the appointment section until a Health Service Record gets associated to such
           appointment record.

        BR 01 –       System shall only allow the TNKIDS Health Service Administrative Group to create
              a Good Cause Exception record for any recorded appointment record that is created in the
              system.

        BR 02 –        System shall require recording the Good Cause Exception Date: that conforms to
              TNKIDS date standards and shall not be less than client‟s DOB and less than or equal to
              system date. If the Appointment begin date is null and a Good Cause Exception is entered, the
              Appointment begin date will be the same as the Good Cause Exception Date shall be generated
              by the system.

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        BR 03 –         System shall provide the users to create “Good Cause Exception” for any Services
              Type or a category except for „Health Notes‟ H/S Type.

        BR 04 –         When user creates “Good Cause Exception reason” record, system shall require the
              user to chose one value describe below.
                    a. In legal custody, not physical
                    b. Child refusal/ guardian refusal
                    c. Contraindication
                    d. Other

        BR 05 –       Users shall required narrative to be recorded for each „Good Cause Exception‟
              Record and shall not greater than 4,000 alphanumeric characters.




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            8.          Creating a Health Service Record
        FR 04 –        The Health Services module shall provide the user with the means to create zero to
           many health service records for an established client in the system. A Health Service record will
           identify whether the service provided is a Medical, Behavioral Health, Dental, Hospitalization,
           COE or Other service that is related to client‟s health and other specific information related to
           the health service such as the provider information etc. Fields for completion of a health service
           record in TNKIDS are:

                      Service Category                              Required at completion
                        Service Type                                Required at completion
                        Service Date                                Required at completion
        Result of Service (Follow-up Appointments)                  Required at completion
                          Provider                                      Not required
                 Provider Professional Title                            Not required
                 Service Provided Address                           Required at completion
                           Facility                                     Not required
                   Good Cause Exception                                 Not required




                                               Service Category

        BR 06 –         For each Health Service record created in the system, the user shall be required to
              select one value for Service Category. Valid values are „Medical, Behavioral Health, Dental,
              Hospitalization, COE, Health Advocacy or Other All‟.

        BR 07 –        System shall allow the user to add Health Service record with the same H/S Type to
              the same client with the same service begin date.




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        BR 08 –        When creating a new Health Service Record, system shall require the user to select a
              single Service Category value.
                                              Service Category
                                                 MEDICAL
                                            BEHAVIORAL HEALTH
                                                 DENTAL
                                             HOPSPITALIZATION
                                                   COE
                                             HEALTH ADVOCACY
                                                   ALL


        BR 09 –         The value selected for Service Category will determine which list values are made
              available to the user for selection in the Service Type.

        BR 10 –         System shall maintain one to many relations between Service Category and Service
              Type. In other words, if the user chooses a single Service Category, as „Medical‟ then system
              shall provide the ability for the user to pick from the appropriate lists of Appendix A or B a
              single Service Type defined.

        BR 11 –         System shall display the Service Category in the order described below.
                                 Sort Order                         Service Category
                                       10                            MEDICAL
                                       20                       BEHAVIORAL HEALTH
                                       30                            DENTAL
                                       40                        HOPSPITALIZATION
                                       50                              COE
                                       60                        HEALTH ADVOCACY
                                       70                              ALL



                                                  Service Type
        BR 12 –         For each Health Service record created in the system, user shall be required to select
              a single Service Type value. (Service Type is an attribute of the health service record, not the
              client.)

                           Please Refer Appendix A, through G for „Service Categories‟




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        BR 13 –       Service Type shall be a predefined set of values that shall be related to the Service
              Category value selected.

        BR 14 –       System shall display the Service Type in the order it is documented in Appendix A
              through Appendix G.

        BR 15 –        If the user chooses „MEDICAL‟ as the Service Category, then the system shall
              derive and display only those Service Type values from the services type table selection.

        BR 16 –        If the user chooses „BEHAVIORAL HEALTH‟ as the Service Category, then the
              system shall derive and display only those Service Type values from the table selection.

        BR 17 –        If the user chooses „DENTAL‟ as the Service Category, then the system shall derive
              and display only those Service Type values from the services type table selection.

        BR 18 –         If the user chooses „HOPSPITALIZATION‟ as the Service Category, then the
              system shall derive and display only those Service Type values from the services type table
              selection.

        BR 19 –        If the user chooses „COE‟ as the Service Category, then the system shall derive and
              display only those Service Type values from the services type table selection.

        BR 20 –         If the user chooses „HEALTH ADVOCACY’ as the Service Category, then the
              system shall derive and display only those Service Type values from the services type table
              selection.

        Training Note: This Service Category should be used to record medical/behavioral health issues that the
                        case manager has documented though a reliable source or has witnessed firsthand, and it is
                        not related to another specific health service.

        BR 21 –        System shall provide the user with the full list of Service Type values only if user has
              not indicated the Service Category. Upon selection of the Service Type the system shall auto-
              populate the Service Category field that will be associated to the selected Service Type.




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                                                    Service Date
        BR 22 –         System shall require the users to record Service Begin „Date‟ for the newly created
              health service record. (Service Date is an attribute of the health service record, not the client.)

        BR 23 –         The Service Begin „Date‟ must be greater than or equal to the client‟s date of birth
              and less than or equal to the current system date at the time the Health Service is recorded.

                                                  Ongoing Services

        Training Note: Ongoing Services are some of the health services described below. They are what a client
                        could be receiving on a continuing basis. Each of these Ongoing Services shall have an end
                        date attached. Until the user has entered the end date the system shall treat the Ongoing
                        Services as active.


        BR 24 –         System shall identify an Ongoing Service as multiple of Health Services Records,
              which are associated to the original Ongoing Health Service Record. When adding an ongoing
              service then system shall require ongoing begin date.

        BR 25 –       System shall identify the services that are related to Ongoing Services within each
              Category uniquely with an “Ongoing Services Indicator”.

        BR 26 –      System shall provide the user a method to distinguish between Ongoing Services and
              non-Ongoing Services when creating a new health service record.

        BR 27 –        System shall provide a method to maintain Ongoing Service for each Service
              Category, thus sub sets of ongoing health services types shall always belong to for each
              Service Category.

        BR 28 –       For only Ongoing Services, system shall provide the user the ability to record the
              Ongoing Services „End Date‟.

        BR 29 –         For all services other than Ongoing Services (i.e. non-ongoing Services) system shall
              default the services „End Date‟ as service „Date‟.

        BR 30 –         When adding a new health service record to a client, system shall display all active
              (not ended) “Ongoing Services” through an interface, so that the user can conveniently
              identify the active Ongoing Services for the client. User should have the ability to end the
              services that are no longer being provided to the client or associate the Health Service record to
              an active Ongoing Services exists in client‟s H/S folder.

        BR 31 –         System shall display all inactivate or ended Ongoing Services from the client medical
              history folder.
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        BR 32 –        For all non-ended Ongoing Services, system shall provide the user having the ability
              to update the Ongoing Services records anytime when user visits the client‟s health service
              folder.

        BR 33 –       System shall allow the user to add same ongoing Services to the same client with the
              same begin date.

        BR 34 –          Deleted Business Rule

        BR 35 –        System shall provide the ability to H/S icon read/write access users to „Mark In
              Error‟ an Ongoing Health Service Record. If the health service record is completed and
              indicate with the completion flag.
        BR 36 –          Deleted Business Rule
        BR 37 –        System shall provide the user having write access to the Health Services icon to mark
              the ongoing service in „Error‟ if for any reason the user incorrectly recorded the ongoing
              service.
        BR 38 –        System shall record the user‟s information & the date that marks the ongoing medical
              service made in error.
        BR 39 –          System shall require from the user an “Error Reason” of marking the ongoing
              service.
        BR 40 –         System shall provide the ability to select & print all Ongoing Services that are ended
              as well as non-ended Ongoing Services through print selection interface. The print detail shall
              display all details that were recorded for each ongoing services record. Printing of the Ongoing
              Services Summary shall includes the client‟s detail to identify the client in the header row, then
              after the detail of what‟s of the Ongoing Services what‟s describe in “Health Services
              Summary Information”.


                                          Service Provided Address
        BR 41 –        System shall require the user to record „Service Provided Address‟. Service Provided
              Address, shall be populated by the „Facility‟ was identified by using the Facility Address, else
              by the „Provider‟ was identified by using the Provider address.

        BR 42 –        If „Facility‟ & „Provider‟ both were identified the „Service Provided Address‟ shall be
              populated by using the Facility Address.




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                                                   Result of Service
                                  (This is the field formerly known as „Result of Visit‟)

        BR 43 –          System shall require the user to record narrative details about the service and/or its
              result in the „Result of Service‟ field.

        BR 44 –         Result of Service shall be an attribute of the health service record.

        BR 45 –         The Result of Service field shall allow up to 4,000 8,000 alphanumeric characters of
              text.

        BR 46 –         If user has not documented narrative for Result of Service then the user shall require
              associating a good cause exception record for the same H/S record where there is no result of
              services is recorded, in order to complete the H/S record.

        BR 47 –         System shall provide the ability to select & print all Result of Service(s) that were
              recorded in all the Health Services records. The print detail shall display service date, service
              type and the result of service for each H/S record. Printing of the H/S Result of Service(s)
              Summary shall includes the client‟s detail to identify the client in the header, then after the
              detail of what‟s of the Services Category/Type, Services Date, Provider Information and the
              Result of Visit for each services.


                                              Good Cause Exception
        BR 48 –       System shall only allow the TNKIDS Health Service Administrative Group to create
              a Good Cause Exception record for any recorded H/S record that is created in the system.

        BR 49 –        System shall require recording the Good Cause Exception Date: that conforms to
              TNKIDS date standards and shall not be less than client‟s DOB and less than or equal to
              system date.

        BR 50 –         Good cause exception date for a health service shall be greater than or equal to begin date of
             the health service.

        BR 51 –        System shall provide the users to create “Good Cause Exception” for any Services
              Type or a category.

        BR 52 –        When user creates “Good Cause Exception reason” record, system shall require the
             user to chose one value describe below.
             a.       In legal custody, not physical     b.     Child refusal/ guardian refusal
             c.       Contraindication                   d.     Other

        BR 53 –       Users shall required narrative to be recorded for each „Good Cause Exception‟
              Record and shall not greater than 4,000 alphanumeric characters.
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                                   Completing a Health Service Record

        BR 54 –        System shall provide the ability to the user a “completion flag” to indicate the record
              has been completed.

        BR 55 –         System shall then record the user completion “Date” and shall be the system date.

        BR 56 –        System shall not allow the users to delete H/S records that are indicated by the
              „completion flag‟.

        BR 57 –          If the „End Date‟ for the health services is not recorded, system shall provide the
              ability for the user to record the „End Date‟ for the H/S. System shall require „End Date‟ for
              the H/S field to be recorded before completing the H/S.

        BR 58 –         System shall provide the ability for the users having Admin access to the H/S icon to
              correct the completed H/S records. System shall not allow the Admin access users to delete
              such H/S records.

        BR 59 –         For reporting purpose system shall consider completed H/S records.

                                Mark in Error of “Health Services Record”
        BR 60 –       System shall provide the ability to End a health services record by recording an „End
              Date‟. The „End Date‟ for the health services record shall not be required field for the user to
              enter.

        BR 61 –         System shall provide the ability to „TNKIDS Health Service Administrative Group ‟
              access user to „Mark In Error‟ a Health Service Record. If the health service record is non-
              ended then system shall populate the system date as the „End Date‟ when the user marks the
              health services record in error.

        BR 62 –        System shall require the user to record the „Error Reason‟ if the user chose to mark
              the record „In Error‟ and shall no more than 4,000 alphanumeric characters to be recorded.

        BR 63 –         System shall not allow the users to modify health services records that are marked in
              error, such health services records that are marked in error, system shall prevent associating
              any kind information such as medication records, special diet, immunization records, DSM
              records, disability records, Medical Conditions, Drug/Food Allergy records etc.




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                                        Provider Name Information
        BR 64 –         For each Health Service record created in the system, the user shall not require to
              search & record Provider Name information. Provider Name relates to the person and/or
              entity that actually provided/delivered the service to the child. (Provider Name is an attribute of
              the health service record, not the client.)

        BR 65 –         When recording provider information, system shall require the user to perform a
              search for existing providers. Users shall have the ability to narrow down the search to an
              interested provider region.

        BR 66 –          If user finds a provider that is recoded in TNKIDS, then system shall provide the
              ability to associate the existing provider information to the client‟s medical health service
              record.

        BR 67 –         If user is unable to locate in a search an existing provider, system shall allow the user
              to create a new provider. First name and the Last name of the Provider are required.

        BR 68 –        When recording provider information, system shall optionally allow the user to record
              the middle name of the provider.

        BR 69 –         When recording provider information, system shall generate a unique provider ID.

        BR 70 –         When recording provider information, the system shall require the user to perform a
              provider address search. If located, the system shall provide the ability to add the address of the
              newly created provider to the current health services. If not located then system shall provide
              the ability to create a new address and associate to the provider information.

        BR 71 –         Provider address should conform to the TNKIDS address standards.

        BR 72 –        System shall provide the ability to record group providers and the group of providers
              can have the same facility address.

        BR 73 –         System shall create as an initial new provider information repository from “100504
              BPN PCP Listing by GRD Rgn.xls” so that when creating new health services records, users
              shall have the ability to search the provider within TNKIDS and attach the found provide to the
              health service.


                                “Provider” professional title information

        BR 74 –         When recording provider information, system shall require the user to select one
              value to indicate the Professional Title of the provider.
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        BR 75 –         Valid Professional Title values are:

                        Sort Order             Provider Professional Title

                             10                        Psychologist
                             20                           Dentist
                             30            Licensed Alcohol and Drug Counselor
                             40                Masters Level Social Worker
                             50                Mental Health Case Manager
                             60                      Nurse Practitioner
                             70                      Ophthalmologist
                             80                         Optometrist
                             90                        Oral Surgeon
                            100                        Orthodontist
                            110                         Pediatrician
                            120                          Physician
                            130                     Physician Assistant
                            140                         Psychiatrist
                            150               Licensed Professional Counselor
                            160                   Psychological Examiner
                            170                      Registered Nurse
                            180                          Surgeon
                            190                          OB/GYN
                            200                       Other Clinician
                            210                            Other



        BR 76 –         Only one Provider can be recorded per health service record, and a provider shall
              have a single professional Title.



                   “Person Name” maintenance (TNKIDS SYSTEM WIDE)
        BR 77 –        When Creating (First, Middle, Second Middle, Third Middle & Last) Names for a
              person, name can only contain alpha (uppercase & lowercase), null Names and the three
              characters what‟s in parentheses ( ‟ . - ) i.e. apostrophe, period, (single) space & hyphen.

        BR 78 –         Names will always start with an alpha and shall not start with three characters
              describe in the above rule.




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        “Provider Professional Title” maintenance
        BR 79 –       System shall provide a “Provider Professional Title” maintenance table so that users
              to TNKIDS data (having the TNKIDS Health Service Administrative Group) can create
              new „Provider Professional Title‟ and attach it to the Health Service record.

        BR 80 –         System shall not allow duplication of the “Provider Professional Title” in the
              system.

        BR 81 –          System shall allow the user to inactivate “Provider Professional Title” in the
              system. Provider Professional Titles that are inactivated in the system shall not have the
              ability to associate those, when recording a new health service record to a Client.

                                          “Provider” Maintenance
        BR 82 –        System shall create a new maintenance interface to record new providers and their
              information in TNKIDS. When a new provider gets created in TNKIDS, system shall create
              the provider as same as a „Person‟ in TNKIDS, thus implies the same rules as when creating a
              new person with subject to exceptions.

        BR 83 –         System shall give the ability to users having Read & Write access to TNKIDS
              Health Service icon to be ability to create new provider information records or update the
              existing provider information except adding the end date for the provider.

        BR 84 –       When recording a new Provider in the system, system shall require the user to
             perform a “Provider Search” to prevent duplicating the provider.
             If the Provider does exist, system shall allow the user to abort creating the provider in order
               to prevent duplicating the Provider in the system.
             If the Provider does not exist, system shall allow the user to create a new Provider.
                      1.      System shall allow the user to create a new provider through a new provider
                              maintenance table.
                      2.      System shall allow the user to create a new provider through health service
                              „Provider‟ field by creating new “<Add Provider>” functionality.

        BR 85 –        System shall require the user to record Provider “First Name; Last Name and Begin
              Date”, when creating a new provider. Provider maintenance shall also allow the user to record
              Provider “Middle Name; Provider Number; Street Number; Street Name; City Name; ZIP
              Code; State Code; Area Code; Phone Number; Area Code; Fax Number; Specialty, Begin Date
              and End Date”.




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        BR 86 –         When creating a new provider and associating an address to the provider system shall
              require to select one of the ADDRESS TYPE NAME as describe “Mailing; Residence; &
              Forwarding”

        BR 87 –        For each new provider created, system shall provide the users to record a unique
              “Provider Number” (Not a required field).

        BR 88 –       System shall only allow the users with access to TNKIDS data having TNKIDS
              Health Service Administrative Group access to end a provider. And TNKIDS data having
              TNKIDS read & write access shall not have the ability to end a provider in the system.

        BR 89 –         Providers whose „End Date‟ is not null shall never be able to provide a health service
              to clients recorded in TNKIDS system, other than health service date less than or equal to
              provider end date.

        BR 90 –         When inactivating or ending provider information, system shall provide to the user a
              narrative text of no more than 4,000 character to record the „Inactivate Reason‟ of the provider.
              This shall not be a required field.


                      “Client PCP” Primary Care Provider & Maintenance
        BR 91 –        At any given time the system shall maintain one and only one active Primary Care
              provider for any client recorded in TNKIDS.

        BR 92 –         System shall provide the ability to record the „PCP Begin Date‟ (PCP – Primary Care
              Provider) and „PCP End Date‟ for each provider information record. PCP is a client specific
              value and not Provider specific. This information will provide the ability to track TNKIDS
              client‟s Primary Care Provider information and will be an attribute of a client and not a
              provider.

        BR 93 –     System shall track the history of the Primary Care Provider for all clients recorded in
              TNKIDS.

        BR 94 –         System shall display the client‟s active PCP as the first provider record when,
              performing a provider search in order to attach the provider information to the client‟s health
              service record.




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                                        “Service Type” maintenance
        BR 95 –         System shall create a new maintenance table to add new Health Service Types for
              existing Service Categories. System also shall provide the ability to identify an ongoing service
              type when creating a new service type.

        BR 96 –         System shall allow the user to inactivate existing Service Type from the system.

        BR 97 –        System shall not allow the user to select the inactive Service Type when recording a
              new health service record.

        BR 98 –         System shall display the inactive Service Type that is already created for the existing
              health service record.

        BR 99 –         System shall require “Inactive Reason” when an existing Service Type is inactivated.

        BR 100 –        System shall provide to the user a narrative text of no more than 4,000 alphanumeric
              characters to record the „Inactivate Reason‟ when an existing Service Type is inactivated. This
              shall be a required field.

        BR 101 –       System shall require “Inactive Date” when an existing Service Type is inactivated.
              “Inactive Date” shall conform to TNKIDS date standards and default to system date.

        BR 102 –        System shall record the employee who marks the Service Type inactivated.

        BR 103 –        When creating a new health services to a client, system shall only allow the active
              service to be associated as health services.

        BR 104 –       Users with access to TNKIDS data having TNKIDS „TNKIDS Health Service
              Administrative Group ‟ access shall have the ability update, inactivate or create new services
              information from services information maintenance.




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                                 Facility Information & Maintenances
        FR 05 –       When recording a new Health Service record for a client, system shall not required to
            record the Facility information where the service was provided for the client or where the client
            was taken for medical attention. Facility Information shall be comprised of the facility name
            and the facility address along with the phone number and fax numbers. Facility name shall be
            able to be searched and attached to the Health Service record. If Facility information cannot be
            found, then the user shall have the ability to create a Facility information record in the system.

        BR 01 –        For each Health Service record created in the system, the system shall not require to
              record the Facility Information. The Facility Information relates to the agency or location
              where the service was provided/delivered to the child.
              (Note: Facility Name is an attribute of the health service record, not the client.)

        BR 02 –         System shall provide the ability to search the Facility Information and associate to the
              health services record. System shall not require Facility information to be associated to each
              H/S record.

        BR 03 –         System shall provide the users having the write access to TNKIDS Health Services
              Icon to create a new Facility information record. Facility information shall have a „Facility
              Name‟ character field not exceeding to 200 50 characters and the Facility Address that shall
              conform to TNKIDS address standard.

        BR 04 –         System shall require a Facility Name to be recorded when a new Facility Information
              is created.

        BR 05 –         System shall require a Begin Date to be recorded if a new facility is created.

        BR 06 –         System shall provide the ability to the user to record the Facility „End Date‟. If an
              End Date is been recorded then system shall not let the user to associate such facility for the
              H/S facility.

        BR 07 –          System shall require a Facility address to be entered for each new Facility is created
              in the system.

        BR 08 –        When creating a new facility and associating an address to facility, system shall
              require to select one of the ADDRESS TYPE NAME as describe “Health Facility &
              Pharmacy” (Note: Medication Prescriber Address Type shall be Pharmacy Address Type)

        BR 09 –        System shall provide a method to record the Facility Phone, Fax Number for each
              newly created Facility Information record.




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                                               Other Insurance
               “Other Insurance” will known as “Health Insurance” from the H/S Application
        FR 06 –       System shall allow the user to recorded „Other Insurance‟ detail if client is covered
            under an insurance plan other than TennCare. System shall also allow the users to record
            multiple insurance information plans if need to be recorded in this Health Services application.
            System also shall retain the data of Other Insurance information and the „Health Insurance
            Provider‟ in the benefit application to be in the same data repository

        BR 01 –       System shall allow the user to record the “Insurance Provider Name” and shall be
              require when creating a new insurance record.

        BR 02 –       System shall allow the user to record the “Group Name” when creating a new Other
              Insurance record.

        BR 03 –        System shall require and allow the user to record the “Coverage Status” the valid
              values are {Primary, Secondary, Other}

        BR 04 –       System shall require and allow the user to record the “Policy Number” when creating
              a new Other Insurance Record.

        BR 05 –         System shall require and allow the user to record the “Coverage Start Date” when
              creating an Other Insurance record.

        BR 06 –       System shall allow the user to record the “Coverage End Date” when creating an
              Other Insurance record. Coverage End Date shall be greater than the Coverage Start Date.

        BR 07 –         System shall allow the user to record the (non negative) “Deductible Amount” when
              creating an Other Insurance record.

        BR 08 –         System shall allow the user to perform a search and select “Insurance Provider
              Address”, however if search could not find a correct address system shall allow the user to
              create a new address and associate to the Provider Address.

        BR 09 –         System shall allow the user to record the “Policyholder Name”. System shall display
              all person names other than sibling names, for the Policyholder Name.

        BR 10 –        System shall derive the Policyholder‟s citizenship information that was record in the
              Person‟s General Tab when creating a new Other Insurance record.




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                                                   Health Notes
        FR 07 –       System shall provide a method for the user to record “Health Notes” for a client in
            TNKIDS (use to be known as Caseworker Reporting). System shall allow the user to create
            zero to many “Health Notes” for a client in TNKIDS. Health Notes are narratives notes and
            can be recorded by a health services staff without any consultation of a physician‟s
            involvement, therefore when user create a „Health Note‟ it shall only have a health note
            narrative and a health note date, a date caseworker reported to a health services staff on a
            client‟s health condition or related client‟s health.

        BR 01 –         System shall provide a method for a users having write access to TNKIDS Health
              Services icon to create zero to many “Health Notes” for a client in TNKIDS.

        BR 02 –        System shall require a Health Note Date that shall be greater or equal to the client‟s
              most recent intake date and less than or equal to system date.

        BR 03 –        System shall require the user to record narrative „Health Note‟. Health Note
              Narrative shall not exceed 4,000 alphanumeric characters.

        BR 04 –         System shall allow the users to print all “Health Notes” in a sorted order as users
              wishes.

        BR 05 –         System shall also allow the user to select all or part of the Health Notes to be able to
              print.




                “10 Digit” Phone & Fax Number (TNKIDS SYSTEM WIDE)
        BR 06 –        When creating a new phone number(s) or fax number (regardless of the type, example
              cell phone, pager number etc.), system shall require the user to record the three-digit area code
              and the seven-digit number. This shall be a numeric field.




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            9.          Health Service Record Details
        FR 08 –       Once the user has created the health service record in TNKIDS, system shall provide
            the user with the ability to record more specific relevant detail to the health service record in
            order to successfully create the medical health service record. System shall derive what detail
            information will be required by the system in order to successfully create the medical health
            service record.

        BR 01 –         When creating a new Health Services Record, system shall allow the user to
              associates an appointment to the H/S. In the event of association of an appointment to an H/S
              occurs, system shall auto populate the "Service Type, Provider, Facility and Service Address"
              from the appointment into the H/S record. However system shall provide the ability to the
              users to change "Provider, Facility and Service Address" in the H/S record and that shall not
              updated the appointment "Provider, Facility and Service Address" information.

        BR 02 –         When an appointment is linked to a HS then user shall not be able to change the
              service type that was carried over from appointment.

        BR 03 –        If the H/S have already "Provider, Facility and Service Address" recorded then let the
              user confirm before overwrite the user selected values with the one from appointment/s.


            A.      EPSDT Seven Components

        BR 04 –         When user initially creates a Health Service record with „EPSDT Medical Screening‟
              as a health Service Type, where the Service Category is equal to „Medical‟, the system shall
              make the seven components field active. Seven Components group are:
                    1. Comprehensive Health & Development History
                    2. Comprehensive Unclothed Physical Exam
                    3. Appropriate Immunizations Based on Age and Health History
                    4. Appropriate Lab Tests Based on Age and Health History
                    5. Health Education
                    6. Vision Screening
                    7. Hearing Screening

        BR 05 –         System shall default all seven components questions to null when user initially
              creates a Health Service record with „EPSDT Medical Screening‟ as a health service.

        BR 06 –      System shall require „Yes or No‟ value to be selected for all seven questions or
              components to be answered.



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        BR 07 –         System shall provide the ability to change the values either „Yes‟ to „No‟ or „No‟ to
              „Yes‟ in the „Seven Components‟ group before saving the record for the very first time. When
              all seven components are answered and saved, user shall not be able to change these values.

        BR 08 –         For all other Service Categories (other than „EPSDT Medical Screening‟) the system
              shall gray out „Seven Components‟, „Reason if No‟, „Date‟ and „Resolution‟ of each individual
              component, as seven components are specifically recorded for „EPSDT Medical Screening‟ as
              a health service, where the Service Category is equal to „MEDICAL‟.

        BR 09 –        If any of the components answered as “No”, the System shall require the user to
              record “Explain if „No‟:” narrative for each of the seven components separately.

        BR 10 –         System shall provide the user to record maximum of 4,000 alphanumeric characters
              in the required data field “Explain if „No‟:” for each seven narrative text boxes.

        BR 11 –         System shall allow the user to record targeted resolution „Date‟ for each of the
              components, and shall conform to TNKIDS date standards. Targeted resolution „Date‟ shall be
              greater than or equal to the „Service Date‟ and shall not be a required field.

        Note:     If the users answer is „No‟ for any component and the targeted resolution date is at a
                  later date, then upon the user completing the missed component, the user shall have
                  the ability to update this targeted resolution „Date‟ for that specific component.

        BR 12 –         System shall require the user to record a maximum of 4,000 alphanumeric characters
              in „Resolution‟ for each individual component. „Resolution‟ narrative shall only be required if
              the user entered a resolution „Date‟.

        BR 13 –        For a previously created health service record with „EPSDT Medical Screening‟, the
              system shall provide the user the ability to update the „Date‟ and „Resolution‟ for each
              individual component.

        BR 14 –         User have to fulfill the „Seven Components‟ that are marked as „No‟ at a later date,
              by taking the client to the same provider (or any other provider) within six months from the
              service date. Therefore the system shall allow the resolution „Date‟ to be greater than
              originating „EPSDT Medical Screening‟ service „service date‟ and less than or equal to the six
              months from the „service date‟.

        BR 15 –         System shall provide the user the ability to update onetime resolution “Date” and
              “Resolution” narrative for each individual component at a later date when a new health service
              is created, regardless of the Service Category. Upon entering resolution “Date” and
              “Resolution” fields, the two fields shall be grayed out.




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        BR 16 –         System shall provide the ability to record the resolution „Provider‟ if different from
              the original service provider and shall not be a required field. „Provider‟ name shall be default
              to all seven components, and users have the ability to change the „Provider‟.

        BR 17 –         When recording „Seven Components‟, if the user answered „Yes‟ then the system
              shall gray out the „Explain if „No‟:‟, resolution „Date‟ and „Resolution‟ narrative fields as there
              will not be a requirements to follow up on the missing components.

        Training Note: There is a great need for training on the business process of how the seven components can
                        be effectively recorded on clients when „EPSDT Medical Screening‟ Health Services is
                        recorded. If „Seven Components‟ answered with “NO” then user must enter
                          “Explain if „No‟:” narrative section on that component. User does not have to
                          record resolution „Date‟ and „Resolution‟ narrative at the same time. However when
                          the incomplete components are completed at a later date (within six months of
                          „EPSDT Medical Screening‟ service date) then user needs to enter „Date‟ and
                          „Resolution‟ fields.

        BR 18 –         System shall provider a placeholder for user to record „Height‟ Ft. (Feet) and In.
              (Inches). This shall be numeric fields and only apply when the user record an „EPSDT Medical
              Screening‟ health services record. (System shall not require these fields).

        BR 19 –       System shall provider a placeholder for user to record „Weight‟ Lbs. (Pounds) and
              Oz. (Ounces). This shall be numeric fields and only apply when the user record an „EPSDT
              Medical Screening‟ health services record. (System shall not require these fields).

        BR 20 –         System shall automatically create a new „Description‟ record with „Height & Weight‟
              in the Person tab, the „Physical Desc. Date‟ shall be equal to EPSDT Date.


        Incomplete Seven Component handling
        BR 21 –          System shall provide the ability to run report to track the missed Seven Components
              for all active custodial clients exist in TNKIDS. All TNKIDS users shall have the ability to
              run the appropriate report in order to find clients who have missed the seven components with
              the seven components missing reason. Users shall have the ability to execute this report for the
              entire state or be able to select a specific region to find information on clients who missed any
              single components on the most recent EPSDT Medical Services recorded for that client.




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            B.      Follow – up Services
        FR 09 –       When recording a new Health Service for a client, the system shall be required to
            track the follow-up services information if the service occurred as a follow-up service and was
            provided to the client. For the initial health service record the system shall not allow the user to
            associate the service with another service in order to indicate it as a follow-up.

        BR 01 –                  When creating a health service record, the system shall be required to indicate
              if the Health Service record is a follow-up from an earlier Health Service record, for other than
              the initial health service record.

        BR 02 –                For the first time a health service is recorded for a client, the system shall not
              be required to indicate if the health service is a follow-up record. System shall maintain a
              Follow-up indicator attribute for the health service record.

        BR 03 –                  If the user indicates that the newly created health service record is a follow-up
              record, then the system shall require the user to identify a single existing health service record
              to associate with the currently entered health service follow-up record so that the system shall
              identify it as a follow-up health service record that has been created in the client‟s Health
              Service folder.

        BR 04 –                 When recording a follow-up service record, the system shall provide the
              ability to the user to select one and only one health service record in order to establish the
              follow-up service in the clients Health Service folder.

        BR 05 –                System shall allow the user to associate several follow-up services to a single
              health service, where follow-up service date is always greater than or equal to the associated
              health service date (where the follow-up was originated).

        BR 06 –               Initial Health Service record “Service Date” shall be less than or equal to the
              newly created follow-up (secondary) Health Service record “Service Date”.

        BR 07 –                System shall conveniently display the linked Health Service record under the
              client medical icon so that health services that are associated to the follow-up can be plainly
              seen.

        BR 08 –                Once the user has recorded a follow-up service for a health service record, the
              system should provide a means for the user to view the client‟s follow-up service health
              history. The history should plainly display all primary health service records and their
              associated follow-ups.

        BR 09 –                 Upon indicating a service to be a follow-up service, the system shall require
              the user to associate the currently recorded health service to a previously created health service
              from the client‟s Health Service folder.
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        BR 10 –                 If the user associates the follow-up service to an incorrect existing health
              service, then the system should allow the user (having access to TNKIDS data with TNKIDS
              Health Service Administrative Group access) to correctly associate the appropriate health
              service record that was previously recorded.

        TRAINING NOTE:            There will be a great need to train the users on how to correctly
                                  record a health service follow-up record and associate the correct
                                  origination of follow-up service(s) in the system in order to track
                                  follow-up services for a client.




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            C.      Psychotropic Medication & Medication Section

                            Administrative Policies and Procedures: 20.18
                           http://www.state.tn.us/youth/dcsguide/policies/chap20/20.18%20Psychotropic%20Medication.pdf


        This “Psychotropic Medication & Medication” section is created due to the several “Administrative
        Policies and Procedures” mainly describe in Policy 20.18, for TNKIDS clients, especially children
        who are in state custody and at risk of custody to be prescribed and administered in accordance with
        all applicable state and federal laws.

        FR 10 –       System shall provide the ability to record for all clients‟ „Psychotropic Medication‟
            and / or „Medication‟ when recording any health services record into the system. If
            „Psychotropic Medication‟ is recorded then system shall allow the user to record the “Consent
            Decision” for each new Psychotropic Medication that is entered through the current health
            service record.
        BR 01 –       System shall require the user to indicate Medication indicator for all active Custodial
              and Non-Custodial client population, whenever a new health service record gets created.
        BR 02 –        The indicator question shall read, “Was Medication Prescribed at this Health
              Services?”

        BR 03 –        System shall require the user to make a selection for the “Was Medication
              Prescribed at this Health Services?” and valid values are {No-Medication, Medication-
              Medical, Medication-Psychotropic, Medication-Both and Unknown}

        BR 04 –       If the choices are Medication- Psychotropic then system shall require recording
              Medication- Psychotropic record into client‟s medication section.

        BR 05 –       If the choices are Medication-Medical then system shall require recording
              Medication-Medical record into client‟s medication section.

        BR 06 –        If the choices are Medication-Both then system shall require recording Medication
              record as well as Psychotropic medication record into client‟s medication section.

        BR 07 –          When a new Health Services get created, system shall display all the active
              Medication-Medical and Medication-Psychotropic Medication that‟s recorded in client‟s
              medical icon. If the client is no longer taking the Medication then the system shall provide the
              ability to end the previously created medication by entering an „End Date‟.




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        BR 08 –         When the „End Date‟ is entered and saved for the previously created Medication
              record, system shall move such ended record into to client‟s medication history folder. System
              shall provide a method to separate Medication-Medical and Medication-Psychotropic in the
              history section.


        Psychotropic Medication information

        BR 09 –       System shall require the „Begin Date‟ to be recorded for each Psychotropic
              Medication record, recorded for the client.

        BR 10 –        „Begin Date‟ of the Psychotropic Medication shall be later than or equal to Health
              Services begin date and earlier than or equal to system date. Begin Date‟ of the Psychotropic
              Medication shall be greater or equal client‟s date of birth and less than or equal to system date.

        BR 11 –         System shall allow the „End Date‟ to be recorded for each Psychotropic Medication
              record, recorded for the client.

        BR 12 –         „End Date‟ of the Psychotropic Medication can be greater than or equal to „Begin
              Date‟ of the same Psychotropic Medication record. Example: If a Psychotropic Medication is
              administered and there is an allergic reaction then the medication needs to be stopped
              immediately.

        BR 13 –         System shall display all non-ended or active Psychotropic Medication at the top of
              the client‟s Psychotropic Medication folder. The non-ended or active Psychotropic Medication
              shall be displayed each time a new health service record is created.

        BR 14 –        System requires the user to record the „Psychotropic Medication Name‟ for each new
              Psychotropic Medication that is created.

        BR 15 –          System shall auto populated the „Class‟ for each new Psychotropic Medication that is
              created.


                     Please Refer Appendix I for „Psychotropic Medication Names & Class‟

                            Appendix I – Psychotropic Medication Name and Class Values




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        BR 16 –         System shall require recording the „Dosage‟ and „UOM‟ (unit of measurement) as
              two separate fields, for each new Medication-Medical and Medication-Psychotropic that
              gets created in the system. „Dosage‟ shall be a number field (that can be recorded as 12.75) and
              „UOM‟ is a list of values and shall be (drop, gram, microgram, milligram, milliliter, other,
              ounce, puff, spray, tablespoon, teaspoon or Unit)

        BR 17 –        If „Other‟ is selected for UOM, system shall allow the user to record the „UOM-
              Other‟ value up to 100 alphanumeric characters and shall not be required.

        BR 18 –         System shall provide the ability to record the “Route” of the Medication-Medical
              and Medication-Psychotropic that was given to the client. This shall be a required field and
              user hall provide the user to select and record values from a list.


                  Please Refer to Appendix M „Rout of Medication & Psychotropic Medication‟

                      Appendix M – Rout Of Medication & Psychotropic Medication



        Training NOTE:          Route is the way the Psychotropic Medication is administered to the client.
                                (Example: injection, orally etc).

        BR 19 –         System shall require recording the „Frequency‟ for each new Medication that gets
              created in the system. Frequency shall be one value that can be recorded for each medical in
              the health service records. Valid frequency values are as describe below and shall allow the
              user to choose from.

                   Sort Order               Frequency – Values               Frequency – Code
                       10                    q day – (every day)                  QDY
                       20                   BID – (twice a day)                    BID
                       30                 TID – (three times a day)                TID
                       40                 QID – (four times a day)                 QID
                       50                    q hs – (at bedtime)                   QHS
                       60                 q AM – (every morning)                  QAM
                       70             q PM – (every afternoon/evening )           QPM
                       80                  q noon – (every noon)                  QNN
                       90                    PRN – (As needed)                     PRN
                      100                           Other                          OTH
                      110                         Unknown                         UNK




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        BR 20 –          System shall require the user to specify the „Other Frequency‟ field if the user has
              selected „Other‟ for the „Frequency‟. „Other Frequency‟ shall be a free form alphanumeric
              field that can contain at least 25 alphanumeric characters.

        Training NOTE:              Other Frequency is used if the correct frequency could not be found.

        PRN Use of Psychotropic Medication
      http://www.state.tn.us/youth/dcsguide/policies/chap20/20.21%20Emergency%20and%20PRN%20Use%20of%20Psychotropic%20Medication.pdf


        Training NOTE:              PRN Usage (Only for Psychotropic Medication).
                                    When „PRN‟ has been selected for Psychotropic Medication Frequency then
                                    the system shall require the user to record the „Regional Health Nurses‟ and
                                    „Central Office‟ approval.

        BR 21 –        If Psychotropic Medication frequency is equal to „PRN‟ then the user shall be
              required to record “Was Prior Approval of PRN obtained?” Valid values are „Yes‟ or „No‟.

        BR 22 –        If „No‟ provide the user to record „Explanation‟ why the Prior Approval of PRN Not
              obtained, shall not exceed 4,000 alphanumeric characters.

        BR 23 –        If Psychotropic Medication frequency is equal to „PRN‟ then user shall be required to
              record “Name of Regional Health Nurses Approving PRN”. System shall allow the user to
              record the Regional Health Nurses name that described in PRN list.

        BR 24 –        System shall only display the Regional Health Nurses name in this list that was active
              on the day of the service was provided.

        BR 25 –         If the users did not find the correct Regional Health Nurse‟s name then the system
              shall allow the users to create a new Regional Health Nurse‟s name from a new „add Regional
              Health Nurse‟ function.

        BR 26 –      System shall record the „Date‟ of “Name of Regional Health Nurses Approving
              PRN” was given.

        BR 27 –         The approval „Date‟ shall be greater than or equal to the service date and less than or
              equal to the system date.

        BR 28 –        If Psychotropic Medication frequency is equal to „PRN‟ then the user shall be
              required to record “Name of Central Office Staff Approving PRN”. System shall display
              names of “TNKIDS Health Service Administrative Group” and allow the user to select name
              from this list.




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        BR 29 –       System shall only display the Central Office “TNKIDS Health Service
              Administrative Group” names describe above in the list that is active on the day the service
              was provided.

        BR 30 –         If the users did not find the correct Central Office “TNKIDS Health Service
              Administrative Group” name then the system shall allow the users (belongs to the same group)
              to associate a new employee to the “TNKIDS Health Service Administrative Group”.

        BR 31 –       System shall record the „Date‟ the Central Office “TNKIDS Health Service
              Administrative Group” approval was given.

        BR 32 –         The approval „Date‟ shall be greater than or equal to the service date and less than or
              equal to the system date.

        BR 33 –        System shall not count toward total number of psychotropic medications; if the child
              has prescribed with psychotropic medications belong into groups G-1 or H.
              (Example: if a child has prescribed any number of psychotropic medications at the same time
              in group G-1 & H then, system shall ignore these psychotropic medications counting towards
              the four medication limit.)

        BR 34 –         System shall count two (2) toward total number of psychotropic medications, if the
              child has prescribed with psychotropic medications in-group J.
              (Example: if the child has prescribed with psychotropic medications in-group J and say client
              is prescribe with two (2) in group J psychotropic medication then system should count as four
              (4) as the number of psychotropic medication is prescribed.)



        Psychotropic Medication Monitoring Alert via email
        (DCS Medication Monitoring Guidelines)
        Training Notes: - New business process on sending email alerts for “clients taking more than three
                          active Psychotropic Medication” will need to be trained well, so that the user ends
                          the Psychotropic Medication properly and to avoid incorrect email automatically
                          deployed.




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        BR 35 –        System shall automatically send an email to the “DCS Medical and Behavioral
              Services Unit” with priority set to high,
                    Each time a new psychotropic medication is added for a client who is already actively
                       taking at least three psychotropic medications or
                    Each time a new psychotropic medication is add for a client who already is taking
                       one or more psychotropic medications from the same grouping as the new
                       medication and the system determines that the combined daily dosage of all of the
                       client's active medications, that belong to the same grouping, exceeds the
                       recommended daily dosage limit for a single medication of that grouping
                    Each time a new psychotropic medication is added for a client who is already taking
                       one or more psychotropic medications that belong to the same class as the new
                       medication but does not belong to the same grouping as that medication

        BR 36 –        System shall record the „Email Sent‟ Date to the “DCS Medical and Behavioral
              Services Unit”.

        BR 37 –        System shall not send another email alert to the “DCS Medical and Behavioral
              Services Unit” if the client‟s Psychotropic Medications combination remains the same however
              changed the dosage.

        BR 38 –        System also shall monitor three areas when the client is administered with
              Psychotropic Medication and automatically sent via an email to “DCS Medical and
              Behavioral Services Unit” with priority set to high. The three cases for an email alert‟s are:
                   1. If daily dose limits exceeded what‟s described in “Appendix I”, defined in “Daily
                       Dose Limit” and first email has not sent for the same client‟s active combination of
                       Psychotropic Medication (i.e. end date is null) Or
                   2. If client age limit is less than that defined for a specific Psychotropic Medication
                       describe in “Appendix I”, defined in “Age Limit” and first email has not sent for the
                       same client‟s active combination of Psychotropic Medication (i.e. end date is null) Or
                   3. Regardless of the two areas describe above, if user record a prescribe Psychotropic
                       Medication that are highlighted in “Red” in “Appendix I” then an email alert shall
                       sent to “DCS Medical and Behavioral Services Unit” Or
                   4. Client less than or equal to 10 11 years of age prescribed with Psychotropic
                       Medication.

        BR 39 –        Daily Dose can be calculated when „frequency‟ is equal to {BID, TID and QID}
              multiply with the „Dosage‟, if {BID, TID and QID} is not recorded then Daily Dose is equal to
              Dose record.

        BR 40 –        The subject of the email shall read as “Psychotropic Medication Monitoring Alert
              for <Client‟s Name> & <Client ID>”.




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        BR 41 –        The Body of the email shall read as what recorded in the narrative section of “A
              psychotropic medication(s) for the above child has been entered in TNKIDS. The
              medication(s) falls outside the DCS Medication Monitoring Guidelines.
        BR 42 –      System shall maintain a log of the electronic mail that been automatically sent to the
              “DCS Medical and Behavioral Services Unit”.

    Informed Consent Decision Information
        Notes: - The new business process on the Informed Consent Decision for Psychotropic Medication
                 and shall be required to record the Informed Consent Decision for each of prescribed
                 Psychotropic Medication that‟s recorded for on behalf of a client. This needs to be
                 coordinated with the training unit on how to correctly record client‟s Informed Consent
                 Decision Section.

        Informed Consent
        BR 43 –        System shall require the user to record “Who provided the Informed consent
             decision?” to be answered only for Psychotropic Medication. The possible multiple values
             that could be recorded as “Consenter” be {Youth, Parent/Guardian, Regional Health Nurse,
             Other}.
        Note:            Youth is the client how is age 16 & older as defined in BR 578.
        Training Note: If “Other” is chosen the users have to select a person other than Parent/Guardian,
                         Regional Health Nurse as a “Consenter” list. If the consenter‟s name does not
                         belong in the list user may need to add the new consenter as a person to the client
                         case.

        BR 44 –         System shall provide a Name field to be recorded for each “Consenter” values.

        BR 45 –         System shall display all names including the client‟s name (regardless of client‟s age)
              and the client‟s guardian(s) who have the parental rights recorded in the client case folder with
              no approved TPR recorded for the parent through „Consenter‟ Person Name field.

        BR 46 –        System shall require the user to record the “Consent Decision” for each new
             Psychotropic Medication that is entered through the current health service record. Valid values
             are “Consent” or “Refusal”.
        BR 47 –        For each “Consent Decision” the system shall require Informed Consent given
             “Date” to be recorded. Informed Consent Date shall be greater than or equal to client‟s H/S
             services date and less than or equal to system date. When user enters a date for the first new
             Psychotropic Medication then system, shall auto populate the same date for all the other new
             Psychotropic Medication that were entered thru the current health services record.

        BR 48 –          If the client has been prescribe two or more medications then the second Psychotropic
              Medication onwards Informed Consent given “Date” shall default to the current Informed
              Consent “Date” that was created under the same health service record. User shall have the
              ability to change this date if needed.
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                          Please Refer Appendix L for “Regional Health Nurses” names.

                                   Appendix L – “Regional Health Nurses” names.



        BR 49 –         System shall not allow the user to select Regional Health Nurses, if their names ended
              prior to service date.
        BR 50 –          If the client has been prescribed two or more medication, then the second
              Psychotropic Medication onwards “Consenter Person Name” shall default current “Consenter
              Person Name” that was created under the same health service record. User shall have the
              ability to change this Name if needed. (Note: This is to reduce the number of times a user has
              to enter data.)

        BR 51 –        System shall derive from client‟s person tab and display the relationship to the client
              in the “Consenter Relationship” field for the person that is recorded in “Consenter Person
              Name”, if the relationship is recorded in the client relationship.

        Training Note:          If the user cannot locate the correct person who has given the Consenter for
                                the medication to be recorded in the “Consenter Person Name” then user has
                                to first record this name and the relationship to the client on the client‟s person
                                tab.

        BR 52 –          In case the Regional Health Nurses is recorded for the “Consenter Person Name”
              field, the system shall record Regional Health Nurses for “Consenter Relationship” field.
        BR 53 –         If the client is selected then “Consenter Relationship” field shall be recorded as „Self‟.

        BR 54 –        If the client has prescribed two or more medications, then the second Psychotropic
              Medication onwards “Consenter Person Name” shall default to current “Consenter Person
              Name” that was created under the same health service record. User shall also have the ability to
              change the second Psychotropic Medication “Consenter Person Name” if needed in the case of
              two or more haven given Consent or Refusal.

        BR 55 –         If the client has prescribe two or more Psychotropic Medications, then the second
              Psychotropic Medication onwards “Consenter Person Relationship” shall default current
              “Consenter Person Relationship” that was created under the same health service record. User
              shall also have the ability to change the second Psychotropic Medication “Consenter Person
              Relationship” if needed in the case of two or more haven given Consent or Refusal.




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        BR 56 –         When for the first time informed consent were given for each of the medications, the
              system shall not allow the user to delete or change the information that is recorded („Informed
              consent given?‟, „Date‟, „Consenter Person Name‟ and „Consenter Relationship‟). The system
              should also provide the ability to the user to record multiple („Informed consent given?‟,
              „Date‟, „Consenter Person Name‟ and „Consenter Relationship‟) records for each Psychotropic
              Medication. This will allow the information to be recorded, if the parent gives consent/refusal
              and then if a non-parent (Regional Health Nurses) gives consent/refusal.

        BR 57 –        System shall provide the ability to „TNKIDS Health Service Administrative Group’
              access user to Admin the informed consent data and correct if needed.

        BR 58 –         If the child is 16 years or older, the system shall allow the child to give his own
              consent. If that child is 16 years or older and „Consenter Person Name‟ is not equal to the
              child‟s name, then the system shall require the narrative field “Reason 16+ Year Old Youth is
              not give the Consent”.

        BR 59 –       User shall have the ability to record this “Reason 16+ Year Old Youth is not give the
              Consent” narrative maximum of 4,000 alphanumeric characters for each of the Psychotropic
              Medications that are entered through the current health service record.

        BR 60 –         If the child is less than 16 years of age and the client‟s parents are not the consenters,
              then system shall require the user to provide and record the explain reason „why parents were
              not involved given the consent‟. “Consenter‟s are Not the Parents” narrative shall not exceed
              4,000 alphanumeric characters and user records one time for all of the Psychotropic
              Medications.

        BR 61 –        If the “Other” have given the consent regardless of the child‟s age then system shall
              require the user to record explain the reason why other were selected to given the consent.
              “Other Consenter Reason” narrative shall not exceed 4,000 alphanumeric characters and user
              records one time for all of the Psychotropic Medications.

        Psychotropic Medication Provider Information
        BR 62 –        System shall require the “Provider Name” to be recorded one time for all the
              Psychotropic Medication(s) that are entered throughout the current health service record.

        BR 63 –         System shall default the “Provider Name” from the Provider information that is
              recorded for the current health service record. User should also have the ability to change the
              Provider Name to another Provider by performing a Provider Name search. If user cannot find
              the correct Provider Name that prescribed the Psychotropic Medication(s), then user shall have
              the ability to create a new Provider Name in the system and attach the Provider information to
              “Provider Name”.


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        Central Office Review Team on clients taking Psychotropic Medications.
        BR 64 –          System shall allow the user having access to H/S data (with access privileges
               TNKIDS Health Service Administrative Group) to review the clients who are taking
               Psychotropic Medications with conditions describe below, and record the “Date Received for
               Review; Review completion Date; Review Completed by Narrative and Comments”. This
               review will be associated to the Psychotropic Medications area of the Health Service that
               triggered the condition by:
        1)   Adding a new psychotropic medication for a client who is already actively taking at least three
             psychotropic medications or
        2)   Adding a new psychotropic medication for a client who already is taking one or more
             psychotropic medications from the same grouping as the new medication and the system
             determines that the combined daily dosage of all of the client's active medications, that belong to
             the same grouping, exceeds the recommended daily dosage limit for a single medication of that
             grouping or
        3)   Adding a new psychotropic medication that exceeds the recommended daily dosage limit of that
             medication or
        4)   Adding a new psychotropic medication for a client who is already taking one or more
             psychotropic medications that belong to the same class as the new medication but does not
             belong to the same grouping as that medication or
        5)   Adding a new psychotropic medication that is marked in red in Appendix I or
        6)   Adding a new psychotropic medication whose recommended age limit is greater than the age of
             the client or
        7)   Adding a new psychotropic medication for a client who is equal to or less than 10 years old.

        BR 65 –        System shall allow the users to create multiple review records on clients who fall in to
              any one of the conditions describe above (option 1 ~ 6) even though H/S record is marked
              completed.
        BR 66 –       System shall provide the ability for the users with TNKIDS Health Service
              Administrative Group access to delete „Review‟ records.
        BR 67 –        Upon successfully creating a Psychotropic Medication review record, the only users
              allowed update and delete access are users with TNKIDS Health Service Administrative
              Group access.
        BR 68 –         For clients who do not fall into (option 1 ~ 6), the system shall not allow any other
              users including TNKIDS Health Service Administrative Group users to create new review
              records in the client‟s medical folder.
        BR 69 –        System shall maintain users and the date such Psychotropic Medication review
              records were created in the system.
        BR 70 –         If system generates an email due to satisfying one on the (option 1 ~ 6) then system
              shall require creating minimum of one review record to be created TNKIDS Health Service
              Administrative Group users.
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        BR 71 –         Psychotropic Medication Review record shall have four fields:
                     Date Received for Review – Date field greater than or equal to Services Date.
                     Review Completion Date – Date field greater than or equal to Date Received for
                      Review.
                     Review Completed By Narrative – Narrative maximum of 4,000 alphanumeric
                      characters.
                     Comments – Narrative field maximum of 4,000 alphanumeric characters.

        BR 72 –         When creating a new Psychotropic Medication review record, system shall require
              the users to record Date Received for Review, Review Completion Date and Review
              Completed by Narrative to be recorded.

        Deleting a Psychotropic Medication Record
        BR 73 –        System shall only allow the user to delete Psychotropic Medication records when
              Psychotropic Medication does not have an End Date from the client‟s Psychotropic
              Medication folder.

        BR 74 –        System shall not allow the user to delete Psychotropic Medication records when
              Psychotropic Medication has an End Date that‟s recorded, such records only be „Marked in
              Error‟.

        BR 75 –        System shall provide the ability to the user having access to TNKIDS data with
              TNKIDS Health Service Administrative Group access to identify incorrectly ended
              Psychotropic Medications and allowing those records to be changed, updated or corrected and
              saved.

        BR 76 –          System shall also provide the H/S read/write access user to mark an ended
              Psychotropic Medication record as „Recorded In Error‟, if the Psychotropic Medication was
              recorded in the client‟s Psychotropic Medication folder. System shall not allow the user to
              delete the incorrectly recorded Psychotropic Medication that was ended. This record shall
              remain in the client‟s Psychotropic Medication folder and shall not be used for any type of
              reporting.

        BR 77 –        System shall record the „Error Date‟ as the recorded date that conforms to TNKIDS
              date standards. „Error Date‟ shall default to system date.

        BR 78 –         System shall require an „Error Narrative‟ maximum of 4,000 alphanumeric characters
              to be recorded for each Psychotropic Medication record that is marked in error.

        BR 79 –        System shall record the creator of the error record. System shall also display through
              the medical health service the person‟s name that recorded the error.

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        “Psychotropic Medications” Name maintenance
        BR 105 –      System shall create a new maintenance table to add new Psychotropic Medications
              Names for existing Psychotropic Medications Names, Class, Daily Dose Limit, Age Limit and
              Grouping (Category, Number). (Refer Appendix I)

        BR 106 –       System shall allow the user to inactivate existing Psychotropic Medications Names
              from the Psychotropic Medications maintenance.

        BR 107 –      System shall not allow the user to select the inactive Psychotropic Medications when
              new Psychotropic Medications are added through a health service record.

        BR 108 –        System shall display the inactive Psychotropic Medications Names that are already
              created for the existing health service records.

        BR 109 –      System shall require “Inactive Reason” when an existing Psychotropic Medications
              Names is inactivated.

        BR 110 –        System shall require “Inactive Date” when an existing Psychotropic Medications is
              inactivated. “Inactive Date” shall conform to TNKIDS date standards and default to system
              date. “Inactive Date” shall be a read only field.

        Note: User may not be able to find the correct date that the FDA pulled the medication from the
              list.
        BR 111 –          System shall record the employee who marks the Psychotropic Medications as
              inactive.
        BR 112 –      System shall not allow the user to activate the inactivated Psychotropic Medications
              Names record.
        BR 113 –      Users with access to TNKIDS data having TNKIDS „TNKIDS Health Service
              Administrative Group ‟ access shall have the ability inactivate or create new Psychotropic
              Medications Names from Psychotropic Medications maintenance.




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            D.      Medication Section

        FR 11 –      System shall provide the functionality needed to track medication information for the
            client when user creates a new Health Service Record. If user‟s response to “Was Medication
            Prescribed at this Health Services?” question resulted with the Medication-Medical then
            system shall require recording a new medication record into the system.


        BR 01 –         System shall determine from the users entry for “Was Medication Prescribed at this
              Health Services?” question, if the result is “Medication-Medical” then system shall require
              user to create a new medication record and associate to the health service that originate the new
              medication.

        BR 02 –         System shall always regard the user recorded medication record be client specific
              record, however keeping a track of origination of the medication by associating to the health
              services record. (Medication is an attribute of the health service record as well as the client.)

        BR 03 –       System shall provide the ability to search a „Medication Name‟ when recording a
              Medication in the medical health service record.

        BR 04 –         System shall provide the ability to create a new „Medication Name‟ when Name
              search fail to make an exact match to a medication that is already exists in the system.

        BR 05 –       System shall provide the ability to record the „Begin Date‟ and the „End Date‟ for
              each medication that is entered in the medical health service record.

        BR 06 –         Begin Date shall be a required field when recording a Medication in the medical
              health service record.

        BR 07 –         „Begin Date‟ shall be later than or equal to Health Services begin date and earlier than
              or equal to system date. „Begin Date‟ shall be later than or equal to Health Services begin date
              and greater than or equal to client‟s date of birth and less than or equal to system date.

        BR 08 –         End Date shall not be a required field. (Note: „End Date‟ can be null on the
              medication, however when the client is no longer using the medication the user should be able
              to enter the end date of the medication.)

        BR 09 –         Medication „End Date‟ shall be greater than or equal to Medication „Begin Date‟.

        BR 10 –        System shall require recording the „Dosage‟ and „UOM‟ (unit of measurement) as
              two separate fields. For each new Medication created in the system. „Dosage‟ shall be a
              number field (that can be recorded as 12.75) and „UOM‟ is a list of values and shall be (drop,
              gram, microgram, milligram, milliliter, other, ounce, puff, spray, tablespoon, teaspoon or Unit)

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        BR 11 –        If „Other‟ is selected for UOM, system shall allow the user to record the „UOM-
              Other‟ value up to 100 alphanumeric characters and shall not be required.

        BR 12 –        System shall provide the ability to record the “Route” the medication was given to the
              client. This shall not be a required field and shall be able to select from a list of values.

                  Please Refer to Appendix M „Rout of Medication & Psychotropic Medication‟

                      Appendix M – Rout Of Medication & Psychotropic Medication


        BR 13 –        System shall provide the ability to record the „Frequency‟ for each medication.
              Frequency shall be required for each medical health service record. (Valid Frequency values
              are same as what‟s indicated in Psychotropic Medication Frequency).

        BR 14 –        If the user is selected „Other Frequency‟, system shall obey the same rules that‟s
              recorded in Psychotropic Medication „Other Frequency‟.

        BR 15 –         System shall default the Health Services Provider name to be the same as Medication
              „Prescribing Provider Name‟. System also shall have the ability to change the defaulted
              provider information for the medication record, that was recorded in the Health Services record
              and associate a new „Prescribing Provider‟.

        BR 16 –         For all the medications that are recorded within one health service record,
              „Prescribing Provider Name‟ shall conform to TNKIDS naming standards. „Prescribing
              Provider Name‟ shall default from the Provider Name. (Note: One health service can contain
              multiple medication records)

        BR 17 –        System shall provide the ability to record one „Prescribing Provider Address‟ for each
              of the medications that are recorded within one health service record. „Prescribing Provider
              Address‟ shall conform to TNKIDS address standards and is optional.
              (Note: One health service can contain multiple medication records)




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        BR 18 –        System shall provide the ability to perform a search through the „Prescribing Provider
              Name‟ and select a „Provider Name‟ that is already created in the system. If „Prescribing
              Provider Name‟ cannot be found, the system shall allow the user to create a new Provider
              Name & Address as Prescribing Provider.

        BR 19 –        System shall display all the non-ended Medication & Psychotropic Medication
              each time a new Health Service record gets created in the client Health Service icon. If the
              medication is ended then the system shall keep the medication information as the client
              medication history information and shall not display in the client‟s active medication.

        BR 20 –         System shall display all the non-ended Medication & Psychotropic Medication on
              top of the client‟s Medication folder. The non-ended medications shall be displayed each time
              a new health service record is created and sorted descending by the health services dated so
              that client‟s most recent medication shall display on the top of the list.

        BR 21 –         System shall provide the ability to record the „Medication Instruction‟ for all the
              Medication & Psychotropic Medication that is recorded for the client. „Medication
              Instruction‟ shall be a free form alphanumeric field that can contain no more than 4,000
              alphanumeric characters.

        Deleting a Medication Record
        BR 22 –       System shall only allow the user to delete Medication records when Medication does
              not have an End Date from the client‟s Medication folder.

        BR 23 –       System shall not allow the user to delete Medication records when Medication has an
              End Date recorded.

        BR 24 –       System shall provide the ability to the user having access to H/S Icon data with
              TNKIDS Health Service Administrative Group access to identify incorrectly ended
              Medications and allowing those records to be changed, updated or corrected and save. The
              same user or another user having H/S read/write access will be able to end the not-ended
              Medications record on the same day or at a later date.

        BR 25 –         System shall also provide the H/S read/write access users with the ability to mark the
              ended Medications as „Recorded In Error‟, if the Medications were recorded in the client‟s
              Medications folder in error. The system shall not let the user delete the incorrectly recorded
              Medications that are ended. This record shall remain in the client‟s Medication folder and
              shall not be use for any type of reporting.




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        BR 26 –        System shall record the „Error Date‟ as the recorded date that conforms to TNKIDS
              date standards. „Error Date‟ shall default to system date.

        BR 27 –        System shall require an „Error Narrative‟ of no more than 4,000 alphanumeric
              characters to be recorded for each Medication record that is marked in error.

        BR 28 –         System shall record the creator of the error record.

        Maintaining a Medication Record in the System
        BR 29 –        „Medication Name‟ shall be a free form alphanumeric field that can contain a
              maximum of 200 alphanumeric characters. System shall have the ability to track if the
              medication is „Generic‟ or its „Trade‟ Name.

        BR 30 –         „Generic Name‟ shall be a free form alphanumeric field that can contain a maximum
              of 200 alphanumeric characters. System shall have the ability to track the „Trade‟ or Branded
              medication for each Generic medication recorded.

        BR 31 –        System shall maintain for each „Trade‟ or Branded medication zero to many Generic
              medication recorders & vice-versa.

        BR 32 –         System shall have the ability to maintain a New Medication Activation Date for each
              new Medication that is created in the system. For the very first time the new medication gets
              created in the system let the system default the Activation Date to be same as Health Service
              date. (Activation Date is a Medication specific data item.)

        BR 33 –        For each new Medication what‟s recorded in the system, user shall have the ability to
              In-Activate the same Medication by recording an Inactive Date for the Medication.

        BR 34 –       System shall require a user to record an alphanumeric free form field that can contain
              a maximum of 200 4K characters for „Reason‟ if a medication gets inactivated.

        BR 35 –         System shall prevent the users to select the In-Activated Medication, when
              performing a Medication Search. However system shall allow the user to associate the
              inactivated medication as long as the inactivation date fall between H/S begin & end date.

        BR 36 –         System shall provide the user detail that created the new Medication record in the
              system.




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        BR 37 –        When creating a new Psychotropic medication user shall required to document the
              Class and Grouping to be recorded.

        BR 38 –        System shall provide the ability to make any updates to the Medication Names that‟s
              recorded in the system except for In-Activated Medication.

        BR 39 –         System shall maintain the users updated audit trail for any Medication in the system.

        BR 40 –        System shall prevent the user to duplicate a Medication that exists in an active
              medication list, in the system.

        BR 41 –         When recording a new Medication Name system shall truncate all the leading &
              trailing spaces.

        BR 42 –         System shall maintain Medication by it ascending Medication Name.




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            E.      DSM Diagnosis Information

        FR 12 –       When recording a new Health Service for a client, the system shall require a user to
            record new “DSM Diagnosis” record, when Health Service Type describe in BR01. System
            shall provide the user the ability to create multiple DSM Diagnosis values for the same client
            without allowing them to be duplicated. The system shall also provide the ability to record
            „Axis‟ information for each DSM Diagnosis that is recorded.

        BR 01 –          System shall allow the user to record a new “DSM Diagnosis” record when ever a
              user record a new Health Service Type that equal to one of the type below.
                      1.    Psychological Evaluation
                      2.    Psychiatric/Medication Evaluation
                      3.    Mental Health Assessment/Intake (EPSDT Behavioral Screening)
                      4.    Psychiatric Hospitalization

        BR 02 –         For all other health services types recorded into client‟s Health Services Icon, system
              shall provide the ability to create new “DSM Diagnosed” record.

        BR 03 –        When ever the user create a new “DSM Diagnosed” record, then the system shall
              require the user to create at least one of the DSM Diagnosis Axis (I thru II V) or “Reason For
              not having a DSM Diagnosis” in the client‟s DSM Diagnosis folder.

        BR 04 –        DSM Diagnosis can be categorized as two unique groups. This diagnosis can be
              predominately divided by using “Axis” numbers. Axis I & II shall be regarded as one group
              and Axis III, IV & V to be regard as the second group.

        BR 05 –        System shall provide the ability to record a multiple DSM Diagnosis record for the
              Axis (I & II) group and assign an Axis number (Valid Axis I or II).

        BR 06 –        When creating a new DSM Diagnosis records for Axis (I & II) group, Systems shall
              provide the ability to perform a search for either by „DSM Diagnosis Code‟ or „DSM
              Diagnosis Name‟ users then have to make a selection and assign an Axis number (Valid Axis I
              or II).

        BR 07 –        System shall provide the ability to record the „Special Instruction‟ for each newly
              created DSM Diagnosis records and shall no more than 4,000 alphanumeric characters.




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        BR 08 –        The DSM records with the Axis (III, IV & V) shall have two narrative text sections
              {Axis (III) & Axis (IV)} with no more than 4,000 alphanumeric characters and a single
              number field to record Axis (V) value.

        BR 09 –          The definitions of Axis shall be know as
        Axis ( I ):      Clinical Disorders (user defined value – Appendix K)
        Axis ( II ):     Personality Disorders or Mental Retardation (user defined value – Appendix K)
        Axis ( III ):    General Medical Conditions (Text field)
        Axis ( IV ):     Psychosocial and Environmental Problems (Text field)
        Axis ( V ):      Global Assessment of Functioning (20 alphanumeric characters Number field)

        BR 10 –        DSM Diagnosis records that are recorded for a client and at any given time a user
              shall have the ability to views the client‟s DSM Diagnosis folder.

        BR 11 –        System shall not allow duplicating DSM Diagnosed records with the same axis for
              same clients.


        Creating an Axis (I & II) group record

        BR 12 –      When recording an Axis (I & II) group, the system shall require the user to select a
              “DSM Diagnosis” Name.



                         Please Refer to Appendix K „Diagnosis Codes and Diagnosis Name‟

                        Appendix K – Diagnosis ID‟s, Diagnosis Codes and Diagnosis Name



        BR 13 –      System shall populate & record the “DSM Diagnosis” Code for the “DSM Diagnosis”
              Name (what user recorded).

        BR 14 –        For each of the “DSM Diagnosis” that the user selected and recorded the system shall
              require the user to indicate if the recorded DSM is either Axis „I‟ or „II‟.

        BR 15 –         System shall provide the ability to record many DSM Diagnosis Axis (I or II) records
              for a selected any Health Services Record.



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        Creating an Axis (III, IV & V) group record

        BR 16 –         System shall allow the user to record „General Medical Condition – Axis III‟
              narrative with no more than 4,000 alphanumeric characters. This shall not be a required field.

        BR 17 –         System shall allow the user to record „Psychosocial & Environmental Problems –
              Axis IV‟ narrative with no more than 4,000 alphanumeric characters. This shall not be a
              required field.

        BR 18 –         System shall allow the user to record „Global Assessment of Functioning – Axis V‟
              numeric field narrative with no more than 20 alphanumeric characters. This shall not be a
              required field.



        DSM Diagnosed – Begin Date

        BR 01 –         For each DSM Diagnosed selected, system shall default the Health Service to be as
              the DSM Diagnosed Begin Date. System shall have the ability to modify or update the DSM
              Diagnosed Begin Date and shall be greater than or equal to client‟s date of birth and less than
              or equal to the system date.

        BR 02 –        System shall sort all the DSM Diagnosed records that are entered for the client‟s
              Health Services Icon, and shall be sorted by descending Health Services Date.


        Deleting a DSM Diagnosis Record
        BR 01 –         System shall only allow the user to mark the incorrectly recorded DSM Diagnosis
              records „In Error‟ and shall not allow the user to delete the DSM Diagnosis record.

        BR 02 –       System shall require that the user to record the “Error Reason” of no more than 4,000
              alphanumeric characters to be recorded when a DSM Diagnosis records be marked in Error.

        BR 03 –        System shall record the „Error Date‟ as the recorded date that conforms to TNKIDS
              date standards. „Error Date‟ shall default to system date.

        BR 04 –         System shall maintain the creator of the error record.




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        Creating “Clinically Diagnosed with Disability” records when creating a new DSM
        Diagnosis record.

        BR 01 –        If the user creates a new DSM axis II with any one of the DSM diagnosis code or
              name listed below, then system shall auto populate Clinically Diagnosed with disabilities
              record with (DISABILITY_CD = MR; DISABILITY_NAME = Mental Retardation; Begin
              Date = DSM Diagnosed Begin Date). System shall maintain the history of the provider detail
              that made the diagnosis.

              DSM diagnosis code & name (317 – Mild Mental Retardation; 318 – Moderate Mental
              Retardation; 318.1 – Severe Mental Retardation; 318.2 – Profound Mental Retardation & 319 –
              Mental Retardation, Severity Unspecified)

        BR 02 –         When creating a new Disabilities record from the Clinically Diagnosed with
              Disability section, system shall populate “Was the Client Clinically Diagnosed with
              Disabilities at this visit?” to read as {Yes}.

        BR 03 –         Clinically Diagnosed with Disabilities records that are recorded for a client and at any
              given time a user shall have the ability to views the client‟s Clinically Diagnosed with
              Disabilities records in Clinically Diagnosed with Disabilities history folder.

        Creating an electronic mail when DSM record is not created.
        BR 01 –        When the user record a new H/S record that belongs to Psychological Evaluation, or
              Psychiatric/Medication Evaluation, or Mental Health Assessment/Intake (EPSDT Behavioral
              Screening) or Partial Psychiatric Hospitalization and did not create DSM Diagnosis and
              completed the Health Services, then the system shall generate an electronic mail to the client‟s
              appropriate Regional Psychologist with the client‟s following information.

        BR 02 –        The subject of the email shall read, as “DSM Diagnosis for <child‟s name> from
              <Service Type> on & <date> is incomplete.

        BR 03 –         The Body of the email shall read as what is recorded in the narrative section of “A
              mental health service for the above child has been entered in TNKIDS. The identified
              service requires a DSM diagnosis. The DSM diagnosis was not entered for this service.
              Please obtain the DSM diagnosis and provide this information to your SAT coordinator. If
              you have difficulty obtaining this information from the mental health provider, please
              contact your DCS Regional Psychologist for assistance.”

        BR 04 –         System shall maintain a log of the electronic mail that was sent automatically to the
              client‟s case manager and the Team Leader.



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        Associating a Related Medication for DSM Diagnosis Record

        BR 01 –        System shall not allow duplicating by attaching the same non-ended medication to a
              DSM Diagnosis record. In other words DSM Diagnosis record shall not have duplicated
              medications associated as related medication.

        BR 02 –        System shall allow the user to associate multiple medication records for a single DSM
              Diagnosis record. This medication/s either shall be non-ended or ended. If ended medication is
              being associated to the DSM Diagnosis record as related medication then system shall only
              allow associating such ended medication when the medication end date greater than or equal to
              the H/S begin date.

        BR 03 –        System shall allow the user to associate any medication at the time of H/S, where the
              medication begin date is less than or equal to the H/S begin date. If the medication have an end
              date then medication end date shall be greater than the H/S begin date.

        BR 04 –        For non-ended medication that is associated for DSM Diagnosis record, system shall
              not allow the user to end such medication with medications end begin date to be less than to
              the H/S begins date.




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            F.      Clinically Diagnosed with Disabilities
        FR 13 –       System shall provide the ability to record Disability information when creating a new
            health service record by requiring the user to answer a single question “Was the Client
            Clinically Diagnosed with Disabilities at this visit?” If the indication is true, then the system
            shall require the user to create a single Disability record in the system. System shall regard the
            disability information to be client specific and not health service specific even though disability
            information was recorded via a Health Service record in the client medical icon.

        BR 01 –        System shall allow the user to record Clinically Diagnosed with Disabilities record(s)
              for any health services type.

        BR 02 –         For all Active Custodial Clients, when a new health service record gets created
              system shall require the user to indicate whether the client was diagnosed with disabilities.
              System shall require the user to indicate whether the Non-Custodial Clients to indicate whether
              the client was diagnosed with disability when a new health service record gets created.

        BR 03 –         System shall prompt question for all Active Custodial Clients “Was the Client
              Clinically Diagnosed with Disabilities at this visit?” shall be require to select minimum of one
              value and possible values are described below. Valid Values are {Yes, No, Not Yet
              Determined}. If {No or Not Yet Determined} is recorded system shall not allow to record a
              Disability record.

        BR 04 –         If „Yes‟ was chosen then system shall require the user to select one to many
              Disabilities.
                 SORT ORDER                             DISABILITY_NAME

                        10                        Emotionally Disturbed (DSM IV)
                        20                                Hearing Impaired
                        30                               Mental Retardation
                        40                               Physically Disabled
                        50                                Visually Impaired
                        60           Other Medically Diagnosed Conditions Requiring Special Care
        BR 05 –         System shall NOT allow the user to duplicate disability record information for the
              client.

        BR 06 –         System shall not allow the user the change from Yes to a No or Not Yet Determined
              for the question “Was the Client Clinically Diagnosed with Disabilities at this visit?”, if a
              disability record was created with the current H/S record.

        BR 07 –        Disability record information shall be client specific and not medical record specific
              even though disability record information was entered into the system through a Health Service
              record. The system shall display all the disability records information that was ever record for
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              the client in one section and the user shall be able to view all disability records information at a
              glance.

        Disability Begin and End Dates
        BR 08 –         For each Disability selected, the system shall require the user to record a Disability
              Begin Date. System shall default the health service date to be same as the Disability Begin
              Date and provide the ability for the user to update if disability were clinically diagnosed on a
              different date.

        BR 09 –         Disability Begin Date shall be greater than or equal to client‟s date of birth and less
              than or equal to health service date.

        BR 10 –        The system shall allow the user to record an End Date for any Disability records in
              the system.

        BR 11 –         End Date should be greater than or equal to the Disability Begin Date and less than or
              equal to the system date.


        Deleting a Disability Record

        BR 12 –        System shall only allow the user to delete Disability records when the Disability
              records do not have an End Date from the client‟s Disability folder.

        BR 13 –        System shall not allow the user to delete Disability records if it does have an Ended
              and save in the client‟s Disability folder.

        BR 14 –         System shall provide the ability to the user to mark the disability „Recorded In Error‟
              that are recorded with an ended date.

        BR 15 –        System shall record the „Error Date‟ as the recorded date that conforms to TNKIDS
              date standards. „Error Date‟ shall default to system date.

        BR 16 –        System shall require an „Error Narrative‟ of no more than 4,000 alphanumeric to be
              recorded for each Disability record that is marked in error.

        BR 17 –         System shall record the creator of the error record.




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        Clinically Diagnosed with Disabilities Provider Name

        BR 18 –        System shall require recording „Diagnosing Provider Name‟ for each new record
              added to the client Clinically Diagnosed with Disabilities. „Diagnosing Provider Name‟ shall
              conform to TNKIDS naming standards and shall default to the provider in the Health Services
              Record.

        BR 19 –       System shall provide the ability to search and select different provider name for the
              Diagnosed Disability.

              (Note: Single health service can contain multiple clinically diagnosed with disabilities
                    records)

        BR 20 –        System shall require recording one „Diagnosing Provider Address‟ for each new
              record added to the client Clinically Diagnosed with Disabilities. „Diagnosing Provider
              Address‟ shall conform to TNKIDS address standards.

              (Note: Single health service can contain multiple clinically diagnosed with disabilities records)

        BR 21 –        System shall provide the ability to perform a search through the „Diagnosing Provider
              Name‟ and select a „Provider Name‟ that is already created in the system. If „Diagnosing
              Provider Name‟ cannot be found the system shall allow the user to create a new Provider Name
              & Address as Diagnosing Provider.


        Disability Detail

        BR 22 –       System shall make available „Disability Detail‟ narrative text of no more than 4,000
              alphanumeric characters that will be associated with the newly added disability record in the
              system.

        BR 23 –         The system should provide a separate text field for each disability identified for a
              child so details about each can be viewed separately.




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        Attaching a Related Medication for Clinically Diagnosed with Disabilities

        BR 24 –         System shall allow the user to attach a non-ended medication to a non-ended
              Clinically Diagnosed with Disability that was newly created.

        BR 25 –       System shall not allow duplicating by attaching the same non-ended medication to
              non-ended Clinically Diagnosed with Disability record.


        Disability History Record
        BR 26 –         The system shall display the Disability Diagnosis Date, Diagnosed Disability Name,
              Disability Detail, Disability Diagnosed Provider Name, and Disability End Date as the client
              Disability history.




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            G.      Immunization Administered
        FR 14 –      When recording a new Health Service for a client, the system shall require indicating
            if an immunization was administered. If this is the case, the system shall require the user to
            record the relevant immunization information administered for the client.

        Note: ACIP recommended universal influenza immunization of all children 23 months through 6
              years of age and routine influenza immunization of all household contacts and out-of-home
              caregivers of children younger than 24 months.

                                Please Refer Appendix J for „Immunization Schedule‟

                        Appendix J – Immunization Schedule for Healthy Child Initiative


        BR 01 –       User should have the flexibility to create new immunization records when creating a
              new Health Service Record.

                        Immunization                                        Dose Number
         Type                             Name

        (HepB)              Hepatitis B Vaccine                        Dose 1, Dose 2 or Dose 3
         (IPV)             Inactivated Poliovirus                   Dose 1, Dose 2, Dose 3 or Dose 4
                            Diphtheria and Tetanus toxoids and      Dose 1, Dose 2, Dose 3, Dose 4 or
        (DTaP)              acellular Pertussis Vaccine                          Dose 5
         (Td)               Tetanus toxoids Vaccine Booster                     Booster
                            Haemophilus influenzae type B           Dose 1, Dose 2, Dose 3 or Dose 4
         (HiB)              conjugate Vaccine
        (MMR)               Measles, Mumps, and Rubella                     Dose 1 or Dose 2
                            Vaccine
         (VAR)              Varicella Vaccine                           Dose 1, Dose 2 or Disease
         (PCV)              Pneumococcal Conjugate Vaccine         Dose 1, Dose 2, Dose 3, Dose 4, Dose
                                                                               5 or Dose 6
        (HepA)              Hepatitis A Vaccine                             Dose 1 or Dose 2
      (LAIV/TIV)            Influenza Vaccine                          Dose 1 or Dose 2 or Booster
         (PPV)              Pneumococcal Vaccine                        Dose 1, Dose 2 or Dose 3

        BR 02 –         System then requires recording the „Dose Number‟ for the immunization that was
              provided. There shall be only one valid value. (Example: (LAIV/TIV) Influenza vaccine is
              recorded then the system shall only record „Dose 1‟ or „Dose 2‟ or Booster and shall not be
              allow to record „Dose 3‟, „Dose 4‟ or „Dose 5‟).


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        BR 03 –        System shall require the user to record the „Vaccine Date‟ and shall default to the
              „Service Date‟.

        BR 04 –         System shall also allow the user to change the „Vaccination Date‟ if needed.

        BR 05 –         System shall validate the „Vaccination Date‟ whenever a new administrated vaccine
              is entering into the client‟s medical folder. „Vaccine Date‟ shall be greater than or equal to
              client‟s date of birth or less than or equal to system date.

        BR 06 –        Vaccine information shall be client specific information what this means, although
              the Vaccine information is entered into the system via a health service record for a client, a
              user should have the ability to view all vaccine information for that client at a single glance via
              the medical icon.

        BR 07 –         System shall calculate the „Age at Vaccination‟ upon entering the „Vaccine Date‟ and
              shall display in a read only field. (Shall be displayed null if the DOB is not recorded).

        BR 08 –         System shall not allow the user to duplicate vaccine record (Example: same vaccine
              record name with the same Dose Number (1 thru 5)). However if the user records the same
              vaccine record name with Dose Number to be “booster” then the system shall allow such
              records to be recorded with different vaccine dates.


        “Immunization” Name & Type maintenance
        BR 09 –        System shall create a new maintenance table to add new Immunization Names &
              Types for existing Immunization maintenance table.

        BR 10 –       System shall allow the user to inactivate existing Immunization Name & its related
              Type from the Immunization maintenance table.

        BR 11 –        System shall not allow the user to select the inactive Immunization Names when
              recording a new Immunization record.

        BR 12 –         System shall display the inactive Immunization Names that are already created for the
              existing health service records.

        BR 01 –        System shall require “Reason” when an existing Immunization gets inactivated.
              “Reason” shall be no more than 4,000 alphanumeric to be recorded for each Immunization
              record, when inactivating Immunization gets inactivated.

        BR 13 –         System shall require “Date” when an existing Immunization gets inactivated. “Date”
              shall conform to TNKIDS date standards and default to system date. “Date” shall be a read
              only field.
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        BR 14 –         System shall record the employee who marks the Immunization record be inactive.

        BR 15 –         System shall not allow the user to activate the inactivated Immunization vaccine
              record.

        BR 16 –         Central Office users with „TNKIDS Health Service Administrative Group‟ access
              rights to TNKIDS data shall have the ability to create new Immunization & Immunization
              Type records from Immunization maintenance and have the ability to inactivate existing
              Immunization & Immunization Type records via the Immunization maintenance.


        Immunization Record Status

        BR 17 –         System shall provide the user with the ability to record „Immunization Current‟ when
              recording a health service record. System shall provide the user with „Yes or No‟ options and
              shall be recorded when a new H/S record gets created.


                                Please Refer Appendix J for „Immunization Schedule‟

                        Appendix J – Immunization Schedule for Healthy Child Initiative



        Deleting an Immunization Record

        BR 18 –        System shall provide the ability to the user having TNKIDS data with TNKIDS
              Health Service Administrative Group access to delete immunization information from the
              client Immunization folder. All other users other than TNKIDS Health Service Administrative
              Group having H/S read/write access shall not have the ability to delete immunizations
              information from the client Immunization folder.




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        BR 19 –        System shall also provide the Health Services read/write access user to mark the
              immunization „Recorded in Error‟ if the immunization is recorded for incorrect client from the
              client Immunization folder. This record shall be remaining in the client‟s immunization
              information folder and shall not be used for any type of reporting.

        BR 20 –        System shall record the „Error Date‟ as the recorded date that conforms to TNKIDS
              date standards. „Error Date‟ shall default to system date.

        BR 21 –        System shall require an „Error Narrative‟ of no more than 4,000 alphanumeric
              characters to be recorded for each immunization record that is marked in error.

        BR 22 –         System shall record the creator of the error record.

        BR 23 –         System shall allow the users to delete immunization records that are recorded for
              client in TNKIDS.




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        Immunizations Notes:

            1. Hepatitis B (HepB) vaccine. All infants should receive the first dose of hepatitis B vaccine
                soon after birth and before hospital discharge; the first dose may also be given by age 2
                months if the infant's mother is hepatitis B surface antigen (HBsAg) negative. Only
                monovalent HepB can be used for the birth dose. Monovalent or combination vaccine
                containing HepB may be used to complete the series. Four doses of vaccine may be
                administered when a birth dose is given. The second dose should be given at least 4 weeks
                after the first dose, except for combination vaccines which cannot be administered before age
                6 weeks. The third dose should be given at least 16 weeks after the first dose and at least 8
                weeks after the second dose. The last dose in the vaccination series (third or fourth dose)
                should not be administered before age 24 weeks.

                Infants born to HBsAg-positive mothers should receive HepB and 0.5 mL of Hepatitis B
                Immune Globulin (HBIG) within 12 hours of birth at separate sites. The second dose is
                recommended at age 1 - 2 months. The last dose in the immunization series should not be
                administered before age 24 weeks. These infants should be tested for HBsAg and antibody to
                HBsAg (anti-HBs) at age 9-15 months.
                Infants born to mothers whose HBsAg status is unknown should receive the first dose of
                the HepB series within 12 hours of birth. Maternal blood should be drawn as soon as possible
                to determine the mother's HBsAg status; if the HBsAg test is positive, the infant should
                receive HBIG as soon as possible (no later than age 1 week). The second dose is
                recommended at age 1-2 months. The last dose in the immunization series should not be
                administered before age 24 weeks.
            2. Diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine. The fourth dose of
                DTaP may be administered as early as age 12 months, provided 6 months have elapsed since
                the third dose and the child is unlikely to return at age 15-18 months. The final dose in the
                series should be given at age >=4 years. Tetanus and diphtheria toxoids (Td) is recommended
                at age 11-12 years if at least 5 years have elapsed since the last dose of tetanus and diphtheria
                toxoid-containing vaccine. Subsequent routine Td boosters are recommended every 10 years.

            3. Haemophilus influenzae type b (Hib) conjugate vaccine. Three Hib conjugate vaccines are
                licensed for infant use. If PRP-OMP (PedvaxHIB or ComVax [Merck]) is administered at
                ages 2 and 4 months, a dose at age 6 months is not required. DTaP/Hib combination products
                should not be used for primary immunization in infants at ages 2, 4 or 6 months but can be
                used as boosters following any Hib vaccine. The final dose in the series should be given at
                age >=12 months.




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            4. Measles, mumps, and rubella vaccine (MMR). The second dose of MMR is recommended
                routinely at age 4¨C6 years but may be administered during any visit, provided at least 4
                weeks have elapsed since the first dose and both doses are administered beginning at or after
                age 12 months. Those who have not previously received the second dose should complete the
                schedule by the visit at age 11-12 years.

            5. Varicella vaccine. Varicella vaccine is recommended at any visit at or after age 12 months for
                susceptible children (i.e., those who lack a reliable history of chickenpox). Susceptible
                persons aged >=13 years should receive 2 doses, given at least 4 weeks apart.

            6. Pneumococcal vaccine. The heptavalent pneumococcal conjugate vaccine (PCV) is
                recommended for all children aged 2-3 months. It is also recommended for certain children
                aged 24-59 months. The final dose in the series should be given at age >=12 months.
                Pneumococcal polysaccharide vaccine (PPV) is recommended in addition to PCV for certain
                high-risk groups. See MMWR 6000;49(RR-9):1-35.

            7. Influenza vaccine. Influenza vaccine is recommended annually for children aged >=6 months
                with certain risk factors (including but not limited to asthma, cardiac disease, sickle cell
                disease, HIV, and diabetes), healthcare workers, and other persons (including household
                members) in close contact with persons in groups at high risk (see MMWR 2004;53[RR-
                6]:1-40) and can be administered to all others wishing to obtain immunity. In addition,
                healthy children aged 6-23 months and close contacts of healthy children aged 0-23 months
                are recommended to receive influenza vaccine, because children in this age group are at
                substantially increased risk for influenza-related hospitalizations. For healthy persons aged 5-
                49 years, the intranasally administered live, attenuated influenza vaccine (LAIV) is an
                acceptable alternative to the intramuscular trivalent inactivated influenza vaccine (TIV). See
                MMWR 2004;53(RR-6):1-40. Children receiving TIV should be administered a dosage
                appropriate for their age (0.25 mL if 6-35 months or 0.5 mL if >=3 years). Children aged <=8
                years who are receiving influenza vaccine for the first time should receive 2 doses (separated
                by at least 4 weeks for TIV and at least 6 weeks for LAIV).

            8. Hepatitis A vaccine. Hepatitis A vaccine is recommended for children and adolescents in
                selected states and regions and for certain high-risk groups; consult your local public health
                authority. Children and adolescents in these states, regions, and high-risk groups who have
                not been immunized against hepatitis A can begin the hepatitis A immunization series during
                any visit. The 2 doses in the series should be administered at least 6 months apart. See
                MMWR 1999;48(RR-12):1-37.




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            H.      Special Diet Information
        FR 15 –       When recording a new Health Service record for a client, system shall not require to
            record a “Special Diet” information, however if the client were identified to be on a special
            diet, then the system shall allow the user to record a new “Special Diet” information record.
            System shall have the ability to track the origination of the health services.

        BR 1 –          When creating a health service record, the system shall provide the ability for the user
              to indicate if the client was prescribed to be on a “Special Diet” by entering a special diet
              reason, begin date, provider name prescribe the special diet and end date.

        BR 2 –         All non-ended special diet shall display sorted descending order of the begin date,
              when the end dated is entered to the special diet system shall move such records to the history
              section.

        Reason for Special Diet
        BR 3 –         To record a Special Diet, the system shall require the user to record, in narrative text,
              the reason(s) the special diet was prescribed for the client.
        BR 4 –          Reason for Special Diet field should allow up to 4,000 alphanumeric characters.

        Special Diet Instructions
        BR 5 –          To record a Special Diet, the system shall require the user to record, in narrative text,
              the instructions for the special diet.
        BR 6 –          Special Diet Instructions field should allow up to 4,000 alphanumeric characters.

        Special Diet Begin Date
        BR 7 –        System shall default the health service date to be the same as client‟s special diet
              Begin Date. User shall have the ability to make changes/updates to the special diet begin date.
        BR 8 –          Begin Date for Special Diet shall be greater than or equal to the client‟s DOB.
        BR 9 –         System shall allow a future date to be recorded for this field since diet restrictions can
              be ordered in advance. Future date as a Begin Date shall be no more than one year from the
              system date.




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        Prescribing Provider
        BR 10 –         System shall default the “Provider Name” from the Provider information that is
              recorded for the current medical health service record. User should also have the ability to
              change the Provider Name to another Provider by performing a Provider Name search. If user
              cannot find the correct Provider Name that prescribed the Special Diet, then the user shall have
              the ability to create a new Provider Name in the system and attach it to the Provider
              information “Provider Name”.

        Special Diet End Date
        BR 11 –         The system shall allow the user to record an End Date for a Special Diet record.
        BR 12 –        The End Date shall be greater than or equal to the begin date and shall be no more
              than one year from the begin date.
        BR 13 –        System shall keep all the ended special diets as client diet history and the user shall
              not be able to delete such records.

        Deleting a special diet record.
        BR 01 –        System shall only allow the user to delete special diet records if the special diet
              record does not have an End Date recorded in the client‟s special diet folder.
        BR 02 –        System shall not allow the user to delete special diet records, when the special diet
              recorded is not recorded with an End Date, even though the user may have the access to H/S
              icon with read/write access.
        BR 03 –         System shall provide the ability to delete special diet records from the client‟s special
              diet folder for users having access with TNKIDS Health Service Administrative Group if the
              special diet is non-ended.




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            I.      Medical Condition Information
        FR 16 –       The system shall provide the ability to the user to record a client‟s medical condition
            that the client may already have. The system shall provide the ability to record Medical
            Condition when the client was provided with any health services. All medical conditions shall
            have a Begin and End Date, thus all medical conditions that are not ended, the system shall
            display via the next new health service that is been recorded. The user shall have the ability to
            end the client‟s medical condition if the condition has changed with the new health service that
            is recorded. System shall also provide the ability to attach the recorded medications that are not
            ended or the newly created medical condition.

        BR 01 –       System shall allow the users to create a new Medical Condition record when creating
              any new health service record.

        BR 02 –         System shall allow the user to record the “Medical Condition” Name in a free form
              text and shall not exceeded 4,000 alphanumeric characters.

        BR 03 –         Each Medical Condition record that is created in the client health service folder shall
              require a “Begin Date” for the recorded medical condition record. System shall default the
              health service date to be the same as the „Begin Date‟ and shall be greater than or equal to
              client‟s date of birth and less than or equal to „Service Date‟.

        BR 04 –       System shall provide display the medical condition information with „Begin Date,
              Medical Condition, Provider Name and End Date‟.

        Note: “Provider Name” shall be the physician that was identified or indicated the client‟s “Medical
              Condition”.

        Training Note:          DCS Health service unit will need to decide and pass necessary training
                                information to training unit, if this field should represent the date the condition
                                was first diagnosed or if the date should represent the time at which the
                                department first became aware of the condition.

        BR 05 –        System shall provide the ability to record the “End Date” for each Medical Condition
              record that is created in the client health service folder. „End Date‟ shall be greater than or
              equal to Begin Date and less than or equal to „System Date‟.




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        Attaching a Related Medication for Medical Condition


        BR 06 –        System shall not allow duplicating by attaching the same non-ended medication to a
              Medical Condition record. In other words Medical Condition record shall not have duplicated
              medications associated as related medication.

        BR 07 –         System shall allow the user to associate multiple medication records for a single
              Medical Condition record. This medication/s either shall be non-ended or ended. If ended
              medication is being associated to the Medical Condition record as related medication then
              system shall only allow associating such ended medication when the medication end date
              greater than or equal to the H/S begin date.

        BR 08 –        System shall allow the user to associate any medication to a Medical Condition at the
              time of H/S, where the medication begin date is less than or equal to the H/S begin date. If the
              medication have an end date then medication end date shall be greater than the H/S begin date.

        BR 09 –         For non-ended medication that is associated for Medical Condition record, system
              shall not allow the user to end such medication with medications begin date to be less than to
              the H/S begins date.


        Provider Detail for Medical Condition record

        BR 10 –         System shall default the provider information same as to be the health service
              provider information. System also shall allow the user to update the provider information that
              identified the medical condition.




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            J.      Drug / Food & Other Allergy Information
        FR 17 –     System shall provide the user with the ability to record and track client‟s “Drug, Food
            & Other” health allergy information in the system when new health service gets created.
        BR 01 –         System shall provide the user to associate zero to many new “Drug, Food & Other”
              health allergy information record(s) to a single new health service gets created.
        BR 02 –         “Drug, Food & Other” health allergy information contains „Category of Allergy‟ for
              each allergy record that is been created (i.e. choice either “Drug, Food or Other”).
        BR 03 –        System shall provide the ability to record „Type of Allergy‟ for each category that is
              recorded and shall not exceeded 4,000 alphanumeric characters.
        BR 04 –         System shall allow the user to create a „Reaction‟ narrative section in order to
              describe the „Type of Allergy‟.
        BR 05 –         „Reaction‟ narrative instruction shall not exceeded 4,000 alphanumeric characters.
        BR 06 –        System shall allow the user to create a „Begin Date‟ for the new allergy record that is
              created and shall default to the health service date. System shall allow the user to update or
              change the begin date.
        BR 07 –        System shall not allow the user to delete an allergy record, as allergy will not expire.
              Therefore system shall provide the ability to mark the “Drug, Food & Other” health allergy
              information record „In Error‟, with „Reason‟ narrative instruction that shall not exceeded 4,000
              alphanumeric characters.
        BR 08 –        TNKIDS standard spell check functionality shall be available for all “Drug, Food &
              Other” health allergy information narratives.
        BR 09 –         The allergy records that are created shall be independent from the medical service
              records that are created for the client. The system shall track the client‟s allergy in a separate
              allergy section without any dependency to the health service records but keeping a track of
              origination of the health service record.
        BR 10 –        Users shall have the ability to view the client‟s allergy records at any given time.
              Records are sorted descending by the „Begin Date‟ of “Drug, Food & Other” health allergy
              information.
        BR 11 –        System shall display the Begin Date, Category of Allergy, Type of Allergy, and
              Reaction when displaying “Drug, Food & Other” health allergy information.
        BR 12 –         System allows the user to print all allergy records „allergy summary‟ from the client‟s
              allergy section, except for records that are „In Error‟.




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            10.         Deleting a Health Service Record
        FR 18 –        System shall provide the TNKIDS Health Service Administrative Group user with
            ability to delete a health service record as needed. This function is necessary to clean client‟s
            medical folder if an error health service record is entered. System shall only remove the health
            service record when delete occurs. When H/S record gets deleted the “child” records such as
            Medication, Psychotropic Medication, Disability, Immunization, DSM Information, Medical
            Conditions and Special Diets that are entered through the H/S record shall be deleted with the
            health services record automatically, as long as those “child” records were entered via the
            health Services record. The deletion of H/S record shall only apply if the H/S record is not
            ended as well as the child records.

        BR 01 –                 System shall provide the TNKIDS Health Service Administrative Group user
              with the ability to delete a health service record as needed from the client‟s health service
              folder, as long as the H/S record is not in a completed state.

        BR 02 –                 If user creates new provider information (Name, Title and Facility) through
              the deleted health service record, the system shall not delete the new provider information that
              is already created, however the system shall delete any references to the provider through the
              health service record.

        BR 03 –                 System shall determine if the health service record that is to be deleted is a
              parent follow-up Service record that is identified from follow-up Services. System shall not
              allow the user to delete the parent follow-up Service record that is identified.

        BR 04 –                 System shall determine if the health service record to be deleted is a child
              follow-up Service record that is identified from follow-up Services. System shall allow the user
              to delete the only child follow-up Service record.

        BR 05 –               Users shall not be able to delete Health Services records when the H/S record
              have a {completed, in error or reopen} status.

        BR 06 –                Users shall not be able to delete initial Ongoing Health Services record, when
              there are other Ongoing Health Services record associated to the initial Ongoing Health
              Services record.

        BR 07 –               Users shall only be able to delete Health Services records when the H/S record
              have a {in complete, or open} status.




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            11.         Health Service Summary Information
        FR 19 –       System shall provide the user with a technique to view the summary of the client‟s
            health service information recorded for the client‟s health service icon, without having to
            access each individual health service record. This summary should display the basic essential
            information to identify a client including client ID. The client health service summary shall
            display all client specific health service details that are ever recorded in the client health
            summary.


        Client‟s Basic Information for Identify the client.

        BR 01 –         The health summary should display client‟s basic information such as full name of
              the client, client‟s date of birth & Age as of the report run, client‟s ethnicity, client‟s SSN and
              the client‟s Client ID in order to clearly identify the client.

        BR 02 –         The Client‟s Basic Information shall be printed in the first page for identification.

        BR 03 –         If the client has an active custody status as of the report run date, then this report shall
              indicate the client custody status.



        Health Services Summary Information
        BR 04 –         This report shall display all health service summary information ever recorded in the
              client‟s health serves folder as a high level. The Type of Service, Service Type, Service Dates,
              Result of Services and all the related information should be displayed in this report.




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        EPSDT Seven Components Summary Information

        BR 05 –         The health summary should display client‟s EPSDT Seven components information
              and it details along with the service date and the Service Type in order to identify the seven
              component records that are recorded in different “EPSDT Medical Screening” health services.
              The seven components are
                    1. Comprehensive Health & Development History
                    2. Comprehensive Unclothed Physical Exam
                    3. Appropriate Immunizations Based on Age and Health History
                    4. Appropriate Lab Tests Based on Age and Health History
                    5. Health Education
                    6. Vision Screening
                    7. Hearing Screening.

        BR 06 –       If the components are not completed for any reason, the summary report shall display
              that summary information as well.



        Follow – up Summary Information


        BR 07 –          The health summary should display client‟s follow-up visits that are tracked and
              recorded in the client‟s health service folder. When this information has been displayed on the
              report, all relevant health service follow-up summaries should also be printed (Example:
              follow-up Service Type, service dates with provider information).



        Psychotropic Medications Summary Information

        BR 08 –        The health summary should display all Psychotropic Medication Information that is
              ever recorded in the client‟s health service folder. Name of the medication and the Begin/End
              Dates, Class, Dosage, Frequency, Provider Name and related information.

        BR 09 –        This report also shall display all consent & refusal information for the prescribed
              Psychotropic Medications.




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        BR 10 –        This report will also provide the detail of 16 & older client‟s Psychotropic Medication
              consent and refusal information.

        BR 11 –        If the client is on more than three Psychotropic Medications, then health summary
              should display all „Active‟ more than three Psychotropic Medication reasons.



        Medications Summary Information

        BR 12 –          The health summary should display all Medication Information that is ever recorded
              in the client‟s health service folder. Name of the medication and the Begin/End Dates, Dosage,
              Frequency, Provider Name and related information.



        DSM Summary Information

        BR 13 –         Health summary should display a list of all DSM diagnosis recorded.

        BR 14 –         Health summary should display all „Axis‟ information for each DSM Diagnosis that
              is recorded.

        BR 15 –         Health summary should also display the relevant date information.

        BR 16 –       Health summary should display any related medication that is recorded for the DSM
              Diagnosis record, for the client.



        Clinically Diagnosed with Disabilities Summary Information

        BR 17 –         Health summary should display a list of all disabilities recorded for a client.

        BR 18 –        Health summary should include the Disability name, Begin Date, Diagnosing
              Provider, Special Instructions.




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        Immunizations Summary Information
        BR 19 –        Health summary should display all Immunization Information that has ever been
              recorded in the client‟s health service folder.

        BR 20 –         Health summary should include the Name of the Immunization, Dates, Dosage &
              related information.

        Special Diet Summary Information
        BR 21 –         The health service summary should display a list of any special diets recorded for the
              client.

        BR 22 –      Special Diet information to be included on the summary includes: Special Diet
              Name, Begin Date, Diagnosing Provider and Special Instructions.

        Client Allergy Summary Information

        BR 23 –         The health service summary should display a list of all allergies that are recorded for
              the client.

        BR 24 –        Allergies information to be included on the summary includes: Type of allergy,
              Reaction and Reaction Date.

        Client Medical Condition Summary Information
        BR 25 –        The health service summary should display a list of all Medical conditions that were
              recorded for the client.

        BR 26 –        Medical conditions information to be included on the summary includes: Medical
              condition, Begin Date, Provider Name, and End Date.




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        Client‟s Health Advocacy & Health Services Notes information
        These rules added because of a H/S presentation meeting held June 25, 2007 for the stakeholders.

            BR 01 –     System shall allow the user to create health related notes such as Well-being
                Screening, Health Advocacy and Health notes categories in the “Health Notes” Section, in
                the client Health Services module.

            BR 02 –   When creating a new “Health Note” system shall require the user to record
                “Category, Type and Source”.

            BR 03 –      The valid values for the “Category” are as below and user shall require selecting one.
                    1.      Well-being Screening
                    2.      General
                    3.      Health Advocacy

            BR 04 –      If user selects “Health Advocacy” as Category then the available Types shall:
                    1.       DCS Case Review / Consultation
                    2.       DCS Other
                    3.       DCS Utilization Review
                    4.       DCS Health History Review
                    5.       DCS Case Review / Consultation F to F
                    6.       DCS Other F to F
                    7.       DCS Utilization Review F to F
                    8.       DCS Medication Review

            BR 05 –    If user selects “General” as Category then the available Types shall:
                    1.     Health Service Notes
                    2.     Other

            BR 06 –    If user selects “Well-being Screening” as Category then the available Types shall:
                    1.     Parent Reporter
                    2.     Child Reporter
                    3.     Other

            BR 07 –    The valid values for “Source” for any of the “Health Advocacy, General & Well-
                       being Screening” are as below and user shall require selecting one.
                    1.     Health Nurse
                    2.     Psychologist
                    3.     Other




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            12.         All Reports that are identified for this ECP
        FR 20 –      Users have requested the reports described below to be created directly from
            TNKIDS. These reports shall display client‟s medical history or on client‟s Psychotropic
            Medications information. The report shall run from TNKIDS on demand or users defined
            frequency.

                                                 Disability Reports
            Report 01 –     Clients having DSM Diagnosis recorded in a health services visit. (Users need to
                            see a report with all the DSM Diagnosis that is recorded for clients as well as if
                            there are any disability records are created).

                                          Good Cause Exception Report
            Report 02 –     Users need to see report that contains information on clients where there is good
                            cause exceptions were recorded in order to complete incomplete appointment.
                            This report shall display all partially completed health services records that were
                            recorded with good cause exception.

                                        Psychotropic Medication Tracking Reports
            Report 03 –     Users need to report that contains information on clients where clients were
                            prescribe Psychotropic Medications – Tracking. This is a county & region base
                            report for the entire state of Tennessee. (All client‟s that ate prescribe with
                            Psychotropic Medications)

                                  Psychotropic Medication Monitoring Reports
            Report 04 –     Users need to report that contains information on clients where clients were
                            prescribe Psychotropic Medications – Monitoring. This is a county & region base
                            report for the entire state of Tennessee. (All client‟s that ate prescribe with
                            Psychotropic Medications)




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            13.         Appendixes

        Appendix A: – Service Type Values – Service Category: MEDICAL

                          Service Type          (TYPE = MEDICAL)             On Going

              Case Management - Medical                                           Y
              Emergency care
              EPSDT Medical Screening
              Hearing Visit
              Home Health Care                                                    Y
              Immunizations
              Laboratory/Diagnostic Testing – Medical
              Maternity Care
              Medical - Other
              Medical Visit
              Medication Management – Medical
              Nutritional Services                                                Y
              Occupational Therapy                                                Y
              Outpatient Surgery / Procedure
              Phone Consultation – Medical
              Physical Therapy                                                    Y
              Speech Therapy                                                      Y
              TB Skin Test – Administered
              TB Skin Test - Read                                                 Y
              Vision Visit



                      Note: The “Service Type” shall be sorted by ascending order




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        Appendix B: – Service Type Values – Service Category: BEHAVIORAL
                       Service Type            (TYPE = BEHAVIORAL)                         On Going

              A&D – Assessment                                                                  Y
              A&D – Counseling                                                                  Y
              A&D – Detoxification                                                              Y
              A&D – Group                                                                       Y
              A&D – Inpatient                                                                   Y
              A&D – Outpatient                                                                  Y
              A&D – IOP                                                                         Y
              Anger Management                                                                  Y
              Case Management – Mental Health                                                   Y
              CCFT                                                                              Y
              CTT                                                                               Y
              Laboratory/Diagnostic Testing - Behavioral Health
              Medication Management - Psychiatric
              Mental Health - Other
              Mental Health Assessment/Intake (EPSDT Behavioral Screening)
              Mobile Crisis Services (Specialized Crisis Services)
              Neuropsychological Evaluation
              Partial Psychiatric Hospitalization
              Phone Consultation - Behavioral
              Psychiatric/Medication Evaluation
              Psychological Evaluation
              Psychosexual Evaluation
              Therapy/Counseling – Family                                                       Y
              Therapy/Counseling – Group                                                        Y
              Therapy/Counseling – Individual                                                   Y
              Therapy/Counseling – Other                                                        Y
              Therapy/Counseling – Outpatient                                                   Y
              Therapy/Counseling – Sex Offender                                                 Y
              Therapy/Counseling – Sexual Abuse Victim                                          Y
              Therapy/Counseling – Other

                      Note: The “Service Type” shall be sorted by ascending order

        Appendix C: – Service Type Values – “Health Notes”

   “Caseworker Reporting” shall no longer be a drop down value. User will have a separate section to record
   caseworker reporting now shall be know as “Health Notes” and shall not be regard as a health service record.
   This will be a narrative section with the reported date.



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        Appendix D: – Service Type Values – Service Category: DENTAL

                           Service Type            (Other = DENTAL)                On Going
              Dental Visit                                                            Y
              EPSDT Dental Screening
              Oral Surgery
              Orthodontic
              Phone Consultation – Dental

                       Note: The “Service Type” shall be sorted by ascending order


        Appendix E: – Service Type Values – Service Category: COE

                       Service Type            (Service Category = COE)            On Going
             COE - Case Consultation
             COE - Case Review
             COE - Medication Management - Psychiatric
             COE - Other
             COE - Pediatric Consultation - Medical
             COE - Phone Consultation
             COE - Psychiatric/Medication Evaluation
             COE - Psychological Evaluation

                       Note: The “Service Type” shall be sorted by ascending order

        Appendix F: – Service Type Values – Service Category: HOSPITALIZATION

                 Service Type (Service Category = HOSPITALIZATION)                 On Going
             Medical Hospitalization                                                  Y
             Psychiatric Hospitalization                                              Y
             Partial Psychiatric Hospitalization                                      Y
             Inpatient Hospitalization                                                Y


                       Note: The “Service Type” shall be sorted by ascending order




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        Appendix G: – Service Type Values – HEALTH ADVOCACY

                                   (Service Category = HEALTH ADVOCACY)
                      Service Type                               Service Type
   DCS Case Review / Consultation                    DCS Case Review / Consultation F to F
   DCS Other                                         DCS Other F to F
   DCS Utilization Review                            DCS Utilization Review F to F
   DCS Health History Review                         DCS Medication Review



                      Note: The “Service Type” shall be sorted by ascending order

        Appendix H: – Ongoing Health Services
        Note: All on going services are identified in Appendix A thru F with an on going indicator.




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         Appendix I: – Psychotropic Medication Name and Class Values


                                                                               Daily Dose         Age      Grouping
              Psychotropic Medication                      Class                 Limit           Limit

1.
       Abilify/ aripiprazole                   Antipsychotic                 >30mg                             E-1

2.
       Adderall/ amphetamines                  Stimulant                     >60mg                             A-1

3.
       Adderall XR/ amphetamines               Stimulant                     >60mg                             A-1

4.
       Ambien/ zolpidem tartrate               Sedative-Hypnotic             ----------       ----------       B-2

5.
       Anafranil/ clomipramine hydrochloride   Antidepressant                >200mg           <10yo            D-4

6.
       Atarax/ hydroxyzine hydrochloride       Antihistamine                 >100mg                            G-2

7.
       Ativan/ lorazepam                       Sedative-Hypnotic             ----------       ----------       B-8

8.
       Aventyl/ nortriptyline hydrochloride    Antidepressant                >50mg            <15yo           D-14

9.
       Benadryl/ diphenhydramine               Antihistamine                 >150mg                            G-1

10.
       BuSpar/ buspirone                       Miscellaneous (antianxiety)   >30mg                             I-1

11.
       Campral                                 Miscellaneous (alcoholism tx) >1998mg                           I-2
       Carbatrol/ carbamazepine extended
       release
                                               Mood-Stabilizer               >800mg           <6yo             C-2
12.

13.
       Catapres/ clonidine hydrochloride       Antihypertensive              >0.3mg                            F-2

14.
       Celexa/ citalopram                      Antidepressant                >40mg                             D-3

15.
       Clozaril/ clozapine                     Antipsychotic                 ----------       ----------       E-3

16.
       Cogentin/ benztropine mesylate          Anticholinergic               >2mg                              H-1

17.
       Concerta                                Stimulant                     >60mg                             A-2

18.
       Cymbalta / duloxetine hydrochloride     Antidepressant                >60mg                             D-5

19.
       Dalmane/ flurazepam hydrochloride       Sedative-Hypnotic             ----------       ----------       B-7

20.
       Daytrana/ methylphenidate patch         Stimulant                     >60mg                             A-2



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                   Appendix I (Cont’d)                                          Daily Dose         Age      Grouping
              Psychotropic Medication                      Class                  Limit           Limit

21.
       DDAVP/ desmopressin                     Miscellaneous (antidiuretic)   >0.6mg           <6yo             I-3

22.
       Depacon/ valproic acid                  Mood Stabilizer                >1000mg          <10yo            C-3

23.
       Depakene/ valproic acid                 Mood Stabilizer                >1000mg          <10yo            C-3

24.
       Depakote/ divalproex sodium             Mood Stabilizer                >1000mg          <10yo            C-3

25.
       Depakote ER/ divalproex sodium          Mood Stabilizer                >1000mg          <10yo            C-3

26.
       Desyrel/ trazodone hydrochloride        Antidepressant                 >150mg                           D-17

27.
       Dexedrine/ dextroamphetamine sulfate    Stimulant                      >30mg                             A-3

28.
       DextroStat/ dextroamphetamine sulfate   Stimulant                      >30mg                             A-3

29.
       Effexor/ venlafaxine                    Antidepressant                 >225mg                            D-8

30.
       Effexor XR/ venlafaxine                 Antidepressant                 >225mg                            D-8

31.
       Elavil/ amitriptyline                   Antidepressant                 >100mg           <12yo            D-1

32.
       Endep/ amitriptyline                    Antidepressant                 >100mg           <12yo            D-1

33.
       Eskalith/ lithium carbonate             Mood stabilizer                >1200mg                           C-8

34.
       Etrafon/ perphenazine-amitriptyline     Combination                    ----------       ----------       J-2

35.
       Focalin/ dexmethylphenidate             Stimulant                      >20mg                             A-4

36.
       Geodon/ ziprasidone hydrochloride       Antipsychotic                  >120mg                            E-5

37.
       Gabitril / tiagabine                    Mood Stabilizer                >32mg                             C-5

38.
       Halcion/ triazolam                      Sedative-Hypnotic              ----------       ----------      B-15

39.
       Haldol/ haloperidol                     Antipsychotic                  >10mg                             E-6

40.
       Inderal/ propranolol                    Antihypertensive               >80mg                             F-4




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                  Appendix I (Cont’d)                                           Daily Dose         Age      Grouping
              Psychotropic Medication                        Class                Limit           Limit

41.
       Klonopin/ clonazepam                      Sedative-Hypnotic            ----------       ----------       B-4

42.
       Keppra / levetiracetam                    Mood Stabilizer              ----------       ----------       C-6

43.
       Lamictal/ lamotrigine                     Mood Stabilizer              >200mg                            C-7

44.
       Lexapro/ escitalopram                     Antidepressant               >30mg                            D-12

45.
       Librium/ chlordiazepoxide hydrochloride   Sedative-Hypnotic            ----------       ----------      B-16

46.
       Lithane/ lithium carbonate                Mood stabilizer              >1200mg                           C-8

47.
       Lithobid/ lithium carbonate               Mood stabilizer              >1200mg                           C-8

48.
       Lithonate/ lithium carbonate              Mood stabilizer              >1200mg                           C-8
       Lunesta                                   Sedative-Hypnotic            -------          -------          B-9
49.

50.
       Luvox/ fluvoxamine                        Antidepressant               >200mg           <8yo            D-10

51.
       Mellaril/ thioridazine hydrochloride      Antipsychotic                ----------       ----------      E-11
       Metadate CD/ methylphenidate
                                                 Stimulant                    >60mg                             A-2
       hydrochloride
52.
       Metadate ER/ methylphenidate
                                                 Stimulant                    >60mg                             A-2
       hydrochloride
53.
       Methadone HCL, Methadose                  Miscellaneous                ------           ------           I-5
54.

55.
       Methylin/ methylphenidate                 Stimulant                    >60mg                             A-2

56.
       Methylin ER/ methylphenidate              Stimulant                    >60mg                             A-2

57.
       Nardil/ phenelzine sulfate                Antidepressant               ----------       ----------      D-19
       Naltrexone Hydrochloride                  Miscellaneous                                                  I-7
58.
                                                 Miscellaneous (alzheimer's
       Namenda
                                                 tx)
                                                                              --------         --------         I-6
59.

60.
       Navane/ thiothixene                       Antipsychotic                >15mg            <12yo           E-12




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                  Appendix I (Cont’d)                                   Daily Dose         Age      Grouping
              Psychotropic Medication                        Class        Limit           Limit

61.
       Neurontin/ gabapentin                    Mood Stabilizer       >1800mg                           C-4

62.
       Noctec/ chloral hydrate                  Sedative-Hypnotic     ----------       ----------       B-3

63.
       Norpramin/ desipramine hydrochloride     Antidepressant        ----------       ----------       D-6

64.
       Orap/ pimozide                           Antipsychotic         >6mg                              E-7

65.
       Pamelor/ nortriptyline hydrochloride     Antidepressant        >50mg            <15yo           D-14

66.
       Parnate/ tranylcypromine                 Antidepressant        ----------       ----------      D-20

67.
       Paxil/ paroxetine                        Antidepressant        >40mg                            D-15
                                                                      >50mg
       Paxil CR                                 Antidepressant                                         D-15
                                                                      >40mg
68.

69.
       Prolixin/ fluphenazine Hydrochloride     Antipsychotic         >10mg                             E-4

70.
       Provigil/ modafinil                      Stimulant             >200mg           <16yo            A-5

71.
       Prozac/ fluoxetine                       Antidepressant        >60mg                             D-9
                                                                      >90mg
       Prozac Weekly/ fluoxetine                Antidepressant                                          D-9
                                                                      >60mg
72.

73.
       Remeron/ mirtazapine                     Antidepressant        >45mg                            D-13

74.
       Restoril/ temazepam                      Sedative-Hypnotic     ----------       ----------      B-12

75.
       Risperdal/ risperidone                   Antipsychotic         >6mg                              E-9

76.
       Risperdal Consta/ risperidone            Antipsychotic         >6mg                              E-9

77.
       Ritalin/ methylphenidate hydrochloride   Stimulant             >60mg                             A-2

78.
       Ritalin LA/ methylphenidate hydrochloride Stimulant            >60mg                             A-2

79.
       Ritalin SR/ methylphenidate hydrochloride Stimulant            >60mg                             A-2
       Rozerem                                  Sedative-Hypnotic     ----------       --------        B-13
80.

81.
       Sarafem/ fluoxetine                      Antidepressant        >60mg                             D-9


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                  Appendix I (Cont’d)                                   Daily Dose         Age      Grouping
              Psychotropic Medication                        Class        Limit           Limit

82.
       Serax/ oxazepam                           Sedative-Hypnotic    ----------       ----------      B-11

83.
       Seroquel/ quetiapine                      Antipsychotic        >200mg                           E-10

84.
       Serzone/ nefazodone hydrochloride         Antidepressant       >300mg                           D-16

85.
       Sinequan/ doxepin                         Antidepressant       >150mg           <12yo            D-7

86.
       Sonata/ zaleplon                          Hypnotic             ----------       ----------      B-14
                                                 Miscellaneous
       Strattera/ atomoxetine hydrochloride
                                                 (antihyperkinetic)
                                                                      >100mg                            I-4
87.
                                                                      >18/75mg
       Symbyax/ fluoxetine-olanzapine            Combination                                            J-1
                                                                      ----------
88.

89.
       Tegretol/ carbamazepine                   Mood Stabilizer      >800mg           <6yo             C-1

90.
       Tegretol XR/ carbamazepine                Mood Stabilizer      >800mg           <6yo             C-1

91.
       Tenex/ guanfacine                         Antihypertensive     >4mg                              F-3

92.
       Tenormin/ atenolol                        Antihypertensive     ----------       ----------       F-1

93.
       Thorazine/ chlorpromazine hydrochloride   Antipsychotic        >200mg                            E-2

94.
       Tofranil/ imipramine hydrochloride        Antidepressant       >100mg                           D-11

95.
       Tofranil-PM/ imipramine pamoate           Antidepressant       >100mg                           D-11

96.
       Topamax/ topiramate                       Mood Stabilizer      >400mg                            C-9

97.
       Tranxene/ clorazepate dipotassium         Sedative-Hypnotic    ----------       ----------       B-5

98.
       Triavil/ perphenazine-amitriptyline       Combination          ----------       ----------       J-2

99.
       Trilafon/ perphenazine                    Antipsychotic        >15mg            <12yo            E-8

100.
       Trileptal/ oxcarbazepine                  Mood Stabilizer      >600mg                           C-10

101.
       Valium/ diazepam                          Sedative-Hypnotic    ----------       ----------       B-6




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                   Appendix I (Cont’d)                                   Daily Dose         Age      Grouping
              Psychotropic Medication                          Class       Limit           Limit

102.
       Versed/ midazolam                         Antianxiety           ----------       ----------      B-10

103.
       Vistaril/ hydroxyzine pamoate             Antihistamine         >100mg                            G-2

104.   Vivatrol / Naltrexone                     Miscellaneous                                           I-7


105.
       Wellbutrin/ bupropion hydrochloride       Antidepressant        >300mg                            D-2

106.
       Wellbutrin XL / bupropion hydrochloride   Antidepressant        >300mg                            D-2

107.
       Wellbutrin SR/ bupropion hydrochloride    Antidepressant        >300mg                            D-2

108.
       Xanax/ alprazolam                         Sedative-Hypnotic     ----------       ----------       B-1

109.
       Zoloft/ sertraline                        Antidepressant        >100mg                           D-18

110.
       Zyprexa/ olanzapine                       Antipsychotic         >15mg                            E-13

111.
       Zyprexa Zydis/ olanzapine                 Antipsychotic         >15mg                            E-13




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        Appendix J: – Immunization that needs to be fulfilled for clients




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        Appendix K: – Diagnosis ID‟s, Diagnosis Codes and Diagnosis Name
      Diagnosis Diagnosis                                           Diagnosis
         ID       Code                                                Name
      2         316         [Specified Psychological Factor] Affecting...[Indicate the General Medical Condition]
      4         V62.3       Academic Problem
      6         V62.4       Acculturation Problem
      8         308.3       Acute Stress Disorder
      10        309.9       Adjustment Disorder Unspecified
      12        309.24      Adjustment Disorder With Anxiety
      14        309         Adjustment Disorder With Depressed Mood
      16        309.3       Adjustment Disorder With Disturbance of Conduct
      18        309.28      Adjustment Disorder With Mixed Anxiety and Depressed Mood
      20        309.4       Adjustment Disorder With Mixed Disturbance of Emotions and Conduct
      22        V71.01      Adult Antisocial Behavior
      24        995.2       Adverse Effects of Medication NOS
      26        780.9       Age-Related Cognitive Decline
      28        300.22      Agoraphobia Without History of Panic Disorder
      30        305         Alcohol Abuse
      32        303.9       Alcohol Dependence
      34        303         Alcohol Intoxication
      36        291         Alcohol Intoxication Delirium
      38        291.8       Alcohol Withdrawal
      40        291         Alcohol Withdrawal Delirium
      42        291.8       Alcohol-Induced Anxiety Disorder
      44        291.8       Alcohol-Induced Mood Disorder
      46        291.1       Alcohol-Induced Persisting Amnestic Disorder
      48        291.2       Alcohol-Induced Persisting Dementia
      50        291.5       Alcohol-Induced Psychotic Disorder, With Delusions
      52        291.3       Alcohol-Induced Psychotic Disorder, With Hallucinations
      54        291.8       Alcohol-Induced Sexual Dysfunction
      56        291.8       Alcohol-Induced Sleep Disorder
      58        291.9       Alcohol-Related Disorder NOS
      60        294         Amnestic Disorder Due to...[Indicate the General Medical Condition]
      62        294.8       Amnestic Disorder NOS
      64        305.7       Amphetamine Abuse
      66        304.4       Amphetamine Dependence
      68        292.89      Amphetamine Intoxication
      70        292.81      Amphetamine Intoxication Delirium
      74        292.89      Amphetamine-Induced Anxiety Disorder
      78        292.11      Amphetamine-Induced Psychotic Disorder, With Delusions
      80        292.12      Amphetamine-Induced Psychotic Disorder, With Hallucinations
      84        292.89      Amphetamine-Induced Sleep Disorder
      86        292.9       Amphetamine-Related Disorder NOS
      90        301.7       Antisocial Personality Disorder
      94        300         Anxiety Disorder NOS
      96        299.8       Asperger's Disorder
      98        314.9       Attention-Deficit/Hyperactivity Disorder NOS




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        Appendix K (cont’d)

      Diagnosis Diagnosis                                         Diagnosis
         ID       Code                                              Name
      102       314.01      Attention-Deficit/Hyperactivity Disorder, Predominantly Hyperactive-Impulsive Type
      104       314         Attention-Deficit/Hyperactivity Disorder, Predominantly Inattentive Type
      106       299         Autistic Disorder
      110       V62.82      Bereavement
      114       296.56      Bipolar I Disorder, Most Recent Episode Depressed, In Full Remission
      118       296.51      Bipolar I Disorder, Most Recent Episode Depressed, Mild
      120       296.52      Bipolar I Disorder, Most Recent Episode Depressed, Moderate
      122       296.54      Bipolar I Disorder, Most Recent Episode Depressed, Severe With Psychotic Features
      124       296.53      Bipolar I Disorder, Most Recent Episode Depressed, Severe Without Psychotic Features
      128       296.4       Bipolar I Disorder, Most Recent Episode Hypomanic
      130       296.46      Bipolar I Disorder, Most Recent Episode Manic, In Full Remission
      132       296.45      Bipolar I Disorder, Most Recent Episode Manic, In Partial Remission
      136       296.42      Bipolar I Disorder, Most Recent Episode Manic, Moderate
      138       296.44      Bipolar I Disorder, Most Recent Episode Manic, Severe With Psychotic Features
      142       296.4       Bipolar I Disorder, Most Recent Episode Manic, Unspecified
      144       296.66      Bipolar I Disorder, Most Recent Episode Mixed, In Full Remission
      146       296.65      Bipolar I Disorder, Most Recent Episode Mixed, In Partial Remission
      148       296.61      Bipolar I Disorder, Most Recent Episode Mixed, Mild
      152       296.64      Bipolar I Disorder, Most Recent Episode Mixed, Severe With Psychotic Features
      154       296.63      Bipolar I Disorder, Most Recent Episode Mixed, Severe Without Psychotic Features
      158       296.7       Bipolar I Disorder, Most Recent Episode Unspecified
      160       296.06      Bipolar I Disorder, Single Manic Episode, In Full Remission
      162       296.05      Bipolar I Disorder, Single Manic Episode, In Partial Remission
      166       296.02      Bipolar I Disorder, Single Manic Episode, Moderate
      168       296.04      Bipolar I Disorder, Single Manic Episode, Severe With Psychotic Features
      172       296         Bipolar I Disorder, Single Manic Episode, Unspecified
      174       296.89      Bipolar II Disorder
      176       300.7       Body Dysmorphic Disorder
      178       V62.89      Borderline Intellectual Functioning
      182       780.59      Breathing-Related Sleep Disorder
      184       298.8       Brief Psychotic Disorder
      188       305.9       Caffeine Intoxication
      192       292.89      Caffeine-Induced Sleep Disorder
      196       305.2       Cannabis Abuse
      198       304.3       Cannabis Dependence
      202       292.81      Cannabis Intoxication Delirium
      206       292.11      Cannabis-Induced Psychotic Disorder, With Delusions
      208       292.12      Cannabis-Induced Psychotic Disorder, With Hallucinations
      212       293.89      Catatonic Disorder Due to...[Indicate the General Medical Condition]
      216       299.1       Childhood Disintegrative Disorder
      218       307.22      Chronic Motor or Vocal Tic Disorder
      222       305.6       Cocaine Abuse
      224       304.2       Cocaine Dependence
      228       292.81      Cocaine Intoxication Delirium
      232       292.89      Cocaine-Induced Anxiety Disorder
      236       292.11      Cocaine-Induced Psychotic Disorder, With Delusions
      240       292.89      Cocaine-Induced Sexual Dysfunction

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        Appendix K (cont’d)
      Diagnosis Diagnosis                                        Diagnosis
         ID       Code                                             Name
      242       292.89      Cocaine-Induced Sleep Disorder
      244       292.9       Cocaine-Related Disorder NOS
      248       307.9       Communication Disorder NOS
      252       300.11      Conversion Disorder
      256       293         Delirium Due to...[Indicate the General Medical Condition]
      260       297.1       Delusional Disorder
      262       290.1       Dementia Due to Creutzfeldt-Jakob Disease
      264       294.1       Dementia Due to Head Trauma
      266       294.9       Dementia Due to HIV Disease
      268       294.1       Dementia Due to Huntington's Disease
      270       294.1       Dementia Due to Parkinson's Disease
      272       290.1       Dementia Due to Pick's Disease
      274       294.1       Dementia Due to...[Indicate the General Medical Condition]
      276       294.8       Dementia NOS
      278       290.1       Dementia of the Alzheimer's Type, With Early Onset, Uncomplicated
      280       290.11      Dementia of the Alzheimer's Type, With Early Onset, With Delirium
      282       290.12      Dementia of the Alzheimer's Type, With Early Onset, With Delusions
      284       290.13      Dementia of the Alzheimer's Type, With Early Onset, With Depressed Mood
      286       290         Dementia of the Alzheimer's Type, With Late Onset, Uncomplicated
      288       290.3       Dementia of the Alzheimer's Type, With Late Onset, With Delirium
      290       290.2       Dementia of the Alzheimer's Type, With Late Onset, With Delusions
      292       290.21      Dementia of the Alzheimer's Type, With Late Onset, With Depressed Mood
      294       301.6       Dependent Personality Disorder
      296       300.6       Depersonalization Disorder
      298       311         Depressive Disorder NOS
      300       315.4       Developmental Coordination Disorder
      302       799.9       Diagnosis Deferred on Axis II
      304       799.9       Diagnosis or Condition Deferred on Axis I
      306       313.9       Disorder of Infancy, Childhood, or Adolescence NOS
      308       315.2       Disorder of Written Expression
      310       312.9       Disruptive Behavior Disorder NOS
      312       300.12      Dissociative Amnesia
      314       300.15      Dissociative Disorder NOS
      316       300.13      Dissociative Fugue
      318       300.14      Dissociative Identity Disorder
      320       302.76      Dyspareunia (Not Due to a General Medical Condition)
      322       307.47      Dyssomnia NOS
      324       300.4       Dysthymic Disorder
      326       307.5       Eating Disorder NOS
      328       787.6       Encopresis, With Constipation and Overflow Incontinence
      330       307.7       Encopresis, Without Constipation and Overflow Incontinence
      332       307.6       Enuresis (Not Due to a General Medical Condition)
      334       302.4       Exhibitionism
      338       300.19      Factitious Disorder NOS
      342       300.19      Factitious Disorder With Predominantly Physical Signs and Symptoms
      344       300.16      Factitious Disorder With Predominantly Psychological Signs and Symptoms
      346       307.59      Feeding Disorder of Infancy or Early Childhood
      348       625         Female Dyspareunia Due to...[Indicate the General Medical Condition]

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        Appendix K (cont’d)
      Diagnosis Diagnosis                                          Diagnosis
         ID       Code                                               Name
      352       302.73      Female Orgasmic Disorder
      354       302.72      Female Sexual Arousal Disorder
      356       302.81      Fetishism
      358       302.89      Frotteurism
      362       302.6       Gender Identity Disorder in Children
      364       302.6       Gender Identity Disorder NOS
      366       300.02      Generalized Anxiety Disorder
      370       304.5       Hallucinogen Dependence
      374       292.81      Hallucinogen Intoxication Delirium
      378       292.89      Hallucinogen-Induced Anxiety Disorder
      380       292.84      Hallucinogen-Induced Mood Disorder
      384       292.12      Hallucinogen-Induced Psychotic Disorder, With Hallucinations
      386       292.9       Hallucinogen-Related Disorder NOS
      388       301.5       Histrionic Personality Disorder
      392       302.71      Hypoactive Sexual Desire Disorder
      394       300.7       Hypochondriasis
      396       313.82      Identity Problem
      400       305.9       Inhalant Abuse
      404       292.89      Inhalant Intoxication
      408       292.89      Inhalant-Induced Anxiety Disorder
      410       292.84      Inhalant-Induced Mood Disorder
      414       292.11      Inhalant-Induced Psychotic Disorder, With Delusions
      416       292.12      Inhalant-Induced Psychotic Disorder, With Hallucinations
      420       307.42      Insomnia Related to...[Indicate the Axis I or Axis II Disorder]
      424       312.32      Kleptomania
      426       315.9       Learning Disorder NOS
      430       296.35      Major Depressive Disorder, Recurrent, In Partial Remission
      432       296.31      Major Depressive Disorder, Recurrent, Mild
      434       296.32      Major Depressive Disorder, Recurrent, Moderate
      438       296.33      Major Depressive Disorder, Recurrent, Severe Without Psychotic Features
      440       296.3       Major Depressive Disorder, Recurrent, Unspecified
      442       296.26      Major Depressive Disorder, Single Episode, In Full Remission
      446       296.21      Major Depressive Disorder, Single Episode, Mild
      448       296.22      Major Depressive Disorder, Single Episode, Moderate
      450       296.24      Major Depressive Disorder, Single Episode, Severe With Psychotic Features
      454       296.2       Major Depressive Disorder, Single Episode, Unspecified
      456       608.89      Male Dyspareunia Due to...[Indicate the General Medical Condition]
      458       302.72      Male Erectile Disorder
      462       608.89      Male Hypoactive Sexual Desire Disorder Due to...[Indicate the Medical Condition]
      464       302.74      Male Orgasmic Disorder
      466       V65.2       Malingering
      468       315.1       Mathematics Disorder
      472       333.1       Medication-Induced Postural Tremor
      474       293.9       Mental Disorder NOS Due to...[Indicate the General Medical Condition]
      478       317         Mild Mental Retardation
      480       315.31      Mixed Receptive-Expressive Language Disorder
      484       293.83      Mood Disorder Due to...[Indicate the General Medical Condition]
      488       301.81      Narcissistic Personality Disorder

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        Appendix K (cont’d)

      Diagnosis Diagnosis                                          Diagnosis
         ID       Code                                               Name
      492       V61.21      Neglect of Child
      496       333.92      Neuroleptic Malignant Syndrome
      498       333.99      Neuroleptic-Induced Acute Akathisia
      502       332.1       Neuroleptic-Induced Parkinsonism
      504       333.82      Neuroleptic-Induced Tardive Dyskinesia
      508       292         Nicotine Withdrawal
      512       307.47      Nightmare Disorder
      516       V71.09      No Diagnosis or Condition on Axis I
      518       V15.81      Noncompliance With Treatment
      522       301.4       Obsessive-Compulsive Personality Disorder
      524       V62.2       Occupational Problem
      526       305.5       Opioid Abuse
      528       304         Opioid Dependence
      530       292.89      Opioid Intoxication
      532       292.81      Opioid Intoxication Delirium
      534       292         Opioid Withdrawal
      536       292.84      Opioid-Induced Mood Disorder
      538       292.11      Opioid-Induced Psychotic Disorder, With Delusions
      540       292.12      Opioid-Induced Psychotic Disorder, With Hallucinations
      542       292.89      Opioid-Induced Sexual Dysfunction
      544       292.89      Opioid-Induced Sleep Disorder
      546       292.9       Opioid-Related Disorder NOS
      548       313.81      Oppositional Defiant Disorder
      550       305.9       Other (or Unknown) Substance Abuse
      552       304.9       Other (or Unknown) Substance Dependence
      554       292.89      Other (or Unknown) Substance Intoxication
      556       292         Other (or Unknown) Substance Withdrawal
      558       292.89      Other (or Unknown) Substance-Induced Anxiety Disorder
      560       292.81      Other (or Unknown) Substance-Induced Delirium
      562       292.84      Other (or Unknown) Substance-Induced Mood Disorder
      564       292.83      Other (or Unknown) Substance-Induced Persisting Amnestic Disorder
      566       292.82      Other (or Unknown) Substance-Induced Persisting Dementia
      568       292.11      Other (or Unknown) Substance-Induced Psychotic Disorder, With Delusions
      570       292.12      Other (or Unknown) Substance-Induced Psychotic Disorder, With Hallucinations
      572       292.89      Other (or Unknown) Substance-Induced Sexual Dysfunction
      574       292.89      Other (or Unknown) Substance-Induced Sleep Disorder
      576       292.9       Other (or Unknown) Substance-Related Disorder NOS
      578       625.8       Other Female Sexual Dysfunction Due to...[Indicate the General Medical Condition]
      580       608.89      Other Male Sexual Dysfunction Due to...[Indicate the General Medical Condition]
      582       307.89      Pain Disorder Associated With Both Psychological Factors and a General Medical Condition
      584       307.8       Pain Disorder Associated With Psychological Factors
      586       300.21      Panic Disorder With Agoraphobia
      588       300.01      Panic Disorder Without Agoraphobia
      590       301         Paranoid Personality Disorder
      592       302.9       Paraphilia NOS
      596       V61.20      Parent-Child Relational Problem
      600       312.31      Pathological Gambling

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        Appendix K (cont’d)

      Diagnosis Diagnosis                                           Diagnosis
         ID       Code                                                Name
      602       302.2       Pedophilia
      606       301.9       Personality Disorder NOS
      608       299.8       Pervasive Developmental Disorder NOS
      610       V62.89      Phase of Life Problem
      614       304.9       Phencyclidine Dependence
      618       292.81      Phencyclidine Intoxication Delirium
      622       292.84      Phencyclidine-Induced Mood Disorder
      624       292.11      Phencyclidine-Induced Psychotic Disorder, With Delusions
      628       292.9       Phencyclidine-Related Disorder NOS
      630       315.39      Phonological Disorder
      632       V61.1       Physical Abuse of Adult
      636       V61.21      Physical Abuse of Child
      638       995.5       Physical Abuse of Child (if focus of attention is on victim)
      640       307.52      Pica
      644       309.81      Posttraumatic Stress Disorder
      648       307.44      Primary Hypersomnia
      652       318.2       Profound Mental Retardation
      656       293.82      Psychotic Disorder Due to...[Indicate the General Medical Condition], With Hallucinations
      658       298.9       Psychotic Disorder NOS
      660       312.33      Pyromania
      662       313.89      Reactive Attachment Disorder of Infancy or Early Childhood
      666       V62.81      Relational Problem NOS
      670       V62.89      Religious or Spiritual Problem
      672       299.8       Rett's Disorder
      674       307.53      Rumination Disorder
      676       295.7       Schizoaffective Disorder
      680       295.2       Schizophrenia, Catatonic Type
      684       295.3       Schizophrenia, Paranoid Type
      686       295.6       Schizophrenia, Residual Type
      690       295.4       Schizophreniform Disorder
      692       301.22      Schizotypal Personality Disorder
      696       304.1       Sedative, Hypnotic, or Anxiolytic Dependence
      700       292.81      Sedative, Hypnotic, or Anxiolytic Intoxication Delirium
      702       292         Sedative, Hypnotic, or Anxiolytic Withdrawal
      704       292.81      Sedative, Hypnotic, or Anxiolytic Withdrawal Delirium
      708       292.84      Sedative-, Hypnotic-, or Anxiolytic-Induced Mood Disorder
      710       292.83      Sedative-, Hypnotic-, or Anxiolytic-Induced Persisting Amnestic Disorder
      712       292.82      Sedative-, Hypnotic-, or Anxiolytic-Induced Persisting Dementia
      716       292.12      Sedative-, Hypnotic-, or Anxiolytic-Induced Psychotic Disorder, With Hallucinations
      718       292.89      Sedative-, Hypnotic-, or Anxiolytic-Induced Sexual Dysfunction
      720       292.89      Sedative-, Hypnotic-, or Anxiolytic-Induced Sleep Disorder
      724       313.23      Selective Mutism
      726       309.21      Separation Anxiety Disorder
      728       318.1       Severe Mental Retardation
      732       995.81      Sexual Abuse of Adult (if focus of attention is on victim)
      736       995.5       Sexual Abuse of Child (if focus of attention is on victim)


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        Appendix K (cont’d)

      Diagnosis Diagnosis                                          Diagnosis
         ID       Code                                               Name
      740       302.9       Sexual Disorder NOS
      742       302.7       Sexual Dysfunction NOS
      746       302.84      Sexual Sadism
      750       V61.8       Sibling Relational Problem
      754       780.52      Sleep Disorder Due to...[Indicate the General Medical Condition], Insomnia Type
      756       780.59      Sleep Disorder Due to...[Indicate the General Medical Condition], Mixed Type
      758       780.59      Sleep Disorder Due to...[Indicate the General Medical Condition], Parasomnia Type
      760       307.46      Sleep Terror Disorder
      764       300.23      Social Phobia
      768       300.81      Somatoform Disorder NOS
      772       307.3       Stereotypic Movement Disorder
      776       307.2       Tic Disorder NOS
      780       307.21      Transient Tic Disorder
      784       312.39      Trichotillomania
      788       300.9       Unspecified Mental Disorder (nonpsychotic)
      790       306.51      Vaginismus (Not Due to a General Medical Condition)
      792       290.4       Vascular Dementia, Uncomplicated
      794       290.41      Vascular Dementia, With Delirium
      796       290.42      Vascular Dementia, With Delusions
      798       290.43      Vascular Dementia, With Depressed Mood
      800       302.82      Voyeurism
      72        292         Amphetamine Withdrawal
      76        292.84      Amphetamine-Induced Mood Disorder
      82        292.89      Amphetamine-Induced Sexual Dysfunction
      88        307.1       Anorexia Nervosa
      92        293.89      Anxiety Disorder Due to...[Indicate the General Medical Condition]
      100       314.01      Attention-Deficit/Hyperactivity Disorder, Combined Type
      108       301.82      Avoidant Personality Disorder
      112       296.8       Bipolar Disorder NOS
      116       296.55      Bipolar I Disorder, Most Recent Episode Depressed, In Partial Remission
      126       296.5       Bipolar I Disorder, Most Recent Episode Depressed, Unspecified
      134       296.41      Bipolar I Disorder, Most Recent Episode Manic, Mild
      140       296.43      Bipolar I Disorder, Most Recent Episode Manic, Severe Without Psychotic Features
      150       296.62      Bipolar I Disorder, Most Recent Episode Mixed, Moderate
      156       296.6       Bipolar I Disorder, Most Recent Episode Mixed, Unspecified
      164       296.01      Bipolar I Disorder, Single Manic Episode, Mild
      170       296.03      Bipolar I Disorder, Single Manic Episode, Severe Without Psychotic Features
      180       301.83      Borderline Personality Disorder
      186       307.51      Bulimia Nervosa
      190       292.89      Caffeine-Induced Anxiety Disorder
      194       292.9       Caffeine-Related Disorder NOS
      200       292.89      Cannabis Intoxication
      204       292.89      Cannabis-Induced Anxiety Disorder
      210       292.9       Cannabis-Related Disorder NOS
      214       V71.02      Child or Adolescent Antisocial Behavior
      220       307.45      Circadian Rhythm Sleep Disorder
      226       292.89      Cocaine Intoxication

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        Appendix K (cont’d)

      Diagnosis Diagnosis                                        Diagnosis
         ID       Code                                             Name
      230       292         Cocaine Withdrawal
      234       292.84      Cocaine-Induced Mood Disorder
      238       292.12      Cocaine-Induced Psychotic Disorder, With Hallucinations
      246       294.9       Cognitive Disorder NOS
      250       312.8       Conduct Disorder
      254       301.13      Cyclothymic Disorder
      258       780.09      Delirium NOS
      336       315.31      Expressive Language Disorder
      340       300.19      Factitious Disorder With Combined Psychological and Physical Signs and Symptoms
                            Female Hypoactive Sexual Desire Disorder Due to...[Indicate the General Medical
      350       625.8       Condition]
      360       302.85      Gender Identity Disorder in Adolescents or Adults
      368       305.3       Hallucinogen Abuse
      372       292.89      Hallucinogen Intoxication
      376       292.89      Hallucinogen Persisting Perception Disorder
      382       292.11      Hallucinogen-Induced Psychotic Disorder, With Delusions
      390       307.44      Hypersomnia Related to...[Indicate the Axis I or Axis II Disorder]
      398       312.3       Impulse-Control Disorder NOS
      402       304.6       Inhalant Dependence
      406       292.81      Inhalant Intoxication Delirium
      412       292.82      Inhalant-Induced Persisting Dementia
      418       292.9       Inhalant-Related Disorder NOS
      422       312.34      Intermittent Explosive Disorder
      428       296.36      Major Depressive Disorder, Recurrent, In Full Remission
      436       296.34      Major Depressive Disorder, Recurrent, Severe With Psychotic Features
      444       296.25      Major Depressive Disorder, Single Episode, In Partial Remission
      452       296.23      Major Depressive Disorder, Single Episode, Severe Without Psychotic Features
      460       607.84      Male Erectile Disorder Due to...[Indicate the General Medical Condition]
      470       333.9       Medication-Induced Movement Disorder NOS
      476       319         Mental Retardation, Severity Unspecified
      482       318         Moderate Mental Retardation
      486       296.9       Mood Disorder NOS
      490       347         Narcolepsy
      494       995.5       Neglect of Child (if focus of attention is on victim)
      500       333.7       Neuroleptic-Induced Acute Dystonia
      506       305.1       Nicotine Dependence
      510       292.9       Nicotine-Related Disorder NOS
      514       V71.09      No Diagnosis on Axis II
      520       300.3       Obsessive-Compulsive Disorder
      594       307.47      Parasomnia NOS
      598       V61.1       Partner Relational Problem
      604       310.1       Personality Change Due to...[Indicate the General Medical Condition]
      612       305.9       Phencyclidine Abuse
      616       292.89      Phencyclidine Intoxication
      620       292.89      Phencyclidine-Induced Anxiety Disorder
      626       292.12      Phencyclidine-Induced Psychotic Disorder, With Hallucinations
      634       995.81      Physical Abuse of Adult (if focus of attention is on victim)

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        Appendix K (cont’d)

      Diagnosis Diagnosis                                          Diagnosis
         ID       Code                                               Name
      642       304.8       Polysubstance Dependence
      646       302.75      Premature Ejaculation
      650       307.42      Primary Insomnia
      654       293.81      Psychotic Disorder Due to...[Indicate the General Medical Condition], With Delusions
      664       315         Reading Disorder
      668       V61.9       Relational Problem Related to a Mental Disorder or General Medical Condition
      678       301.2       Schizoid Personality Disorder
      682       295.1       Schizophrenia, Disorganized Type
      688       295.9       Schizophrenia, Undifferentiated Type
      694       305.4       Sedative, Hypnotic, or Anxiolytic Abuse
      698       292.89      Sedative, Hypnotic, or Anxiolytic Intoxication
      706       292.89      Sedative-, Hypnotic-, or Anxiolytic-Induced Anxiety Disorder
      714       292.11      Sedative-, Hypnotic-, or Anxiolytic-Induced Psychotic Disorder, With Delusions
      722       292.9       Sedative-, Hypnotic-, or Anxiolytic-Related Disorder NOS
      730       V61.1       Sexual Abuse of Adult
      734       V61.21      Sexual Abuse of Child
      738       302.79      Sexual Aversion Disorder
      744       302.83      Sexual Masochism
      748       297.3       Shared Psychotic Disorder
      752       780.54      Sleep Disorder Due to...[Indicate the General Medical Condition], Hypersomnia Type
      762       307.46      Sleepwalking Disorder
      766       300.81      Somatization Disorder
      770       300.29      Specific Phobia
      774       307         Stuttering
      778       307.23      Tourette's Disorder
      782       302.3       Transvestic Fetishism
      786       300.81      Undifferentiated Somatoform Disorder




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        Appendix L: – Regional Health Nurses; Regional HAR; Regional SAT and
                      Regional Psychologist User Classification.

        Regional Health Nurses
            BR 01 –     For BR number correction

            BR 02 –     Regional Health Nurses shall have the Read/Write access to TNKIDS Health
                        Services Module.

            BR 03 –     System shall provide the ability for the TNKIDS Health Service Administrative
                        Group & Regional Health Nurses to have maintenances interface in order to
                        add/activate/inactivate RHN employees in the system.

          Regional Health Nurses              Region Name                    TNKIDS EI

        Julia Patton                   Davidson                                 EI37357
        Betsy Pursiful                 East TN                                  EI14341
        Chip Dantzler                  Hamilton                                 EI27149
        Katressa Tipton                Knox                                     EI17228
        Patsy Sanford                  Mid-Cumberland                           EI31031
        Kelli Rayford                  Mid-Cumberland
        Sarah Martin                   South Central Region                     EI31560
        Susan Smith                    Northeast
        Rebecca Pitcher                Northwest                                EI41113
        Evelyn Horne                   Shelby                                   EI47380
        Teresa Magat                   Shelby
        Cheryl Brazelton               Southeast                                EI21552
        Sara Webb                      Southwest                                EI44124
        Jennifer Anderson              Upper Cumberland                         EI24262
        Lynn Pollard                   Central Office                           EI34047
        Patricia Slade                 Central Office                           EI37159
        Tricia Lea                     Central Office
        Deborah Gatlin                 Central Office




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        Regional HAR Users
            BR 04 –     Regional HAR Users shall have the Read/Write access to TNKIDS Health
                        Services Module.

            BR 05 –     System shall provide the ability for the TNKIDS Health Service
                        Administrative Group & Regional HAR Users to have maintenances
                        interface in order to add/activate/inactivate HRA employees in the system.

           Regional HAR Names                  Region Name                     TNKIDS EI

        Daphne Richardson               Davidson
        Charles R. Baumgardner          East Tennessee
        Sara (Sally) Lockett            Hamilton
        Carol Lowdermilk                Knox
        Herbert Smith                   Mid-Cumberland
        Anthony Mills                   Northeast
        Tina Lawson                     Northwest
        Debra Butler                    Shelby
        Suzanne Clark                   Shelby
        Mike Stone                      South Central
        Pamela Vasterling               Southeast
        Tiffany Lusby-Spivey            Southwest
        Cherie Long                     Upper Cumberland
        Diana Yelton                    Central Office
        Patricia Slade                  Central Office
        Tricia Lea                      Central Office
        Deborah Gatlin                  Central Office




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        Regional SAT Users
            BR 06 –     Regional SAT Users shall have the Read/Write access to TNKIDS Health
                        Services Module.

            BR 07 –     System shall provide the ability for the TNKIDS Health Service
                        Administrative Group & Regional SAT Users to have maintenances interface
                        in order to add/activate/inactivate SAT employees in the system.

           Regional SAT Names                Region Name                   TNKIDS EI

        Tina Rush                      Davidson
        Becky Barbee                   East Tennessee
        Julia Bean                     East Tennessee
        Wanda Roden                    Hamilton
        Patricia Stephens              Knox
        Chenille Lanier                Mid-Cumberland
        Cheryl Fountain                Northeast
        Tammy Spangler                 Northeast
        Amy Miles                      Northwest
        Virginia Winton                Shelby
        Suzan Sargent                  Shelby
        Denise Ring                    South Central
        Linda Qualls                   Southeast
        Thelma Murphy                  Southwest
        Libby West                     Upper Cumberland
        Betty A. Miller                Central Office




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        Regional Psychologists Users
            BR 08 –     Regional Psychologists Users shall have the Read/Write access to TNKIDS
                        Health Services Module.

            BR 09 –     System shall provide the ability for the TNKIDS Health Service
                        Administrative Group & Regional Psychologists to have maintenances
                        interface in order to add/activate/inactivate Regional Psychologists employees
                        in the system.

          Regional Psychologists Names                Region Name                  TNKIDS EI

        Corinne C. S. Tureau                   Davidson
        Bill Daniel                            East Tennessee
        David Rose                             Hamilton
        Jim Montgomery III                     Knox
        Lisa Pellegrin                         Mid-Cumberland
        Joseph (Joe) Neumann                   Northeast
        Randolph (Randy) Potts                 Northwest
        Jill I. Amos                           Shelby
        Archie Carden                          South Central
               -----                           Southeast
        Deryl Hilliard                         Southwest
        Carolyn Valerio                        Upper Cumberland
        Tricia Lea                             Central Office


        Appendix M: – Rout of Medication & Psychotropic
                    Rout Sort                 Route – Values                   Route – Code
                     Order

                         10                          Oral                            OR
                         20                          Eye                             EY
                         30                           Ear                            ER
                         40                         Nasal                            NS
                         50                       Inhalation                         IH
                         60                     Dermal Patch                         DP
                         70                         Rectal                           RT
                         80                        Vaginal                           VG
                         90                Subcutaneous Injection                    SI
                        100                Intramuscular Injection                    II
                        110                      Intravenous                         IV
                        120                       Unknown                            UN

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Last Updated: July 19, 2007                                                          PVCS revision 1.15

                                               Final Document
                         Health Services & Services Tracking ECP


                                       Stakeholder Approval

                  Requirements & Business Rules Sign-Off Document

         Prepared by: Geshan Alwis (Business Analyst)                       Date: March 12, 2007

                 I have read and understood the elements outlined in Requirements & Business Rules
                 for “Health Services & Services Tracking ECP” Functional document. I am satisfied
                 with the new requirements detailed in this documented and the changes that will be
                 made to Medical Icon, and shall be known as Health Services Module in TNKIDS
                 application.




Business Owner(s)
Signatures
                      Audrey Corder
                      (Director of office of child & family well-being)




                      Tricia Lea
                      (Director of Medical and Behavioral Services)




                      Betty. A Miller
                      (Director Program Coordinator)




                      Deborah Gatlin
                     (Consulting Child & Adolescents Psychiatric)


 Last Updated by: Geshan Alwis                             Page 99 of 99    Last printed: 7/2/2011 11:56:00 PM
 Last Updated: July 19, 2007                                                       PVCS revision 1.15

                                                     Final Document

				
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