VA-HOMELESSNESS SCREENING (66)    REMINDER DEFINITION (811.9)

• EDIT DATE:   2012-10-18 15:54:47
  EDIT BY:   USER,SEVENTEEN
  EDIT COMMENTS:   

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The Secretary of the Department of Veterans Affairs has made it a 
will guide staff to refer Veterans for further assessment and the
appropriate intervention to prevent or quickly end homelessness.
priority to eliminate homelessness in our Veteran population.
 
The objective of the VA-Homelessness Screening Clinical Reminder is to: 
(a) identify Veterans and their families who are at imminent risk of 
homelessness or who have very recently become homeless; (b) ensure that 
those who are at-risk or who are currently homeless are referred for the
appropriate assistance; and (c) update the current living situation for
Veterans. Information collected by the VA-Homelessness Screening reminder

• FINDING ITEM:   VA-HOMELESSNESS - ALREADY RECEIVING SERVICES
  NO. OF FOUND TEXT LINES:   4
  NO. NOT FOUND TEXT LINES:   0
  FOUND TEXT:   

  Either a visit in a clinic with a Stop Code indicating homelessness, or 
  the Health Factor, "ALREADY RECEIVING ASSIST WITH HOUSING", or a local
  Progress Note title indicative of Homelessness assistance was found. Any 
  of which EXCLUDES Homelessness Screening for 6 months.
  

  USE IN PATIENT COHORT LOGIC:   AND NOT
  BEGINNING DATE/TIME:   T-6M
• FINDING ITEM:   VA-REMINDER DEFINITION
  CONDITION:   I V="DUE NOW"
  INTERNAL CONDITION:   I V="DUE NOW"
  NO. OF FOUND TEXT LINES:   0
  NO. NOT FOUND TEXT LINES:   0
  COMPUTED FINDING PARAMETER:   VA-HOMELESSNESS FREQUENCY 2Y
  REMINDER FREQUENCY:   2Y
• FINDING ITEM:   NEGATIVE - HAS STABLE HOUSING
  WITHIN CATEGORY RANK:   0
  OCCURRENCE COUNT:   3
  NO. OF FOUND TEXT LINES:   1
  NO. NOT FOUND TEXT LINES:   0
  FOUND TEXT:   

  Veteran has current stable housing.
  

  USE IN RESOLUTION LOGIC:   OR
• FINDING ITEM:   POSITIVE - HAS WORRIES ABOUT HOUSING
  WITHIN CATEGORY RANK:   0
  NO. OF FOUND TEXT LINES:   2
  NO. NOT FOUND TEXT LINES:   0
  FOUND TEXT:   

  The last homelessness screen was POSITIVE - Veteran has worries about 
  next 60 days.
  

  USE IN RESOLUTION LOGIC:   OR
• FINDING ITEM:   NEGATIVE - HAS NO HOUSING CONCERNS
  WITHIN CATEGORY RANK:   0
  OCCURRENCE COUNT:   3
  NO. OF FOUND TEXT LINES:   1
  NO. NOT FOUND TEXT LINES:   0
  FOUND TEXT:   

  Veteran has no immediate housing concerns.
  

  USE IN RESOLUTION LOGIC:   OR
• FINDING ITEM:   POSITIVE - HAS NO STABLE HOUSING
  WITHIN CATEGORY RANK:   0
  NO. OF FOUND TEXT LINES:   1
  NO. NOT FOUND TEXT LINES:   0
  FOUND TEXT:   

  The last homelessness screen was POSITIVE - Veteran has no stable housing.
  

  USE IN RESOLUTION LOGIC:   OR
• FINDING ITEM:   DECLINES HOMELESS SCREEN
  WITHIN CATEGORY RANK:   0
  NO. OF FOUND TEXT LINES:   1
  NO. NOT FOUND TEXT LINES:   0
  FOUND TEXT:   

  Veteran declined homelessness screening at this visit.
  

  USE IN RESOLUTION LOGIC:   OR
• FINDING ITEM:   UNABLE TO PERFORM HOMELESS SCREEN
  WITHIN CATEGORY RANK:   0
  NO. OF FOUND TEXT LINES:   2
  NO. NOT FOUND TEXT LINES:   0
  FOUND TEXT:   

  Veteran or caregiver unable to answer homelessness screening questions at 
  this visit.
  

  USE IN RESOLUTION LOGIC:   OR
  BEGINNING DATE/TIME:   T-6M
• FINDING ITEM:   NURSING HOME RESIDENT
  WITHIN CATEGORY RANK:   0
  NO. OF FOUND TEXT LINES:   1
  NO. NOT FOUND TEXT LINES:   0
  REMINDER FREQUENCY:   2Y
  FOUND TEXT:   

  Veteran is living in a stable institutional setting.
  

  USE IN RESOLUTION LOGIC:   OR
  BEGINNING DATE/TIME:   T-2Y

• FUNCTION FINDING NUMBER:   1
  FOUND TEXT:   

  Positive Screen more recent than Negative Screen. Frequency changed to 6M.
  

  LOGIC:   (FN(1)!FN(2))&(FN(3)'
  REMINDER FREQUENCY:   6M
  FUNCTION STRING:   (FI(3)!FI(5))&(MAX_DATE(3,5)'
  NO. FOUND TEXT LINES:   1
  NO. NOT FOUND TEXT LINES:   0

  FUNCTION LIST:

  • FUNCTION NUMBER:   1
    FUNCTION:   FI

    FUNCTION PARAMETER LIST:

  • FUNCTION NUMBER:   2
    FUNCTION:   FI

    FUNCTION PARAMETER LIST:

  • FUNCTION NUMBER:   3
    FUNCTION:   MAX_DATE

    FUNCTION PARAMETER LIST:

  • FUNCTION NUMBER:   4
    FUNCTION:   MAX_DATE

    FUNCTION PARAMETER LIST:

The reminder applies to all Veterans, EXCEPT any Veteran where one of
3. Those that have had a Progress Note written with a SPECIFIC Title (that
is already entered into the logic of the Computed Finding [VA-PROGRESS
NOTE]) by a provider in a NON-Homelessness Stop Code clinic, who provided
those services.
 
Entering a Beginning Date/Time of T-6M on that Reminder Term is a logic
trick to ensure that only visits in those locations, or the Specific
Health Factor, or the specific Progress Note Title IN THE PAST 6 MONTHS
are evaluated.
 
the following findings in the Reminder Term (Finding #1) apply: 
This reminder's frequency is set to 1 year, but this required somewhat
complex resolution logic so that various findings and conditions resolve
the reminder for different time frames.
 
Negative Screens result in resolution for 6 Months. This was accomplished 
by creating a Function Finding - FF(#1), that sets the frequency.
 
 ---- Begin: FF(1) ----------------------------------------------
              Function String: MAX_DATE(3,5)'<MAX_DATE(2,4) 
     Expanded Function String: 
1. Those who have had a visit in one of the specific Stop Code Clinics
      MAX_DATE(POSITIVE - HAS WORRIES ABOUT HOUSING, 
      POSITIVE - HAS NO STABLE HOUSING)'<MAX_DATE(
      NEGATIVE - HAS STABLE HOUSING,NEGATIVE - HAS NO HOUSING CONCERNS)
          Match Frequency/Age: 6 months for all ages 
                   Found Text: Positive Screen more recent than Negative
                   Screen. Frequency changed to 6M.
 ---- End: FF(1) ----------------------------------------------
 
Finding #9 - NURSING HOME RESIDENT - resolves the reminder for 2 years 
(Frequency set on that finding, but Beginning Date/Time set to T-2Y, so 
(Homelessness-related) listed in the Reminder Location List ; or 
that after 2 years, the finding no longer applies, and normal frequency 
(1Y) applies), until and if that living arrangement is documented again.
 
Findings #2 & #4 - NEGATIVE - HAS STABLE HOUSING and NEGATIVE - HAS NO 
HOUSING CONCERNS - are BOTH Required for Negative Screen. If BOTH are
found, the reminder is resolved for 1 year, but if 3 consecutive screens
are negative, and the Computed Finding that looks at the Reminder
Definition VA-HOMELESSNESS FREQUENCY 2Y is evaluated as TRUE, it is
resolved for 2 years.
 
 
A Positive Screen (Finding #5 - POSITIVE - HAS NO STABLE HOUSING; or
Finding #3 -POSITIVE - HAS WORRIES ABOUT HOUSING ) resolves for 6 months,
as does documenting UNABLE TO PERFORM HOMELESS SCREEN (Finding #7).
 
Finding #6 (Declines Homeless Screen) Resolves for 1 year.
                                 
Customized RESOLUTION LOGIC defines findings that resolve the Reminder:
 FI(9)!(FI(2)&FI(4))!FI(6)!FI(3)!FI(5)!FI(7)
 
Expanded Resolution Logic:
2. Those who have had the Health Factor, ALREADY RECEIVING ASSIST WITH
 FI(NURSING HOME RESIDENT)!(FI(NEGATIVE - HAS STABLE HOUSING)&
 FI(NEGATIVE - HAS NO HOUSING CONCERNS))!FI(DECLINES HOMELESS SCREEN)!
 FI(POSITIVE - HAS WORRIES ABOUT HOUSING)!
 FI(POSITIVE - HAS NO STABLE HOUSING)!
 FI(UNABLE TO PERFORM HOMELESS SCREEN)
HOUSING entered into a visit by using the corresponding option in the
dialog; or 
 

• REMINDER FREQUENCY:   1Y
  AGE MATCH TEXT:   

  All Veterans should be screened for current or imminent homelessness, 
  annually. Veterans who are homeless or are in imminent danger of becoming 
  homeless should be screened every 6 months.
  

  NO. OF AGE MATCH LINES:   3
  NO. OF AGE NO MATCH LINES:   0