NYSCRI Child Comprehensive Assessment Update (NYCCAU)

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Form Details

• Form Properties
  1. Form Title: NYSCRI Child Comprehensive Assessment Update
  2. Start from an Existing Form - Yes, NYSCRI Child Comprehensive Assessment v2.
  3. Copyrighted Form - No
  4. Billable Progress Note - No
  5. Have multiple versions open at same time - No
  6. Open Blank on new version - No
• Required Fields - Yes, Diagnosis
• Lookup Tables - None
• Pre-Fill Logic - Yes
  1. Organization Name will prefill from Setup → Program/Billing Defaults → Company Info Tab.
  2. Program Name will prefill from the Program the patient is enrolled in.
  3. Date of most recent Comprehensive Assessment will prefill from NYSCRI Child Comprehensive Assessment v2 completion date.
  4. Diagnosis Tab will prefill from any form with Diagnosis.
• Fill to Logic - Yes
  1. Diagnosis Tab will fill to any form with a Diagnosis.
• Signatures
  1. Individual Served Signature
     • Sig type: Patient
  2. Guardian Signature
     • Sig type: None
  3. Provider Signature
     • Sig type: Provider
     • Route-to function is available.
     • Signature locks the form.
  4. Clinical Supervisor Signature
     • Sig type: Clinical Supervisor
     • Route-to function is available.
     • Signature locks the form.
     • N/A defaults to checked.
  5. Team Leader Signature
     • Sig type: Team Leader
     • Route-to function is available.
     • Signature locks the form.
     • N/A defaults to checked.
  6. Psychiatrist Signature
     • Sig type: Psychiatrist
     • Route-to function is available.
     • Signature locks the form.
     • N/A defaults to checked.

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Update Tab

1. Organization Name and Program Name will prefill from Program/Billing Defaults.
2. Select a reason for the update.
3. Date of most recent Comprehensive Assessment will prefill from most recent NYSCRI Child Comprehensive Assessment v2 or NYSCRI Child Comprehensive Assessment Update.
4. Check the box(es) next to the section(s) of the assessment (including addendums), which you are updating.
5. List each assessment section being updated with narrative explanation below it.
6. Select if any evidence-based screening tool(s), for either mental health or substance use, was utilized. If yes, specify.
   • Grey out - Selecting No will grey out text field.

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Diagnosis Tab

1. Add/edit the diagnosis
   • Prefill - Diagnosis will prefill from the most recent completed form and fill to subsequent forms that contain the diagnosis field.
2. A primary diagnosis must be selected to save/lock the form.

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Needs Tab

1. Enter any service preferences.
2. Treatment recommendation/assessed needs.
   • Select Status: Active, Individual Declined, Deferred, Referred Out
     • Active needs will prefill to the Needs section of the NYSCRI Initial Individualized Action Plan Review and the NYSCRI Individualized Action Plan Review.
3. Explain why individual declined to work on needs area and/or indicate rationale(s) for why need area(s) is deferred/referred out.
   • NOTE: Treatment Recommendation/Assessed Needs and Individual Declined/Deferred/Referred Rationale(s) section populates from previous version.
4. Select any further evaluations needed (if any).

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Treatment Tab

1. Enter any level of care/indicated service recommendations.
2. Enter any individual served/guardian/family responses to recommendations.
3. Select if a change in IAP is required.
   • If yes, complete the IAP Revision/Review form to record needed changes in goal(s), objective(s), interventions, services, frequency, and/or provider type.

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Signatures Tab

Signature Credentials (see Credentials)

1. Individual Served Signature
   • Sig type: Patient
2. Guardian Signature
   • Sig type: None
3. Provider Signature
   • Sig type: Provider
   • Route-to function is available.
   • Signature locks the form.
4. Clinical Supervisor Signature
   • Sig type: Clinical Supervisor
   • Route-to function is available.
   • Signature locks the form.
   • N/A defaults to checked.
5. Team Leader Signature
   • Sig type: Team Leader
   • Route-to function is available.
   • Signature locks the form.
   • N/A defaults to checked.
6. Psychiatrist Signature
   • Sig type: Psychiatrist
   • Route-to function is available.
   • Signature locks the form.
   • N/A defaults to checked.

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