Last Name Required to create unique record number (URN) in CAREWare and encrypted unique client ID (UCI) that is sent to HRSA for the RSR

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1 Required Fields in Minnesota CAREWare The following table summarizes the fields that are required in Minnesota CAREWare. It also tells you whether the field is cross-provider (viewable/editable by all providers serving this client); whether the fields are required for the Ryan White Services Report (RSR), for Minnesota data collection (MN), and/or as a CAREWare function (CW); the frequency with which the data must be entered or submitted; and any corresponding notes. If a field does not appear in this table, it is not required. Cross- Required By? Frequency of Data Entry DEMOGRAPHICS TAB Last Name Required to create unique record number (URN) in CAREWare and encrypted unique client ID (UCI) that is sent to HRSA for the RSR First Name Required to create URN in CAREWare and encrypted UCI that is sent to HRSA for the RSR Middle Name Full middle name. Leave blank if no middle name or middle name is unknown. Used for de-duplication Gender Required to create URN in CAREWare and encrypted UCI that is sent to HRSA for the RSR Birth Date Required to create URN in CAREWare Only year of birth is sent to HRSA State State required in CAREWare to generate the list of counties that apply to the state. Used locally for data analysis/description of clients served County Used locally for data analysis/description of clients served Zip Code Only the first three digits of zip code sent to HRSA Used locally for data analysis/description of clients served Ethnicity Race HIV Status HIV status cannot be Unknown HIV+ Date Required in CAREWare if you select any of the following for HIV Status: HIV Positive (not AIDS), HIV Positive (AIDS status unknown), or CDC-defined AIDS AIDS Date Required in CAREWare if you select CDC-defined AIDS for HIV Status. Only year of AIDS diagnosis is sent to HRSA HIV Risk Factors Required by the RSR for ALL clients, even those whose HIV Status is Negative (affected) or Unknown Common Notes Required to denote change of address Updated 11/5/2013

2 SERVICE TAB Vital Status Vital status cannot be Unknown Deceased Date Must enter date of death if Deceased is selected for Vital Status Enrollment Status Enrollment status cannot be Unknown Enrollment Date Will need to enter an enrollment date the first time you enter a service for a client. This field will not need to be updated after that, unless you realize that there was an error Closure Date Must enter closure date if client s enrollment status is not Active. Required in CAREWare to accurately report enrollment status in RSR Note: If a client gives consent to share their service information, all of the following fields (Date Case Manager) are automatically shared with the provider(s) authorized by the client. Date (of service) Information about services received by a client needs to be entered monthly. However, the date should be entered for each service a client received during that month. So if a client received case management on three different dates, each date would be entered Service Name Contract The contract field will automatically be populated when you select a service Units Each agency will receive a spreadsheet that describes what to count as a unit (e.g., bus card, session, billable unit, etc.) for each type of service the agency provides Price The price for most services will be set at $0.00 and you can leave as $0.00. Some services that are billed based on unit cost will have the unit cost set in CAREWare. Do NOT change the unit cost for these services. Cost The cost will automatically calculate for services with a unit rate (number of units x price = cost) Case Manager Name of case manager required for medical case management services - 2 -

3 ANNUAL REVIEW TAB Date of Insurance Assessment Date client s insurance coverage was assessed. Required in CAREWare for current insurance info to be included in RSR Primary Insurance Other Insurance Do not need to complete if client only has one source of insurance (identified under Primary Insurance) or has no insurance (also identified under Primary Insurance) Date of Poverty Level Assessment Date client s household income and household size were assessed. Required in CAREWare for current poverty level info to be included in RSR Household Income Required by CAREWare to calculate Poverty Level Household Size Required by CAREWare to calculate Poverty Level Poverty Level Automatically calculated by CAREWare after Household Income and Household Size are entered Date of Housing Assessment Date client s housing status was assessed. Required in CAREWare for current housing info to be included in RSR Housing Arrangement Note: Only Ryan White-funded primary care providers are required to report the following information for clients who received a Ryan White-funded primary care visit during the quarter. Date Client Counseled Date client received risk reduction counseling. Required in CAREWare for current info to be included in RSR Was Client Counseled about HIV Transmission Risks? Who Counseled About Transmission Risks? Date of Mental Health Screening Date client received mental health screening. Required in CAREWare for current screening info to be included in RSR Was Client Screened for Mental Health? Date of Substance Abuse Screen Date client received substance abuse screening. Required in CAREWare for current screening info to be included in RSR Was Client Screened for Substance Abuse? - 3 -

4 FORM I Client s Country of Birth Will only need to enter once. Will not need to be changed after that unless you get new information Date Client Moved to MN Will only need to enter once. Will not need to be changed after that unless you get new information Form Date Date must be entered to save the form. Date must fall within the current reporting period Client Saw HIV Medical Provider in Last 6 Months Date of Last Appointment Required if you select Yes for Client Saw HIV Medical Provider in Last 6 Months If No, Was Referral Made to HIV Medical Provider - Yes, Date of Referral If Referral Made, Was There a Follow-up? - Yes, Date of Follow-up with Client - Yes, Date of Follow-up with Provider If you select No for Client Saw HIV Medical Provider in Last 6 Months, the Yes, Date of Referral check box will activate. If you check the box (meaning you provided a referral), you must enter a date of referral. If you don t check the box, it means you did not provide a referral. If you check the Yes, Date of Referral box and provide a referral date, the Yes, Date of Follow-up with Client and Yes, Date of Follow-up with Provider check boxes will activate. If you check either one or both (meaning you followed up), you will be required to enter the associated date of follow-up. Not checking the box means that you did not do that type of follow-up (not checking both boxes means you did not do any follow-up) - 4 -

5 ENCOUNTERS TAB Only required for Primary Care providers Note: If a client gives consent to share their clinical information, all of the following fields are automatically shared with all case management and/or clinical staff at the provider(s) authorized by the client. Medications These fields are required in CAREWare to answer the RSR - Start Date questions of whether the client was on ART and/or PCP prophylaxis during the reporting period - Medication - The OI field is only activated if you select OI Prophylaxis as - Unit the response to the Indication field - Strength - The Stop Date is only required if the client stopped taking a - Frequency medication - Indication - OI - Stop Date Labs Screening Labs Screenings Immunizations - Vaccine Pregnancy - Estimated Conception Date - Prenatal Care Date - ART Taken These fields required in CAREWare to answer the RSR questions about CD4 counts and viral loads Select the test that was done (CD4 Count or Viral Load), enter the date the test was conducted, and enter the result These fields required in CAREWare to answer the RSR questions about Hepatitis B, Hepatitis C and Syphilis screenings Select the screening that was done, enter the date it was conducted, and enter the result These fields required in CAREWare to answer the RSR questions about TB screenings and Pap Smears Select the screening that was done, enter the date it was conducted, and enter the result These fields required in CAREWare to answer the RSR question about Hep B vaccination. Select the vaccine provided and enter the date on which it was provided These fields required in CAREWare to answer the RSR questions pertaining to pregnant HIV positive women - 5 -