Free HSRS Core Deskcard - Wisconsin

2009 HSRS CORE DESKCARD
MODULE TYPE 1
CLIENT CHARACTERISTICS (Field 7)
19 23 25 26 27 28 29 86 02 03 14 04 05 10 12 16 17 39 07 08 32 79 09 36 59 71 50 55 57 18 43 44 45 33 91 92 99 Developmental disability - brain trauma Developmental disability - cerebral palsy Developmental disability ­ autism spectrum Developmental disability - mental retardation Developmental disability - epilepsy Developmental disability - other or unknown Family member of developmental disability client Severe emotional disturbance Mental illness (excluding SPMI) Serious and persistent mental illness (SPMI) Family member of mental health client Alcohol client Drug client Chronic alcoholic Alcohol and other drug client Family member of alcohol and other drug client Intoxicated driver Gambling client Blind / visually impaired Hard of hearing Blind / deaf Deaf Physical disability / mobility impaired Other handicap Unmarried parent Victim of domestic abuse Regular caregiver of dependent person Frail elderly Abused / neglected elder Alzheimer's disease / related dementia Migrant Refugee Cuban / Haitian entrant Corrections / criminal justice system client (adults only) Hurricane Katrina evacuee Hurricane Rita evacuee None of above

301 Court intake and studies 603 Intake assessment 500 600 Community Support 509 Community support Work Related and Day Services 108 Work related services 706 Day center services - nonmedical Supported Employment Community Residential Services 202 Adult family home 205 Shelter care 506 Community based residential facility 705 Detoxification - social setting Community Treatment Services 305 Restitution 501 Crisis intervention 507 Counseling / therapeutic resources 704 Day treatment - medical Inpatient and Institutional Care 703 Detoxification - hospital setting 503 Inpatient 505 DD center / nursing home Institution for Mental Disease

08 09 10 11 12 13 98

Noncompliance with the program Service not available Court dismissed Client no longer income eligible Court order expired / client not income eligible Somewhat successful completion Other reason

MODULE TYPE
Used on HSRS reports 1 CORE Human Services Reporting System 5 FSP Family Support Program 6 AODA Alcohol and Other Drug Abuse 9 MH Mental Health A LTS Long-Term Support SOS DESK (608) 266-9198 8:00 - 11:30 A.M. and 12:30 - 4:00 P.M. or leave voice mail message. E-mail Address: [email protected] FAX: (608) 267-2437 HSRS Handbook and Terminal Operator's Guide: http://www.dhs.wisconsin.gov/HSRS/index.htm WI Department of Health Services Division of Enterprise Services F-20031I (Rev. 01/2009)

615 700

800

900

925

Client specific reporting is not required on the following cluster. However, it may be used on an optional basis. 200 Community Prevention, Access and Outreach 403 Recreational / alternative activities 408 Community prevention, organization and awareness 601 Outreach 602 Information and referral 605 Advocacy and defense resources 606 Health screening and accessibility Developmental disability Family member / other of DD client Mental health (DSS use only) Family member / other of mental health client Alcohol and other drug abuse (DSS use only) Family member / other of AODA client Physical and sensory disability Family member / other of P and SD client Adults and elderly Family member / other of adults and elderly client Children and family

TARGET GROUP (Field 17)
01 72 31 75 18 74 57 76 58 77 64

SPC CLUSTER/CATEGORY (Field 16)
100 104 107 300 Child Day Care - Crisis / Respite 101 Child day care - crisis / respite Supportive Home Care Specialized Transportation and Escort Community Living / Support Services 102 Adult day care 103 Respite care 106 Housing / energy assistance 110 Daily living skills training 112 Interpreter services and adaptive equipment 401 Congregate meals 402 Home delivered meals 404 Family planning 406 Protective payment / guardianship 604 Case management Investigations and Assessments

CLOSING REASON (Field 13)
(Optional) 01 Assessment complete / decision not to serve 02 Successful completion 03 Client referred 04 Client no longer wants service 05 Client relocated 06 Death of client 07 Objectives not attained

400