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MHSA - Partnership Assessment Form - Cal-PM

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Collect Mental Health Services Act (MHSA) partnership data.

► Notes
  • The term "partner" refers to the client.
  • Avatar will only allow one 'Finalized' Partnership Assessment Form because a patient can only have one partnership established with the state at a given time. Subsequent information is reported to the state by submitting a Key Event Tracking Form, and a 3M to report quarterly information. The Key Event Tracking Form can also be used to end the partnership between the state and patient.
  • If a patient has been inactivated for more than one year (no submitted KET's or quarterly 3M Forms), a new Partnership Assessment Form (PAF) needs to be submitted, referencing the previous partnerGUID.
  • When a patient is discharged from an episode which reports MHSA data, submit a discontinuation Key Event Tracking Form (KET) to inactivate the patient. The patient's status will become inactive for the partnership within the associated episode. When the client is admitted to a program again (new episode), submit a reestablishment Key Event Tracking Form (KET) to update the client status to active, unless the patient has been inactive or more than one year, in which case a new Partnership Assessment Form (PAF) is required.
  • When the first Partnership Assessment Form (PAF) is compiled, myAvatar creates and assigns an Assessment_GUID which is the unique identifier for the particular MHSA assessment. Additionally, the Assessment_GUID for the PAF is also set as the Partner_GUID, which is the unique identifier for the partnership. Subsequent MHSA Assessments will all have a unique Assessment_GUID. Assessment_GUID's are filed under the Partner_GUID which allows the state identify all transactions for a given partnership.
  • Deleting a Key Event Tracking record will also clear associated GUID values that were created within the MHSA XML Submission form.

Note: This form must be filed with a Final status (Assessment Status field) before the following forms can be opened, and before assessment data can be submitted to the state:

  • Quarterly Assessment Form
  • Key Event Tracking Form

If required, Final status can be changed to draft in the MHSA Assessments Draft/Final Override form.

  • Age categories:
    • Children and Youth, aged 0-15
    • Transitional Age Youth (TAY), aged 16-25
    • Adults, aged 26-59
    • Older Adults, aged 60 and older
  1. Go to: Avatar PM > Client Management > California Data Reporting > MHSA Assessments > Partnership Assessment Form
  2. In the Select Client screen, enter the client ID in the Client Name/ID field, select the Search button, and select the corresponding entry.
    • If the client has multiple episodes, the Episode Selection pre-display shows. Select the client episode, select Edit.
    • If the client has previous partnership assessments, the pre-display shows. Select the assessment, select Edit.
  3. In the Partnership Date field, enter the date the partnership was set up. This date is used to calculate the partner’s age.
  4. The Partnership Form Type field shows the partner's age category.
  5. In the Who referred the partner? field, select the partner's referral source.
  6. In the Assessment Status field:
    • Select Draft to create a partner assessment record that is in process. When the assessment is completed the status can be changed to Final.
    • Select Final for an assessment that has been completed.
  7. When finished, select Submit.
► Additional Sections
► Registry Settings
► SQL Tables
  • SYSTEM.mhsa_part_assess_form
  • SYSTEM.mhsa_part_assess_form_2