Electronic Long-Term Services and Supports (eLTSS) Release 1 - US Realm

This page is part of the electronic Long-Term Services and Supports Implementation Guide (v1.0.0: STU 1) based on FHIR R4. This is the current published version in it's permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

StructureDefinition: ELTSSServicePlanModel

The official URL for this profile is: 

http://hl7.org/fhir/us/eltss/StructureDefinition/eLTSSServicePlanModel

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from Element

Summary

Mandatory: 0 element (1 nested mandatory element)
Must-Support: 3 elements

Structures

This structure refers to these other structures:

This structure is derived from Element

NameFlagsCard.TypeDescription & Constraintsdoco
.. eLTSSServicePlanModel 0..*
... beneficiary Σ1..1Reference(eLTSS Person Logical Model)The person for whom the plan is for.
... effectiveDate SΣ0..1PeriodThe date upon which the plan goes into effect. Start date is required, end date is optional.
... supportPlanner 0..1BackboneElementThe person (e.g., Case Manager, Care Coordinator, Plan Coordinator) who helped develop the plan.
.... name 0..1stringThe name of the person (e.g., Case Manager, Care Coordinator, Plan Coordinator) who helped develop the plan.
.... phoneNumber 0..*stringThe primary phone number (and extension when applicable) of the support planner.
... planMonitor Σ0..1BackboneElementThe person responsible for monitoring the plan.
.... name 0..1stringThe name of the person responsible for monitoring the plan.
.... phoneNumber 0..*stringThe primary phone number (and extension when applicable) of the plan monitor.
... emergencyBackupPlan 0..*stringDescription of how to address unforeseen events.
... goal SΣ0..*stringA statement of a desired result that the person wants to achieve.
... preference Σ0..*stringPresents the person’s personal thoughts about something he or she feels is relevant to his or her life experience and may be pertinent when planning.
... strength Σ0..*stringA favorable attribute of the person, his/her support network, environment and/or elements of his/her life.
... assessedNeed SΣ0..*stringThe clinical and/or community-based necessity or desire as identified through an assessment that should be addressed by a service.
... identifiedRisk 0..*stringAn aspect of a person’s life, behavior, environmental exposure, personal characteristic, or barrier that increases the likelihood of disease, condition, injury to self or others, or interaction with the criminal justice system.
... riskManagementPlan 0..*stringDescription of planned activities to minimize identified risks that endanger the person’s health and safety.
... service 0..*Reference(eLTSS Service Logical Model)A service provided under this plan.
... serviceOptionsGivenIndicator 0..1booleanStates whether or not the person was given a choice of services outlined in the plan.
... serviceSelectionIndicator 0..1booleanStates whether or not the person participated in the selection of the services outlined in the plan.
... agreementIndicator 0..1booleanStates whether or not the person agrees to the services outlined in the plan.
... serviceProviderOptionsGivenIndicator 0..1booleanStates whether or not the person was offered a choice of providers for each service.
... serviceProviderSelectionAgreementIndicator 0..1booleanStates whether or not the person feels he/she made an informed choice in selecting the provider for each service.
... personSettingChoiceIndicator 0..1booleanIndicator that reflects the setting in which the person resides is chosen by the individual.
... personSettingChoiceOptions 0..1stringThe alternative home and community-based settings that were considered by the individual.
... personSignature 0..1BackboneElementThe person's signature as proof of identify and intent for the plan.
.... value 0..1base64BinaryThe depiction of the person's signature as proof of identify and intent for the plan.
.... printedName 0..1stringThe printed or typed name of the person.
.... date 0..1dateThe date the person signed the plan.
... representativeSignature 0..*BackboneElementThe guardian or legally authorized representative’s signature as proof of identity and intent for the plan.
.... value 0..1base64BinaryThe depiction of the guardian or legally authorized representative’s signature as proof of identity and intent for the plan.
.... printedName 0..1stringThe printed or typed name of the guardian or legally authorized representative.
.... date 0..1dateThe date the guardian or legally authorized representative signed the plan.
... supportPlannerSignature 0..1BackboneElementThe support planner’s signature as proof of identity and intent for the plan.
.... value 0..1base64BinaryThe depiction of the support planner’s signature as proof of identity and intent for the plan.
.... printedName 0..1stringThe printed or typed name of the support planner.
.... date 0..1dateThe date the support planner signed the plan.
... serviceProviderSignature 0..*BackboneElementThe service provider’s signature as proof they agree to the services they will provide.
.... value 0..1base64BinaryThe depiction of the service provider’s signature as proof they agree to the services they will provide.
.... printedName 0..1stringThe printed or typed name of the service provider.
.... date 0..1stringThe date the service provider signed the plan.

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. eLTSSServicePlanModel 0..*
... beneficiary Σ1..1Reference(eLTSS Person Logical Model)The person for whom the plan is for.
... effectiveDate SΣ0..1PeriodThe date upon which the plan goes into effect. Start date is required, end date is optional.
... supportPlanner 0..1BackboneElementThe person (e.g., Case Manager, Care Coordinator, Plan Coordinator) who helped develop the plan.
.... name 0..1stringThe name of the person (e.g., Case Manager, Care Coordinator, Plan Coordinator) who helped develop the plan.
.... phoneNumber 0..*stringThe primary phone number (and extension when applicable) of the support planner.
... planMonitor Σ0..1BackboneElementThe person responsible for monitoring the plan.
.... name 0..1stringThe name of the person responsible for monitoring the plan.
.... phoneNumber 0..*stringThe primary phone number (and extension when applicable) of the plan monitor.
... emergencyBackupPlan 0..*stringDescription of how to address unforeseen events.
... goal SΣ0..*stringA statement of a desired result that the person wants to achieve.
... preference Σ0..*stringPresents the person’s personal thoughts about something he or she feels is relevant to his or her life experience and may be pertinent when planning.
... strength Σ0..*stringA favorable attribute of the person, his/her support network, environment and/or elements of his/her life.
... assessedNeed SΣ0..*stringThe clinical and/or community-based necessity or desire as identified through an assessment that should be addressed by a service.
... identifiedRisk 0..*stringAn aspect of a person’s life, behavior, environmental exposure, personal characteristic, or barrier that increases the likelihood of disease, condition, injury to self or others, or interaction with the criminal justice system.
... riskManagementPlan 0..*stringDescription of planned activities to minimize identified risks that endanger the person’s health and safety.
... service 0..*Reference(eLTSS Service Logical Model)A service provided under this plan.
... serviceOptionsGivenIndicator 0..1booleanStates whether or not the person was given a choice of services outlined in the plan.
... serviceSelectionIndicator 0..1booleanStates whether or not the person participated in the selection of the services outlined in the plan.
... agreementIndicator 0..1booleanStates whether or not the person agrees to the services outlined in the plan.
... serviceProviderOptionsGivenIndicator 0..1booleanStates whether or not the person was offered a choice of providers for each service.
... serviceProviderSelectionAgreementIndicator 0..1booleanStates whether or not the person feels he/she made an informed choice in selecting the provider for each service.
... personSettingChoiceIndicator 0..1booleanIndicator that reflects the setting in which the person resides is chosen by the individual.
... personSettingChoiceOptions 0..1stringThe alternative home and community-based settings that were considered by the individual.
... personSignature 0..1BackboneElementThe person's signature as proof of identify and intent for the plan.
.... value 0..1base64BinaryThe depiction of the person's signature as proof of identify and intent for the plan.
.... printedName 0..1stringThe printed or typed name of the person.
.... date 0..1dateThe date the person signed the plan.
... representativeSignature 0..*BackboneElementThe guardian or legally authorized representative’s signature as proof of identity and intent for the plan.
.... value 0..1base64BinaryThe depiction of the guardian or legally authorized representative’s signature as proof of identity and intent for the plan.
.... printedName 0..1stringThe printed or typed name of the guardian or legally authorized representative.
.... date 0..1dateThe date the guardian or legally authorized representative signed the plan.
... supportPlannerSignature 0..1BackboneElementThe support planner’s signature as proof of identity and intent for the plan.
.... value 0..1base64BinaryThe depiction of the support planner’s signature as proof of identity and intent for the plan.
.... printedName 0..1stringThe printed or typed name of the support planner.
.... date 0..1dateThe date the support planner signed the plan.
... serviceProviderSignature 0..*BackboneElementThe service provider’s signature as proof they agree to the services they will provide.
.... value 0..1base64BinaryThe depiction of the service provider’s signature as proof they agree to the services they will provide.
.... printedName 0..1stringThe printed or typed name of the service provider.
.... date 0..1stringThe date the service provider signed the plan.

doco Documentation for this format

This structure is derived from Element

Summary

Mandatory: 0 element (1 nested mandatory element)
Must-Support: 3 elements

Structures

This structure refers to these other structures:

Differential View

This structure is derived from Element

NameFlagsCard.TypeDescription & Constraintsdoco
.. eLTSSServicePlanModel 0..*
... beneficiary Σ1..1Reference(eLTSS Person Logical Model)The person for whom the plan is for.
... effectiveDate SΣ0..1PeriodThe date upon which the plan goes into effect. Start date is required, end date is optional.
... supportPlanner 0..1BackboneElementThe person (e.g., Case Manager, Care Coordinator, Plan Coordinator) who helped develop the plan.
.... name 0..1stringThe name of the person (e.g., Case Manager, Care Coordinator, Plan Coordinator) who helped develop the plan.
.... phoneNumber 0..*stringThe primary phone number (and extension when applicable) of the support planner.
... planMonitor Σ0..1BackboneElementThe person responsible for monitoring the plan.
.... name 0..1stringThe name of the person responsible for monitoring the plan.
.... phoneNumber 0..*stringThe primary phone number (and extension when applicable) of the plan monitor.
... emergencyBackupPlan 0..*stringDescription of how to address unforeseen events.
... goal SΣ0..*stringA statement of a desired result that the person wants to achieve.
... preference Σ0..*stringPresents the person’s personal thoughts about something he or she feels is relevant to his or her life experience and may be pertinent when planning.
... strength Σ0..*stringA favorable attribute of the person, his/her support network, environment and/or elements of his/her life.
... assessedNeed SΣ0..*stringThe clinical and/or community-based necessity or desire as identified through an assessment that should be addressed by a service.
... identifiedRisk 0..*stringAn aspect of a person’s life, behavior, environmental exposure, personal characteristic, or barrier that increases the likelihood of disease, condition, injury to self or others, or interaction with the criminal justice system.
... riskManagementPlan 0..*stringDescription of planned activities to minimize identified risks that endanger the person’s health and safety.
... service 0..*Reference(eLTSS Service Logical Model)A service provided under this plan.
... serviceOptionsGivenIndicator 0..1booleanStates whether or not the person was given a choice of services outlined in the plan.
... serviceSelectionIndicator 0..1booleanStates whether or not the person participated in the selection of the services outlined in the plan.
... agreementIndicator 0..1booleanStates whether or not the person agrees to the services outlined in the plan.
... serviceProviderOptionsGivenIndicator 0..1booleanStates whether or not the person was offered a choice of providers for each service.
... serviceProviderSelectionAgreementIndicator 0..1booleanStates whether or not the person feels he/she made an informed choice in selecting the provider for each service.
... personSettingChoiceIndicator 0..1booleanIndicator that reflects the setting in which the person resides is chosen by the individual.
... personSettingChoiceOptions 0..1stringThe alternative home and community-based settings that were considered by the individual.
... personSignature 0..1BackboneElementThe person's signature as proof of identify and intent for the plan.
.... value 0..1base64BinaryThe depiction of the person's signature as proof of identify and intent for the plan.
.... printedName 0..1stringThe printed or typed name of the person.
.... date 0..1dateThe date the person signed the plan.
... representativeSignature 0..*BackboneElementThe guardian or legally authorized representative’s signature as proof of identity and intent for the plan.
.... value 0..1base64BinaryThe depiction of the guardian or legally authorized representative’s signature as proof of identity and intent for the plan.
.... printedName 0..1stringThe printed or typed name of the guardian or legally authorized representative.
.... date 0..1dateThe date the guardian or legally authorized representative signed the plan.
... supportPlannerSignature 0..1BackboneElementThe support planner’s signature as proof of identity and intent for the plan.
.... value 0..1base64BinaryThe depiction of the support planner’s signature as proof of identity and intent for the plan.
.... printedName 0..1stringThe printed or typed name of the support planner.
.... date 0..1dateThe date the support planner signed the plan.
... serviceProviderSignature 0..*BackboneElementThe service provider’s signature as proof they agree to the services they will provide.
.... value 0..1base64BinaryThe depiction of the service provider’s signature as proof they agree to the services they will provide.
.... printedName 0..1stringThe printed or typed name of the service provider.
.... date 0..1stringThe date the service provider signed the plan.

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. eLTSSServicePlanModel 0..*
... beneficiary Σ1..1Reference(eLTSS Person Logical Model)The person for whom the plan is for.
... effectiveDate SΣ0..1PeriodThe date upon which the plan goes into effect. Start date is required, end date is optional.
... supportPlanner 0..1BackboneElementThe person (e.g., Case Manager, Care Coordinator, Plan Coordinator) who helped develop the plan.
.... name 0..1stringThe name of the person (e.g., Case Manager, Care Coordinator, Plan Coordinator) who helped develop the plan.
.... phoneNumber 0..*stringThe primary phone number (and extension when applicable) of the support planner.
... planMonitor Σ0..1BackboneElementThe person responsible for monitoring the plan.
.... name 0..1stringThe name of the person responsible for monitoring the plan.
.... phoneNumber 0..*stringThe primary phone number (and extension when applicable) of the plan monitor.
... emergencyBackupPlan 0..*stringDescription of how to address unforeseen events.
... goal SΣ0..*stringA statement of a desired result that the person wants to achieve.
... preference Σ0..*stringPresents the person’s personal thoughts about something he or she feels is relevant to his or her life experience and may be pertinent when planning.
... strength Σ0..*stringA favorable attribute of the person, his/her support network, environment and/or elements of his/her life.
... assessedNeed SΣ0..*stringThe clinical and/or community-based necessity or desire as identified through an assessment that should be addressed by a service.
... identifiedRisk 0..*stringAn aspect of a person’s life, behavior, environmental exposure, personal characteristic, or barrier that increases the likelihood of disease, condition, injury to self or others, or interaction with the criminal justice system.
... riskManagementPlan 0..*stringDescription of planned activities to minimize identified risks that endanger the person’s health and safety.
... service 0..*Reference(eLTSS Service Logical Model)A service provided under this plan.
... serviceOptionsGivenIndicator 0..1booleanStates whether or not the person was given a choice of services outlined in the plan.
... serviceSelectionIndicator 0..1booleanStates whether or not the person participated in the selection of the services outlined in the plan.
... agreementIndicator 0..1booleanStates whether or not the person agrees to the services outlined in the plan.
... serviceProviderOptionsGivenIndicator 0..1booleanStates whether or not the person was offered a choice of providers for each service.
... serviceProviderSelectionAgreementIndicator 0..1booleanStates whether or not the person feels he/she made an informed choice in selecting the provider for each service.
... personSettingChoiceIndicator 0..1booleanIndicator that reflects the setting in which the person resides is chosen by the individual.
... personSettingChoiceOptions 0..1stringThe alternative home and community-based settings that were considered by the individual.
... personSignature 0..1BackboneElementThe person's signature as proof of identify and intent for the plan.
.... value 0..1base64BinaryThe depiction of the person's signature as proof of identify and intent for the plan.
.... printedName 0..1stringThe printed or typed name of the person.
.... date 0..1dateThe date the person signed the plan.
... representativeSignature 0..*BackboneElementThe guardian or legally authorized representative’s signature as proof of identity and intent for the plan.
.... value 0..1base64BinaryThe depiction of the guardian or legally authorized representative’s signature as proof of identity and intent for the plan.
.... printedName 0..1stringThe printed or typed name of the guardian or legally authorized representative.
.... date 0..1dateThe date the guardian or legally authorized representative signed the plan.
... supportPlannerSignature 0..1BackboneElementThe support planner’s signature as proof of identity and intent for the plan.
.... value 0..1base64BinaryThe depiction of the support planner’s signature as proof of identity and intent for the plan.
.... printedName 0..1stringThe printed or typed name of the support planner.
.... date 0..1dateThe date the support planner signed the plan.
... serviceProviderSignature 0..*BackboneElementThe service provider’s signature as proof they agree to the services they will provide.
.... value 0..1base64BinaryThe depiction of the service provider’s signature as proof they agree to the services they will provide.
.... printedName 0..1stringThe printed or typed name of the service provider.
.... date 0..1stringThe date the service provider signed the plan.

doco Documentation for this format

 

​Other representations of profile: Schematron

Terminology Bindings

Constraints

IdPathDetailsRequirements