Scenario 5: Client referred » client assessed » client triaged to lower intensity service (at another service provider) » client begins or completes low-intensity treatment » client requires step up and is referred to higher intensity OSP service » client completes treatment » exits OSP
| Stage | Element | Response Option Cells in yellow represent specific response options for a scenario. Fields in grey with ‘--‘ should be left blank because they are not applicable to the listed scenario. |
| SERVICE PROVIDER 1 (NLO) (receiving initial referral into OSP) | ||
| 1. Referral Received | Hub/ Network Lead Organization | 100, 200, 300, 400, 600, 800, 900, 1000, 1100, 1300 |
| Date referral received | YYYYMMDD | |
| OHIP # | Number | |
| Referral Source Type | 1-8, 77 | |
| OHIP billing number | Number | |
| PHQ 9 referral score | Score | |
| GAD 7 referral score | Score | |
| 2. Referral Completed | Date referral completed | YYYYMMDD |
| Referral Type | 1 | |
| OHIP # (if not collected prior) | Number | |
| Unique Client ID | Number | |
| Client/Patient First Name | As written | |
| Client/Patient Last Name | As written | |
| Address | As written | |
| City | As written | |
| Postal Code | As written, NFA, UNK, FSA | |
| Service Request ID- Incoming | -- | |
| 3. Initial Screen/ Screen for Eligibility | Screening for eligibility date | YYYYMMDD |
| Outcome of eligibility screen | 1 | |
| 4. Clinical Intake and Triage Assessment | Date of Birth | YYYYMMDD |
| Francophone | 1-2, 88, 99 | |
| Requires French language services | 1-2 | |
| Main spoken language | 1-35, 77, 88, 99 | |
| Main spoken language – Other | As written | |
| Interpreter required | 1-2 | |
| Gender | 1-7, 77, 88, 99 | |
| Sexual Orientation | 1-6, 77, 88, 99 | |
| Racial/ethnic group | 1-8, 10-16, 77, 88, 99 | |
| Work status | 1-6, 77, 88, 99 | |
| Student status | 1-3, 77, 88, 99 | |
| Client has less than 5 years in Canada | 1-2, 88, 99 | |
| Was client born in Canada? | 1-2, 88, 99 | |
| If no, what year did client arrive in Canada? | YYYY | |
| Family income | 1-8, 77, 88, 99 | |
| How many people does this income support? | Number | |
| Health status | 1-8, 77, 88, 99 | |
| Prior mental health counselling | 1-2, 88, 99 | |
| Session date | YYYYMMDD | |
| Session type | 1 | |
| Session attendance | 1-5 | |
| Duration of session | Number | |
| Provider ID | Number | |
| Triage service recommendation | 4-7 | |
| Reason for triage decision | 1-13 | |
| PHQ-9 score (ASSESSMENT) | Score | |
| GAD-7 score (ASSESSMENT) | Score | |
| WHODAS score (ASSESSMENT) | Score | |
| HAI-SW scale score (ASSESSMENT) | Score | |
| OCI-R scale score (ASSESSMENT) | Score | |
| PDSS-SR scale score (ASSESSMENT) | Score | |
| PCL-5 scale score (ASSESSMENT) | Score | |
| SPIN scale score (ASSESSMENT) | Score | |
| Severity Measure for Specific Phobia- Adult Scale score | Score | |
| (ASSESSMENT) | ||
| AUDIT-C score (ASSESSMENT) | Score | |
| DUDIT score (ASSESSMENT) | Score | |
| PSWQ scale score (ASSESSMENT) | Score | |
| Main Problem descriptor (ASSESSMENT) | 2-5, 7-11 | |
| 5. Enrollment | OSP Program enrollment date | YYYYMMDD |
| 6. Service/Treatment | Service Delivery Site | -- |
| Treatment start date | -- | |
| Session date | -- | |
| Session type | -- | |
| Session attendance | -- | |
| Duration of session | -- | |
| Provider ID | -- | |
| OSP Program Service | -- | |
| Service Delivery Type | -- | |
| Linguistic/ culturally specific service | -- | |
| PHQ-9 score (TREATMENT) | -- | |
| GAD-7 score (TREATMENT) | -- | |
| WHODAS score (TREATMENT) | -- | |
| WSAS score (TREATMENT) | -- | |
| HAI-SW scale score (TREATMENT) | -- | |
| OCI-R scale score (TREATMENT) | -- | |
| PDSS-SR scale score (TREATMENT) | -- | |
| PCL-5 scale score (TREATMENT) | -- | |
| SPIN scale score (TREATMENT) | -- | |
| Severity Measure for Specific Phobia- Adult | -- | |
| Scale score (TREATMENT) | ||
| AUDIT-C score (TREATMENT) | -- | |
| DUDIT score (TREATMENT) | -- | |
| PSWQ scale score (TREATMENT) | -- | |
| Main Problem descriptor (TREATMENT) | -- | |
| Treatment completion date | -- | |
| 7. Client Hold | Type of client hold | -- |
| Stage of client hold | -- | |
| Client hold start date | -- | |
| Client hold end date | -- | |
| 8. Client Exit/ Not Accepted to Program/ Service Request Outgoing | Exit date | YYYYMMDD |
| Stage of client exit or referral | 7 | |
| Exit disposition | 10 | |
| Ineligible due to: | -- | |
| Where was referral/service request made? | 500, 700, 1200 | |
| Date referral/service request was made | YYYYMMDD | |
| Service Request ID- Outgoing | Number | |
| SERVICE PROVIDER 2 (Low Intensity service provider receiving service request from NLO) | ||
| 2. Referral Received | Hub/ Network Lead Organization | 500, 700, 1200 |
| Date referral received | YYYYMMDD | |
| OHIP # | Number | |
| Referral Source Type | -- | |
| OHIP billing number | -- | |
| PHQ 9 referral score | -- | |
| GAD 7 referral score | -- | |
| 2. Referral Completed | Date referral completed | YYYYMMDD |
| Referral Type | 2 | |
| OHIP # (if not collected prior) | Number | |
| Unique Client ID | Number | |
| Client/Patient First Name | As written | |
| Client/Patient Last Name | As written | |
| Address | As written | |
| City | As written | |
| Postal Code | As written, NFA, UNK, FSA | |
| Service Request ID- Incoming | Number | |
| 3. Initial Screen/ Screen for Eligibility | Screening for eligibility date | -- |
| Outcome of eligibility screen | -- | |
| 4. Clinical Intake and Triage Assessment | Date of Birth | YYYYMMDD |
| Francophone | -- | |
| Requires French language services | -- | |
| Main spoken language | -- | |
| Main spoken language – Other | -- | |
| Interpreter required | -- | |
| Gender | -- | |
| Sexual Orientation | -- | |
| Racial/ethnic group | -- | |
| Work status | -- | |
| Student status | -- | |
| Client has less than 5 years in Canada | -- | |
| Was client born in Canada? | -- | |
| If no, what year did client arrive in Canada? | -- | |
| Family income | -- | |
| How many people does this income support? | -- | |
| Health status | -- | |
| Prior mental health counselling | -- | |
| Session date | -- | |
| Session type | -- | |
| Session attendance | -- | |
| Duration of session | -- | |
| Provider ID | -- | |
| Triage service recommendation | -- | |
| Reason for triage decision | -- | |
| PHQ-9 score (ASSESSMENT) | -- | |
| GAD-7 score (ASSESSMENT) | -- | |
| WHODAS score (ASSESSMENT) | -- | |
| HAI-SW scale score (ASSESSMENT) | -- | |
| OCI-R scale score (ASSESSMENT) | -- | |
| PDSS-SR scale score (ASSESSMENT) | -- | |
| PCL-5 scale score (ASSESSMENT) | -- | |
| SPIN scale score (ASSESSMENT) | -- | |
| Severity Measure for Specific Phobia- Adult Scale score | -- | |
| (ASSESSMENT) | ||
| AUDIT-C score (ASSESSMENT) | -- | |
| DUDIT score (ASSESSMENT) | -- | |
| PSWQ scale score (ASSESSMENT) | -- | |
| Main Problem descriptor (ASSESSMENT) | -- | |
| 5. Enrollment | OSP Program enrollment date | -- |
| 6. Service/Treatment | Service Delivery Site | Site Number |
| Treatment start date | YYYYMMDD | |
| Session date | YYYYMMDD | |
| Session type | 2, 3 | |
| Session attendance | 1-5 | |
| Duration of session | Number | |
| Provider ID | Number | |
| OSP Program Service | 2-4 | |
| Service Delivery Type | 1-7, 77 | |
| Linguistic/ culturally specific service | 1-5, 77 | |
| PHQ-9 score (TREATMENT) | Score | |
| GAD-7 score (TREATMENT) | Score | |
| WHODAS score (TREATMENT) | Score | |
| WSAS score (TREATMENT) | Score | |
| HAI-SW scale score (TREATMENT) | Score | |
| OCI-R scale score (TREATMENT) | Score | |
| PDSS-SR scale score (TREATMENT) | Score | |
| PCL-5 scale score (TREATMENT) | Score | |
| SPIN scale score (TREATMENT) | Score | |
| Severity Measure for Specific Phobia- Adult | Score | |
| Scale score (TREATMENT) | ||
| AUDIT-C score (TREATMENT) | Score | |
| DUDIT score (TREATMENT) | Score | |
| PSWQ scale score (TREATMENT) | Score | |
| Main Problem descriptor (TREATMENT) | 2-5, 7-11 | |
| Treatment completion date | YYYYMMDD (Entered at end of planned treatment, if applicable) | |
| 7. Client Hold | Type of client hold | -- |
| Stage of client hold | -- | |
| Client hold start date | -- | |
| Client hold end date | -- | |
| 8. Client Exit/ Not Accepted to Program/ Service Request Outgoing | Exit date | YYYYMMDD |
| Stage of client exit or referral | 3 | |
| Exit disposition | 2 or 10 | |
| Ineligible due to: | -- | |
| Where was referral/service request made? | 100, 200, 300, 400, 600, 800, 900, 1000, 1100, 1300 | |
| Date referral/service request was made | YYYYMMDD | |
| Service Request ID- Outgoing | Number (new) | |
| SERVICE PROVIDER 1 (NLO) (receiving service request from Low Intensity service provider) | ||
| 1. Referral Received | Hub/ Network Lead Organization | 100, 200, 300, 400, 600, 800, 900, 1000, 1100, 1300 |
| Date referral received | YYYYMMDD | |
| OHIP # | Number | |
| Referral Source Type | -- | |
| OHIP billing number | -- | |
| PHQ 9 referral score | -- | |
| GAD 7 referral score | -- | |
| 2. Referral Completed | Date referral completed | YYYYMMDD |
| Referral Type | 3 | |
| OHIP # (if not collected prior) | Number | |
| Unique Client ID | Number | |
| Client/Patient First Name | As written | |
| Client/Patient Last Name | As written | |
| Address | As written | |
| City | As written | |
| Postal Code | As written, NFA, UNK, FSA | |
| Service Request ID- Incoming | Number | |
| 3. Initial Screen/ Screen for Eligibility | Screening for eligibility date | -- |
| Outcome of eligibility screen | -- | |
| 4. Clinical Intake and Triage Assessment | Date of Birth | YYYYMMDD |
| Francophone | -- | |
| Requires French language services | -- | |
| Main spoken language | -- | |
| Main spoken language – Other | -- | |
| Interpreter required | -- | |
| Gender | -- | |
| Sexual Orientation | -- | |
| Racial/ethnic group | -- | |
| Work status | -- | |
| Student status | -- | |
| Client has less than 5 years in Canada | -- | |
| Was client born in Canada? | -- | |
| If no, what year did client arrive in Canada? | -- | |
| Family income | -- | |
| How many people does this income support? | -- | |
| Health status | -- | |
| Prior mental health counselling | -- | |
| Session date | Populated only if client receives additional assessment at step up | |
| Session type | Populated only if client receives additional assessment at step up | |
| Session attendance | Populated only if client receives additional assessment at step up | |
| Duration of session | Populated only if client receives additional assessment at step up | |
| Provider ID | Populated only if client receives additional assessment at step up | |
| Triage service recommendation | -- | |
| Reason for triage decision | -- | |
| PHQ-9 score (ASSESSMENT) | -- | |
| GAD-7 score (ASSESSMENT) | -- | |
| WHODAS score (ASSESSMENT) | -- | |
| HAI-SW scale score (ASSESSMENT) | -- | |
| OCI-R scale score (ASSESSMENT) | -- | |
| PDSS-SR scale score (ASSESSMENT) | -- | |
| PCL-5 scale score (ASSESSMENT) | -- | |
| SPIN scale score (ASSESSMENT) | -- | |
| Severity Measure for Specific Phobia- Adult Scale score | -- | |
| (ASSESSMENT) | ||
| AUDIT-C score (ASSESSMENT) | -- | |
| DUDIT score (ASSESSMENT) | -- | |
| PSWQ scale score (ASSESSMENT) | -- | |
| Main Problem descriptor (ASSESSMENT) | -- | |
| 5. Enrollment | OSP Program enrollment date | -- |
| 6. Service/Treatment | Service Delivery Site | Site Number |
| Treatment start date | YYYYMMDD | |
| Session date | YYYYMMDD | |
| Session type | 2, 3 | |
| Session attendance | 1-5 | |
| Duration of session | Number | |
| Provider ID | Number | |
| OSP Program Service | 1 | |
| Service Delivery Type | 1-7, 77 | |
| Linguistic/ culturally specific service | 1-5, 77 | |
| PHQ-9 score (TREATMENT) | Score | |
| GAD-7 score (TREATMENT) | Score | |
| WHODAS score (TREATMENT) | Score | |
| WSAS score (TREATMENT) | Score | |
| HAI-SW scale score (TREATMENT) | Score | |
| OCI-R scale score (TREATMENT) | Score | |
| PDSS-SR scale score (TREATMENT) | Score | |
| PCL-5 scale score (TREATMENT) | Score | |
| SPIN scale score (TREATMENT) | Score | |
| Severity Measure for Specific Phobia- Adult | Score | |
| Scale score (TREATMENT) | ||
| AUDIT-C score (TREATMENT) | Score | |
| DUDIT score (TREATMENT) | Score | |
| PSWQ scale score (TREATMENT) | Score | |
| Main Problem Descriptor (TREATMENT) | 2-5, 7-11 (Note that client may be stepped up for a different problem area. If applicable, indicate new problem area here.) | |
| Treatment completion date | YYYYMMDD (Entered at end of planned treatment, if applicable) | |
| 7. Client Hold | Type of client hold | -- |
| Stage of client hold | -- | |
| Client hold start date | -- | |
| Client hold end date | -- | |
| 8. Client Exit/ Not Accepted to Program/ Service Request Outgoing | Exit date | YYYYMMDD |
| Stage of client exit or referral | 3 | |
| Exit disposition | 1-11 | |
| Ineligible due to: | -- | |
| Where was referral/service request made? | -- | |
| Date referral/service request was made | -- | |
| Service Request ID- Outgoing | -- | |
Related articles
Scenario 6: Client completes service at assessment NLO and receives booster sessions before exit
Scenario 8a: Client transferred to low-intensity treatment
Scenario 8b: Client transferred to low-intensity treatment
