array("MUSC Health Women's Health Services","(843) 792-5300")); $FORM_GLOBAL['provider_array']=array('0'=>array('Sharon Bond','1982719423'),'1'=>array('Eugene Chang','1336255777'), '2'=>array('Jessica Day','1366797607'),'3'=>array('Angela Dempsey','1518919489'), '4'=>array('Donald Fylstra','1174638688'),'5'=>array('Christopher Goodier','1669678421'), '6'=>array('Gretchen Hahn','1245284926'),'7'=>array('Donna Johnson','1831205277'), '8'=>array('Gweneth Lazenby','1215134655'),'9'=>array('Julio Mateus-nino','1700077997'), '10'=>array('Roger Newman','1366557860'),'11'=>array('Allison Nissen','1528211224'), '12'=>array('Charles Rittenberg','1376658856'),'13'=>array('Amelia Rowland','1477668952'), '14'=>array('Ashlyn Savage','1013940089'),'15'=>array('John Schnorr','1003924523'), '16'=>array('Michael Slowey','1316972318'),'17'=>array('David Soper','1063527513'), '18'=>array('Scott Sullivan','1356457717'),'19'=>array('Steven Swift','1447366968'), '20'=>array('Cristian Thomae','1306934658'),'21'=>array('Rebecca Wineland','1528267879'), '22'=>array('Alexandra Rowin','1740591452'),'23'=>array('Head','1295795854'), '24'=>array('Krista Wagoner','1619238359'),'25'=>array('Sterrett','1417246778'), '26'=>array('Liza Bergrin','1689100968'),'27'=>array('Matt Finneran','1720348998'), '28'=>array('Mallory Alkis','1912264151'),'29'=>array('Rachel Powell','167993075'), '30'=>array('Lauren Brown','1679954291'),'31'=>array('Jessica McLaughlin','1861755712'), '32'=>array('Rachael Cowherd','1043604374'),'33'=>array('Khilen Patel','1386026144'), '34'=>array('Eliza McElwee','1629458435'),'35'=>array('Ryan Cuff','1114289675'), '36'=>array('Lisa Bystry',''),'37'=>array('Angela Choi',''), '38'=>array('Megann Helton-Rieter',''),'39'=>array('Faye Leboeuf',''), '40'=>array('Michelle Meglin',''),'41'=>array('Judy Osborne',''), '42'=>array('Raksha Soora',''),'43'=>array('Jessica Tarleton',''), '44'=>array('Tara Van Leuven',''),'45'=>array('Genevieve Wolpert',''), '46'=>array('Maria Thomae','')); $FORM_GLOBAL['race_array']=array('1'=>'White','2'=>'Black or African American','3'=>'American Indian/Alaska Native','4'=>'Asian', '5'=>'Native Hawaiian or Other Pacific Islander','6'=>'Other','7'=>'Patient Refused','8'=>'Unknown','9'=>'Hispanic','10'=>'More than one race'); # - - - - - - - - - - - - - - - - - - - - - - - - # # Care Coordinator Work Log Configuration # Instrument: Care Coordinator Work Log (MH/SUD/SDoH) # care_coordinator_work_log_mhsudsdoh # - - - - - - - - - - - - - - # $CC_GLOBAL['ccwl_0']='Our behavioral health team has made several attempts to contact this patient, but we have not been successful.'; $CC_GLOBAL['ccwl_0_no_success']="We recommend further assessment of mental health and substance use at the patient's next scheduled appointment."; $CC_GLOBAL['ccwl_1']='Our behavioral health team has contacted the patient, but the patient was not scheduled for an appointment.'; $CC_GLOBAL['ccwl_1_cns0']='Based on our clinical evaluation, behavioral health services are not needed at this time.'; $CC_GLOBAL['ccwl_1_cns1']='The patient is not interested in clinical services.'; #$CC_GLOBAL['ccwl_1_cont_screen']='We will continue to screen the patient for mental health and substance use problems via text messaging every 2-3 months.'; $CC_GLOBAL['ccwl_1_cns2']='The patient is interested in behavioral health services, but is unable to attend an appointment due to: '; $CC_GLOBAL['ccwl_1_cns2_cont']='We will continue to work with the patient to access care.'; $CC_GLOBAL['ccwl_2']='Our behavioral health team has made contact with the patient and she is scheduled for behavioral health services on DATE via'; $CC_GLOBAL['ccwl_2_new']='Our behavioral health team has made contact with the patient and she is scheduled for behavioral health services on'; $CC_GLOBAL['ccwl_3']='Our behavioral health team has made contact with the patient and she was given information about how to access additional supports.'; #$CC_GLOBAL['ccwl_3_con']='We will continue to screen the patient for mental health and substance use problems via text messaging every 2-3 months.'; $CC_GLOBAL['ccwl_4']='Our behavioral health team continues to work with this patient to ensure optimal behavioral health care.'; $CC_GLOBAL['ccwl_5']=''; $CC_GLOBAL['letter_head']="Women’s Behavioral Health Program\nScreening Progress Note\n\n"; $CC_GLOBAL['letter_1']="We have completed a maternal mental health and substance use disorder screening for Ms. "; $CC_GLOBAL['letter_2']=" via text messaging. Her responses indicate she "; $CC_GLOBAL['low_risk']="is at low risk for mental health or substance use problems"; $CC_GLOBAL['pos_dep_risk']="elevated depressive symptoms"; $CC_GLOBAL['prevent_risk']="risk factors for the development of postpartum depression"; $CC_GLOBAL['sa_low_risk']="minimal risk factors for substance use"; $CC_GLOBAL['sub_abuse_risk']="risk factors for substance use"; $CC_GLOBAL['dom_abuse_risk']="risk factors for domestic violence"; $CC_GLOBAL['letter_bottom']="We will continue to screen the patient for mental health and substance use problems via text messaging every 2-3 months. Thank you for allowing us to take part in your patient's care. Please do not hesitate to contact us if you have any questions or concerns.\n\nWomen’s Behavioral Health Care Coordinator\n843-323-5274"; # - - - - - - - - - - - - - - - - - - - - - - - - # # SBIRT PDF Global Variables: # - - - - - - - - - - - - - - # # FDF header section $PDF_GLOBAL['fdf_header'] = <<> >> endobj trailer << /Root 1 0 R >> %%EOF; FDF;