Cross-Tab Dependencies

Foreign key relationships and referential integrity between schemas

Overview

The CoBHRM data model uses referential integrity to link records across schemas. Understanding these dependencies is critical for successful data submission - parent records must exist before child records can be created.

Dependency Diagram

Foreign Key Reference

Child Schema	Parent Schema	Foreign Key Field(s)	Constraint
ADMISSION	CLIENT	BHASO_CLIENT_IDENTIFIER	Client must exist
DISCHARGE	ADMISSION	BHASO_ADMISSION_IDENTIFIER	Admission must exist
DIAGNOSIS (DXA)	ADMISSION	BHASO_ADMISSION_IDENTIFIER	Admission must exist
DIAGNOSIS (DXD)	ADMISSION	BHASO_ADMISSION_IDENTIFIER	Admission must exist; filled out at discharge
SUBSTANCE USE (SIA)	ADMISSION	BHASO_ADMISSION_IDENTIFIER	Admission must exist
SUBSTANCE USE (SID)	ADMISSION	BHASO_ADMISSION_IDENTIFIER	Admission must exist; filled out at discharge
ACT	ADMISSION	BHASO_ADMISSION_IDENTIFIER	Admission must exist
ASCENT (ASA)	ADMISSION	BHASO_ADMISSION_IDENTIFIER	Admission must exist
ASCENT (ASQ)	ASCENT (ASA)	BHASO_ADMISSION_IDENTIFIER	ASA must exist
ASCENT (ASD)	ASCENT (ASA)	BHASO_ADMISSION_IDENTIFIER	ASA must exist
SC BABY	ADMISSION	BHASO_ADMISSION_IDENTIFIER	Admission must exist
SC PREGNANCY RISK	ADMISSION	BHASO_ADMISSION_IDENTIFIER	Admission must exist

Submission Order

Records must be submitted in dependency order:

1. Level 1: CLIENT

   Submit all CLIENT (CLI) records first

2. Level 2: ADMISSION

   Submit ADMISSION (ADM) records that reference existing clients

3. Level 3a: Admission Children

   Submit records that depend only on ADMISSION:

   • DIAGNOSIS at Admission (DXA)
   • SUBSTANCE USE at Admission (SIA)
   • ACT
   • ASCENT Admission (ASA)
   • SC BABY (BAB)
   • SC PREGNANCY RISK (PRS)
4. Level 3b: DISCHARGE and Discharge Records

   Submit DISCHARGE (DIS) records, plus records filled out at discharge:

   • DIAGNOSIS at Discharge (DXD)
   • SUBSTANCE USE at Discharge (SID)
5. Level 4: ASCENT Follow-ups

   Submit ASCENT records that depend on ASA:

   • ASCENT Quarterly (ASQ)
   • ASCENT Discharge (ASD)

Key Fields

BHASO_CLIENT_IDENTIFIER

• Purpose: Uniquely identifies a client across all records
• Assigned by: BHASO (provider organization)
• Format: Alphanumeric, no length limit
• Scope: Client and Admission schemas only

# All records for the same client use the same identifier
BHASO_CLIENT_IDENTIFIER
CLT-000001

BHASO_ADMISSION_IDENTIFIER

• Purpose: Uniquely identifies a treatment episode
• Assigned by: BHASO (provider organization)
• Format: Alphanumeric, no length limit
• Scope: ADMISSION and all child schemas

# Admission creates the case identifier
RECORD_TYPE|BHASO_CLIENT_IDENTIFIER|BHASO_ADMISSION_IDENTIFIER
ADM|CLT-000001|CSE-000001

# Child records reference the admission identifier
RECORD_TYPE|BHASO_ADMISSION_IDENTIFIER
DIS|CSE-000001
DXA|CSE-000001
SIA|CSE-000001

Legal Status / Service Identifier Cross-Validation

Pending update: Both the Legal Status codes and Service Identifier codes have been renumbered (see their respective Appendix A pages for current values). The cross-validation matrix below still references the previous code numbering and is expected to be replaced before April 1, 2026 once the new mapping is finalized at the Co-BHRM meeting.

At discharge, the Legal Status must be compatible with the admission’s Service Identifier. The following matrix shows which legal statuses are allowed with each service category.

Service Categories

Category	Service Identifier Codes	Services
Withdrawal Management (WM)	01, 02, 12	Ambulatory Medical WM, Residential WM, Medically Managed Inpatient WM
SUD Services	03, 04, 05, 06, 07, 08, 09, 10, 11	TC, IRT, TRT, OTP, Outpatient, STIRT, IOP, Day Treatment, Medically Managed Inpatient
Mental Health Services	17, 18, 19, 20, 21, 22	MH Outpatient, MH Residential, MH Inpatient, Crisis Stabilization, Crisis Respite, Psychiatric Hospitalization

Legal Status Restrictions

Legal Status	Code	Allowed Service Categories
Voluntary	01	All (no restriction)
Court-directed voluntary	02	Mental Health only (17-22)
Forensic	03	Mental Health only (17-22)
72-hour evaluation and treatment	04	Mental Health only (17-22)
Short-term certification	05	Mental Health only (17-22)
Long-term certification	06	Mental Health only (17-22)
Children’s Code C.R.S. 19-1-101	07	Mental Health only (17-22)
Involuntary Alcohol/Drug Commitment	08	SUD only (03-11)
Conditional Release	09	Mental Health only (17-22)
DYS Commitment	10	Mental Health only (17-22)
DYS Detention	11	Mental Health only (17-22)
DOC/Community Parole	12	Mental Health only (17-22)
Emergency Commitment	13	Withdrawal Management only (01, 02, 12)

Submitting a discharge with a Legal Status that does not match the admission’s Service Identifier category will produce a cross-field validation error (XFD-004).

Cardinality Rules

Parent	Child	Cardinality	Notes
CLIENT	ADMISSION	1:M	Multiple treatment episodes allowed
ADMISSION	DISCHARGE	1:0..1	One discharge per admission (none while active)
ADMISSION	DIAGNOSIS (DXA)	1:1	One diagnosis record per admission (supports up to 3 MH + 1 SUD ICD codes within the record)
DISCHARGE	DIAGNOSIS (DXD)	1:1	One diagnosis record per discharge (supports up to 3 MH + 1 SUD ICD codes within the record)
ADMISSION	SUBSTANCE USE (SIA)	1:0..1	Required for SUD admissions; omitted for MH-only
DISCHARGE	SUBSTANCE USE (SID)	1:0..1	Required for SUD discharges; omitted for MH-only
ADMISSION	ACT	1:0..M	Monthly records; multiple if episode > 30 days
ADMISSION	ASCENT (ASA)	1:0..1	One Ascent admission per treatment episode (only if enrolled)
ASA	ASCENT (ASQ)	1:0..M	Quarterly assessments; multiple if episode > 90 days
ASA	ASCENT (ASD)	1:0..1	One Ascent discharge
ADMISSION	SC BABY	1:0..M	Multiple babies (twins, etc.)
ADMISSION	SC PREGNANCY RISK	1:0..1	One pregnancy risk screening per admission