Individual Information
The Individual Information screen displays read-only information about the individual for whom the incident is being filed.
Note: The information displayed on this screen is collected from the individual's integrating case management system (HCSIS) at the time of incident creation.
Note: For ODP-ID/A, if a licensed provider or extended care facility creates an incident for an individual without an MCI number, specific fields on this screen will be editable to facilitate the capture of demographic information of the individual.
| Field Name | Field Description |
| MCI | This read-only field displays the individual's Master Client Index (MCI) number. |
| SSN | This read-only field displays the individual's Social Security Number (SSN). |
| BSU | This read-only field displays the individual's Base Service Unit (BSU) Number. |
| Individual Name | This read-only field displays the name of the individual for whom the incident or complaint was created. |
| Case Management System | This read-only field displays the system from where the individual's information on this screen was obtained. |
| Residential County | This read-only field displays the individual's residential county. |
| Funding County/Joinder | This read-only field displays the individual's county/joinder. |
| Region | This read-only field displays the Region for the individual. |
| Waiver/Program | This read-only field displays the waiver/ program in which the individual is enrolled. |
| Gender | This read-only field displays the gender of the individual. |
| Date of Birth | This read-only field displays the individual's date of birth. |
| Phone Number | This read-only field displays the individual's phone number. |
| This read-only field displays the individual's e-mail address. | |
| Address Line 1 | This read-only field displays the address of the individual. |
| Address Line 2 | This read-only field displays additional address information of the individual. |
| Address Line 3 | This read-only field displays additional address information of the individual. |
| City | This read-only field displays the city corresponding to the above address. |
| State | This read-only field displays the state corresponding to the above address. |
| Zip Code | This read-only field displays the zip code corresponding to the above address. |
| SC Entity Name | This read-only field displays the name of the SC entity that provides SC services to the individual. |
| Assigned SC | This read-only field displays the name of the individual's SC. |
| Assigned SC Phone | This read-only field displays the contact phone number for the SC. |
| Assigned SC Email | This read-only field displays the contact email address for the SC. |
| Race | This read-only field displays the individual's race(s). Note: This question only appears for ODP-ID/A incidents. |
| Ethnicity | This read-only field displays the individual's ethnicity. Note: This question only appears for ODP-ID/A incidents. |
| Does a Plan Exist? | This read-only field displays whether a plan exists for the individual. Note: This question only appears for ODP-BSASP incidents. |
| Program Diagnosis | This read-only field displays information related to an individual's diagnosis. |
| Needs Level | This read-only field displays the individual’s Needs Level. Note: This question only appears for ODP-ID/A incidents. |
| Needs Group | This read-only field displays the individual’s Needs Group. Note: This question only appears for ODP-ID/A incidents. |
| Living Situation | This read-only field displays the individual's living situation. Note: This question only appears for ODP-ID/A incidents. |
| Living Arrangement | This read-only field displays the individual's living arrangement. Note: This question only appears for ODP-BSASP incidents. |
| Living Situation Qualifier | This read-only field displays additional information about the individual's living arrangement (when applicable). Note: This question only appears for ODP-ID/A incidents. |
| Living Situation Arrangement | This read-only field displays additional information about the individual's living arrangement (when applicable). Note: This question only appears for ODP-BSASP incidents. |
| Special Indicator | This read-only field displays whether the individual is a member of a special group. Note: This question only appears for ODP-ID/A incidents. |
| Harry M. Litigation | This read-only field displays designation of whether the individual meets the criteria for the Harry M. Settlement. Note: This question only appears for ODP-ID/A incidents. |
| Other Special Needs | This read-only field displays whether the individual has any other special needs. Note: This question only appears for ODP-ID/A incidents. |
| Primary Language | This read-only field displays the primary language the individual uses. If the individual is non-verbal, this field displays the language used by those who support the individual. Note: This question only appears for ODP-ID/A incidents. |
| Specify if other language | If "Other" was specified in the "Primary Language" field, this field displays the other language specified. Note: This question only appears for ODP-ID/A incidents. |
| Is Interpreter Needed | This read-only field displays whether the individual needs an interpreter. Note: This question only appears for ODP-ID/A incidents. |
| If yes, Interpreter is needed for | This read-only field displays the reason for which an interpreter is needed. Note: This question only appears for ODP-ID/A incidents. |
| Primary Mode of Communication | This read-only field displays the individual's primary mode of communication. |
| Ambulation | This read-only field displays the individual's level of mobility. Note: This question only appears for ODP-ID/A incidents. |
| Restrictive Procedure Plan in Place | This read-only field displays whether a Restrictive Procedure Plan was in place at the time of incident creation. Note: This response is determined based on the approved Plan for the individual that is effective at the time of incident creation. |