| Main Purpose |
The purpose of this module is to record services provided
to clients. Module 2A is for use by medical providers in medical settings. Module 2B is
for use by agencies primarily providing psychosocial services. Some agencies may need to
use both Module 2A and Module 2B. Module 2C is for recording medications provided or
ordered. |
| Description |
- The form collects services provided to a given individual on a particular day or at a
given contact episode.
- This module can be a fax-in form or a download from a data base.
- A separate "residential form" for hospices and other residential treatment
facilities could be developed.
|
| Target Projects for Form |
- All projects that see clients as service users (not training projects that assess client
outcomes as a function of training).
- This evaluation tool would be maximally useful if all projects code this information
from all clients.
|
| Major Evaluation Function |
- The module characterizes the natural course of service delivery for each client.
- Types of services and their date of delivery are recorded.
- Service histories can be documented for different modal types of clients.
- Service histories can be related to program outcomes./li>
- The cost of different service histories can be related to program outcomes.
|
| Implementation |
- Module 2A Current Version (dated 4/26/96) Activation Number: 7636.
- Module 2A (Short Form) Current Version (dated 2/14/96) Activation Number: 22680.
- Module 2B Current Version (dated 6/10/97) Activation Number: 19995.
- Module 2B (Short Form) Current Version (dated 6/10/97) Activation Number: 20214.
- Module 2C Current (dated 4/23/96) Activation Number: 20912.
- Module 2L (for Larkin Street Youth Services Site) Current Version (dated 1995)
Activation Number: 56782.
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| Citation(s) |
- Huba, G. J., Melchior, L. A., Staff of The Measurement Group, and
HRSA/HAB's SPNS Cooperative Agreement Steering Committee (1996). Module 2A: Intervention-Services Form.
Available: www.TheMeasurementGroup.com. Culver City,
California: The Measurement Group.
- Huba, G. J., Melchior, L. A., Staff of The Measurement Group, and
HRSA/HAB's SPNS Cooperative Agreement Steering Committee (1997). Module 2B: Intervention-Services Form.
Available: www.TheMeasurementGroup.com. Culver City,
California: The Measurement Group.
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