Jira Service Management

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Include, at a minimum, the project summary, project aims, and data processing approach (types of data being requested, e.g. member data and medical claims, how they will be linked and used to address aims)."}]}]},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":15},"layout":"default","localId":"fb38066e-0f9d-4429-a896-4ac7d4503e38"}},{"type":"panel","attrs":{"panelType":"info"},"content":[{"type":"paragraph","attrs":{"localId":"8949d57d-785e-4017-9504-5cd4728425a5"},"content":[{"type":"text","text":"Evaluation Criteria","marks":[{"type":"strong"}]}]},{"type":"paragraph","attrs":{"localId":"7eb3ca9f-0242-4dab-b563-4fcc7c970772"},"content":[{"type":"text","text":"The following (5) evaluation criteria are "},{"type":"text","text":"required ","marks":[{"type":"em"}]},{"type":"text","text":"by the Arkansas Healthcare Transparency Initiative (HTI) Advisory Committee for the data request review and approval process. Complete these entries in detail. Utilize additional documentation if necessary. Attach additional documentation using the Attachment box at the top of the page."}]},{"type":"paragraph","attrs":{"localId":"8ad7145e-fe2a-4e41-a73f-3abf0a3d5565"},"content":[{"type":"text","text":"Click "},{"type":"text","text":"HTI Goals and Purposes","marks":[{"type":"link","attrs":{"href":"https://achiapcd.atlassian.net/wiki/spaces/HTIR/pages/2945286155/Arkansas+HTI+APCD+Goals+and+Purposes"}}]},{"type":"text","text":" for reference when responding to evaluation criteria below. "}]},{"type":"paragraph","attrs":{"localId":"e3607585-1ac4-4b21-a34b-3bad346e2937"},"content":[{"type":"text","text":"The Arkansas HTI team will be happy to assist you as needed."}]}]},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":52},"layout":"default","localId":"93b59ed5-0743-41fa-af49-37d7b834b675"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":18},"layout":"default","localId":"826e7ead-3e56-4a58-88e0-df3e5d11b8ce"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":19},"layout":"default","localId":"3b355dc3-87f3-4a99-9cd3-fc00999651c5"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":20},"layout":"default","localId":"c1a04bea-19f0-41b0-bf16-9be32bb6063f"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":21},"layout":"default","localId":"a9b3cad3-e8a2-40eb-98d6-71049968db25"}},{"type":"layoutSection","content":[{"type":"layoutColumn","attrs":{"width":50},"content":[{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":22},"layout":"default","localId":"1af337cf-e377-4c06-b1ba-e4238bacc5c6"}}]},{"type":"layoutColumn","attrs":{"width":50},"content":[{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":23},"layout":"default","localId":"c0679e75-f1d3-4567-bd2b-ea03c2c54ad8"}}]}]},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":47},"layout":"default","localId":"1a50c41b-690c-4a1e-9921-b41045fbc5ad"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":65},"layout":"default","localId":"a411ad8b-97d7-4675-a9ca-33a90b864b6a"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":51},"layout":"default","localId":"c660379f-a5d6-49f2-9523-91271d1bc031"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":49},"layout":"default","localId":"f933bb6e-0ee1-43fe-8b55-424b66c4ac72"}},{"type":"rule"},{"type":"heading","attrs":{"level":1,"localId":"c504210d-2942-4b8d-b5c2-c46106d0d571"},"content":[{"type":"text","text":"Data Request Information"}]},{"type":"panel","attrs":{"panelType":"warning"},"content":[{"type":"paragraph","attrs":{"localId":"054d31d0-d5ee-4b8c-a841-20db003507c9"},"content":[{"type":"text","text":"Note: "},{"type":"text","text":"Ark. Code Ann. § 23-61-907","marks":[{"type":"strong"}]},{"type":"text","text":" prohibits the use of data to reidentify or attempt to reidentify an individual without obtaining the individual's consent."}]}]},{"type":"heading","attrs":{"level":2,"localId":"eaf82d13-165f-425f-b945-4123845ad069"},"content":[{"type":"text","text":"Claims-Based Data"}]},{"type":"panel","attrs":{"panelType":"info"},"content":[{"type":"paragraph","attrs":{"localId":"c2f39441-99b2-48bd-9e22-d11b567ac29d"},"content":[{"type":"text","text":"Select the file types and data date ranges required for the project."}]},{"type":"paragraph","attrs":{"localId":"98e2b4f6-2172-44fd-a6b6-5ae28996545b"},"content":[{"type":"text","text":" Assumptions:"}]},{"type":"bulletList","content":[{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"acf9ceaf-5bc2-411d-92c6-a3b726779637"},"content":[{"type":"text","text":"Available data is from January 1, 2013, forward. Check with HTI/Arkansas APCD technical support to determine latest data available."}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"43f34aec-92ea-4f75-ab22-09ee299bef57"},"content":[{"type":"text","text":"The selected date range will be applied to all file types unless otherwise noted in the Other Parameters section."}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"cb13b884-4b97-4f1f-871e-aab6f2122680"},"content":[{"type":"text","text":"Members/enrollees are pulled based on the presence of active segments during the selected date range."}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"7d8edb3d-b122-4e43-b587-cc4881322add"},"content":[{"type":"text","text":"Medical claims are pulled on service date occurring in the selected date range."}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"d8fe93eb-eaf2-474d-9ed0-7c41f717da2d"},"content":[{"type":"text","text":"Pharmacy claims are pulled on fill date occurring in the selected date range."}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"d272df5d-a44a-4461-88e7-991881713d80"},"content":[{"type":"text","text":"Dental claims are pulled on service date occurring in the selected date range."}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"ae22aca5-4b1e-4c64-b56c-8f63a9837e33"},"content":[{"type":"text","text":"Custom pull criteria or data transformations should be described in the Claims Based Data Other Parameters section."}]}]}]}]},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":53},"layout":"default","localId":"719d341d-51fb-408a-9150-a44c3b2f3b7a"}},{"type":"layoutSection","content":[{"type":"layoutColumn","attrs":{"width":50},"content":[{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":27},"layout":"default","localId":"6fd01b6b-19cc-4150-89e6-30710ebbfb7f"}}]},{"type":"layoutColumn","attrs":{"width":50},"content":[{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":28},"layout":"default","localId":"f074e4bf-fae3-464d-b036-8715e4f37668"}}]}]},{"type":"heading","attrs":{"level":2,"localId":"de1ad1e4-0532-4330-89c0-532a2c37a121"},"content":[{"type":"text","text":"Member Enrollment Selection Table (MEST)"}]},{"type":"panel","attrs":{"panelType":"info"},"content":[{"type":"paragraph","attrs":{"localId":"ce0884eb-ec37-4091-af40-5e1ff4621cb6"},"content":[{"type":"text","text":"NEW! ","marks":[{"type":"strong"}]},{"type":"text","text":"Member Enrollment Selection Table (MEST) is a supplemental dataset to enhance use for understanding continuously covered enrollees, transitions in coverage and coverage gaps. It should be applied with claims based data pulls."}]},{"type":"paragraph","attrs":{"localId":"c89fe246-6de8-4e21-b6b5-bee8bc898232"},"content":[{"type":"text","text":"Assumptions:"}]},{"type":"bulletList","content":[{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"abd9a8d6-e4c6-402f-ac1c-1e4bf6ba3935"},"content":[{"type":"text","text":"MEST data is available from January 1, 2016, forward. Check with HTI/Arkansas APCD technical support to determine latest data available."}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"cfe32521-3cd9-463a-821b-3133033beb4d"},"content":[{"type":"text","text":"MEST data date ranges should align with selected Claims-Based data date ranges from 2016 forward."}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"c39a3853-f64e-4161-8079-ad5565386214"},"content":[{"type":"text","text":"MEST cannot be purchased without including APCD enrollment and claims data."}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"7b8b6e14-3760-48ed-9e80-8bc40c982a13"},"content":[{"type":"text","text":"Select MEST data by year, e.g. MEST Starting Year: 2016 and MEST Ending Year: 2020."}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"48fd6c23-612d-45cc-abc1-265e5a90d7df"},"content":[{"type":"text","text":"MEST Custom pull is the process for Arkansas APCD team to pull selected HTI claims-based data that match the MEST data for the data requester."}]}]}]}]},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":54},"layout":"default","localId":"070906f9-5ee4-449d-a783-b8eb55eef283"}},{"type":"layoutSection","content":[{"type":"layoutColumn","attrs":{"width":50},"content":[{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":62},"layout":"default","localId":"b068a2c4-3418-4af4-bebe-bd3282d36f1b"}}]},{"type":"layoutColumn","attrs":{"width":50},"content":[{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":64},"layout":"default","localId":"a4348783-4117-42a6-bd0f-e55a1a124cc0"}}]}]},{"type":"heading","attrs":{"level":2,"localId":"badf9296-03b5-46ca-85fe-68884894507c"},"content":[{"type":"text","text":"Non-Claims-Based Data"}]},{"type":"panel","attrs":{"panelType":"info"},"content":[{"type":"paragraph","attrs":{"localId":"7201ba24-7a07-4aac-9311-c797f562db0a"},"content":[{"type":"text","text":"Select the file types and data date ranges required for the project."}]},{"type":"paragraph","attrs":{"localId":"d60042fc-cf37-456d-a323-f03b2c5bd8b4"},"content":[{"type":"text","text":" Assumptions:"}]},{"type":"bulletList","content":[{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"c06548cb-8e97-40a9-ae1d-0b74d5c17ce8"},"content":[{"type":"text","text":"Non-Claims data can only be requested with Arkansas APCD data."}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"1f5d109c-6d33-49e0-a612-46feea1e9646"},"content":[{"type":"text","text":"Available data is from January 1, 2013, forward. Check with HTI/Arkansas APCD technical support to determine latest data available."}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"704b18c7-eb5e-4022-99d0-fd106c9f9a44"},"content":[{"type":"text","text":"The selected date range will be applied to all file types unless otherwise noted in the Other Parameters section."}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"5056a5ca-af4d-496a-93cd-620bdde9265d"},"content":[{"type":"text","text":"Birth certificate data are pulled based on the child’s birthdate."}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"61631fdf-ddfb-4e2b-a1d4-06bd191f2222"},"content":[{"type":"text","text":"Death certificate data are pulled based on the individual’s date of death."}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"021dcea1-d4ef-449c-a186-7b67b4bd5cc6"},"content":[{"type":"text","text":"Hospital discharge data are pulled based on the patient’s date of service. "},{"type":"text","text":"NOTE: ","marks":[{"type":"strong"}]},{"type":"text","text":" These data are only for self-pay and uninsured patients."}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"b01f6362-06eb-4443-91c8-1348a77d2858"},"content":[{"type":"text","text":"Emergency Department data are pulled based on the patient’s date of service. "},{"type":"text","text":"NOTE: ","marks":[{"type":"strong"}]},{"type":"text","text":"These data are only for self-pay and uninsured patients."}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"07f47723-7d24-4033-898c-c67a5e7bbc27"},"content":[{"type":"text","text":"Cancer Registry data are pulled based on the patient’s date of diagnosis."}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"3eb2afbe-faf3-4b1b-a389-dabc1a3fd5c4"},"content":[{"type":"text","text":"Arkansas Workers Compensation data are pulled based on the individual’s date of service."}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"aca008e8-cbd4-4072-aa8f-ff186a826aa3"},"content":[{"type":"text","text":" Medical Marijuana data are pulled based on the cardholder’s date of enrollment."}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"b07741d9-0372-4909-b33d-a3ffc7f390f3"},"content":[{"type":"text","text":"Custom pull criteria or data transformations should be described in the Other Parameters box."}]}]}]}]},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":30},"layout":"default","localId":"244e2425-b4d2-41b2-ac0f-d1537c9ccb15"}},{"type":"layoutSection","content":[{"type":"layoutColumn","attrs":{"width":50},"content":[{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":32},"layout":"default","localId":"9f97bec0-7225-45f1-aa42-9147b5cc58b1"}}]},{"type":"layoutColumn","attrs":{"width":50},"content":[{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":33},"layout":"default","localId":"3f6746c5-bc01-4101-b496-58dd96e577b6"}}]}]},{"type":"heading","attrs":{"level":2,"localId":"de1ad1e4-0532-4330-89c0-532a2c37a121"},"content":[{"type":"text","text":"HTI Mother/Infant Crosswalk"}]},{"type":"panel","attrs":{"panelType":"info"},"content":[{"type":"paragraph","attrs":{"localId":"e6ab1459-81a7-4955-8590-74e9a0cec02f"},"content":[{"type":"text","text":"NEW! ","marks":[{"type":"strong"}]},{"type":"text","text":"The HTI Mother/Infant Crosswalk is a supplementary, reusable dataset that enables data users to link mother and infant data within the Arkansas HTI claims-based and non-claims-based data."}]},{"type":"paragraph","attrs":{"localId":"cd15361f-4425-45a4-9df4-872dabae5cf8"},"content":[{"type":"text","text":"Assumptions:"}]},{"type":"bulletList","content":[{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"ebd67002-2f60-4ca8-bd22-4fc889547da5"},"content":[{"type":"text","text":"Data is available from January 1, 2016, forward. Check with HTI/Arkansas APCD technical support to determine latest data available."}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"9a5baf1b-27fb-4dc5-ac69-e4fb87ca40f5"},"content":[{"type":"text","text":"This crosswalk cannot be purchased without including APCD enrollment and claims data. Non-claims-based data can be purchased as necessary."}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"017573f4-decc-42fe-aea4-b13a90113a29"},"content":[{"type":"text","text":"Select data by year, e.g. Starting Year: 2016 and Ending Year: 2019."}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"3da4d39a-c390-4338-8f94-0d40d3d1306a"},"content":[{"type":"text","text":"There is a three year minimum for any purchase of this crosswalk data."}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"d55f9f89-5613-469a-9e7b-dfffc0b20e48"},"content":[{"type":"text","text":"Mother/Infant Crosswalk Custom pull is the process for Arkansas APCD team to pull selected HTI claims-based and non-claims-based data that match the Mother/Infant Crosswalk data for the data requester."}]}]}]}]},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":69},"layout":"default","localId":"007cf366-e500-4c3e-b278-9b1918fa8143"}},{"type":"layoutSection","content":[{"type":"layoutColumn","attrs":{"width":50},"content":[{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":70},"layout":"default","localId":"dbad7cef-864a-4c36-9473-786ce0d2c0ea"}}]},{"type":"layoutColumn","attrs":{"width":50},"content":[{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":71},"layout":"default","localId":"00c90468-358e-4ffd-8b50-5ae4f6595b57"}}]}]},{"type":"heading","attrs":{"level":2,"localId":"de1ad1e4-0532-4330-89c0-532a2c37a121"},"content":[{"type":"text","text":"HTI Diabetes Analytic Data Mart"}]},{"type":"panel","attrs":{"panelType":"info"},"content":[{"type":"paragraph","attrs":{"localId":"9df9873a-58d9-4c7a-b01b-3a87b26fb4dd"},"content":[{"type":"text","text":"NEW! ","marks":[{"type":"strong"}]},{"type":"text","text":"The HTI Diabetes Analytic Data Mart"},{"type":"text","text":" ","marks":[{"type":"strong"}]},{"type":"text","text":"is a reusable, analyzable data mart containing multiple years of enrollment, medical, pharmacy, and dental service information for individuals diagnosed with types 1 and 2 diabetes (with and without complications)."}]},{"type":"paragraph","attrs":{"localId":"4a084681-c715-475b-ab3f-45f8e819b5d2"},"content":[{"type":"text","text":"Assumptions:"}]},{"type":"bulletList","content":[{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"cc1b0007-ce6b-4b02-a63e-424d7dd9d4c4"},"content":[{"type":"text","text":"Data is available from January 1, 2016, forward. Check with HTI/Arkansas APCD technical support to determine latest data available."}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"8570b1c7-f7c2-4bc2-af8d-87ad5466ced6"},"content":[{"type":"text","text":"This data mart does not require the purchase of claims-based data from the APCD. Non-claims-based data can be purchased as necessary."}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"390f5590-a783-4de2-aa7e-386a14ed8fe6"},"content":[{"type":"text","text":"Six linked datasets are available. There is a three dataset minimum for any purchase."}]}]}]}]},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":66},"layout":"default","localId":"aa88157d-ceea-4ab2-a9d3-270e65d6d196"}}]},{"version":1,"type":"doc","content":[]},{"version":1,"type":"doc","content":[{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":48},"layout":"default","localId":"f4396a9d-8a90-4c46-9564-2b0dab7dabbc"}},{"type":"heading","attrs":{"level":1,"localId":"62de403a-157a-4527-acd5-972c854c671a"},"content":[{"type":"text","text":"Data Delivery Format"}]},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":34},"layout":"default","localId":"0806fc4a-76fa-4371-9af4-1c91bc37ebd5"}},{"type":"rule"},{"type":"heading","attrs":{"level":1,"localId":"663539e9-0bc0-4a08-9c13-9049ba017efb"},"content":[{"type":"text","text":"Data Merging"}]},{"type":"panel","attrs":{"panelType":"warning"},"content":[{"type":"paragraph","attrs":{"localId":"838ae1f8-89bb-4c63-b5b1-60f858e544de"},"content":[{"type":"text","text":"Note: "},{"type":"text","text":"Ark. Code Ann. § 23-61-907","marks":[{"type":"strong"}]},{"type":"text","text":" prohibits the use of data to reidentify or attempt to reidentify an individual without obtaining the individual's consent."}]}]},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":35},"layout":"default","localId":"27bfb01d-401a-4a28-a694-3eeef9dc54e0"}}]},{"version":1,"type":"doc","content":[{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":37},"layout":"default","localId":"fce2724e-a136-400e-9c9f-07430d799288"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":38},"layout":"default","localId":"732b3023-6d03-4136-a6b8-4c03440ef64a"}}]},{"version":1,"type":"doc","content":[{"type":"rule"},{"type":"heading","attrs":{"level":1,"localId":"ce9658eb-d1f4-49ec-911a-121c63fb09d1"},"content":[{"type":"text","text":"Publication and Dissemination"}]},{"type":"panel","attrs":{"panelType":"info"},"content":[{"type":"paragraph","attrs":{"localId":"1d0528c0-75d9-4e67-9368-2f6163721a44"},"content":[{"type":"text","text":"Provide information about how the output will be used at the project conclusion."}]}]},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":39},"layout":"default","localId":"881fbe73-5825-4b62-a666-84da9294ff65"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":40},"layout":"default","localId":"c0dcaaf1-f7dc-495b-9dd0-16abada4aef5"}},{"type":"heading","attrs":{"level":1,"localId":"e1c36f82-0a7c-40d1-84b5-975022b9ec6c"},"content":[{"type":"text","text":"Key Personnel and Principal Investigators"}]},{"type":"paragraph","attrs":{"localId":"8351359a-3ab9-46f1-81d9-d4e3627bba1f"},"content":[{"type":"text","text":"In a separate document, list all key personnel and PIs that will be assigned to this project and attach the document using the Attachment box at the top of the page. "}]},{"type":"paragraph","attrs":{"localId":"39b4cba6-00f1-4b95-87b0-101387d7bf86"},"content":[{"type":"text","text":"For all key personnel and PIs, describe the experience, if any, with prior or current projects of comparable scope and complexity to the project. CVs or resumes may be required."}]},{"type":"heading","attrs":{"level":1,"localId":"ba770b7a-059b-4d9c-b5bc-a1c77a44de8d"},"content":[{"type":"text","text":"Other Project Participants"}]},{"type":"paragraph","attrs":{"localId":"f0c990e9-b5cf-4957-ab8e-6abb3e57a83a"},"content":[{"type":"text","text":"In a separate document, provide the name, role, and organization of all the receiving organization's employees, contractors, and clients that will have access to the data. This document can be attached using the Attachment box at the top of the page or submitted at a later date via this ticket. "}]},{"type":"heading","attrs":{"level":1,"localId":"841a9927-4fde-493f-b979-d6de97444a39"},"content":[{"type":"text","text":"Third-Party Participation"}]},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":41},"layout":"default","localId":"2eb73bf0-d40a-47f0-bbba-5a6e3d7cbf4b"}}]},{"version":1,"type":"doc","content":[{"type":"panel","attrs":{"panelType":"info"},"content":[{"type":"paragraph","attrs":{"localId":"8902775e-cad2-4669-a77d-c78fdb470456"},"content":[{"type":"text","text":"Third-party information for all individuals or organizations who will have access to the data or who will be named as being affiliated with this project will be required. This should be prepared as a separate document and can be attached using the Attachment box at the top of the page or submitted at a later date via this ticket."}]}]},{"type":"paragraph","attrs":{"localId":"ddc1ef1b-1fa7-4a2e-9c34-34df7b75ab34"},"content":[{"type":"text","text":"Information required for third-party individuals or organizations: "}]},{"type":"bulletList","content":[{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"1c60f29a-43fc-4884-a2d7-1104669b16c7"},"content":[{"type":"text","text":"Company Name"}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"7dfeb477-363b-40a0-9b66-d4aafa7fdd17"},"content":[{"type":"text","text":"Contact Person"}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"35259702-0bf9-4324-8d85-0695c039a577"},"content":[{"type":"text","text":"Title"}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"ee8af60d-ae9b-46d0-b7d9-67e277882bfe"},"content":[{"type":"text","text":"Email"}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"bbb171e3-7e7d-4d48-81b7-cd45268304b7"},"content":[{"type":"text","text":"Phone Number"}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"bf5a8a95-03d1-407b-a05c-e7cf6a89504e"},"content":[{"type":"text","text":"Mailing Address"}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"ea41ea16-c00a-4f68-9bc0-2995558a2cb0"},"content":[{"type":"text","text":"City"}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"e9a184e8-bf79-485b-b37e-f7024200447c"},"content":[{"type":"text","text":"State"}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"36ff7f92-bc0c-4fd8-9901-0d2340ccba5a"},"content":[{"type":"text","text":"Zip"}]}]}]}]},{"version":1,"type":"doc","content":[{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":43},"layout":"default","localId":"6221b8f0-cfe4-42d8-b9d4-9c44fd23104c"}}]},{"version":1,"type":"doc","content":[{"type":"panel","attrs":{"panelType":"info"},"content":[{"type":"paragraph","attrs":{"localId":"1d69cf43-52eb-4fb4-8fe6-c0483324dddd"},"content":[{"type":"text","text":"If yes, submit their data management policies and procedures in your Data Management Plan which can be attached to this ticket using the Attachment box at the top of the page or submitted at a later date via this ticket."}]}]},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":45},"layout":"default","localId":"21e15132-80c3-4bdb-9da0-d003ca1e6bb6"}}]}],"conditions":{"36":{"t":"sh","i":{"co":{"cIds":{"35":["1"]}}},"o":{"sIds":["3"]}},"42":{"t":"sh","i":{"co":{"cIds":{"41":["1"]}}},"o":{"sIds":["5"]}},"44":{"t":"sh","i":{"co":{"cIds":{"43":["1"]}}},"o":{"sIds":["7"]}}},"sections":{"4":{"name":"Dissemination","conditions":[]},"5":{"name":"Third Party","conditions":["42"]},"2":{"name":"Always on","conditions":[]},"7":{"name":"Off-site","conditions":["44"]},"3":{"name":"Yes","conditions":["36"]},"6":{"conditions":[]},"1":{"name":"HTI File Dates","conditions":[]}},"questions":{"8":{"type":"cm","label":"Organization Type","description":"Please select the choice(s) which most closely match your Org type. ","validation":{"rq":true,"mns":1},"jiraField":"customfield_12220","questionKey":""},"33":{"type":"da","label":"Non-Claims Based Data End Date","description":"","validation":{"rq":true},"jiraField":"customfield_12553","questionKey":""},"22":{"type":"da","label":"Proposed Project Start Date: ","description":"","validation":{"rq":true},"jiraField":"customfield_12680","questionKey":""},"37":{"type":"pg","label":"If yes, what is the purpose?","description":"","validation":{"rq":false},"choices":[],"questionKey":""},"13":{"type":"ts","label":"Contact Phone Number","description":"","validation":{"rq":true},"jiraField":"customfield_12678","questionKey":""},"35":{"type":"cs","label":"Do you plan to merge or combine the data with other data files?","description":"Note, this does not include comparing the data with other data files (e.g., Census data).","validation":{"rq":false},"choices":[{"id":"1","label":"Yes","other":false},{"id":"2","label":"No","other":false}],"questionKey":""},"5":{"type":"ts","label":"City","description":"","validation":{"rq":true},"jiraField":"customfield_12674","questionKey":""},"10":{"type":"tl","label":"Contact Person","description":"","validation":{"rq":true},"jiraField":"customfield_12676","questionKey":""},"38":{"type":"pg","label":"Which data elements will be used to merge or combine the Initiative data with other data files?","description":"","validation":{"rq":false},"choices":[],"questionKey":""},"18":{"type":"pg","label":"2. Describe real or potential conflicts of interest or anti-competitive concerns and how they will be mitigated.","description":"","validation":{"rq":true,"mnw":5},"choices":[],"questionKey":""},"41":{"type":"cs","label":"Will a third-party or other organization have access to the Initiative Data? ","description":"","validation":{"rq":true},"choices":[{"id":"1","label":"Yes","other":false},{"id":"2","label":"No","other":false}],"questionKey":""},"3":{"type":"tl","label":"Organization","description":"Enter the name of your organization","validation":{"rq":true},"jiraField":"customfield_12671","questionKey":""},"52":{"type":"pg","label":"1. Describe how this project will be consistent with the HTI’s goals and purpose. 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Complete these entries in detail. Utilize additional documentation if necessary. Attach additional documentation using the Attachment box at the top of the page."}]},{"type":"paragraph","attrs":{"localId":"8ad7145e-fe2a-4e41-a73f-3abf0a3d5565"},"content":[{"type":"text","text":"Click "},{"type":"text","text":"HTI Goals and Purposes","marks":[{"type":"link","attrs":{"href":"https://achiapcd.atlassian.net/wiki/spaces/HTIR/pages/2945286155/Arkansas+HTI+APCD+Goals+and+Purposes"}}]},{"type":"text","text":" for reference when responding to evaluation criteria below. 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Code Ann. § 23-61-907","marks":[{"type":"strong"}]},{"type":"text","text":" prohibits the use of data to reidentify or attempt to reidentify an individual without obtaining the individual's consent."}]}]},{"type":"heading","attrs":{"level":2,"localId":"eaf82d13-165f-425f-b945-4123845ad069"},"content":[{"type":"text","text":"Claims-Based Data"}]},{"type":"panel","attrs":{"panelType":"info"},"content":[{"type":"paragraph","attrs":{"localId":"c2f39441-99b2-48bd-9e22-d11b567ac29d"},"content":[{"type":"text","text":"Select the file types and data date ranges required for the project."}]},{"type":"paragraph","attrs":{"localId":"98e2b4f6-2172-44fd-a6b6-5ae28996545b"},"content":[{"type":"text","text":" Assumptions:"}]},{"type":"bulletList","content":[{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"acf9ceaf-5bc2-411d-92c6-a3b726779637"},"content":[{"type":"text","text":"Available data is from January 1, 2013, forward. Check with HTI/Arkansas APCD technical support to determine latest data available."}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"43f34aec-92ea-4f75-ab22-09ee299bef57"},"content":[{"type":"text","text":"The selected date range will be applied to all file types unless otherwise noted in the Other Parameters section."}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"cb13b884-4b97-4f1f-871e-aab6f2122680"},"content":[{"type":"text","text":"Members/enrollees are pulled based on the presence of active segments during the selected date range."}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"7d8edb3d-b122-4e43-b587-cc4881322add"},"content":[{"type":"text","text":"Medical claims are pulled on service date occurring in the selected date range."}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"d8fe93eb-eaf2-474d-9ed0-7c41f717da2d"},"content":[{"type":"text","text":"Pharmacy claims are pulled on fill date occurring in the selected date range."}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"d272df5d-a44a-4461-88e7-991881713d80"},"content":[{"type":"text","text":"Dental claims are pulled on service date occurring in the selected date range."}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"ae22aca5-4b1e-4c64-b56c-8f63a9837e33"},"content":[{"type":"text","text":"Custom pull criteria or data transformations should be described in the Claims Based Data Other Parameters section."}]}]}]}]},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":53},"layout":"default","localId":"719d341d-51fb-408a-9150-a44c3b2f3b7a"}},{"type":"layoutSection","content":[{"type":"layoutColumn","attrs":{"width":50},"content":[{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":27},"layout":"default","localId":"6fd01b6b-19cc-4150-89e6-30710ebbfb7f"}}]},{"type":"layoutColumn","attrs":{"width":50},"content":[{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":28},"layout":"default","localId":"f074e4bf-fae3-464d-b036-8715e4f37668"}}]}]},{"type":"heading","attrs":{"level":2,"localId":"de1ad1e4-0532-4330-89c0-532a2c37a121"},"content":[{"type":"text","text":"Member Enrollment Selection Table (MEST)"}]},{"type":"panel","attrs":{"panelType":"info"},"content":[{"type":"paragraph","attrs":{"localId":"ce0884eb-ec37-4091-af40-5e1ff4621cb6"},"content":[{"type":"text","text":"NEW! ","marks":[{"type":"strong"}]},{"type":"text","text":"Member Enrollment Selection Table (MEST) is a supplemental dataset to enhance use for understanding continuously covered enrollees, transitions in coverage and coverage gaps. It should be applied with claims based data pulls."}]},{"type":"paragraph","attrs":{"localId":"c89fe246-6de8-4e21-b6b5-bee8bc898232"},"content":[{"type":"text","text":"Assumptions:"}]},{"type":"bulletList","content":[{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"abd9a8d6-e4c6-402f-ac1c-1e4bf6ba3935"},"content":[{"type":"text","text":"MEST data is available from January 1, 2016, forward. Check with HTI/Arkansas APCD technical support to determine latest data available."}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"cfe32521-3cd9-463a-821b-3133033beb4d"},"content":[{"type":"text","text":"MEST data date ranges should align with selected Claims-Based data date ranges from 2016 forward."}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"c39a3853-f64e-4161-8079-ad5565386214"},"content":[{"type":"text","text":"MEST cannot be purchased without including APCD enrollment and claims data."}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"7b8b6e14-3760-48ed-9e80-8bc40c982a13"},"content":[{"type":"text","text":"Select MEST data by year, e.g. MEST Starting Year: 2016 and MEST Ending Year: 2020."}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"48fd6c23-612d-45cc-abc1-265e5a90d7df"},"content":[{"type":"text","text":"MEST Custom pull is the process for Arkansas APCD team to pull selected HTI claims-based data that match the MEST data for the data requester."}]}]}]}]},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":54},"layout":"default","localId":"070906f9-5ee4-449d-a783-b8eb55eef283"}},{"type":"layoutSection","content":[{"type":"layoutColumn","attrs":{"width":50},"content":[{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":62},"layout":"default","localId":"b068a2c4-3418-4af4-bebe-bd3282d36f1b"}}]},{"type":"layoutColumn","attrs":{"width":50},"content":[{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":64},"layout":"default","localId":"a4348783-4117-42a6-bd0f-e55a1a124cc0"}}]}]},{"type":"heading","attrs":{"level":2,"localId":"badf9296-03b5-46ca-85fe-68884894507c"},"content":[{"type":"text","text":"Non-Claims-Based Data"}]},{"type":"panel","attrs":{"panelType":"info"},"content":[{"type":"paragraph","attrs":{"localId":"7201ba24-7a07-4aac-9311-c797f562db0a"},"content":[{"type":"text","text":"Select the file types and data date ranges required for the project."}]},{"type":"paragraph","attrs":{"localId":"d60042fc-cf37-456d-a323-f03b2c5bd8b4"},"content":[{"type":"text","text":" Assumptions:"}]},{"type":"bulletList","content":[{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"c06548cb-8e97-40a9-ae1d-0b74d5c17ce8"},"content":[{"type":"text","text":"Non-Claims data can only be requested with Arkansas APCD data."}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"1f5d109c-6d33-49e0-a612-46feea1e9646"},"content":[{"type":"text","text":"Available data is from January 1, 2013, forward. Check with HTI/Arkansas APCD technical support to determine latest data available."}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"704b18c7-eb5e-4022-99d0-fd106c9f9a44"},"content":[{"type":"text","text":"The selected date range will be applied to all file types unless otherwise noted in the Other Parameters section."}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"5056a5ca-af4d-496a-93cd-620bdde9265d"},"content":[{"type":"text","text":"Birth certificate data are pulled based on the child’s birthdate."}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"61631fdf-ddfb-4e2b-a1d4-06bd191f2222"},"content":[{"type":"text","text":"Death certificate data are pulled based on the individual’s date of death."}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"021dcea1-d4ef-449c-a186-7b67b4bd5cc6"},"content":[{"type":"text","text":"Hospital discharge data are pulled based on the patient’s date of service. "},{"type":"text","text":"NOTE: ","marks":[{"type":"strong"}]},{"type":"text","text":" These data are only for self-pay and uninsured patients."}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"b01f6362-06eb-4443-91c8-1348a77d2858"},"content":[{"type":"text","text":"Emergency Department data are pulled based on the patient’s date of service. "},{"type":"text","text":"NOTE: ","marks":[{"type":"strong"}]},{"type":"text","text":"These data are only for self-pay and uninsured patients."}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"07f47723-7d24-4033-898c-c67a5e7bbc27"},"content":[{"type":"text","text":"Cancer Registry data are pulled based on the patient’s date of diagnosis."}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"3eb2afbe-faf3-4b1b-a389-dabc1a3fd5c4"},"content":[{"type":"text","text":"Arkansas Workers Compensation data are pulled based on the individual’s date of service."}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"aca008e8-cbd4-4072-aa8f-ff186a826aa3"},"content":[{"type":"text","text":" Medical Marijuana data are pulled based on the cardholder’s date of enrollment."}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"b07741d9-0372-4909-b33d-a3ffc7f390f3"},"content":[{"type":"text","text":"Custom pull criteria or data transformations should be described in the Other Parameters box."}]}]}]}]},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":30},"layout":"default","localId":"244e2425-b4d2-41b2-ac0f-d1537c9ccb15"}},{"type":"layoutSection","content":[{"type":"layoutColumn","attrs":{"width":50},"content":[{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":32},"layout":"default","localId":"9f97bec0-7225-45f1-aa42-9147b5cc58b1"}}]},{"type":"layoutColumn","attrs":{"width":50},"content":[{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":33},"layout":"default","localId":"3f6746c5-bc01-4101-b496-58dd96e577b6"}}]}]},{"type":"heading","attrs":{"level":2,"localId":"de1ad1e4-0532-4330-89c0-532a2c37a121"},"content":[{"type":"text","text":"HTI Mother/Infant Crosswalk"}]},{"type":"panel","attrs":{"panelType":"info"},"content":[{"type":"paragraph","attrs":{"localId":"e6ab1459-81a7-4955-8590-74e9a0cec02f"},"content":[{"type":"text","text":"NEW! 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"}]},{"type":"heading","attrs":{"level":1,"localId":"841a9927-4fde-493f-b979-d6de97444a39"},"content":[{"type":"text","text":"Third-Party Participation"}]},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":41},"layout":"default","localId":"2eb73bf0-d40a-47f0-bbba-5a6e3d7cbf4b"}}]},{"version":1,"type":"doc","content":[{"type":"panel","attrs":{"panelType":"info"},"content":[{"type":"paragraph","attrs":{"localId":"8902775e-cad2-4669-a77d-c78fdb470456"},"content":[{"type":"text","text":"Third-party information for all individuals or organizations who will have access to the data or who will be named as being affiliated with this project will be required. This should be prepared as a separate document and can be attached using the Attachment box at the top of the page or submitted at a later date via this ticket."}]}]},{"type":"paragraph","attrs":{"localId":"ddc1ef1b-1fa7-4a2e-9c34-34df7b75ab34"},"content":[{"type":"text","text":"Information required for third-party individuals or organizations: "}]},{"type":"bulletList","content":[{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"1c60f29a-43fc-4884-a2d7-1104669b16c7"},"content":[{"type":"text","text":"Company Name"}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"7dfeb477-363b-40a0-9b66-d4aafa7fdd17"},"content":[{"type":"text","text":"Contact Person"}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"35259702-0bf9-4324-8d85-0695c039a577"},"content":[{"type":"text","text":"Title"}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"ee8af60d-ae9b-46d0-b7d9-67e277882bfe"},"content":[{"type":"text","text":"Email"}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"bbb171e3-7e7d-4d48-81b7-cd45268304b7"},"content":[{"type":"text","text":"Phone Number"}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"bf5a8a95-03d1-407b-a05c-e7cf6a89504e"},"content":[{"type":"text","text":"Mailing Address"}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"ea41ea16-c00a-4f68-9bc0-2995558a2cb0"},"content":[{"type":"text","text":"City"}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"e9a184e8-bf79-485b-b37e-f7024200447c"},"content":[{"type":"text","text":"State"}]}]},{"type":"listItem","content":[{"type":"paragraph","attrs":{"localId":"36ff7f92-bc0c-4fd8-9901-0d2340ccba5a"},"content":[{"type":"text","text":"Zip"}]}]}]}]},{"version":1,"type":"doc","content":[{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":43},"layout":"default","localId":"6221b8f0-cfe4-42d8-b9d4-9c44fd23104c"}}]},{"version":1,"type":"doc","content":[{"type":"panel","attrs":{"panelType":"info"},"content":[{"type":"paragraph","attrs":{"localId":"1d69cf43-52eb-4fb4-8fe6-c0483324dddd"},"content":[{"type":"text","text":"If yes, submit their data management policies and procedures in your Data Management Plan which can be attached to this ticket using the Attachment box at the top of the page or submitted at a later date via this ticket."}]}]},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","parameters":{"id":45},"layout":"default","localId":"21e15132-80c3-4bdb-9da0-d003ca1e6bb6"}}]}],"conditions":{"36":{"t":"sh","i":{"co":{"cIds":{"35":["1"]}}},"o":{"sIds":["3"]}},"42":{"t":"sh","i":{"co":{"cIds":{"41":["1"]}}},"o":{"sIds":["5"]}},"44":{"t":"sh","i":{"co":{"cIds":{"43":["1"]}}},"o":{"sIds":["7"]}}},"sections":{"4":{"name":"Dissemination","conditions":[]},"5":{"name":"Third Party","conditions":["42"]},"2":{"name":"Always on","conditions":[]},"7":{"name":"Off-site","conditions":["44"]},"3":{"name":"Yes","conditions":["36"]},"6":{"conditions":[]},"1":{"name":"HTI File Dates","conditions":[]}},"questions":{"8":{"type":"cm","label":"Organization Type","description":"Please select the choice(s) which most closely match your Org type. 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