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Feature ID: CL-18
Status: ✅ Implemented
Spec Reference: CL-18-sdoh-screening-social-needs.md
Last Updated: 2026-02-23
Last Verified: 2026-02-23

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Overview

CL-18 adds SDOH screening (e.g. PRAPARE, AHC-HRSN), social needs tracking, community resource referrals, and ICD-10-CM Z-code (Z55–Z65) documentation. Integration is via patient chart (CL-01), comprehensive assessment (CL-02), PF-70 code library, and an optional event for analytics/workflow.

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Integration Points (from Spec)

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API / Data Contracts

  • Screenings: cl_sdoh_screenings (chart_id, instrument, screened_at, screened_by, responses JSONB, needs_identified[], custom_fields). No public REST API; access via Supabase client and RLS.
  • Referrals: cl_social_referrals (chart_id, screening_id, resource_name, resource_type, need_category, status, referred_at, referred_by, outcome_notes, outcome_at, custom_fields). Same access pattern.
  • Z-codes: PF-70 code library provides type-ahead and validation for Z55–Z65; link from screening or problem list (CL-01).

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Event Contracts

  • Published (optional): cl_sdoh_screening_completed — for analytics/workflow.
Payload (final schema in EVENT_CONTRACTS.md when implemented): Consumers MUST resolve patient identity from chart_id; patient_id is not in the payload (see EVENT_CONTRACTS.md).
  • Consumed: None for MVP.

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Security and RLS

  • Tables: cl_sdoh_screenings, cl_social_referrals — RLS enabled; org-scoped via SECURITY DEFINER helpers; UPDATE policies with WITH CHECK per constitution §5.2.4.
  • PHI: Screening responses and referral data are PHI; no PHI in logs or external AI.
  • Permissions: cl.sdoh_screenings.view / .create, cl.social_referrals.view / .create / .update; seed via migration (PF-30).

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CL-18-EN-01 — SDOH/HRSN screening block adapter (CL-75, shipped 2026-07-02)

The SDOH/HRSN screening (justice-legal domain + Z55–Z65 crosswalk-as-data) ships as a CL-75 typed block (sdoh-adapter) over cl_sdoh_screenings (PR #2212), resolved onto surfaces via getResolvedSurfaceBlocks; the closed-loop referral surface in this doc is its downstream consumer.