<PreEncounterReport ReportType="Rules" SPA="DMH Use Only">
	<SenderData ProviderName="My Org" ProviderETIN="XXX500" BatchNumber="20060908-1902" ElementID="1001"/>
	<DocumentFunction DocumentNumber="20060907-1902-001" DocumentFunction="1" ElementID="1002">
		<ConsumerData>
			<Name LastName="xxxxxxxx" FirstName="xxxx" MiddleName="x" Prefix="xx" Credential="PHD" ElementID="1003"/>
			<Demographics Gender="02" DateOfBirth="####-##-##" SSN="" HearingStatus="144" PreferredLanguage="164" MaritalStatus="2" EmploymentStatus="8" Occupation="01" ElementID="1004"/>
			<Address Street1="123 xxxxxxx" Street2="Apt #" City="xxxxxx" State="XX" County="###" Zip="#####" Country="US" ElementID="1005"/>
			<Race White="1" Black_AfricanAmerican="0" Asian="0" NativeHawiian_PacificIslander="0" AmIndian_NativeAlaskan="0" OtherRace="0" NotOfHispanicOrigin="1" Hispanic_Mexican="0" Hispanic_Cuban="0" Hispanic_PuertoRican="0" OtherHispanic="0" ElementID="1006"/>
			<StandardMeansTest FromDate="yyyy-01-01" MonthlyAbilityToPayAmt="750" PreparedBy="Jean Adir" ElementID="1007"/>
		</ConsumerData>
		<EpisodeCare Division="ADA" EnrollingProviderSiteName="Columbia" EnrollingProviderSiteID="406" AdmissionDateTime="yyyy-05-12 12:00 PM" AdmissionReason="1" ReferralSource="19" LocalChartNumber="AX3456" FamilySize="2" NumberOfChildrenInCare="0" ElementID="1008">
			<Commitments CommitmentType="200" CommitmentFromDate="yyyy-05-12" CommitmentCounty="217" PrimaryIndicator="1" ElementID="1009"/>
			<ProgramAssignment Program="ADACSTARGen " ProgramFromDate="yyyy-05-15" ProgramFromTime="12:00 PM" Status="1" LivingArrangement="20" ProgramLevel="1Basic" ElementID="1010">
				<Error Type="BusinessRules" Code="R4" Message="Cannot be in multiple ADA programs simultaneously"/>
			</ProgramAssignment>
		</EpisodeCare>
	</DocumentFunction>
</PreEncounterReport>
