Electronic Health Record for Mental Health Agencies


  1. Benefits of an EHR for Mental Health Agencies
  2. Interoperability in an Electronic Record
  3. Direct Billing
  4. Customer Support and Training
  5. Data Security
  6. Compliance
  7. FAQs – Mental Health Software

1. Benefits of an EHR for Mental Health Agencies

The scope of AWARDS as a mental health EHR is deep and wide, with the ability to track clients and manage cases while helping mental health providers comply with government and funder standards.

  • Progress notes link directly to service plans
  • Sophisticated, user-friendly group & activities capabilities
  • Full entitlements module tracks & reports on income, insurance, eligibilities, and subsidies
  • Utilization reports including last note audit and caseload & program activity reports
  • DSM-5 and ICD-10 codes mapped for full diagnosis through IMO™
  • Medication module with prescriptions tracking and med monitoring tools
  • Scheduler to track program events and appointments

AWARDS helps your organization thrive by offering:

  • Standardization of agency data collection & charting procedures
  • More staff accountability through reporting, audit trails & reminders
  • Easier access to your data, accessible from any location at the agency
  • Increased efficiency allowing staff more time to provide supports & services
  • Easy audits available through AWARDS’ robust reporting functionality
  • Real-time collaboration across multi-site organizations
  • Standard workflow for all agency employees
  • Safe, secure & HIPAA compliant data storage
  • An EHR package certified for Meaningful Use
  • Seamless integration between clinical data and electronic billing
  • Web-based cloud technology, eliminating hardware & infrastructure maintenance costs

2. Interoperability in an Electronic Record

AWARDS is interoperable with any Health Information Exchange (HIE).

If your organization is using AWARDS to manage the data related to the services you provide, you have the tools to participate in any Health Information Exchange without duplicate data entry. AWARDS will serve as a single portal to send data in any format required, safely and securely.

What Is a Health Information Exchange?

The Affordable Care Act of 2010 created an optional Medicaid State Plan benefit for states to establish Health Information Exchanges (HIEs) to coordinate care for people with Medicaid who have chronic conditions. HIEs can sometimes look like data warehouses – receiving data and archiving it so that other participating providers can, with the proper consent, see the data from other providers. HIEs can also sometimes look like traffic cops, directing data from one provider to another, just making sure the files are secure and properly formatted. Generally, speaking, HIEs would only be found where there is a community of providers interested in providing care based on a client-centric philosophy – by integrating and coordinating all primary, acute, behavioral health, and long-term services and support to treat the whole person. One common example of an HIE is a Regional Health Information Systems (RHIO). But an HIE is really any third party than can receive and send health data.

Why Is Interoperability Important to My Agency?

In order to provide a single network of care provision for each care recipient, it is becoming increasingly critical for each health care provider, whether offering behavioral or physical care, to have an Electronic Health Record (EHR) to manage its data about its cases and services.  In fact, if behavioral health providers can integrate themselves into a network of care providers such that they are able to divert even a small percentage of potential ER visits, the money saved in our Medicaid and Medicare programs would ensure their survival for many years to come. Aside from the importance of electronic documentation is the technical issue of how to share Patient Health Information (PHI) safely and securely.  There are two issues at play here. One is the format and data contents of the data being shared. In many cases, HIEs are taking advantage of the support of the Federal government to work with a file called the Continuity of Care Document (CCD). The challenge lies in making sure that the record-keeping systems used by each respective organization can recognize the fields of the CCD in the same way. The second issue is how these files will actually be transmitted, safely and securely, from one system to another. Here again, there are several options, but the two most used are the HL7 file format and the Direct Protocol. Both have different uses, but both are widely accepted. Indeed, much of the conversation—and ever-changing requirements—revolve around this issue of Interoperability among databases, namely the capability of exchanging data automatically with other data management systems with correct interpretation of the information being shared.

Interoperability of AWARDS Software for Human Service Providers

At Foothold, we took proactive steps to prepare our providers to be part of this vision. We established a partnership with InterSystems, a global leader in software for connected care, and integrated with AWARDS the InterSystems HealthShare® platform, which is currently being used in HIEs extensively across the US and across the world.  Many of the agencies we serve would not be able to afford this level of sophistication on their own, but because of our partnership with InterSystems, providers who use AWARDS have the ability to leverage our product and service as part of a larger community, and participate in any Health Information Exchange across the country through our Interoperability Center. For any questions about Interoperability at Foothold or to get started with using AWARDS, contact us at mu@footholdtechnology.com. We look forward to working with you to create the new landscape of care.

3. AWARDS BillingBuilder™ EHR Billing

For all agencies looking to bill directly for the services they provide, we offer BillingBuilder™, our Build-Your-Own Billing module that allows users to configure billing files for dozens of payers in addition to the direct link to Medicaid and Medicare already built into the software. Your agency’s clinical and programmatic data will flow seamlessly from the AWARDS electronic chart into the proper structure in the billing module. From there, you can use the module to create claims to be paid. With BillingBuilder™, AWARDS establishes a more direct relationship between program services and billing activities. Because both fiscal and program service staff rely on a single system for billing-related information, there are fewer opportunities for errors in communication, and less time and energy is expended on reporting of this information. Furthermore, your Foothold support team will work with you to address the inevitable changes in regulations, ensuring your agency’s continued compliance. Results for your agency include more internal control and greater transparency in the billing process as well as increased success with audits. There is additional support and an additional cost associated with BillingBuilder™.

4. Customer Support & Training

The Foothold System

You could have the greatest software in the world, but if you don't have people to train you and answer your questions, you won't get what you need from it. With origins and roots in human services, no software vendor is better prepared to support you than Foothold Technology. When you choose AWARDS, you get more than software--you get a whole system of help that is always just a call or a click away.

Your Senior Project Manager (SPM)

From Day 1, you get a team of seasoned experts led by a Senior Project Manager (SPM) dedicated to you for the life of our work together. Your SPM will serve as your single point of contact to:
  • Coordinate all your implementation and training activities.
  • Offer expertise from a combined 60+ years of experience working with agencies like yours.
  • Work with you to think through your agency's growth and challenges.

Your Implementation Consultant (IC)

The average length of an AWARDS implementation is four months. To get your team up and running, you'll work with an Implementation Consultant (IC) as well as your SPM. Your IC will:
  • Learn, evaluate, and understand the programs, policies, and goals of your agency.
  • Walk you through all the functionality of AWARDS.
  • Configure the software to reflect your agency's unique needs.
  • Assist you in developing a training and roll-out plan.
  • Prepare you to meet your desired milestones.

Your Training and Support

Our "Train-the-Trainer" model will give you onsite expertise of AWARDS and help minimize the problems caused by staff turnover.
  • Classroom-style training in Foothold's training facility or at a site of your choosing.
  • Extensive online Help library with step-by-step instructions and video tutorials.
  • FootholdConnect series of free, ongoing trainings offered via web conference.
  • A Quality Assurance team (also known as Help Desk) to provide technical support.

Foothold Training Philosophy

Foothold Technology utilizes the Train-the-Trainer model of training new users on AWARDS. This enables Foothold customers to develop a robust internal training and support team, nurture real ownership of the agency's database by the staff who use it, and keep training costs to a minimum. Start-up training consists of three full days of live training, and comes standard with a new AWARDS contract. These three days of training cover many basics of AWARDS use and help those in attendance to become effective trainers for other users within their agency. In addition, most contracts include additional training days which can be used at any time.

AWARDS Certification Program

Because AWARDS is in use by more than 900 agencies across the nation, we offer an AWARDS Certification program. The Certification curriculum is a rigorous, three-level training program for agencies aiming to turn staff members into true AWARDS experts. These experts can then provide invaluable support to various departments within the agency. Complete implementation and utilization of AWARDS requires well-trained personnel to train, assist, and support staff as they enter and work with client information in your database. In addition to an intensive understanding of the software and its application to the agency, the Certification courses also ensure a working knowledge of the planning and coordination aspects of project management and implementation. Candidates are asked to attend required workshops and complete exams that assess readiness for certification. For more information about our training programs and policies, please contact our Training department at trainer@footholdtechnology.com, or speak with your Foothold representative.

5. Data Security for Behavioral Health Providers

With Foothold Technology, your data will be protected by the highest level of security available anywhere. In fact, this level of security is so expensive that, without us, very few nonprofits could afford the kind of cutting edge protection we provide.

At Your Agency

Foothold Technology employs a highly sophisticated series of usernames and passwords to protect data from unauthorized viewing and manipulation within your agency. Because agencies are comprised of people with different responsibilities and roles, AWARDS ensures that staff members do not have access to information they don't need to or shouldn’t see. This is one of the many features of our software that we will customize to fit your specific organizational structure and business rules.

The Road to Foothold’s Data Center

Many agencies are justifiably concerned by the prospect of sending highly confidential data across the internet. Recent technology, however, eliminates these concerns. Your data will undergo the latest 256-bit encryption process that renders it completely unintelligible to outsiders and intruders. (This is the same online security used by banks.) Information sent from your offices to our offices cannot be unscrambled. Additionally, because no data is ever stored at your office, there is no danger of outsiders breaking into your network or loss of data due to fire or other disastrous situations.

At Foothold’s Data Center

Foothold uses two world-class data centers, in two different states, to host our clients’ data. These data centers feature uninterruptible power supplies and highly sophisticated disaster prevention and recovery systems. Biometric confirmation of identity is required to enter our data centers. The data centers feature porous floors to prevent flood damage, “dry” sprinkler pipes, fire suppression gas instead of water, a diesel generator that picks up immediately in the advent of a power failure (during the Great Blackout of 2003, our customers who still had power were able to use AWARDS with no interruption in service), industrial air filtering and air conditioning technologies, and a live 24-hour armed guard.

Our main data center is run by Verizon, while our backup data center is maintained by Datapipe. In our data centers, we use servers with multiple hard drives in RAID arrays, with multiple CPUs, SANs and redundant power supplies, so that if any internal components malfunction, there is immediate failover -- with minimal interruption in service. Our servers also make use of firewalls in both hardware and software form. We also copy all data to a second server so that if an entire server malfunctions, there is another one ready, again with no service interruption. Lastly, a copy of your data is electronically transferred offsite once a week for safekeeping. No data security and storage procedure is 100% failure proof, but with Foothold, you are able to make use of a continually upgraded, state-of-the-art security program that is well beyond the means of nonprofit agencies acting alone.

As another layer of security, we have contracted with a third party to provide escrow services, whereby a copy of the entire AWARDS application and your data are put into a vault every quarter. This service guarantees you will have a copy of both your data and our software in case an unforeseen event closes our company. Escrow services are an additional charge.

non-profit, medical, practice, billing, software, chicago, il, illinois, new york, city, ny

6. Compliance

To ensure compliance with federal and local requirements, updates to AWARDS are performed behind the scenes, while our Client Services team communicates with you about how these changes might affect your workflow. Because Foothold grew out of human service agencies, we can be proactive about preparing our clients for upcoming changes in technology and the industry. AWARDS is HIPAA-compliant, is federally certified as an Electronic Health Record (EHR) for Meaningful Use and offers full interoperability with any other federally certified system for participation in Health Information Exchanges (HIE) and RHIOs. It is also the only record-keeping system that is certified as both a Behavioral Health EHR software system and a HMIS software package (Homeless Management Information System). Below are just a few of our certifications.

National, State and Local Standards

Meaningful Use Certification

Drummond Certified | ONC-ACB Complete EHR AMBULATORY - 2014 EditionThis AWARDS Electronic Health Record is 2014 Edition compliant and has been certified by an ONC-ACB in accordance with the applicable certification criteria adopted by the Secretary of the U.S. Department of Health and Human Services. This certification does not represent an endorsement by the U.S. Department of Health and Human Services or guarantee the receipt of incentive payments.

Product Information

Regulation § 170.523(k)(1)(i)-(ii) requires that developers post the following information on their website. This information can be found on the product’s Certificate of Compliance issued by Drummond Group upon successfully achieving certification.
  • Developer organization name: Foothold Technology
  • Date the product was certified: 12/20/2017
  • Product name: AWARDS 3.0
  • Unique certification number:
  • Certification criteria to which the product has been certified: 170.315 (a)(1-14); (b)(1-6); (c)(1-3); (d)(1-9); (e)(1-3); (g)(2-9); (h)(1)
  • CQMs to which the product has been certified: 2v7; 68v7; 69v6; 128v6; 137v6; 138v6; 156v6; 159v6; 160v6; 161v6; 166v7; 169v6; 177v6
  • Any additional software the certified product relied upon to demonstrate its compliance with certification criteria: used: IMO 2.0 (Intelligent Medical Objects), Surescripts ePrescribing, Digital Rx (H2H Solutions)
  • ONC Disclaimer:This Health IT module(s) is 2015 Edition compliant and has been certified by an ONC-ACB in accordance with the applicable certification criteria adopted by the Secretary of the U.S. Department of Health and Human Services. This certification does not represent an endorsement by the U.S. Department of Health and Human Services. Drummond Group is accredited by ANSI and approved by ONC for the ONC Health IT Certification Program to certify: Health IT Module(s) and Certification of other types of Health IT for which the Secretary has adopted certification criteria under Subpart C of 45 CFR.
Costs and Limitations

AWARDS Is a Certified EHR

If you are using AWARDS and have an Eligible Professional (EP) on your staff (a Psychiatrist, Doctor, Nurse Practitioner or APN), you may be able to collect $63,750 per EP through the Federal Meaningful Use incentive program. (Five EPs? $318,750!)

HIPAA Information for our Clients

While AWARDS is HIPAA-compliant, Foothold understands that our customers may be confused about their responsibilities under HIPAA and experiencing some difficulty in determining whether and to what degree HIPAA affects them. Below you will find a link to a BAA that you should ask us to sign as well as a link to the Federal HHS home for HIPAA-related questions. (This information is provided “as is” without any express or implied warranty. This information does not constitute legal advice. If you require legal advice, you should consult with an attorney.) Additionally, Foothold has developed relationships with a number of high-quality, nationally known security firms and would be happy to put you in touch with them should you be interested.

For the most part, our industry has never really thought of itself as being part of the larger physical healthcare system and so, in many cases, HIPAA is thought of as something that your vendors can take care of for you. While that may be true in many cases, you are, in all likelihood, a Covered Entity under HIPAA and as a result, it is worth your looking into whether and to what degree your organization reflect the principles behind HIPAA.

Click here for a sample agreement that should be signed by and between the provider and any and all Business Associates as defined by HIPAA.

Click here for a link to the Federal HHS HIPAA Page.

HIPAA 5010 Certified | 270 EDI Health Care Eligibility/Benefit Inquiry

HIPAA 5010 Certified | 837P EDI Health Care Claim - Professional

HIPAA 5010 Certified | 837I EDI Health Care Claim - Institutional

Here are a few links with valuable information on HIPAA and compliance.

HIPAA Compliance in AWARDS

Among other things, the new HIPAA regulations are designed to protect the security and privacy of agencies and the consumers they serve. At Foothold Technology, security is our top priority. Using Secure-Socket Layer (SSL) and 256-bit encryption technologies, Foothold Technology’s security is second to none. We utilize several layers of encryption to protect data from both external sources and internal accessibility. Below are a number of our specific security measures which should address any concerns you may have.
  • AWARDS safeguards the confidentiality of chart records.
  • All system users must authenticate themselves using a login and encrypted password. Passwords must meet minimum standards such as not using words found in a dictionary.
  • Your agency has its own separate database and database server process with login accounts for your agency’s staff only.
  • The database server is protected by a “firewall” that by default blocks all access except the secure sockets layer connection to the web server process running for your agency alone.
  • All data transmitted to and from the database server uses 256-bit encryption, the highest legal limit. This is the same encryption used by online banking.
  • Physical access to the servers is under lock and key. Backup media can be transported offsite by messenger and stored at a secure site under lock and key.
  • No access to chart records is permitted unless the user is Direct Care staff in that clinical program as determined by caseload information, or the user is a supervisor in that program, or that program’s director has granted a specific permit to the user.
  • Access to progress notes is restricted to the past 10 days unless the consumer is on the caseload of the user, or the user is the program director, or the program director has issued a specific permit to the user. All exception permits have expiration dates set at the time the permit is issued.
  • AWARDS keeps an audit trail each time a progress note is viewed.
  • AWARDS blocks all access to notes concerning incidents except by the note writer and users who have a permit to access these notes.
  • Whenever an exception permit is issued to grant access to chart records, all administration staff with permits to issue such permits are automatically notified by an internal email message.
Foothold Technology completed a 3rd party HIPAA compliance assessment. Check out this summary from our cybersecurity consulting firm, GreyCastle.

New York State Office of Mental Health - PROS

Personalized Recovery Oriented Services (PROS) is a comprehensive recovery-oriented program for individuals with severe and persistent mental illness. The goal of the program is to integrate treatment, support, and rehabilitation in a manner that facilitates the individual’s recovery. Goals for individuals in the program are to: improve functioning, reduce inpatient utilization, reduce emergency services, reduce contact with the criminal justice system, increase employment, attain higher levels of education, and secure preferred housing.1 AWARDS has tools that make PROS reporting and billing easier, including:
  • End-to-end screening and tracking of individuals receiving services in any of the PROS Components including CRS, IR, ORS and optional Clinical Treatment
  • One-click availability of the automated PROS Monthly Summary Record of Services (PROS Units Calculator)
  • Intensive case tracking including Individualized Recovery Plans, PROS Progress Notes and Groups, Onsite/Offsite Program Attendance Tracking
  • Standardization of agency data collection and charting procedures
  • More staff accountability through reporting, audit trails and reminders
  • Easier access to your data, accessible from any location at the agency
  • Easier audits using AWARDS' robust reporting functionality
1"PROS Description". New York Office of Mental Health. http://www.omh.ny.gov/omhweb/pros/

New York State Office of Mental Health - APGs

In 2010, the New York State Department of Health (NYSDOH) announced that the federal Centers for Medicare and Medicaid Services (CMS) approved the State Plan Amendment authorizing the Ambulatory Patient Group Payment (APG) Medicaid payment methodology for freestanding Diagnostic and Treatment Centers and Ambulatory Surgery Centers on June 14, 2010. Foothold Technology is prepared to handle the transition to new service categories, codes, and billing rules. Click here to learn more about APGs and AWARDS.

HL7 - Health Level Seven International

HL7 International | ANSI Accredited Standards Developer - Member 2014

"Level Seven" refers to the seventh level of the International Organization for Standardization (ISO) seven-layer communications model for Open Systems Interconnection (OSI) - the application level. The application level interfaces directly to and performs common application services for the application processes. Although other protocols have largely superseded it, the OSI model remains valuable as a place to begin the study of network architecture. View our updated certification here.

7. FAQ – Mental Health Software

Q: Is your software certified?

Yes. AWARDS is certified as an Electronic Health Record (EHR) for Meaningful Use and is fully interoperable with any other federally certified system for participation in Health Information Exchanges (HIEs) and Regional Health Information Organizations (RHIOs). AWARDS is the only web-based Homeless Management Information System (HMIS) software system that is also certified as a Behavioral Health EHR .

Q: What is “Software As A Service”?

Software as a Service (SaaS) is a way of delivering software over the Internet rather than loading it into a computer. A few related terms are “cloud computing” and being “web-based.” The software and data reside at a professional data center instead of being installed on individual computers.

Q: How can Software As A Service help me?

The SaaS model provides top-of-the-line software that is more affordable, more secure, easier to upgrade, easier to fix and much easier to implement than traditional software. One major problem with running a nonprofit organization is that direct-care staff spends too much time and energy keeping and reporting data for other agencies. Staff members often spend as much time working on reports, records and filing as they do serving their clients. Using traditional software to solve this problem would require the purchase of the application itself, the networking hardware to run it, and a highly skilled network administrator. This can cost upwards of $300,000, with ongoing costs of $100,000 per year. Foothold Technology offers a superior level of service, without any administrative burdens, for a fraction of the cost.

Q: What software does Foothold use?

Foothold Technology has created a software application that supports an array of agency standard activities including: client charts, direct Medicaid billing, hospitalization records, property maintenance, personnel, email, government reporting, internal auditing and vacancy management. This application, named AWARDS (Affordable Wide Area Relational Database System) is written in PHP on a Postgres database in a UNIX environment presently on Linux servers.

Q: Can the software be configured for my organization?

Yes. AWARDS was designed by and for human service providers, so you’ll find much of the functionality you need is already there. However, we recognize that every agency is unique. Therefore, when you get started, you will have your own Implementation Consultant helping you to configure the database to reflect your agency’s particular needs. You can also create your own custom forms and assessments with the ReportBuilder tools built into each module of AWARDS.

Q: Why does the interface look so simple?

AWARDS is designed for ease of use by agency staff. The software is intentionally self-explanatory; no user manual is necessary but we do provide comprehensive online help. The user logs on to the AWARDS homepage, enters a password and username, chooses an activity and is then taken through a series of pages designed to collect all information relevant to the task at hand. The menu screens provide clear graphics of options while simultaneously using as little data as possible to enable the fastest web transmission possible. The email application in AWARDS is also unique in that it is linked to other application modules. Email in AWARDS is used to deliver “ticklers,” “key data entry alerts” and “snapshot reports” while maintaining HIPAA compliance.

Q: Who owns the data?

You own the data, which is kept securely and confidentially in Foothold’s data center.

Q: Is training included?

Yes. Classroom-style training is provided in Foothold’s facility or at a site of your choosing. We use a train-the-trainer model, which allows your agency to develop onsite expertise of AWARDS and create the institutional memory that will be required for successful usage of AWARDS as staff turnover takes its toll.

Q: What about technical support?

We provide an unmatched level of customer support and partnership. On day one, your agency will be led by a Senior Project Manager and Implementation Consultant, who are dedicated to you for the life of our partnership. Our training model includes classroom-style training, an extensive online help library with video tutorials, and ongoing learning opportunities through a series of free online webinars. Technical support is provided through a secure Help Desk and Quality Assurance team. .

Q: What are the hardware requirements for using your software?

You need a computer with the latest version of a web browser such as Internet Explorer, Firefox, or Chrome and an Internet connection. AWARDS works with any operating system. However, if an agency uses Windows XP, we recommend either upgrading the operating system or using Chrome or Firefox as the browser.


We take security and compliance very seriously.
The future
of care requires interoperability.
We spend more time,
effort and energy on client support than anything else.