This value set binding seems problematic: SHALL contain exactly one [1..1] code, which SHOULD be selected from ValueSet Social History Type 2.16.840.1.113883.3.88.12.80.60 DYNAMIC (CONF:1198-8558). If @codeSystem is not LOINC, then this code SHALL contain at least one [1..*] translation, which SHOULD be selected from CodeSystem LOINC (2.16.840.1.113883.6.1) (CONF:1198-32951).

We believe it does not reflect what is needed and being done today by implementers, and as stated does provide guidance that is helpful for validation. 

Discussed this with C-CDA IAT Participants on 3/24/2021 - Recommendation was to Create a new Grouping Value Set and then make the existing SCT value set one member (for backward compatibility) and make a new LOINC value set with a set of concepts supplied from the community (call to EHRs, Regenstrief, and Gravity Community to gather the concepts/loinc codes to see this member value set).

Once this value set was created, the Social History Observation template would need to be modified to use the new grouping value set with DYNAMIC binding. The binding strength of Observation.code is CWE, so this would be equivalent to an extensional binding strength in FHIR.

This issue should be tagged as both Terminology and TemplateStructure.