How Do Social Workers Formally Make Client Referrals To Community Resources And/or Program Services?

Welcome to the Toolkit

Many individuals describe publicly funded family unit planning centers as their "usual source of care."ⁱ In this regard, family planning service sites are often an entry betoken for other services needed by their clients, and visits may include referrals for other related services. Family planning agencies must provide referrals for medical and social needs that go beyond a site'southward scope of services equally a core component of furthering the goals of access, equity, and quality in family planning services.²

Picture of provider sitting at table with client

The purpose of this toolkit is to back up Title X grantees' ability to provide effective referrals. It has too been designed to help with oversight of subrecipients in their network who provide referrals. This toolkit provides guidance on setting up systems for consequent provision of referrals. It includes sample policies and strategies for providing high-quality supportive and effective referrals. The toolkit also contains resource for preparation subrecipients and service sites.

Title X programs are expected to provide advisable referrals for medical, advisory, educational, and social services related to family planning for clients who desire such services.²

Title 10 grantees, subrecipients, and/or service sites are expected to develop and implement plans to coordinate with and refer clients to other providers of wellness care and social services, optimally with signed, written collaborative agreements.

Title 10-funded agencies should provide for coordination and employ of referrals and linkages with, at a minimum:

Providers of other health intendance services not provided on-site (e.g. primary or specialty care such as infertility, communicable diseases, prenatal care, pregnancy termination)
Other medical facilities (including hospitals) when medically indicated
Infant intendance, foster care, adoption
Local wellness and welfare departments (e.thousand. SNAP, WIC)
Voluntary agencies (due east.chiliad., domestic violence, crisis intervention, Alcoholics Bearding)
Coincident services which may be necessary to facilitate clinic attendance (eastward.yard. childcare, transportation)
Health services projects supported by other federal programs, who are in shut concrete proximity to the Title X site, when viable, in order to promote access to services and provide a seamless continuum of care.

Title 10 grantees are expected to have a written policy that requires subrecipients and service sites to have policies for providing needed referrals.

Activeness Steps	Supportive Resources
Develop written policies for providing needed referrals. Sample policy templates can be modified with agency or site-specific data.	Availability of Social Services Sample Policy Template View Coordination and Use of Referrals and Linkages View Provision of Medical Services Related to Family Planning Sample Policy Template View
Develop written policy for nondirective counseling and referral. The sample policy template tin exist modified with agency or site-specific information.	Nondirective Counseling and Referral Sample Policy Template View

Referrals should exist provided when a clinical service provider determines that a client has either medical or social service needs beyond the scope of the clinic'south services. Not all referrals, however, require the same level of support to the customer.

Referral-making encompasses a spectrum of potential information-giving and supportive behaviors. These range from providing information on specific services to follow-up on service utilization and outcomes and continuous assessment and improvement of the quality of referrals. "Cold" and "warm" are often used to depict referral behaviors at 2 points along this spectrum.

A cold referral means providing information to the client most another bureau or service. This means that information technology is the customer's responsibility to contact the agency or service (for instance, after giving the client a business card or proper name and phone number for a local resource).

A warm referral involves contacting another agency or service provider on the client's behalf. This means calling and making an appointment for the client, providing back up to overcome barriers to care, and following upward to determine if the appointment is kept.

Bureau policies should indicate the type of referral that is unremarkably most appropriate for each service. Referral type may also depend on the client'south private circumstances, so providers should use their best sentence.

A common cold referral may be appropriate for services like: WIC Weight management treatment Primary intendance for elevated blood pressure Alcoholics Anonymous	A warm referral may exist advisable for services like: Syphilis treatment HIV-positive exam result Prenatal intendance
A cold referral may be appropriate for clients who: Have reliable internet/phone access, transportation, and housing Can communicate in English (if services are limited to this) Take admission to social, fiscal, and other supports	A warm referral may exist appropriate for clients who: Lack reliable net/telephone access, transportation, and housing May feel linguistic communication barriers/ challenges Lack admission to social, financial, and other supports

Title Ten agencies should identify other health intendance and social service agencies serving the same target population to explore whether having an informal or formal relationship may be mutually benign. Information technology is important to develop partnerships with community groups, programs, and organizations that represent various sectors and stakeholders, including those addressing social, economic, and environmental factors—the social determinants—that bear upon sexual and reproductive health.

Action Steps	Supportive Resources
Develop partnerships with community groups, programs, and organizations that represent various sectors and stakeholders, including those addressing social, economic, and environmental factors.	Engaging Diverse Community Partners Task Assistance View
Initiate conversations with key specialists, hospitals, and community services around mutual expectations for referrals. Be prepared to talk over the value of partnering with a Title X agency.	Value Proposition Template View
Determine the value-add together of potential referral partnerships.
Develop a list of local resources, including key contacts at each organization.	Local Resource Listing View
Verify referral information (contact information, hours, location) on an annual ground to ensure that it is current.

A memorandum of understanding (MOU) is a written document, mostly non legally binding, that outlines a voluntary agreement betwixt parties. Information technology can facilitate inter-agency communication, coordination of services, and continuity of care for clients. A MOU does non demand to include complicated legal conditions, exclusions, indemnifications, etc. It should back up the work of the collaboration, not inhibit information technology.

Activeness Steps	Supportive Resources
Meet with leadership and/or program managers to discuss referral needs and request collaboration.
Develop a written common referral MOU, if during the coming together this is determined to be appropriate.	Title X Sample MOU Template View
Mail a cover letter of the alphabet and typhoon MOU, requesting a response with signatures to indicate approving of the collaboration.	Sample MOU Introductory Letters for Family Planning Referrals View

Providing high-quality referrals involves assessing private clients' circumstances, identifying potential barriers, and helping them to problem-solve and reduce all barriers, therein increasing their ability to access referral services. Without support, clients may receive referral information, merely notwithstanding not access services. Some of the many barriers Title X clients face in accessing services are related to:

Finances
Language
Transportation
Lack of child care
Age-based consent problems
Legal and policy
Fear of a lack of privacy
Fearfulness of sentence
Fear of scorn, intimidation, coercion, or threats
Fear of disclosing immigration status

Ensure staff have adequate training and support to aid clients with ways to overcome these barriers so they can admission the services they need.

Staff must be prepared to provide appropriate referrals and grooming, identify roles, and develop processes to ensure consistent implementation.

Activity Steps	Supportive Resources
Ensure all clinic staff and administration understand the need for and skills related to providing effective referrals.	Providing Effective Referrals Training Guide View
Provide frontline staff with an opportunity to practice skills such as: Identify referral needs Speak directly to the referral provider (every bit advisable) Provide a verbal and/or written handoff (with the person's consent) Manage difficult situations Follow up with the client well-nigh the referral	Referral Quality Staff Observation Activity, Instructions, and Handouts View
Designate staff roles to provide referrals, along with a process for communicating that referrals have been made.

Ensure that referrals and associated processes are well-documented. Shut the communications loop for loftier-priority referrals past establishing clear expectations for client-centered advice while respecting client autonomy and confidentiality. Assess periodically how effective agency referrals are and arrange accordingly.

Action Steps	Supportive Resources
Conspicuously certificate referrals. Employ a standard protocol and consistent documentation for referrals in the medical record. The reason for referral, informed consent of the client, and whatsoever correspondence with the referral provider/ organization should be included.
Develop shared referral tools and processes for services that you regularly refer to (and those that regularly refer to you).	Referral Class Template View
Close the loop. Determine preferred and acceptable methods of advice and set articulate expectations with the client at the fourth dimension of making the referral.
Runway referrals. Utilize referral management software, EHR downloads, or manually proceed a record to ensure constructive management of referrals.
If a referral isn't completed, talk to the client during the next visit to find out why, and document the response. Clients are non obligated to follow up with referral recommendations.
Periodically assess the effectiveness of referral services. Ask clients about their referral experience, and inquire the partner agencies about their experience giving and receiving your customer referrals.	Patient Experience Comeback Toolkit View

Frost JJ, U.S. Women's Apply of Sexual and Reproductive Health Services: Trends, Sources of Care and Factors Associated with Use, 1995–2010, New York: Guttmacher Found, 2013, https://www.guttmacher.org/written report/us-womens-use-sexual-and-reproductive-health-services-trends-sources-intendance-and-factors, accessed December 7, 2021.
Code of Federal Regulations 42 CFR 59.five. https://world wide web.ecfr.gov/current/title-42/affiliate-I/subchapter-D/office-59 Accessed Dec 7, 2021.
Title X Statutes, Regulations, and Legislative Mandates. https://opa.hhs.gov/grant-programs/title-x-service-grants/championship-x-statutes-regulations-and-legislative-mandates Accessed December 7, 2021.