CREATING A REFERRAL

How to use this PDS section: When a staff person creates a participant in the PDS, s/he also starts the process of creating the referral. Upon first contact with the participant, home visitors then complete the referral documentation. Participants may have multiple referrals to HFM because they may transfer from one program to another or leave the program and then re-enroll later. While programs only create a participant once in PDS, participants may have more than one referral to accurately reflect their experience in HFM.

Why this information is important: The participant record, including referral information, is the jumping-off point for many other PDS records—keeping this information complete, accurate, and up-to-date helps programs best serve families.

HFM policies related to this PDS section: Eligibility Policy, Service Level and Creative Outreach Policy, Community Linkages & Referrals Policy

Step-by-Step Instructions:

Fields with an asterisk (*) are required.

1.   Once a program makes first contact with a participant, go to the participant’s record and click on Referral at the top of the screen.

2. The “Referral History” section shows all the participant’s referrals to HFM.

2.1 Click View to view a specific referral. Click Edit to edit a referral. Be sure to click Edit on the most recent referral to make changes to appropriate referral.

3. Enter information in the “Consent Requirements” section.

3.1 Consent signed: Check the box if the participant signed the HFM consent form. In most cases, programs do not have this information at the time they are creating a new participant in PDS. You can create a referral without saving information in the “Consent Requirements” section and return later to update the profile.

3.1.1 Signed date: Enter the date that the participant signed the HFM consent form. This field is required if you checked the Consent Signed box.

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3.2 Declined to sign: Check the box if the participant declined to sign the HFM consent form.

3.2.1 Declined date: Enter the date that the participant signed the HFM consent form. This field is required if you checked the Consent Declined box.

3.3 You may check either the Consent Signed or Declined to Sign box; you cannot check both. When one box is checked, the other box is grayed out and inactive.

3.4 If Consent Signed was checked off, the current program staff will be able to view all records created/maintained by prior program(s). If Declined to Sign was checked off, the current program staff cannot view any records created/maintained by prior program(s).

4. In the “Current Referral” section, you will find the required information you entered when you created the participant. If necessary, enter information in the “Current Referral” section after making first contact with the participant. You may have additional information or corrected information to document in the referral record.

4.1 Service Level: This will auto-populate based on the participant’s current Service Level.

4.2 *Referral Date: Enter the date you received the referral, not the date you enter the referral into PDS. Ideally referrals are entered into PDS as soon as they are received.

4.3   Date of First Contact: Enter the date of the first contact with the participant e.g. the first time you speak with a participant either in person or on the phone. See the section on Contact Logs for more information on recording contacts.

 

4.3   Outcome of Contact: Based on the response the participant has to the program offer of services (or based on the reason a program could not make contact with the participant), select the appropriate outcome from the drop down box.

• Assign Service Level: Select when programs have made first contact with a primary participant and the participant has agreed to receive services or has not declined all services. Only primary participants should be designated as Assign Service Level.
• Declined All Services: select when the participant declines all services. Only those who are eligible to receive services and then decline them, should be designated as Declined all services.
• Not Eligible: Select for any referral in which the participant cannot receive services because they are ineligible, including for the reason of No Program Capacity.
• Not located: Select when a program discovers after repeated attempts to contact the parent and seek alternate contact information that the contact information is incorrect.
• Lost to follow up: Select when after a minimum of three months of Outreach the program is unable to make first contact with a parent despite having correct contact information.
• Transfer: This option only appears when a participant has been transferred from another HFM program with your program as the receiving program. Select if you are receiving a transferred HFM participant. (Transfer is grayed out in the example below but is in active option.)
• Re-enroll: This option only appears when a previously discharged participant is being re-enrolled in services. (Re-enroll is grayed out in the example below but is in active option.)
• Inactive options: Declined as primary, engaged as secondary; Not eligible, engaged as Secondary; and Assigned to RIO are grayed out and cannot be selected.

   

4.4   *Parenting Status at Referral: Select the appropriate response based on the participant’s parenting status:

• Pregnant: Select if the participant is pregnant/expecting to become a father at the time of referral
• Postpartum: Select if the participant is postpartum/has already become a father at the time of referral.

4.5   If pregnant, EDC/Estimated Date of Birth: Enter the estimated date of birth for the baby if the participant was pregnant/expecting to become a father at the time of referral. If the child has been born at the time of referral, this can be left blank.

4.6 City/Town Residence at Referral: From the dropdown menu, select the city or town where the new participant lives at the time s/he is referred to the program.

5. Enter or update information in the “Referral Source” section.

5.1 *Organization Category: Select the option from the dropdown menu that best describes the referral source for this participant.

• Other, specify: Select if the organization category is not listed in the dropdown menu. If you select this option, enter as much information as possible in the remaining fields in the “Referral Source” section (e.g. organization/entity name and referral name/phone).
• Inactive options: FIRSTLink and MELD are inactive options and cannot be selected.

5.2 Organization/Entity City Select the Referral Source organization’s city from the drop down menu. If the organization is in a Boston neighborhood, you must select Boston.

5.2.1 Catchment only: By default, the Catchment only checkbox is selected when creating a new participant. When this box is checked, you will see only towns and cities in your catchment area. Un-select this box if you want to enter a referral source outside of your catchment area. In the example below, the user can only see the city in the catchment area (CT City) when the box is selected. When the user un-selects the box, all Massachusetts towns appear in the dropdown menu.

5.3 Organization/Entity Name Depending on the organization category and city you select, the organization/entity name may already be saved in PDS. The dropdown menu will populate with previously saved referral sources. Check the dropdown menu to see if the organization/entity name is listed. In the example below, the there are three hospitals already listed in Brockton.

5.3.1 If you do not see the organization/entity name in the drop down menu, you can create a new organization/entity by clicking the green plus sign next to the drop down menu.

You will be able to enter information in the Organization/Entity Name, Division/Department, Referral Contact Name, and Referral Contact Phone fields. Click the yellow arrow button if you want to return to the dropdown menus without entering information.

5.4 Division/Department If you selected an existing organization in step 9.3, you may see a division/department already saved in the dropdown menu. If you see the referral source’s division/department listed, select it. In the example below, there are two departments already listed for one of the hospitals in Brockton.

 

5.4.1 If you do not see the division/department in the dropdown menu, you can create a new entry by clicking the green plus sign next to the division/department name drop down menu.

5.5 Referral Contact Name If you selected an existing organization, you may see a referral contact name already saved in the Referral Contact Name field. If you see the contact’s name listed, select it. In the example below, there is one referral contact name already saved in PDS.

5.5.1 If you do not see the referral source contact name in the dropdown menu, you can create a new entry by clicking the green plus sign next to the referral contact name drop down menu. This step is not required if you do not have a specific contact at the referring organization.

5.6 Referral Contact Phone If you selected an existing referral contact, a phone number may appear in this box. If a number does not appear or if the contact phone number is out of date, enter a new referral contact number.

6.   Enter information in the “Reasons Not Eligible” section only if the referred parent is not eligible for services as primary participant.

Refer to the Eligibility Policy for an explanation of each reason the participant is not eligible. Select each check box that is appropriate:

• No program capacity
• Not first baby
• Primary participant’s age
• Baby over 1 year old
• Out of service area
• No longer pregnant/no longer parenting
• Other: Select if the participant is not eligible for a reason not listed above. Specify the reason in the box at right.

‎7.   Enter information in the “If not enrolled, referrals made to other programs” section. If the participant does not enroll in the program for any reason (ineligibility or declining services), the program should seek to make referrals to other community services as appropriate. Indicate the referrals made to other services by marking the box next to the description of the services.

7.1 If you select Other Home Visiting Program or Other Program can enter the name of the program in the text box next to the check box.

 

 

Creating a Referral (Sept 2019)

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