Referrals to other service providers
How do you determine options for referrals to other service providers against the range of client needs?
If a client requires support that does not fall within the scope of your agency, you may need to investigate other options and refer them to another service provider. There are a number of important issues to consider when you choose to refer a client to another agency, or to another member of your team, be it an emergency referral or part of treatment planning. The most important consideration should be:
- Is this the best possible service provider to refer this client to?
- Will they be able to adequately meet the needs of this client?
- Are there specific protocols (cultural and/or otherwise) that must be followed to ensure effective referral processes?
To do this, you need a good understanding of the services and requirements of the agency that you are providing referrals to, and of the skills and expertise of other members of your own team.
Read the case studies below and then reflect.
Penny calls asking for help because she can no longer cope. The worker spends time assessing Penny’s situation and together they decide to involve a local support service for material aid, budgeting, and rental assistance to alleviate the major presenting issues.
In some situations you may receive information that is not within your service’s brief, and looking at other options for the client may be the most appropriate action. Another example further demonstrates this.
Toni calls wanting somewhere to stay. Toni is sixteen and has just been told that she has to leave her flat and find somewhere else to live. She says she does not know anyone to stay with or anyone who can help her.
Larry takes the call. It appears obvious that Toni will benefit from the help of a youth accommodation agency and is not in need of the protective services intervention that your agency offers. Larry looks at options with Toni and refers her to a more appropriate service.
Now that you have some ideas about what may constitute a referral to another service, it is time to look at how you can achieve this.
Service providers are workers in agencies who can offer your clients a service, resource or program to meet their needs. They could be government, private or community-based agencies. They could specialise in meeting particular needs, such as drug and alcohol support services, or they could offer general support to your client, such as counsellors or foster and respite care.
When you think about identifying other service providers for your client, consider:
- existing service providers. Do your clients already have workers and agencies involved in their life?
- new service providers. What services/assistance do your clients agree they need and who can provide it?
Make sure you are fully aware of the service options available to your client. You may need to locate a resource file that lists service provider details, such as telephone numbers. You need to understand the referral protocols for various services/agencies in your area.
If you decide that your agency cannot help the client, consult them about other options they would be willing to investigate or give them a choice about alternative services.
You may need to negotiate with another service directly or on behalf of a client to make sure that the referral is agreed upon and the roles and expectations of the service provider and client are clear.
A word of caution: Service providers only need to know as much personal information about your client as will directly help them deliver their particular service. It would not be necessary, for instance, to reveal personal details about your client’s family history to the worker helping them with job training skills.
* Remember to obtain your client’s consent to discuss their needs with service providers and assure them that some information remains confidential. Most agencies have a form outlining ‘Consent to Release of Information’ which clients sign; this identifies the type of information they consent to being shared and the names of agencies with whom this information can be shared.
Finally, it is important that you are familiar with any policies or procedures that exist in your agency for exploring other options and referring to other services. If you do not know, ask your supervisor for assistance.
Make sure you are clear about your agency’s guidelines for the release of information.
Protocols, policies and procedures for client referrals
Refer the client appropriately, following organisational protocols, policies and procedures.
The urgency of referral will be determined by several factors:
- level of risk involved
- wishes of the client
- immediate nature of the demands for service (that is, response to crisis v. response to long-standing needs)
- ability of yourself and/or your agency or service to meet all or some of the client's needs
- wishes of other relevant stakeholders, e.g. family, friends and other members of the treating team.
After the initial assessment, you should have a reasonably good understanding of the above factors and you will need to make a decision relating to the need for referral. There may be no need for referral at all. This would occur, for example, when your service is able to meet all of the client’s immediate needs.
If your service is unable to meet the immediate needs of the client and, in particular, if there is a high level of risk involved (for either self-harm or harm to others), the urgency of referral will be high. You will need to make a quick decision about what to do and where to refer the client. In order to do this effectively, you will need to have a good knowledge of what emergency procedures may be required and what other services or agencies are available within the community. It is useful to keep a list of most frequently used services handy so that you can recommend the best possible care for the client.
Instigating emergency procedures if required
If there is a high level of risk for self-harm or harm to others, you may need to instigate emergency procedures, such as referral to an in-patient facility, or 24-hour community-based care and support services. In general, support workers should consult with their supervisors in relation to these critical cases, as the level of responsibility and duty of care often requires the involvement of a more senior staff member.
In some cases, such as with mental health cases, you will need to be aware of the procedures to be followed in the case of involuntary admission to an in-patient facility. This will include the legal requirements necessary for involuntary admission and detention under the Mental Health Act 2000 (Qld), which must be adhered to stringently, with accurate documentation using the required forms. Clear explanations of all procedures enacted under the Mental Health Act 2000 must be given to the client and significant others as soon as possible, including written explanations.
Other situations besides risk of harm to self or others may call for emergency procedures related to referral. These may include welfare crises, such as lack of accommodation or food, and medical crises, such as drug intoxication or withdrawal. It would be useful to have a list of all available emergency resources, their contact numbers, and concise information on the nature of their services, located in the office.
Evaluating benefits of client referrals
Apply accepted procedures to evaluate the benefit to the client of referral to another service.
In cases where you are maintaining a service to a client and have only referred them to another agency for a specific reason, then it is important for you to ensure that their needs have been met by that other service.
This can be achieved by:
- asking the client for feedback about the referral
- checking with stakeholders for their perspective on the effectiveness of the referral
- consulting with the referral agency to establish the level and quality of assistance given.
If it appears that this referral has been ineffective in meeting the client's needs, then some form of evaluation is essential to determine the reasons for this failure. It may be that the referral was inappropriate and the required assistance was outside the scope of that organisation; it could also be that the service did not provide a welcoming environment for the client and hence they felt alienated and unable to request/access the specific assistance. (This is sometimes the case for indigenous clients accessing rigid mainstream services.) It may be that the client did not attempt to access the service or approached the worker in such a fashion that they were refused service.
Finding out the specific reason can be enlightening in planning any future referrals for this client. It can also provide an ideal opportunity to provide feedback to other agencies and/or guidance to clients about what is required to access services.