The Referral Tool can be
accessed at: www.hinwd.org
A recording of the training on using the Referral Tool can be found at https://drive.google.com/file/d/14ovNNwsLzAzrcZFIPKcdrbH42QWW5q8g/view?usp=sharing
The Referral Tool contains fields that capture all necessary information an agency should share as part of a referral. It is not necessary to complete all the fields. Note that the mandatory items are identified with a red asterisk (*). The agency making the referral should provide enough information to allow the agency receiving the referral to understand how and why they should be contacting the individual.
Skip patterns are imbedded within the automated tool.
Additional items may appear based upon responses and Doors selected throughout
the tool.
The initial Referral Tool page will provide multiple tabs to
select, for example General Information or Participant Information. Click on
the tab to begin entering data.
To allow the tool to be used to make multiple referrals for
the same individual, the Referral Section is broken into two major components:
1) Common information to be
shared with all Doors receiving the referral and 2) Supplemental information to be shared with a specific Door
receiving a referral.
Completing the Referral Section- Common Information
The initial portion of this section collects information
that provides an overview of the individual and identifies potential next
steps.
Referral Request Date: The first item documents the
date that the referral form is being completed. The current date the Referral
Tool is being accessed will be automatically highlighted when the calendar icon
(📅) next to the date field is
selected. The date can be selected from this calendar field or entered directly
as text (mm/dd/yyyy).
Reason the participant is seeking support or information:
The second item collects the reason why the individual is contacting the
agency. The major purpose of this field is to ensure that other agencies are
aware of why the individual first reached out and this does not get lost as the
individual is handed off to another agency(ies).
Responses to this item should be brief and convey the
primary reason. For example, “The
caller’s spouse recently suffered a stroke and needs support after leaving the
hospital.” Because later fields collect
information on the types of programs or actions that might benefit the
individual, it is not necessary to enter this information here unless the
individual explicitly identified this.
Identify the relationship between the caller and
participant and other information helpful to the Door(s): The third item
collects information about the caller and other important information for the
agency receiving the referral. If the caller is the individual who will receive
services, enter “self-referral”. If the caller is not the individual who will
receive services, collect information including the relationship to the
individual, contact information, and whether the caller is a guardian or legal
representative.
Is the individual, parent/guardian aware that the
referral is being made: The final items in this section are mandatory
(marked with an *) and document
whether 1) the individual who will potentially be receiving services and 2) the
individual’s parent/guardian is aware that a referral to another NWD agency is
being made. This will allow the agency receiving the referral to better
understand how they should be approaching the contact with the individual and
their parent/guardian. If the individual and/or parent/guardian is not aware
that a referral is being made or it is unclear whether they know about the
referral, staff should follow agency protocol and/or consult with a supervisor
to determine if the referral should be made.
Participant Information
Items 1-15 contain basic demographic information. These
items can be completed from the individual’s record if one is available.
This section primarily collects basic demographic
information. Guidance about specific items can be found below:
- Item 2 Date of Birth and Item 3 Age- Select the age from the calendar icon (📅) or enter (mm/dd/yyyy) and the age in Item 3 will automatically be calculated.
- Item 4- If the individual is homeless, indicate whether or not he/she has an address where information can be mailed.
- Item 9- To facilitate a person-centered process, document what gender the individual identifies as.
- Item 10- Select the participant's primary language from the drop down menu provided
- Item 11- Select the participant's ethnicity from the drop down menu provided. Check all that apply.
- Items 12-15- If "yes" the individual has a guardian, representative, or other person who assists in decision making, use items 12-15 to document the name, contact information, and relationship of this person. If "no" the individual does not have a guardian, representative, or other person providing assistance, mark “N/A” in item 12 and skip to item 16.
Insurance Information and Support Needed
Item 17- Provides
a high-level summary of the potential areas in which the individual may require
support based upon what the individual has already shared. This is not intended
to be a comprehensive summary of all needs and support areas and there is no need to ask the individual
about all the areas; the agency receiving the referral will be
performing its assessment with the individual.
Item 18- This is
a mandatory item that captures whether the participant experiences
blindness or visual impairment. This item will be used to separate referrals to
DVR into their services for the blind section or the vocational rehabilitation
section.
Item 19- This is an open text field to describe
any additional information related to the individual’s support needs, including
information about his/her disability, diagnosis(es), and accommodations that
the agency receiving the referral should be aware of.
Referrals Made During this Contact
Item 20- This is mandatory
(*) and documents all NWD agencies
that have been determined to be appropriate for the individual to be referred
to. Using the drop down tab, select all the NWD agencies that should receive
this referral. This item will also guide the supplemental items that appear for
each selected Door.
Item 21 & 21a-
These items are used to document whether the individual has been referred to
agencies outside of the NWD Network, such as service and equipment providers,
non-NWD State agencies, and other community resources. Note that the referral
tool is ONLY intended to provide
referrals within the NWD Network. Agencies outside of the Network may be
documented in Item 21a, but will not receive an automated referral. Doors
should use the current mechanisms for providing referrals to non-NWD agencies.
The staff completing the referral form should enter his/her
information using items 22-26. All of these items with the exception of item 25
are mandatory (*).
Item 26- This
email address will be used by the system to notify staff at the Door providing
the referral when the receiving Door has acted upon the referral. Your agency
should determine whether the staff person providing the referral or the Door
Referral Contact should be provided in item 26.
Completing the Referral Section- Supplemental Information
Agencies selected in Item 20 may want additional information
provided when a referral is made to their agency. This section will be used to
complete supplemental information for each agency identified within item 20.
Note that information only needs to be provided for Doors to which referrals
are being made.
Each Door-specific supplement contains two primary
components 1) the broad referral criteria for each Door, provided in bold
and/or italic text and 2)
Door-specific Information that the receiving agency will need.
There are also two common final items on each page, “Reason
for the referral to (agency name)” and “Provide any additional information for
the agency receiving the referral”. The first item should be used to document
why the individual is being referred to the agency and whether he/she has
requested to access any specific programs or services. For example, a referral
to EAD may read, “Mr. Aloha may benefit from a support plan for meeting his
LTSS needs and would be interested in Kupuna Care or Title III services. Very poor eating habits and tending to want
to be isolated are also concerns.”
The second item should be used to document information that
is relevant for the assessor or case manager at the agency receiving the
referral to be aware of. For example,
“Mr. Aloha has a communicable disease and precautions should be taken” or “Mr.
Aloha has a pet dog that has been known to bite visitors”.
Submitting the Referral Section
After completing all of the common and supplemental
information, to generate referrals to the Doors identified in item 20, click
the “Save” button located either at the upper left corner of the screen, or below
the tab titled “Agency Staff Who Initiated the Referral(s)”
Note that once you have clicked the “Save” button you will not be able to go back and change your answers.
Feedback Loop Section
The Feedback Loop Section is comprised of several steps that
will allow the agency(ies) receiving the referral to receive notification of,
view, and act upon the referral. Once the referral has been acted upon, the
system will generate a notification that the referral has been acted upon to
the agency who provided the referral, thereby closing the loop in the referral
process.
Delegating and Opening the Feedback Loop
When a referral to a Door has been generated, each Door has
a primary Door contact, the DRC, who will receive email notifications. Doors
should assign a staff to monitor these notification emails, triage the referral
and delegate the referral to the appropriate staff. We recommend that multiple staff
be trained on the Tool and how to monitor the email as backup, however each
Door should assign one staff to lead
the monitoring effort.
Note: To update
or obtain the login information for your Door-specific email address, please
message andrew@hcbs.info and Christopher.Tu@doh.hawaii.gov.
When a Door receives a referral, staff will receive the
following email notification:
To view the referral, click on the linked referral ID field
within the email. This will redirect your browser to the Referral Tool login
page.
Logging-in to the Referral System
If you have a DOH login: DRCs who have a DOH login
may use their DOH username and password.
If you do NOT have a DOH login: Because the Referral
Tool is hosted on a HIPAA-compliant platform, DRCs who do not have a DOH
username and password will need to sign-up for multifactor authentication
(MFA). MFA requires the user to sign-up for access to the system and provide a
phone number that can receive SMS text messages. If you are your agency’s DRC
you should receive an invitation to access the site to your email. Follow the
login prompts to sign up for MFA. If you have trouble with this process contact
andrew@hcbs.info and Christopher.Tu@doh.hawaii.gov..
To complete the non-DOH sign-in after signing up for MFA, enter your email address and click the “Next” button.
The system will text you a code to enter to verify that it
is you. This is required for the platform to be HIPAA-compliant.
If you have trouble accessing text messages on your phone,
you may also receive a call with a code by clicking “Sign in another way”.
Accessing the Referral
After logging-in to the system, the referral that you
received the email about will automatically show.
Accessing the Referral Dashboard
To access the Dashboard, click on “Referral Requests” in the
left menu.
The Dashboard view that appears has the following columns:
- ID- General, system generated ID
- Referral Request ID- The individualized ID based on the date and time referral was generated
- Title/View- Contains a button labeled “View” to view the specific referral
- Referred Agencies- Agencies to whom the referral was sent
- Agencies: Responded- Agencies who received the referral and have acted upon it
- Agencies: No Response- Agencies who received the referral and have not acted upon it
- Staff Agency Lookup- Agency who generated the referral
- Staff Information- Name and contact information of the staff who created the referral can be found within these columns
To access a specific
referral, click “View” in the “Title” column.
Completing the Feedback Loop
Triaging the Referral
After logging into the referral, the DRC should review the
referral and, if necessary, triage it to other staff. To generate a PDF of the referral to share with other staff, click the “Print”
print button at the top of the page.
This will bring up a screen
that allows the user to export the referral to a PDF, Excel, or Word file or
print or email the file based on the icon that is selected in the top right
corner.
Agencies should then use
their current intake processes to act upon the referral.
Acting on the Referral
To do this, scroll to the bottom of the referral page until
“+ New entry” appears. Click on this button.
Clicking “New entry” brings up a page to provide brief
information about the referral that is being addressed. Complete the following
fields:
Title- Enter your name and a brief summary title, for example “Aloha Bob triaged referral to intake”
Staff Agency Lookup- Click on the dropdown menu and select your agency
Comment- Provide a brief summary of the actions taken on the referral. If the referral has simply been picked up and no further action has occurred, you could enter “Referral picked up and staff will be reaching out to individual within the next 48 hours”. If the participant has been contacted, provide a brief summary of the contact and next steps
After entering this information click “Save” in the top left
or bottom right corner to save the information. If you wish to disregard the
information, click “Cancel” in the top left or bottom right corner.
The entry will then be saved in the list at the bottom of the
referral. Each row indicates an entry by a distinct Door who received the
referral.
Notification of Completion
Selecting “Referral Picked Up” will generate an email to the
Door that provided the referral to inform them that the agency that received
the referral has completed its work with the individual. The extent of support
the agency was able to provide is documented in the “Response from the Agency
Receiving Referral” section. If an individual is referred to multiple Doors,
the Door that provided the referral will receive notification when each Door
completes the Feedback Loop Section.
As mentioned earlier, this message will be sent to the staff
email provided in item 25. Your agency should determine whose email address
should be provided in item 25: the staff person leading the referral or the
Door Referral Contact.
