Referral Presentation 14

Referral: definition Directing a client of HIV prevention program to other specialized services to provide access to an expanded package of services (professional medical, psychological, legal, social and personal services, etc.) in compliance with client’s needs. Presentation 14

Referral: definition (2) Referral implies providing a client with services that he cannot be obtained in HR project, but which a client needs at this time. Referral is one of the social functions (social services) of a harm reduction project, which provides a continuum of care for IDUs and providing a transition from low threshold (syringe, consulting a social worker) services to professional service (medical, psychological, legal, economic assistance, employment, re- socialization). Presentation 14

Thus, the goal of a social worker is…. to provide a "bridge" between the organization and host organization. This can be achieved only by active participation in the life of the client. Professional resource for achieving this is motivational counseling. Presentation 14

Referral is NOT an attempt of getting rid of a client!!!! Presentation 14 referral

Referral is a bridge! Presentation 14

Factors Ensuring Effective Referral 1. The contract between the organization implementing harm reduction project and strategic partners where a client is referred to. – state health services, social services, psychological services, legal services, family planning centers, employment centers, rehabilitation centers, community centers. It is crucial that the contract contains the terms – “referral” (Duty of Parties section) – “hosting and service provision to a referred client“ (Responsibilities section) – "mutual information on the results of referral" (Results reporting section) Presentation 14

Factors Ensuring Effective Referral 2. Journal describing referred clients with obligatory consideration of results monitoring. Referral details Track of changes (with respect to the place a client was referred to) Time for controlling results – Consider example on the next page. Presentation 14

Journal Example DateClien t No Client reque st Refe rred to Referral results Changes after referral Respo sible for super vision GDF1 28 Psychol ogist counsel ing State social servic es Was counsele d by psycholo gist (name) Decided to participate in rehab. programme. Control time: Social Worker (name) Presentation 14

Factors Ensuring Effective Referral 3. Referral Form/slip Can be provided by the host organization to an NGO. Can be developed by an NGO. Includes information: – Project/organization name – Client’s ID (Name, code, etc) – Reason – Name of the host organization – Name of the person who will host a client – Exact time a client should visit – Contact details of the person in host organization – Contact details of the person who is referring. – Map (optional) Presentation 14

Factors Ensuring Effective Referral 4. Responsible referral (supervision) Same people should be involved into client referral, supervision and control. At the same time, it is a good idea to have a one social worker in the organisation who will control social workers for fulfilling their referral plans. Presentation 14

Factors Ensuring Effective Referral 5. Feedback. Host organization should also have a person responsible for reporting to the organization on the results of the referred client: – whether s/he attended or not attended – what results have been achieved – what the prospects are for future cooperation with this client – etc/. We refer a client until we get constructive results from a client. This why referral must ensure continuity in the client supervision. Presentation 14

Nota Bene Following all the indicated steps prepares your organization for a more complicated service called case-management. Presentation 14

Documenting Referral in your organization (summary) Referral is more effective if your organization has Partnership agreements Referral Journal Contact details (who? when? Where to? Why? name? Time?) Referral forms Reference book is an asset Presentation 14

Supervising a client during referral Often referral is described as a process of directing a client, planning with the client and coordinating client’s access to services. The client is supervised and accompanied by a social worker or other staff member. Presentation 14

Supervising a client during referral Reminder: Client referral is an effective intervention model that provides a client with an access to services which are based at the community level, are flexible, pragmatic and attentive to issues of sexual and cultural identity. BUT it is also important to connect a client with services physically: – accompany a client to the service location – wait while the client is getting services – reflect on client’s emotions & experience with respect to the visits. In the absence of individual approach to every client we can talk only about doing formal job. Fact of providing a referral card cannot be seen as a referral. Presentation 14

Referral = direction + supervision Using this approach, the counselor is recommended to: identify client’s needs with respect to methods of treatment and institutions; know geographic location of service provider; introduce services to a client; monitor progress in the treatment of the clients; evaluate the services provided by external services to clients. Presentation 14

Effective first and secondary client referral includes the following: 1. Clear and open communication between the professionals involved: between the harm reduction project and a strategic partner. 2. Clarity of responsibilities and their measures of each expert involved (should be clear for three parties: organization, host organization, client). 3. Information on other professionals involved and the nature of their participation in a particular case. 4. Agreement between a client and an organization is better to have in a written form. (optional for referral). Presentation 14

Tracking change as a part of referral monitoring Tracking change of the referral results is important for both a client (change assessment), and a project (evaluation of the project efficacy). This information is important as it can provide useful information – about the effectiveness of referral – efficacy of post-referral activities (treatment, counseling, further prospective; Presentation 14

During monitoring consider the following: Monitor 3-4 times: – Immediately upon referral – In one week – In 1 or 3 months after referral All information collected during monitoring is recorded into the "Referral Monitoring Journal" (Annex to the "Referral Journal"). Presentation 14

During monitoring consider the following: For monitoring purposes it is better to use direct eye – contact, although phone can also be used. Rarely written communication can be used. It is always a good idea to inform a client about the monitoring procedure before referral, so that the client has a choice. Time for monitoring is scheduled before the client leaves the program (organization). Monitoring should be carried out regardless of whether the client used the services or not. Presentation 14

During monitoring consider the following: During monitoring a client can be offered additional help or services as this procedure is quite flexible. The main rule to remember is that a clint should not feel isolated or have a feeling that you tried to get rid of him/her. Help, supervision, monitoring and feedback are the main components of effective referral system. Presentation 14