Submitting a Referral to a Contracted Network Program

 

 

 

Filling Out the Standard Referral Form

This information in this form will go to the organization supporting the program. When filling out the form:

 

• Personal seeker info will auto populate to the form when you are inside of their profile.
• Select their preferred language to translate the notification.
• Choose their contact method — This applies to both notifications and how the organization will follow up. Options include: phone, text, or email. Select “Do not reach out” if the seeker doesn’t have any of these methods available or is in an unsafe situation.
• Add a note —The comment will be visible in the seeker’s notification, as well as to the CBO provider and any navigators in your group. Since it’s shared, do not include any PII or PHI.
  
  
• Gain their consent to send the referral to the program organization.

 

Filling Out the Screener

Every field that is required will have an asterisks next to it. This screener will be attached to the referral for the contracted providers to review. Fill out:

 

• The FSFN case ID is assigned to individuals within the Florida Safe Families Network (FSFN) system.
• If this is not applicable, you will enter 999999
• The case name will refer to the seeker who is receiving the service

 

 

Use the dropdown menus to select the correct answers for: whether the seeker is a child, if they are Medicaid eligible, and if they are In Network.

 

 

From the Services dropdown, select the service you want to refer for. You’ll see the contracted price listed next to each service.

If the seeker needs more than one service from this provider, you’ll submit a separate referral for each service.

 

 

 

Enter the number of Service Units you’re requesting. 

For example, enter “1” for a one-time health screening, or enter the total number if you’re requesting multiple sessions, like counseling.

Next, choose how often the service should happen. If you’re only requesting one service unit, you can select “monthly” for the frequency.

 

 

 

• Add in how the service will achieve a task or goal. You can include content from a case plan or a known priority issue
• Choose the correct option if the service is court-ordered.

 

 

You can also mark the service as time-sensitive — but only select “Yes” if the court has specified that services must be provided within 24 to 96 hours.

 

Finally, select whether this is an Independent Living (IL) case.

You can also include any relevant notes. Then click on Review and Submit.

 

 

 

 

 

Once you finish the screener, you can start another search, return to your seeker’s profile, or end session to help the next person.