Continuity and Coordination of Care (including communicating with referring professionals, making referrals, and coordinating treatment with primary health or psychiatric providers)
Communicating with Referring Professionals
a. Communications with referring professionals are managed within the rules of confidentiality and professional courtesy. The basic rule is that no contact will be made without the written informed consent of the client and then only within the parameters of that consent [Release of Information Consent Form].
b. The consent authorization allows the therapist to do the following:
· to write or call the referring professionals to thank them for referrals and to inform them that the clients they referred made an appointment and came for the first session;
· to contact the referring person to request further information, accompanied by the client’s signed release; and
· to respond to the referring professional’s request for information about the client, again with the client’s signed release.
c. The therapist documents any of the contacts noted above in the clinical record.
d. Contacts with referring professionals help to build good relations with community persons whose goodwill and trust the Center depends on for its reputation as a quality program and for referrals.
Making Referrals
See Samaritan Center Resource Library section II. Clinical Services, E. Appendices, 7. Appendix G. in addition to the Policy and Procedure statements below.
1. Referral to another Agency or professional
The following classes of clients need to be referred outside the Center:
Persons assessed to be in need of psychiatric or psychological evaluation and/or treatment who refuse to avail themselves of such recommended treatment.
Persons who put themselves in jeopardy by refusing to follow treatment recommendations. In such cases it is imperative that the therapist compose a written agreement which both client and therapist sign agreeing on compliance. If the client continues to be non-compliant termination is appropriate. In termination it is required that at least two possible referrals for treatment be made and documentation of such action be included in the record.
Persons related to a Center staff person or in some other relationship (besides therapy) with a Center therapist, including Center Board members and their immediate families.
Persons assessed to be a current danger to self or others, or who are actively psychotic.
When the intake therapist is uncertain about the presence of potentially dangerous acting out, psychosis, or current drug abuse, the judgment about admitting the person as a client to the Center shall be reserved until after an evaluation by an appropriate expert.
2. Referral for Psychiatric Consultation / Hospitalization
Therapists are to make appropriate referrals. Psychiatric consultation may be necessary for obtaining insurance coverage or for evaluation for medication. The consulting psychiatrist shall attend staffing conferences on a monthly basis to be available for consultation.
In case hospitalization is required for a client of the Center, the therapist should assist the client in connecting with the hospital psychiatric inpatient program, and seek a release of information signed by the client so that the therapist receives records of the clients treatment while hospitalized.
3. Suicidal Clients
Clients who are assessed to be in a major depression or in danger of self-destructive or suicidal behavior must be referred for a psychiatric/medication evaluation. Continuation in treatment will depend on the recommendation of the psychiatrist and the client’s willingness to cooperate in using medication, psychiatric monitoring, hospitalization or other additional treatment as recommended by the psychiatrist and therapist.
4. Emergency Procedures
When an emergency call is received from a current client of a Center therapist, he or she is responsible for responding. If the primary therapist is unavailable for taking an emergency call, the first available therapist will manage the emergency.
If an emergency call is received from someone who is not a client of the Center, he or she will be referred to the community mental health center for emergency services, and efforts to assist them in making that contact will be offered. Should an emergency call be received when the Center is closed, the 24-hour answering message refers clients in crisis to the nearest emergency room and/or provides the name and telephone number for an emergency mental health center, and provides information on how to contact the on-call therapist.
In the event of a psychiatric emergency at the Center, the consulting psychiatrist and 911 will be contacted.
Coordinating Treatment with Primary Health or Psychiatric Providers
Policy: The Center seeks to coordinate treatment with clients’ primary care healthcare provider and/or psychiatric healthcare provider.
Procedure: At intake the Center requests that each client respond to a request for a mutual exchange of information with their primary healthcare and/or psychiatric care provider, and clarifies the extent of the information authorized to be shared . If the client declines to authorize this exchange of information it is indicated in the clinical record.
See samples below:
The Samaritan Counseling Center of the Fox Valley
Consent for Physician’s Consultation
Client Name: ______Date of Birth ______
Client: We are requesting the name of your primary care physician, i.e., your family doctor, internist, obstetrician-gynecologist, or pediatrician, the person whom you go to for your primary medical care. We are asking your permission to consult with this physician if necessary in the course of your treatment at Fox Valley Pastoral Counseling. With your permission, we will provide a summary of your treatment when your treatment is completed.
Physician Name: ______Clinic Name: ______
Clinic Address: ______
______
Client (or guardian) signature Date
______
Therapist Date
Physician: You have been identified as this client’s physician. We want to inform you that your patient was seen for outpatient psychotherapy at our clinic and has authorized us to consult with you as necessary regarding their treatment. .
Please let us know the most appropriate way(s) to consult with you.
1. _____ We have no record of having provided recent medical care to the client.
2. I would recommend . . .
_____ Consultation by phone as requested by the client or thought necessary by the therapist, or
_____ Consultation in the following way (i.e. e-mail address)______
3. _____ The client has a medical history of a nature that should be considered in treatment planning,
here described briefly: ______
4. _____ I would like the client to schedule an office visit with me.
5. _____ I would like to receive a discharge summary when treatment is completed..
______
I. Physician’s signature Date
A.Please Return to
1478 Kenwood Drive suite 1 – Menasha, WI 54952
(920) 886-9319
(920) 886-9357 Fax
COUNSELING & MEDIATION CENTER CONSENT TO TREATMENT/EVALUATION
With your mental health professional you will be planning your treatment/evaluation for ways to address the concerns that bring you to the Center. You may be asked to sign initial and periodic treatment plans. In making these treatment plans individual, family, or group therapy will be used to assist you in achieving your goals. You will be seeing Kim Kadel, MS, LCMFT.
Evaluation and therapy can be emotionally challenging and may temporarily increase some symptoms as problems are addressed. Certain mental conditions may have medical or biological origins or contributions. The clinical staff of the Counseling & Mediation Center do not practice medicine, surgery, or prescribe medication. Kim Kadel will consult with your primary care physician unless you decline. In order for such consultation to occur, your informed consent to release information is needed. Please check one of the boxes & complete the following paragraph to provide such consent:
r I, hereby authorize the Counseling & Mediation Center to
disclose to my physician: ,
(client's physician)
located at: , (address & phone)
my treatment records. The purpose or need for such disclosure is treatment consultation. This consent may be revoked by me in writing at any time except to the extent that action has been taken in reliance thereon. If not revoked, this consent expires on case closing.
Or:
r I do not give my consent for such consultation.
You may expect your treatment/evaluation information will be kept confidential and will not be released without your written consent. There are some exceptions however. If you choose to use insurance benefits, we will need your consent to release such information that they need to process your claim. In addition, by law you cannot expect confidentiality in situations involving intent to harm self or others, suspected child abuse, court subpoenas, or when the treatment/evaluation is court ordered.
I have read the above information regarding clinical services and hereby consent to treatment and/or evaluation.
(signature of client/parent) (date)