Are you an MD, psychologist, or psychiatrist looking to set up a network of effective addiction treatment for your patients? What should you do? How can you ensure that your processes are strong? We explore here. Then, we invite your questions or comments at the end.
Referring clients as a part of your practices
Referral to treatment is a critical component of the treatment process. It involves establishing a clear method of follow-up with patients that have been identified as having a possible dependency on a substance or in need of specialized treatment. What are some key considerations? Referring clients to treatment usually involves:
- assisting a patient with accessing specialized treatment
- selecting an appropriate treatment facility
- helping navigate barriers to treatment
The manner in which a referral to treatment is provided can have tremendous impact on whether the client will actually follow through and seek services with the referred provider, or not. So, how can you streamline this process?
What to look for in a treatment center?
We sought experts to help us answer this question of process…and to help you outline steps that can work for you. Hudson Health Services Inc. is a drug and alcohol treatment organization located in Salisbury, Maryland. The center offers inpatient substance abuse treatment including detoxification, partial hospitalization, and supportive housing.
In this interview, we talk to Kennedy Hinman, Director of Development about how psychologists and therapists can start setting up a referral relationship between addiction treatment centers. We explore the benefits of this relationship and some common challenges. If you have any additional questions or want to leave a comment, please send us a message in the section at the bottom of the page. We try to respond to all questions with a personal and prompt reply!
ADDICTION BLOG: Where do psychologists and mental health professionals begin when looking for a referral partnership with an addiction treatment center? What is the first step that you suggest in the process?
HUDSON HEALTH SERVICE: The first step for any referral professional should be to call the addiction treatment program and begin to ask questions.
It is okay to admit that you are not the expert when it comes to Substance Use Disorders or navigating the admission process. It can be really complicated at times. Allow the Admissions Coordinator, or their designated representative, to explain the process to you, including:
- admission criteria
- insurances the program accepts
- an example of the patient’s daily schedule
- treatment planning
- discharge/aftercare planning
Better yet! Schedule some time with someone from the organization to allow them to come to you, and your staff, to answer any questions you may have. I know when I meet a group in person; I essentially become their personal treatment concierge for their first few referrals just to get them more comfortable with the process. It’s all about team work.
ADDICTION BLOG: Should referrals be local, or can they be out-of-state?
HUDSON HEALTH SERVICE: The determining factor is usually whether or not a program is contracted with the individual’s insurance carrier. Additionally, some individuals choose to self-pay for treatment, which eliminates the need to utilize their insurance (if they choose).
Hudson is contracted with most private commercial insurance plans, many self insured plans, and some Medicaid plans. This allows us to serve individuals in our neighboring states who are covered under many different insurance plans. However, ee accept referrals from both local and out-of-state locations.
ADDICTION BLOG: What kind of financial benefit is typical or fair in a mental health referral relationship?
HUDSON HEALTH SERVICE: We do not have any kind of financial agreement set up with any of our referral sources, and it is not our practice to accept payment, or pay out, for referrals.
I know there are some services who farm referrals, but we do not use those services. We have a very successful, organically grown referral network and believe that it keeps business more personal when referral sources can connect a name to a face. It also alleviates fear in the potential client that they can do the same.
ADDICTION BLOG: What kinds of release papers are required in order to set up a referral relationship with an addiction treatment center?
HUDSON HEALTH SERVICE: When a provider sends a referral to our program, we automatically suggest that the client sign a Release of Information for that provider. We have a standard release, and one that can be modified to include or exclude specific information about a person’s treatment episode. This allows us to communicate with the referring provider and provide them with updates about a person’s progress, their treatment plan, and coordinate their discharge.
ADDICTION BLOG: How often should treatment centers send primary physicians, psychologists, or psychiatrists client updates?
HUDSON HEALTH SERVICE: I think it is important for referring providers to be clear about their expectations for the program providing the treatment. With proper releases, we can send referring providers as much or as little information as they would like, and at whatever interval they would like.
ADDICTION BLOG: What are some of the best practices in information sharing between treatment centers and “home” medical or mental health professionals?
HUDSON HEALTH SERVICE: It is important that all parties involved in a referral to treatment for Substance Use Disorders acknowledge the importance of each other’s contribution to the care of a particular individual, and in doing so, agree that the frequency and content of communication should match the clinical need.
Medication changes, mental status changes, risk of self harm, harm to others, or a decrease in a person’s level of cooperation in a program are examples of common situations that would initiate communication between providers. We find that the more information a referring provider gives us about a client, increases the likelihood of successful outcomes.
ADDICTION BLOG: Continuity of care is a big issue when dealing with referrals. What are some examples of common mistakes that both treatment centers and mental health professionals might make? How can these be avoided?
HUDSON HEALTH SERVICE: One mistake made by referring mental health professionals is allowing the client to believe that a quick detox or a short stint in an inpatient program will take care of their Substance Use Disorder.
Addiction is not like the flu. It does not take over your life, run its course, then go away and you suddenly feel all better. Addiction is a chronic disease that is treatable, and should be part of a person’s regular conversations with their Primary Care Physicians and/or Mental Health Providers, to ensure that symptoms are recognized early on and can be addressed.
Aftercare is vital to a person’s successful recovery from a Substance Use Disorder(s) and should be encouraged by providers with whom they have frequent contact. For example, a discharge coordinator may set up Intensive Outpatient or Outpatient Treatment, mental health appointments, supportive housing, encourage 12-step involvement, and an array of other services deemed appropriate to help them in these early stages.
Sometimes, just dropping one item can have a domino effect that can lead a client right back to square one. Substance Abuse Professionals or treatment centers are not off the hook. A mistake commonly made by a facility would be not doing their own research. With resources, such as Supportive Housing, being slim, referrals could be made to programs that are not providing the care that they advertise to be. I’ve heard stories of people being discharged to Sober Housing only to find out once they get there that there’s a drug dealer living right next door.
We, too, must to do our research.
ADDICTION BLOG: What are some positive examples of aftercare and discharge planning?
HUDSON HEALTH SERVICE: Keeping within the context of this discussion, an ideal example of coordination of aftercare would be:
1. Addressing and making appropriate referrals for subsequent outpatient treatment for the client’s Substance Use Disorder
2. Coupling that with a Mental Health professional to address any co-occurring disorders
3. Placing the client in safe, affordable, supportive housing
4. And, then, coordinating with these providers to support the individual in these early stages of recovery
ADDICTION BLOG: Can patients easily adapt to the new conditions of the treatment center they are referred to?
HUDSON HEALTH SERVICE: For many people, the answer to that question is: Yes!
As intimidating as entering an inpatient program can be, once they submerge themselves into our community they find that it’s very welcoming. They find connections with other people who felt the same way upon admission.
ADDICTION BLOG: What are some suggestions that “home” based mental health and medical professionals can offer to patients looking to go to inpatient or outpatient treatment?
HUDSON HEALTH SERVICE: One suggestion referring providers can offer to their clients seeking treatment, either inpatient or outpatient is to do their own research. Take a look at the program’s website, learn about what they offer, and familiarize yourself with the area. I always think it’s a good idea for people to call us and talk with our Admissions Counselors. They are a wealth of information and can ease many of the fears that people have about entering into treatment.
Another suggestion I would make to referring professionals who are working with an individual to find treatment is to always have a Plan A, Plan B, and maybe even a Plan C. It is easy to get discouraged when looking for availability at treatment programs, especially inpatient programs sometimes beds are full. Place your client on a couple waiting lists if necessary, and follow up with the program on a regular basis.
ADDICTION BLOG: How are patients included in the process of selecting treatment they’ll be referred to? How often are their preferences different from those suggested by the treatment center?
HUDSON HEALTH SERVICE: Any person seeking treatment, whether it is at an inpatient program or on an outpatient basis, should be very involved in the process.
For admission into any program, a person will have an initial assessment by a qualified Substance Abuse Professional to determine what level of care a person needs. Once this is done, there should be several options laid out for the person that should be discussed with whomever will be involved in the referral process, including family if the person wishes them to be. From this point, the individual should begin their research process and determine availability at each of the programs.
There are times that individual preferences may differ from the suggestions of the Substance Abuse Professional. Ultimately, the client has the choice to make, and it will either be aligned with what the professional assessment suggests, or they will try another way. Sometimes this works out, sometimes it does not, and they end up having to reconvene and decide on another treatment option for the person. It’s very important to not look at these instances as failures, but rather an opportunity for learning more about themselves, the disease of addiction, and other available options.
ADDICTION BLOG: Is there anything else you would like to share with our readers?
HUDSON HEALTH SERVICE: Hudson Health Services, Inc. is a non-profit 501(c)(3) organization providing treatment and housing for individuals with SUD in Maryland. If you would like more information about our programs please call 1-888-288-9086 or email Kennedy Hinman at firstname.lastname@example.org. You can also visit us on the web at www.Hudson-Health.org.