Referral and Follow Up for Screening

While screening and counseling are important in-office interventions, often times, more community support is needed to address a need. The following resources will help you think about how to create clinic to community linkages and develop referral resources to best support the needs of the family.

• Early Intervention, IDEA Part C Services, and the Medical Home: Collaboration for Best Practice and Best Outcomes - Includes suggestions for collaboration with EI and a review of the core components of the IDEA Part C program.
• Referral Directory Templates (Word) (Excel) - Worksheet to guide practices in identifying resources available in the community to assist families.
• Road Map to Address the Social Determinants of Health Through Community Collaboration - A Pediatrics article that presents a systematic approach to identifying social needs and building partnerships to address them.
• Beyond Developmental Screening: Children Identified At-Risk - A webinar highlighting the methods used to develop and implement community-specific pathways for children identified at-risk, includes a link to a script for follow up call to family.
• Road Map to Address the Social Determinants of Health Through Community Collaboration - A Pediatrics article that presents a systematic approach to identifying social needs and building partnerships to address them.
• PRAPARE Toolkit - Provides a chapter on building capacity to address social determinants of health and developing cross-sector partnerships.
• SAMHSA-HRSA Partnership Checklist - Can be used by practices to assess potential partnership strategies.

Referral Directories:

• Behavioral Health Treatment Services Locator - Confidential and anonymous source of information on treatment facilities for mental health and substance use problems.
• gov - A free, national telephone service that helps identify health and human services.
• Child Care Resource and Referral Search - Directory of Child Care Resource and Referral agencies that can assist families with locating child care.
• Find Your Local Foodbank- Directory of foodbanks across the country.
• Homeless Shelter Directory - Directory of homeless shelters and service organizations serving the homeless.
• HUD Resource Locator - Directory of affordable housing and homeless resources.
• Information for Families - Directory of family service organizations by state for children with special healthcare needs.
• Neighborhood Navigator - Free searchable directory from the American Academy of Family Physicians that lists over 40,000 social services by zip code, including food, housing, and legal aid. Can be accessed by health care providers and families.
• State by State Resources for Families - Directory of local resources on child care, health, social services, financial assistance, and support for children with special needs.
• United Way 211 - Links to a variety of local resources and services.