Strengthening referrals in WIC

1. Strengthening referrals in WIC

2. Thinking about participants you spoke to in the last week, what was the most important referral you made? What made that referral important?

3. How to take a good referral and make it great!

4. How do referrals improve health outcomes for the families we serve? What factors influence whether a participant takes advantage of the referral offered? Discussion

5. Use your participant centered skills Identify and prioritize needs Provide specific referral information Help address barriers Follow up at the next visit Steps to offering a great referral

6. Ask permission to offer • May be helpful when discussing sensitive referrals. Consider: • Cultural beliefs - as these may greatly influence how a participant views asking for help • Feelings - since asking for help may be difficult for some participants. They may have feelings of shame, fear, powerlessness, or distrust Use participant centered skills

7. A thorough assessment will help identify potential referrals. Work with the participant to prioritize which referrals are most important to them. A participant may not prioritize her/his needs the same way you would. You can make suggestions and provide guidance and the participant will make the final decision. Identify and prioritize needs

8. Let the participant know how the agency can help. When possible, provide a contact name, address or map, phone number and the best time to call. Let the participant know what paperwork to take to the referral organization. Provide a specific referral

9. Ask the participant how they plan to use the referral. Actively listen for any barriers that might prevent them from using the referral. Help the participant figure out how they can address barriers. You do not have to have the answers. Guide the participant so that they find the solutions that work best for them. Help address Barriers

10. At the next visit, check in with the participant about the referrals. Ask a question such as “How did the referral for _____ go for you?” • If the participant accessed the referral agency, affirm their efforts. • If the participant did not follow up on the referral, explore if the need still exists and if any additional assistance is needed. Follow up

11. Referrals can be offered from any WIC staff. Clerical staff – May make referrals to OHP, SNAP/food stamps, TANF and/or immunizations when enrolling participants. Certifier’s- May make unique referrals based on the need(s) that arise during the visit. Everyone has a role

12. How can TWIST help?

13. Referral categories make it easy to find resources that fit the participant’s needs. TWIST can help find a resource

14. Email and website now available New fields have been added

15. Discussion questions What referral resources do we need in TWIST?

16. Enrollment button or Certification tab Anyone can make and document referrals Documenting your referrals

17. One referral record • Referrals will automatically show in both places, regardless of where they are documented.

18. Click “More Info” and then click “Print” on the popup to generate a written referral that can be given to the participant. Producing written referrals from TWIST

19. Which referrals are required?

20. Alcohol or Drug Use Immunizations Oregon Health Plan (Medicaid) Three required referrals

21. Use the normal assessment process to screen for alcohol, tobacco, or drug use • If a positive response for alcohol or drug use, • Refer to treatment and provide a written referral • Provide written information on the dangers of alcohol and drug use • Refer to Policy 880 for more information 1. Alcohol or Drug Use Referrals

22. Locally produced listing of treatment options TWIST produced referral Options for providing a written referral

23. Locally produced material What You Eat Makes a Difference (57-701) Noodle Soup pamphlet ordered from the state Options for providing information

24. 2. Immunization Referrals • Screen ages 3 to 24 months • If immunizations are due, or if unable to review immunization record, must refer to health care provider • Optional to print referral letter from the TWIST Immunization Status button • See Policy 481 for more information

25. Shows date of info Missing shots Can print for PMD TWIST lesson Ch. 3, 404 Referral Letter

26. Every participant must be referred to Oregon Health Plan at every certification if they are not currently enrolled. A written referral must be provided 3. Oregon Health Plan Referrals

27. Locally produced materials TWIST produced referral Safenet card Options for written referrals to OHP

28. Case Studies

29. Kim applies for WIC for her 18 month old daughter, Sara. While completing the enrollment screens at check in, you find out that she recently left her husband and is temporarily staying with a friend. She works part time and thinks she might be eligible for food stamps. She has no immunization record and no primary doctor for Sara. When you click on the Immunization Status button, it says that since she is new, there is no information about her in TWIST yet. What referrals would you make? How would you make the referrals meaningful? Case Study: Kim and Sara

30. Lauren is a 6 weeks postpartum woman bringing in her new baby, Elizabeth. During counseling she breaks into tears when you ask about alcohol use. You find out that since her husband was deployed overseas she has been really sad and has been drinking a lot to help her sleep. She wants to keep breastfeeding but is sure that the alcohol is bad for the baby. She is on OHP and has a OB-GYN. What referrals would you make? How would you make the referrals meaningful? Case Study: Lauren and Elizabeth

31. Thank You