Referral Procedure

Section 2060.380  Referral Procedure a)         The organization shall have policies and procedures to ensure that each client/patient/resident is informed of SUD services provided by other appropriately licensed organizations and that options are available to access services or levels of care that are not available within the organization.  These procedures shall contain the following: 1)         A release of information form that documents the written, dated signature of the client/patient/resident for communication, referral, transfer, or re-release of any relevant portion of the record, including consent or non-consent for the release of confidential medical information, if applicable; the reason for referral; a summary of services received to date; additional services needed or requested; and any necessary continued coordination of services; 2)         A process to inform about and assist clients/patients/residents with access to reasonable community resources, vocational rehabilitation, education, and employment services, if requested or identified as an assessed need; 3)         The method by which a client/patient/resident may request a referral to the DHS/SUPR Helpline (1-833-2-FIND-HELP); and 4)         A process to ensure that all clients/patients/residents are offered an evaluation by a qualified prescriber regarding MAR, including a determination if it is medically necessary. b)         All referrals made for SUD intervention or treatment services, as defined in this Part, shall only be made to organizations licensed under this Part, to those individuals or organizations that are specifically exempted from licensure as specified in Section 15-5 of the Act or to similarly licensed and regulated organizations in other states. c)         Organizations shall also establish policies and procedures to ensure compliance with the Health Care Worker Self-Referral Act [225 ILCS 47] which prohibits entering into an arrangement under which a patient seeking mental health or SUD treatment is referred to a mental health or SUD organization in exchange for a fee, a percentage of the organization's revenues that are related to the patient, or any other remuneration that takes into account the volume or value of the referrals.