Healthy Child Development State Resource Center
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Referral and Care Coordination

Developmental screening, referral for further evaluation, and ongoing interventions and services require coordination among primary care providers, specialists, early care and education providers, early intervention and special education programs, and families to ensure children and families receive appropriate services and do not fall through the cracks. Referral and care coordination require appropriate tools, such as referral forms, feedback mechanisms, and methods of communication among the providers and agencies serving children and families. Many states have developed tools and models that can guide others in developing care coordination systems. On this page, you can find examples of referral forms that are compliant with federal health (HIPAA) and education (FERPA) privacy and confidentiality requirements; feedback forms to inform primary care providers of the results of evaluations; and referral guidelines. The below map shows states that have standardized referral forms. 

States with Standardized Referral Forms


Referral Map
Legend:
Has standardized referral form (33)
No known form (18)

Policy Trends

  • 33 states (including Washington, DC) have a standardized referral process to facilitate children and families accessing follow up services after identification of need, compared to only 14 in 2016.
  • Most states have forms specific to Part C Early Intervention referrals. Forms in 7 states (Arizona, Colorado, Connecticut, Georgia, Minnesota, Oregon, and Vermont) can refer children to a variety of services, including early intervention.
  • Referrals in 7 states can now be made online (Arizona, Arkansas, Idaho, Indiana, Maine, Missouri, and Ohio)
  • 15 states (Colorado, Hawaii, Illinois, Kansas, Maryland, Minnesota, Nevada, New Mexico, North Carolina, Oregon, Texas, Vermont, Virginia, Washington, DC, and Wisconsin) have a form that enables referral feedback to be sent back to the referring provider.
  • 5 states (Colorado, Delaware, Montana, Texas, and Vermont) have forms for use by a specific type of provider, such as primary care, child care, education, or a state department of human services.
  • 4 states (Arizona, Colorado, Oregon, and Washington, DC) have a standardized form available in Spanish.
This information is based on a 2018 NASHP environmental scan. Please email Elinor Higgins with any updates.

Resource Topics

Referral Forms

Care coordination resources

Other referral resources

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