How do I refer ANY patient for any social work or care management services?
- Order in Epic: “Consult to Social Work (ID9065)”
- Write out your reasons for referral
- Refer for: care coordination, transport assistance, M11Q (home health aid), insurance assistance, crisis intervention e.g. domestic violence, housing issues etc.
- Do NOT refer for: VNS consults for home RN visits, home PT/OT, home safety assessments (consult them directly), wheelchair clinic referrals (consult them directly), disability forms, prior authorizations.
- Send the patient to the front desk of his/her Firm to sign in for social work (pt does NOT have to register).
- If pt can’t stay to see SW, write phone # in the consult so SW can reach out to the pt.
- Triage Social Workers
Firm A: Elke Santos-Medina, LMSM
Firm B: Sandra Misas-Galindo
Firm C: Oscar Duran, LMSW
- Triage Care Coordinator, All Firms
- Homeless Population Specialist, All Firms
Care Coordinator/Asthma Care Coach
- TEAM BASED Care Management SW/Care Management Teams
- Firm A Blue
Lutgarda Hernandez, BA (CC)
- Firm A Red
- Firm A Brown
- Firm B Purple
Irasema Ari Mendoza, BA (CC)
- Firm B Orange
- Firm B Pink
- Firm C Yellow
- Firm C Green
- Firm C Grey
- IMA Nurse Clinical Coordinators (Care Coordination Center)
Lourdes Nunez-Ferreras (RN)
- Specialty Clinics Health Home Social Work/Care Coordinator Teams