Among children and parents in medically underserved communities, there is a high incidence of chronic and acute conditions that may not have been diagnosed or appropriately treated. At the New York Children’s Health Project, one in four homeless children is in need of a referral to a specialist. But families in these communities have difficulty accessing specialty care, due to a range of social, economic, and geographic barriers. If these referrals are not completed in a timely manner, hospital-based services may become necessary. RMI is staffed by case managers who provide families with the assistance they need to access specialty care, including telephone reminders to parents, round-trip transportation to appointments as needed, help with navigating the health care sites, family-oriented health education, and enhanced communication between primary care and specialist providers.
Results from the longest running program, the New York Children’s Health Project, are very impressive. The program serves a homeless population at high risk for complex health and developmental problems. With the implementation of RMI, adherence rates increased to 65%, which is comparable to that among non-transient, higher income populations.
The Referral Management Initiative is an indispensable part of the “medical home” model implemented by The Children’s Health Fund for medically underserved and disadvantaged children. By definition, the medical home provides comprehensive services, including referral to specialty care providers – referrals, for example, to pediatric endocrinologists, cardiologists, and neurologists; to behavioral health specialists; to ophthalmologists and audiologists; to nutritionists and dentists. As part of the medical home, RMI ensures that children and families receive the assistance they need to access specialty care.
The Referral Management Initiative has been in operation since 1996 at the CHF flagship programs in New York City. RMI is operational at other programs within the CHF National Network including the Children’s Health Project of Washington DC, the Dallas Children’s Health Project, the South Florida Children’s Health Project, and the Los Angeles Children’s Health Project.
The Referral Management Initiative is a partnership between
GlaxoSmithKline and The Children's Health Fund.
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