Smart Referral Network (SRN)

 

 

If you are a community member in Monterey County and are looking for programs and services, please visit 211montereycounty.org.

 

 

Access services, track, and report on referral outcomes

83 participating agencies have signed agreements representing 162 programs and 704 users.

 

The SRN allows users to make “closed loop” referrals. Case Managers, other front line workers, and residents in need of services use the program to identify needed services and enroll in them.

 

83

Participating Agencies

162

Smart Referral Network programs

30%

Enrollment Rate

17,047

Referrals Made

 

Features

 

 

Couple applying for services

Applications

For disaster relief, utility bill and rent assistance, MediCal programs

 

Girl in support group

Target Population Specific

Mental Health and Substance Use Disorders, Community Schools, People Experiencing Homelessness

 

Smart Referral Client Level Reports

Reports

Partners run reports on the Social Determinants of Health outcomes of services, referrals made and received, and referrals that result in services. 

 

woman chatting with chatbot on her phone

Chatbot Self-Referral Tool

United Way Monterey County has developed a chatbot that allows individuals to connect with more than 50 local agencies and hundreds of services.

Try the Chatbot!

 

 

Available Live Training and Technical Assistance:

Referral Workflow, Care Management, Data Collection, Integration, Analysis and Consent:

workflow icon

Design referral and care management workflows that support receiving, analyzing, and sharing client information while reducing administrative burden and errors.

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Provide consultation on sending referrals to community benefit organizations for client enrollment in services.

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Offer strategic support for data collection, exchange, management, and utilization. Support reporting of bi-directional closed-loop referral information and social determinants of health (SDOH) analytics to improve client level outcomes and population health management.

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Support better connections for clients to access care, improving health outcomes, and care coordination effectiveness between cross functional community benefit organizations.

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Support the development of cross database data integration tools and systems

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Support with the collection of client consent and compliance with consent policies

Training Learning Objectives:

  • Gain knowledge in creating actionable workflow plans to make, receive, follow up and respond to referrals.
  • Learn how to determine service needs for clients from local programs for which they are eligible, obtain client consent, and submit electronic referrals.
  • Learn how to utilize chat bot self-enrollment tool that supports clients themselves to identify services and self-refer.
  • Understand how to collaborate more effectively with local community benefit organizations on care plans.
  • Learn how to document client interactions and manage cases and case files through the SRN.
  • Understand how to document client referral and SDOH outcomes, analyze data, and leverage it to access clients to services and improve client SDOH outcomes.

 

 

Participating Agencies

Making A Difference Together

Chris Torre’s story reflects the power of collective impact and how a community working together can make a difference in a family’s life. Mr. Torre, a single father with three children, found himself homeless after a series of unfortunate events. As is often the case, homelessness was not the only problem. The family also experienced unemployment, lack of child care, and food and transportation barriers.

Chris Torre family

Several agencies within the Active Referral Network (ARN), a collaborative administered and managed by UWMC, helped the Torre family get back on their feet. As a first step, Mr. Torre was referred to a Prosperity Planner with Goodwill Central Coast, who helped him find shelter and employment. Meanwhile, Castro Plaza Family Resource Center worked with the North Monterey County Unified School District to arrange child care and access to transportation. The Housing Resource Center helped the family move to a new home and provided them with beds and furniture. Additionally, the children were given new school supplies from UWMC’s Stuff the Bus program.

“Along the way I have met some of the most humble people, who always went above and beyond their job descriptions. United Way Monterey County and Castroville Family Resource Center treated me and my kids like family. Thank you for all you guys do. I’ll forever be grateful” —Chris Torre

The Torre family is now in a permanent home and the children are attending school and thriving. They are grateful for the support provided by United Way and its partners and recognize the value of having a robust community network to rely on to ensure that they remain on their path to financial stability.

 

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bring whole person care to life in your community.

 

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Central California Alliance for Health logo

"The results of our collaborative efforts mean we have increased capacity within workflows to navigate referrals and coordinate care as well as to document, use, and share SDOH outcomes. Provider teams are better able to make care decisions for individuals, and our community leaders are better able to design broader population health strategies using aggregate data. Individuals in our community with the most significant complexities are benefiting from this partnership."

Stephanie Sonnenshine
Chief Executive Officer
Central California Alliance for Health