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4.27 ICF – Referral For Specialized Services
Individuals served may require an evaluation or service from professional service providers. A referral process is necessary to provide efficient and timely delivery of such services. The services requiring a referral may include Occupational Therapy, Physical Therapy, Speech Therapy, Psychological, nutritional, legal representation, self-help, self-advocacy, and other support groups. In the ICF setting, the facility is responsible for paying for any specialized services that aren’t covered by the individuals’ insurance provider.
The following steps must be taken:
- An Interdisciplinary/person-centered team should discuss the need for evaluation.
- A referral form should be sent to the specialized service provider for evaluation.
- A copy of the completed evaluation or ongoing formal service plan will then be forwarded to the QIDP.
- The QIDP is responsible for ensuring coordination with the PCP team and coordinating further supports/equipment needs or addendums as recommended for the individual.
- All team members should be notified of the recommendations and further support needs and these changes should be reflected in the individuals’ PCP.

Last Revised: 4/29/22