Janna Shoe, LBSW CIRS United Way of Greater Houston 2-1-1 Texas/United Way HELPLNE

1. Janna Shoe, LBSW CIRS United Way of Greater Houston 2-1-1 Texas/United Way HELPLNE TAIRS Conference October 22, 2013

2. Workshop Objectives Understand how AIRS Standards and Quality Indicators for Professional Information & Referral. (Version 7.0, Revised March 2013) serve as important foundation for I&R services. Learn about Quality Indicators for I&R.

3. Basic Principles of I&R Also known as the I&R Bill of Rights: Maintains accurate, comprehensive, unbiased information about the health and human services available in their community. Provides confidential and/or anonymous access to information. Provides assessment and assistance based on the inquirer’s need(s).

4. Basic Principles cont. Provides barrier-free access to information. Recognizes the inquirer’s right to self-determination. Provides an appropriate level of support in obtaining services. Ensures that inquirers are empowered to the extent possible. Ensures that inquirers have the opportunity to access the most appropriate I&R service available in the system.

5. Purpose of AIRS Standards Establish reference points that define expected practices within the field and guidelines that communities can use when they develop an I&R program to meet the needs of their people. The Standards are the foundation for AIRS Accreditation and provide organizational context for professional certification: CIRS, CIRS-A, or CRS

6. I&R Services Nearly every health and human services organization performs some I&R. Whenever a client is referred to another service, that’s I&R. And these “non-I&R” organizations generally use I&R products such as directories and websites to get their information on what programs are available in the community.

7. I&R System There are often different types of I&R services within a particular area (for example, a large regional service and a smaller neighborhood service, or a comprehensive service serving everyone and a specialized service providing extra support to a particular group or a number of agencies that between them serve an entire state or province). I&R Service • 2-1-1 • ADRCs • Area Agencies on Aging • Child care R&R • City, county and state • Crisis Services • For-profits • Libraries • Military, Family Services • Voluntary Action Centers • United Ways

8. Role of I&R Assessment Information giving Referral giving Advocacy Crisis Intervention Follow up Resource Database Data Collection, Analysis, Reporting Cooperative Program Development Community Outreach Emergency Preparedness & Disaster Response

9. AIRS Standards and Quality Indicators Six areas of the standards: Standard I: Service Delivery Standard II: Resource Database Standard III: Reports and Measures Standard IV: Cooperative Relationships Standard V: Disaster Preparedness Standard VI: Organizational Effectiveness

10. I&R Matching Exercise Example listed on card- Match with the appropriate AIRS Standard

11. I.Service Delivery Standard 1: Assessment and Referral Provision • I&R service conducts an assessment in which the inquirer has one-to-one interaction with an I&R specialist. • Quality Indicators: I&R service ensures thorough training and supervision has been completed for I&R specialists. • Examples: Identify themselves/agency, establish rapport, professional, appropriate tone, explore resources; obtain demographics, encourage call back.

12. l. Service Delivery • Barrier Free Access • Applicable Technology • Staffing structure • Coordination for 24hr service • High quality experience • Core Telephone Service • No Cost • Privacy/Confidentiality • Release of Information • Assess Caller Risk • Permission • Challenging Inquirers • Complaint Process

13. l. Service Delivery Standard 2: Information Provision The I&R service provides information to an inquirer in response to a direct request for such information. Response can range from limited information to a detailed description of community service systems. Quality indicators: description of intake; agency policies/procedures; active listening skills, accurate information, encourages re-contact, recording nature of call; met or unmet needs.

14. Discussion Question What are some examples of telecommunications or applicable technology I&R uses for service delivery?

15. l. Service Delivery Standard 3: Methods of Access to Community Resource Information • I&R provides community resource information in variety of ways. Quality indicators: access by telephone; Email, IM, text/SMS, etc, makes all or part of database available online at no cost; compile and distribute directory (print or electronic); menu-driven recorded voice info; community kiosks.

16. l. Service Delivery Standard 4: Inquirer Advocacy I&R service offers advocacy, when necessary, to ensure people receive benefits and services for which they are eligible. Quality Indicators: Advocacy policy; intervention when needed; additional calls on inquirer’s behalf; referral to advocacy organizations; records advocacy efforts.

17. l. Service Delivery Standard 5: Crisis Intervention I&R service is prepared to assess and meet immediate, short-term needs of inquirers experiencing crisis. Quality Indicators: Written crisis intervention polices/procedures; protocols for specific types of emergencies; lethality risk assessment tool; pre-arranged agreement with formal crisis intervention service; training for skills; reporting mandates;

18. l. Service Delivery Process for endangerment situations; rescue services including 911; connection to formal crisis intervention services; records crisis intervention provided. Intervention skills: De-escalate and stabilize individual; help remain calm. Help inquirer talk about and work through feelings as part of the assessment and problem-solving stages. Keep inquirer on the telephone pending referral or rescue.

19. I. Service Delivery Standard 6: Follow - Up I&R service has a policy that addresses conditions under which follow-up must be conducted. Quality indicators: Conducted with permission of inquirer; conditions for follow-up: Vulnerable households without A/C in summer or heat in winter Older adults having trouble expressing needs Families with young children needing food Individuals with disabilities who’ve received eviction order People with no health insurance who need health care Individuals needing emergency shelter or detox services

20. I. Service Delivery Follow-up consists of successful contact; finds out if need was met or unmet; generally done 1-3 days after original inquiry of endangerment situations and 7-14 days in other situations. I&R service determines if need has been met or additional referrals are needed. I&R service documents the follow-up results for use in reports. Information gathered during follow-up relating to incorrect information in resource database is submitted to resource specialist for verification or correction. Follow-up process evaluates effectiveness of existing community service providers/or identifies gaps in community services.

21. II. Resource Database Standard requires I&R service develop, maintain, use and disseminate an accurate, up-to-date resource database. Standard 7: Inclusion/Exclusion Criteria Quality Indicators: Uniform criteria published for staff and public; written policy describes inclusion/exclusion criteria; • Addresses human service needs of all groups • Includes government, non-profit, relevant for-profit orgs • May include support groups • Addresses needs of target populations • Includes political cause and issue-oriented action groups • Reviewed at minimum every two years • Publishes service charge fee for inclusion

22. II. Resource Database Standard 8: Data Elements Resource database contains standardized information about orgs that meet criteria for inclusion, services provided and locations (sites) where services available. Quality indicators: Required vs. Recommended data elements; Additional Sites (Locations/Branches); Service/Service Group and Service Site(s)

23. II. Resource Database Standard 9: Classification System/Taxonomy I&R service uses the AIRS/211 LA County Taxonomy of Human Services to index and facilitate retrieval or resource information. Quality indicators: Current Taxonomy License. Customizes Taxonomy to adapt to community. Customization is reviewed annually. Local modifications are reported to AIRS/211 La County Taxonomy editor. Structure and contents respond to meet service changes. Uses I&R software that supports Taxonomy.

24. II. Resource Database Standard 10: Content Management and Indexing I&R ensures through training, database management procedures and supervision that resource specialists organize information about orgs into database records that accurately and concisely reflect the agency, its locations and services/programs; index the services using AIRS/211 LA County Taxonomy of Human Services in accordance with recognized and consistent practices.. Quality indicators: Software, staffing to maintain database, training and supervision; understanding of human service delivery system, style guide, rules, well-written, concise narrative, indexing, community needs analysis, proof-read and eliminate grammatical errors.

25. II. Resource Database Standard 11: Database Search Methods Information in resource database will be accessible in ways that support the I&R process including search and retrieval by org, site and program name/type of service available. Quality indicators: searchable by related AKAs; area served; target population. I&R service has considered types of filters that may be relevant in their community and permits searches using those parameters (age, etc).

26. II. Resource Database Standard 12: Database Maintenance I&R service has procedures to ensure information in database is accurate and complete. Quality indicators: Standardized profiles or “survey” Documented process to update resources annually Procedures in place for integrating interim changes Procedure for identifying new resources Acquire information for new database records Verification procedures Alternative update methods/non-response Provides updates to staff on changes Written statement on right to edit information

27. III. Reports and Measures Delivery of I&R services generate valuable information about the problems/needs of a community and availability of resources to meet those needs. Standard 13: Inquirer Data Collection I&R service establishes and uses a secure, computerized system for collecting and organizing data that facilitates appropriate referrals, and provides basis for describing requests for service and unmet needs, identifying service gaps/overlaps, needs assessment, developing products and expansion of resource database.

28. III. Reports and Measures Standard 13 Quality Indicators: Maintains documentation for all inquirers. Data collected is based on I&R agency policy, local, state and or national requirements. Data collected facilitates analyses to support: • Human service needs of inquirers • Community needs assessment • Community planning • Allocation of funding • Research

29. III. Reports and Measures Standard 13: Quality Indicators Data collection provides information to identify: Service requests Met/Unmet needs (original contact/follow up and customer satisfaction surveys) Trends in community service provisions and/or gaps in service Total # of incoming contacts/inquiries by phone recorded by phone system and answered by I&R specialist. Transaction call or non-transaction calls Total # of I&R contacts/inquiries from other sources* Total # and types of problems/needs Geographic and demographic profiles Organization discussed during course of inquiry or referrals made

30. III. Reports and Measures *Total # of I&R contacts/inquiries addressing problems or needs include: • Transaction calls • Face-to-face contacts (walk-ins or I&R interactions in other settings such as community facilities) • Email contacts • Voicemail contact responses • Instant Message (IM) contacts • Text/SMS messaging contacts • Online chat contacts • Video relay/chat contacts • Regular mail contacts

31. III. Reports and Measures Standard 13 Quality Indicators: Collects information about other types of I&R activities, but those figures should not be added to the contact/inquiry total. Examples: • Website visitor activity (total visits, unique visitors, individual page visits). • People accessing recorded information. • Social Media postings. • Outreach presentations. • Brochures and/or other publications distributed. • Outgoing advocacy calls. • Outgoing customer satisfaction/quality assurance calls. • Outgoing follow-up calls. • Outgoing calls to verify resource information. • Community problems/needs reporting.

32. III. Reports and Measures Standard 14: Inquirer Data Analsysis and Reporting I&R service has a reporting tool and uses inquirer data and/or data from resource database to support community planning activities. Quality indicators: List data elements your I&R service reports should or already include.

33. IV. Cooperative Relationships I&R service must work collaboratively with other I&R services at local, regional, state and national levels while participating in broader service delivery system in their community. Standard 15: Cooperative Relationships Within the I&R System Comprehensive and specialized I&R providers develop cooperative working relationships to build a coordinated I&R system that ensures broad access to I&R maximizing utilization of existing I&R resources, avoids duplication and encourages seamless access to community resource information.

34. IV. Cooperative Relationships Quality indicators: • Participates in ongoing cooperative program planning and development activities • Participates in shared policies, • Avoids duplication efforts; encourages integration • Database collaboratives or partnerships • Identify changing community needs/respond timely • Community-wide data collection, analysis, reporting • Maximize resources to I&R system as a whole • Communicate with other I&R services regarding promotional efforts

35. IV. Cooperative Relationships Standard 16: Cooperative Relationships With Service Providers I&R service strives to develop cooperative working relationships with local human service providers to build an integrated service delivery system. Quality indicators: Explores opportunities for joint service delivery, address issues that have critical impact on community; encourages collaborating service providers to participate in community-wide data collection, analysis and reporting activities.

36. Discussion Question Name an agency or organization that an I&R service may participate with to address community wide issue(s).

37. VI. Disaster Preparedness Describe requirements an I&R service must meet in order to connect people to critical resources in times of disaster. Standard 17: Emergency Operations/Business Contingency Plan Written disaster plan specifically addresses incident common to the area, but also prepares for emergencies in general. Two components: Emergency Operations component defines what constitutes a disaster as well as organizations’ disaster response expectations, internally and from view of stakeholders. Describes steps the organization needs to take to meet community’s needs in aftermath of an event.

38. VI. Disaster Preparedness 2. A Continuity of Operations Plan (COOP) component that references emergency preparedness and mitigation activities such as structural alterations and changes in business continuity; and delineates steps to be taken before, during, and after an emergency to prevent or minimize business interruption and ensure long-term recovery.

39. VI. Disaster Preparedness Standard 17: Quality Indicators: Policies and procedures ensure organizations mission-essential functions are continued. Personnel coordination: Designation of key staff. Delegations of authority. Order of succession. Notification of personnel during duty and non-duty hours. Designation of mission-essential functions. Designation of alternative facilities. Continuity of communications among staff before, during and after. Securing vital records and databases. Plans for reconstitution and termination of plan.

40. VI. Disaster Preparedness Standard 17: Quality Indicators: Written procedures address specific types of emergencies including power outages, fires, medical emergencies, bomb threats, radiological threats, workplace violence, and other incidences. Procedures to contact emergency personnel. Written procedure for emergency evacuation of the facility following a disaster. Designates exits, assembly area, damage assessment, instructions for shutting off gas, electricity and water. Documents designated leadership roles/responsibilities of managers and staff before, during, and aftermath. Maintains service delivery during and after emergency; relocation; alternate modes of service delivery; alternate sites. Ensures facility has capability of handling to increased needs. Performs periodic drills and practice emergency procedures. Supports staff emergency plans for home and families.

41. VI. Disaster Preparedness Standard 18: Formal Relationships with Government and Private Sector Emergency Operations and Relief Agencies Participate in ongoing cooperative disaster response planning in community and establish relationships to become recognized as integral part of community’s plan. Quality indicators: understands command and control structure within their jurisdiction, own role and other organizations, relief and recovery phases of disaster; obtains NIMS (National Incident Management System) certification; VOAD agreements; community meetings addressing plans for disaster preparedness, mitigation, response, relief, and recovery.

42. VI. Disaster Preparedness Standard 19: Disaster Resources Service develops, maintains and/or uses accurate up-to-date computerized resource database containing information on available community resources in times of disaster. Quality indicators: Resource database includes information on organizations with formal role in emergency response. Adds information about organizations that have no formal role but emerge in context of particular disaster. Monitors social media and mass media to keep abreast of information of new resources and changing situations. Streamlined verification process to ensure data validation. Disseminates disaster-related information in community.

43. VI. Disaster Preparedness Standard 20: Disaster-Related I&R Service Delivery I&R service provides information and referral services to the community during and following a disaster or emergency. Quality Indicators: Adequate staffing Mutual assistance Off-site location assistance Effective Skills Government response system Disaster Stress-Debriefing

44. VI. Disaster Preparedness Standard 21: Disaster-Related Inquirer Data Collection/Reports I&R service tracks inquirer requests for service and referrals; collects demographic info and is prepared to produce reports regarding requests for disaster-related services and referral activity. Quality indicators: Collects and organizes inquirer data; describe requests for disaster-related services; identify gaps or overlaps; timely reports; produces an after-action report (AAR) documenting activities of agency focusing on worked well and what needs to be improved through revisions of agency’s disaster plan and/or additional staff training.

45. VI. Disaster Preparedness Standard 22: Disaster Related Technology Requirements I&R service has technology in place that facilitates ability of org to maintain service delivery during times of disaster or a localized emergency. Quality indicators: Regular and emergency methods of electronic communication. After hours contacts and pre- or post- disaster communication. IM, text/SMS, satellite phones or mobile devices. Relationship with telephone provider, Internet Service Provider (ISP), Web service hosting vendor, I&R software vendor-ensure high priority for continued services.

46. VI. Disaster Preparedness Standard 22: Quality Indicators: 3. Ability to reroute calls to another location.; MOU with out of region I&R service. 4. Access resource database via Internet, stand-alone single user copy on laptop, directory or other print version. 5. Conducted risk assessment of facility identifying equipment, connections and other vulnerable resources. 6. Has Uninterruptable Power Supply (UPS) on critical systems. 7. Emergency generator or other power back-up. 8. Back up systems for telephones, PBX/ACD. Multiple T1 lines. 9. Reprogram its phone lines and data network remotely.

47. VI. Disaster Preparedness Standard 23: Disaster Training and Exercise I&R service trains staff on emergency operations and business expectations upon hiring and provides ongoing training at least annually. Participates in community disaster exercises to its emergency ops plan. Quality indicators: General staff training; specific types of disasters common to area; in-house disaster plan; skills set required to meet needs of people; volunteer surge plan. The most important thing to remember during a disaster is the basic training of I&R.

48. V. Organizational Requirements Describe the governance and administrative structure an I&R service needs in order to carry out its mission. Standard 24: Governance Has a governing body (Board of Directors) that is constituted according to laws of its state.

49. V. Organizational Requirements Standard 24: Quality Indicators: Mission statement Organizational policies Public policy- participates in own community and state, national organizations that seek to further goals of I&R. System advocacy- supports changes in community. Letter writing campaigns/ Visits to political representatives Testimony at public hearings Mobilization of concerned members of public Coalitions or association work/Holding press conferences Writing and disseminating issue-oriented social media Writing articles or letters to local newspapers Offering interviews to local radio and television stations. Offering services as knowledgeable public speaker.

50. V. Organizational Requirements Standard 24: Quality Indicators: 5. Complaints Process 6. Code of Ethics 7. Nondiscrimination statement 8. Insurance coverage 9. Finance 10. Facilities