 Follow-ups: Completing the Circle of I&R 211info Oregon and Southwest Washington Kurt Perkins, Director of Programs

This presentation is intended to benefit:  The front-line I&R call-taker  Dedicated specialty program lines  Managers looking to improve on quality assurance, outcomes and customer service  Anyone who has contact with clients after the initial call for resources

By attending this presentation participants will have the tools to:  Implement and/or improve upon their own I&R Follow-up Program  Appreciate the importance of the role of follow-ups within the total I&R experience  Have a better understanding of the impact of follow-ups on: - Clients- Public Policy - Service Quality- Media Relations - Provider Resources - Funding - Community Needs

AIRS Standard 5 The primary purpose of follow-up is for the benefit of inquirers to see if there needs were met.

AIRS Standard 5, Quality Indicator 1 Follow-up is conducted, when possible, with the permission of the inquirer and never compromises the safety of the inquirer.

AIRS Standard 5, Quality Indicator 2 The follow-up policy of the I&R service includes examples of situations in which the follow-up should normally occur. These may include: - Vulnerable households that are without heat during the winter - Older adults having trouble expressing their needs - Families with young children needing food

- Individuals with disabilities who have received an eviction order - People with no health insurance who need health care - Individuals needing emergency shelter - Individuals needing detoxification or withdrawal management

AIRS Standard 5, Quality Indicator 3 Follow-up consists of successfully contacting the inquirer to find out if their need was met and if not, the reasons why not. Follow-up is generally conducted within one to three days of the original inquiry in cases of endangerment and within 7-14 days in other situations.

AIRS Standard 5, Quality Indicator 4 If the inquirer has not received services or the need has not been met, the I&R service determines whether there is still a need and makes additional appropriate referrals. The I&R service also determines whether the inquirer has additional, new needs and makes appropriate referrals prior to completing the contact.

AIRS Standard 5, Quality Indicator 5 The I&R service documents the follow-up results (whether service was received or there was an unmet need) for use in reports.

AIRS Standard, Quality Indicator 6 Information gathered during follow-up relating to elements in the resource database is verified and used to update resource database information that may be incorrect.

AIRS Standard 5, Quality Indicator 7 Information gathered during the follow-up process is also used as a further means of evaluating the effectiveness of existing community service providers and for identifying gaps in community services.

AIRS Standard 5, Quality Indicator 8 The I&R service conducts regular satisfaction/quality assurance surveys with a specified percentage of inquirers to assess overall service performance and I&R service outcomes. The surveys may occur during the original contact with an inquirer (if done for customer satisfaction purposes only), in conjunction with follow-up after determining whether the inquirer’s needs have been met or in a separate call made for quality assurance purposes.

I&R Service Delivery Outcomes: A Practical Guide  A publication put out in March 2014 by AIRS  Available for download on the AIRS website  Designed to assist you in developing an effective Follow-up Program of your own

 History

The Buddy System Prior to February 2012…

 Call takers were expected to gather three positive follow-up responses per shift  Follow-ups were assigned to a matched partner  Each partner had a specified half hour off the phones each week to complete their assigned follow-ups

Why it Didn’t Work  Differing levels of comfortability  Staffing changed  Follow-up times were not matched to the availability of our clients  Our service area expanded  Our call volume increased  Follow-ups were not seen as a priority along with incoming calls  Timeliness

Time for a Change  We created a new position: Follow-up Specialist  We restructured our Follow-up Survey  We designed and implemented a bilingual Follow-up Training Program for the entire call center

 The Position

It Takes a Team To formulate the Follow-up Specialist position, a leadership team comprised of representatives from the call center, resource, reporting, social media, outreach and development departments met to determine how each of their needs could best be incorporated.

Core Function Assists clients and performs a critical quality-assurance role by conducting follow-up calls. Offers referrals and compassionate problem-solving if appropriate. Responses to a follow-up questionnaire are entered into a database, and anecdotes are shared with marketing and development staff.

Core Accountabilities  Work directly with clients: Conduct follow-up calls using the 211info protocol. Communicate in an amiable, kind and professional manner to customers. Screen clients and offer appropriate resources. Collect and enter client information into the 211info electronic record systems in compliance with contract and reporting requirements. Facilitate advocacy between client and service provider when necessary.  Report on results of calls: Compile results of follow-up calls to inform 211info reports to funders, partners and other stakeholders. Offer feedback to supervisor about issues raised during calls. Collect anecdotal information for use in agency communications. Participate in training sessions designed to improve internal and external customer service and agency operations. Make recommendations about database improvements.

 Correspondence, training and special projects: Monitor and respond as necessary to all agency communications tools; participate in training, staff meetings and scheduled discussions designed to improve internal and external customer service and agency operations; make recommendations about database improvements; participate in other projects as assigned.  Support CIC: Answer and return phone calls, texts and s from diverse clients who need efficient, accurate, confidential and unbiased social service referrals. Collect demographic information, screen clients for eligibility for social service programs, search database for referrals and assist with creative problem solving.

Core Competencies  Forward Thinking: Consider efficiencies, explore options and recognize trends that may affect agency operations.  Critical Thinking: Collect and evaluate client and referral data to identify improvements in service delivery.  Planning and Organizing: Organize work effectively to reflect 211info’s priorities and ensure timely execution.

 Flexibility: React and adjust positively to change.  Cultural Competency: Work effectively with diverse clients and staff.  Promote Shared Values: Build internal support for 211info values and represent the agency positively in public.  Customer Service Focus: Seek methods to improve external and internal customer service.

Qualifications  Minimum one year of crisis intervention/hotline service, or one year of experience with a social service organization or call center.  Analytical skills to identify practical solutions to barriers and service gaps that prevent clients from receiving the assistance they need.  English/Spanish bilingual preferred/required.  Bachelor’s degree in social work, psychology or other human service. Experience may substitute for degree.

 Strong customer service delivery.  Knowledge of social services, governmental bodies and geography of Oregon and Southwest Washington preferred.  Ability to work effectively with diverse clients experiencing a problem or crisis.  Certification by Alliance of Information and Referral Systems (AIRS) is a plus; certification is required after two years.  Strong written and verbal communication skills, including spelling and grammar.

 Follow-up Survey Helpful Notes

1. What circumstances led you to seek assistance?  Underemployed/Unemployed - Fired, quit, laid off, hours cut, self employed & not enough work coming in.  Uninsured/Underinsured - No insurance, maxed out existing insurance, procedure or need not covered by insurance.  Loss of Benefits - Unemployment ran out, food stamps got cut, maxed out on short term disability or TANF.  Catastrophic Injury/Illness - Illness or injury that kept caller from work, medical needs or care of injured or ill household dependent, death in household.  Change in Household Status - Divorce, births, addition of grandchildren or elder parents to household.

 Fixed Income - TANF, SSI, SSD, pension  Relocation - New to area.  Other - Usually an informational question not based on economic need. Example “Can you help me find an AA meeting tonight?” A pop up box will open up for you to clarify the response. Client Declined Did Not Ask

Notes  Try asking directional probing questions like, “Is there a reason why you were unable to pay for utilities this month?” If you don’t get a clear initial answer, avoid listing responses.  Only one response can be selected. Select the initial response provided by the caller. Even though you might hear, “I broke my arm, which caused me to lose my job and no I don’t have any insurance…” The initial response is, “I broke my arm.”

We Are The Safety Net

2. Were the referrals provided by the 211info Specialist appropriate for your needs?  Yes [Skip to 4]  No [Skip to 4]  Referrals were not provided  Client Declined [Skip to 7]  Did Not Ask [Skip to 7] Notes For all negative answers a pop-up box will appear to let you clarify the response. Remember to I- Square the resource department or make the call center management team aware of inaccuracies in the record or mis- referrals being provided.

3. Did the 211 Specialist help you think of possible alternative solutions to getting your needs met?  Yes, Database Referrals Provided  Yes, Database Referrals Were Not Provided [Skip to 6]  No [Skip to 6]  Client Declined [Skip to 7]  Did Not Ask [Skip to 7] Notes This question is under review for replacement as it is currently only being asked on Unmet Need calls where no referrals are provided.

4. Have you contacted any of the referrals provided and received assistance?  Yes, assistance received [Skip to 7] - Mark this when caller has received assistance from any of the referrals provided even if they had multiple needs and referrals.  Yes, in progress of receiving assistance [Skip to 7] - Has an appointment, application pending, check is in the mail…This is for when caller indicates that they have not received assistance yet, but they will be receiving it.  Yes, left message but no call back [Skip to 6]  Yes, but no assistance was received - Proceed to question 5.

 No, Unable to Contact Referral [Skip to 6] -Be sure to confirm phone number and contact times of the referral for the caller if this is the case.  No, Did Not Contact Referrals [Skip to 6] -Ask the caller if they need the referrals again especially if they have not gotten their needs met in any other way since contacting us.  Client Declined [Skip to 7]  Did Not Ask [Skip to 7]

5: Did the referrals say why they were unable to help you at this time?  Caller Faces Barriers - i.e. transport, etc. -Agency hours, location, amount of payment required …prevented caller from being able to access services.

 Caller Ineligible Due to Previous Assistance  Caller Ineligible Due to Geographic Location  Caller Ineligible Due to Degree of Need  Caller Ineligible Due to Income Level  Caller Ineligible Due to Marital Family Status  Caller Ineligible Due to Age  Caller Ineligible Due to Gender  Caller Ineligible Due to Race Notes These ineligibilities are prescreening qualifications that might not be evident in the referral record due to different funding streams for similar services within an agency. Please check the record, complete I -Square and inform the call center management team of mis-referrals when appropriate.

 Caller Refused Assistance -Caller is offered assistance by a referral but decided not to accept it. This usually happens because the amount of assistance offered was too small, the paperwork required was too invasive or the caller was able to get their needs met in another way.  Program Full or Out of Funds -Includes long wait lists.  Program/Service Does Not Exist - Please check the record and complete I-Square and inform the call center management team of mis-referrals when appropriate.  Other  Client Declined  Did Not Ask

6. Have you been able to get your needs met in another way since you called 211?  Established a Payment Plan -Landlord, utility company.  Family/Friends -Borrowed money from or paid for outright.  Church  Agency Outside of the Referrals Provided -Please mark this even if the agency is in our referral database, but was not provided by the 211info Specialist.

 Sold Possessions -Pawn shop, yard sale, Craigslist.  Paid out of Pocket  Other  No  Client Declined  Did Not Ask

7. By talking with 211, do you have a better understanding of what resources might be available to you?  Yes  No -If No, explain what 211info is to the caller.  Caller Already Aware of Resources Prior to Calling  Client Declined  Did Not Ask

8. Overall, were you satisfied with the level of service provided by 211?  Yes  No  Client Declined  Did Not Ask

9: Would You Call 211 Again?  Yes  No  Client Declined  Did Not Ask

Additional Considerations  The importance of the correlation of the survey questions to the original demographic data and referrals provided during the initial call in order to provide detailed and accurate comprehensive reporting and customer service (Questions 3 and 6).  The inclusion of “Skip” queues to assist with smooth call flow (Question 4).

 Drop-down” boxes under each “no” or “other” response for explanatory notes (Question 8).  Limiting the number of questions to the absolute minimum necessary to ensure a positive experience for the both the client and the Follow-up Specialist.

 Techniques of Polling

Always read the questions verbatim, as written, each time This gives accurate comparison data – apples to apples. When questions are asked differently across specialists and/or respondents, the data is no longer comparable. A slight change in wording may change the way an individual responds.

Always clarify vague responses Assuming that you know what a respondent meant, leads us down a slope of sloppy data collection.

Do NOT read option lists Allow the respondent to offer a response without being guided. Do not accept the initial “don’t know” or “vague response.” After the second “don’t know” or “vague response” on the same question, enter Client Declined and move to the next question. If you need to stop the survey before the end to aid an individual with a crisis or because the respondent no longer wants to continue, abandon the survey without saving the follow-up

 Scripting

Introduction Hello, may I please speak with ?” Once the client is on the phone, proceed “Hello, this is from 211info.You recently contacted us to get some information about. I was hoping to ask just a few questions about that experience, if that would be alright?”

 If consent is given, proceed with the survey  If consent is not given, always use the following refusal avoidance technique: “I understand, When would be a better time to call back?”

Closing “Those are all the questions that I have. Thanks you very much for answering the survey. Your response will help us better serve other clients. Please remember to contact 211info, if you are in need of services in the future. Have a fine.”

Additional Scripting for FAQ’s and Situations Q: When a caller says, “May I ask who’s calling?” R: “I’m calling to perform a follow-up for a service that requested.” If the caller persists… R: “I’m sorry, but the service our agency provides is confidential, I’ll be happy to identify myself once I have on the line. If this is still insufficient… R: Thank the individual who answered the phone for their time and end the call.

Q: When a caller asks, “Why are we doing this survey” or “Why should I answer the survey questions?” R: “The questions you answer improve our quality and allow 211info to better serve you and people like you in the future. Your participation is greatly appreciated by our entire organization.”

Q: When a caller says, “I’m busy right now.” R: “ Is there a better time for me to contact you?” Depending on their response, reschedule the follow-up or thank them for their time and remind them that: R: “211info is available 8am-6pm, Monday through Friday, if you are in need of assistance again.”

 Effective Management More Tools

Managing Follow-ups  Using a standard for scheduling Follow-ups. We use a standard of 2 weeks /10 business days after the initial call for services, allowing time for the client to access and receive assistance.  Asking each client the best time to reach them for a Follow- up. We can schedule Follow-ups for the general categories of Morning, Afternoon, Evening and Anytime in addition to specific time slots down to the ½ hour.

 Having a dedicated outgoing telephone number for Follow- ups that shows up on the client’s Caller ID as an incoming call from 211. This identification increases our client answer rate and indicates our attempt to contact the client even if they are unavailable at the time.  Making notations regarding the original client contact that might be helpful to the Follow-up Specialist in addition to the referrals provided and demographic information.

Training  In our general call center, each individual taking calls receives a specialized training on the Follow-up Program.  Scripting: “We like to follow-up with our callers to find out how these resources worked out and check on the service you received today, may I have your first name and telephone number? Thank-you. If you’re selected our Follow-up Specialist will call you back in a couple of weeks. If you need anything else, we are here Monday through Friday 8am to 6pm.”

 Call takers are expected to ask each client, including those who have unmet needs if they would like to receive a follow-up, with the exception of:  Information Only Calls  -Callers without their own phones, as we are a confidential agency  -Crisis Calls*  -Mandatory Reporting Calls*  -Domestic Violence Calls* *These calls are warm transferred during initial contact onto the appropriate agencies for immediate and follow-up services in consideration of client service and safety.

 New call center trainees review the AIRS Standards for Follow-ups so that they have an understanding of the importance of follow-ups in 211info’s policy of dedicated client service.  Call takers also have the opportunity to sit side-by-side with a Follow-up Specialist and listen to live outgoing calls.

25  As a result of this training about 25% of all clients calling into the general lines of the call center each month respond positively when asked if they would like to receive a follow- up call.  Of the those callers consenting to receive a follow-up, 25% of those contacted by a Follow-up Specialist result in a completed survey.

 Specialty Programs

 Who Benefits?

Our Callers Even if their initial call ended in an unmet need or our initial referrals could not assist then, they are so appreciative that someone has called them back to check-in.

Our Staff The call center staff who provides referrals all day is always appreciative to know that they have helped make a difference.

Partners & Funders Follow-ups help us show outcomes and give us insight into our callers, our communities and our resources.

Caller Stories

Special Acknowledgement As the Lead Follow-up specialist for 211info Ann helped to develop our current Follow-up program protocol, questions, manual and training. She carries out follow-up trainings for the Community Information Center, Specialty Lines and other 211info Follow-up Specialists. She conducts follow-up calls using the 211info protocol. Offers feedback to 211info’s Community Information Center and Resource Team about the quality of the customer service as well as the quality of the referrals received; Assists in Compiling results of follow-up calls to inform 211info reports to funders, partners and other stakeholders; Collects anecdotal information for use in agency communications, both internal and external. She has been with 211info for 3 years after graduating from the Oregon College of Art and Craft with a Bachelor of Arts in Craft. Her area of concentration was Book Arts.

Thank You  Kurt Perkins, Director of Programs, 211info  E:  D: (503)