1. Advocacy and Follow-up United Way of New York City 2-1-1 / 311 Initiatives Answers That Help Training on Information and Referral Spring 2010 John Plonski President - NYS AIRS jpnysairs@gmail.com Cathleen Dwyer Kelly, CRS, CIRS cat@cdkconsulting.com www.cdkconsulting.com

2. Objectives Review Standards – What are they – Why do we care Discuss Advocacy Review Empowerment Discuss Follow-up Quality Assurance/QA Plan Tips and tricks from you all…

3. Introductions Who are you Why are you here What do you want to learn

4. AIRS Standards Comprehensive document Based on best practices First version, 1973 Major revisions in 2008 – Version 6.0 Cornerstone of accreditation Free download – www.AIRS.org

5. AIRS Standards define information and referral process in concrete terms; address all aspects of an I&R services operation establish criteria for database development; mandate support for community planning activities; incorporate a broad view of collaboration describe the role of information and referral services in times of disaster.

6. Why Do We Provide Advocacy and Follow-up? AIRS Standards 3, 5, and 14 say we must Ensures consumers obtain services for which they are eligible and need Enables consumers to negotiate a system with which they may be unfamiliar Track unmet needs Provide concrete information about service provision to stakeholders Starts ongoing cycle of Quality Assurance

7. What Is Advocacy? The basic goal of the I&R provider is to empower the consumer (Self Advocacy). – CONTACT: Focusing on establishing rapport – CLARIFICATION: Focusing on the problem – CLOSURE: Focusing on actions for the consumer to take Programs that intercede on behalf of individuals and/or groups to ensure that they receive the benefits and services for which they are eligible and that organizations within the established service delivery system meet the collective needs of the community; that attempt to marshal public support for a particular issue or cause; or that seek to influence legislation, local ordinances or administrative rulings in order to benefit specific interest groups or achieve specific social, political or environmental goals. See also Inquirer Advocacy, Self-Advocacy, System Advocacy.

8. Advocacy? Agency (or I&R worker) will directly intercede on behalf of individuals and/or groups of individuals to ensure that they receive the benefits and services for which they are eligible or need

9. Advocacy Levels of Advocacy – Individual Advocacy – System Advocacy How does it relate to empowerment (in a bit!)

10. Individual Advocacy With permission of the consumer* – when the need is critical – barriers to their successfully accessing services * In times when the consumer is in immediate danger to themselves or others agency policy should maintain that immediate action will be taken to protect the individual or others without the need for consumer permission.

11. Individual Advocacy occurs when the consumer: Needs help with establishing eligibility Is denied services to which they are entitled Has a complaint about a service Is unable to represent themselves effectively Is unable to effectively communicate needs due to: – Language – Age – Physical or developmental disabilities – Communication impairments – Emotional situations – Mental health issues – Poverty

12. Individual Advocacy is: Not case management Directly connects the consumer with service providers Assists with making initial contact with needed services Consistent with written agency policies Properly documented

13. System Advocacy I&R Service tries to ensure adequate availability of essential community services Collection, analysis, and dissemination about unmet needs

14. System Advocacy Can initiate changes in community conditions, structures or institutions with the goal of better serving the actual needs of the community Not necessarily legislative advocacy (lobbying) unless such action is part of the agencys mission

15. System Advocacy AIRS Standard 14: The I&R service shall utilize inquirer data and/or data from the resource database to support community planning activities (or planning at other levels), internal analysis for management purposes and system advocacy.

16. System Advocacy The I&R service creates reports that can be used for system advocacy, i.e., support for changes in community conditions, structures or institutions when modifications in the service delivery system are required to ensure the adequate availability of essential community services.

17. System Advocacy Letter writing campaigns Visits to political representatives Testimony at public hearings Holding press conferences Writing articles or letters to local newspapers

18. System Advocacy Interviews on radio and television Public speaking Mobilizing concerned members of the public Working through coalitions or associations to advance a cause

19. Empowerment Empowerment should enable personal development as well as increasing influence over services Service users should feel personally empowered by the experience.

20. Empowerment things can go wrong: if service users feel that their views have not been listened to or taken seriously, which can have the effect of making people feel disempowered rather than empowered

21. Empowerment and Advocacy May Overlap Self-advocacy seeks to empower service users to speak up for themselves by expressing their own needs and representing their own interests. This process can enable the service users to regain some control and power over their experience. Many advocacy projects have an explicit goal of consciousness-raising and power sharing for service users (Conlon and Lindow, 1994).

22. Peer advocacy Peer advocacy is a process whereby one person advocates for another who has experienced, or is experiencing, similar difficulties or discrimination. Survivors of the mental health system may be more acceptable advocates for mental health users by being able to show empathy and understanding (Atkinson, 1999).

23. Citizen Advocacy Citizen advocacy is usually a one- to-one and long-term partnership between a trained unpaid citizen advocate and a service user (Brandon, 2001).

24. Professional or paid advocacy Professional or paid advocacy involves a trained paid worker responding to an identified problem, event or change in someone's life. The advocate's support is time-limited (Barnes, 2000).

25. http://www.lfcc.on.ca/mothers.html

26. What Is Follow-up? The process of contacting inquirers to determine if their needs have been met – as a result of the information and/or referrals provided in their initial contact

27. Follow-up If inquirers needs have not been met: – Specialist determine the reason for the needs not being met – If necessary, advocate for the individual – Or, supply more appropriate referrals

28. Follow-up Should occur when doubt exists regarding the consumers ability to self advocate Is a measure of the clients satisfaction with services provided Is a major component the the I&Rs Quality Assurance activities …A tool used to verify resource database accuracy

29. Reasons for follow-up Safety check in cases where the inquirer has described a dangerous situation Service outcome measurement Measure inquirer satisfaction Collect information on unmet needs

30. Reasons for follow-up Provide additional assistance Asserts the uniqueness of your I&R service Staff support and satisfaction Training tool for new staff

31. Follow-up Outcomes: Success? Number of calls answered? High percentage of calls answered within predetermined parameters? Low call abandonment rate? Number of referrals given? None... Some... All of the above?

32. The Measure of Success – Answer rates – Number of referrals given – Any other tangible datum we deem important to us and is measurable – However, Success depends on the perception of the individual involved in the I&R process

33. Satisfaction Perception of the client equals Client Satisfaction: – Product – Did I get what I wanted and was it what I expected? – Process – Was it easy to get the product in a timely, efficient manner? – People – Were the people I interacted with responsive, efficient, and courteous ?

34. The Perception of the Inquirer Is Influenced by 5 Drivers The Perception of the Inquirer Is Influenced by 5 Drivers The five influences of Inquirer Satisfaction are: 1. Timeliness 2. Knowledge/Competence 3. Courtesy/Comfort 4. Fairness 5. Outcome

35. Satisfaction Based on What the Client Wants Better and faster services Access to services via multiple portals 24/7 access to services One stop shopping/first call resolution Accurate, complete, and appropriate information Service that is responsive, timely, efficient, helpful, and friendly

36. What Happens Next? Follow-up Outcomes Connected with the referral(s) and their need was met Did not connect but their need was met Connected but need was not met Did not act Additional I&R services are required

37. Follow-up Methods and Procedures Develop a method that will work for your agency Use discretion in making follow- ups in certain situations Define specific instances where follow-ups must be made

38. More Thoughts About Follow-up Ask! – how to handle instances where someone else answers the phone – how to handle instances where a machine answers the phone – how to handle caller ID – other situations??

39. Follow-up Determine the best time Have a set number of times that follow-up will be attempted and explain this to the consumer Decide who will make the follow- up contact

40. Follow-up Have documentation of the original call available to the person making the follow-up It can be helpful to have a script for the specialist following up

41. Advocacy + Follow-up = QA AIRS Standard 28: Program Evaluation and Quality Assurance: – The I&R service shall have the ability to assess the quality and effectiveness of all aspects of its operation including its service delivery, resource database, reports and measures, cooperative relationships, disaster preparedness, and organizational structure…

42. Quality Assurance …These determinations shall be made both through on-going quality assurance procedures and periodic, formal evaluations that are used to implement measurable improvements.

43. Advocacy + Follow-up we can use these to help plan our QA cycle... The Shewhart Cycle

44. Quality Assurance Agency-wide mindset and the responsibility of everyone in the agency, top to bottom Includes Management and how it is applied Staff skills, competence, and experience Morale and motivation Consumer satisfaction Cooperative relationships QA is a constant cycle of review and change

45. Quality Assurance Plan - Design or revise service delivery components to improve results. Initially this would mean assessing that which you have in place. Do - Implement the Plan and measure its performance

46. Quality Assurance Check - Assess the measurements made in the Do part of the cycle and report the results to decision makers Act - Decide on changes needed to improve the process

47. Advocacy and Follow-up: Strengthening the I&R System Then start over with the Plan phase and apply what has been learned from the previous phases. Continue to do all four parts sequentially over and over till the service has improved to the point of satisfaction.

48. MARK YOUR CALENDAR! For the 2010 AIRS Training & Education Conference "In Focus: I&R Excellence" May 23- 26, 2010 - Rochester, New York May 23-26, 2010 Hyatt Rochester, Radisson Riverside & The Rochester Convention Center Rochester, New York For more details go to: www.airs.org