Aging NetworkInvolvement in 211:A Teleconference Panel Discussionand Peer ExchangePrepared by theNational Aging I&R Support CenterNational Association of State Units on Aging1225 I Street, NW Suite 725Washington, DC 20005November 2000
IntroductionAging Network Involvement in 211:A Teleconference Panel Discussion and Peer ExchangeOn July 21, 2000 the Federal Communications Commission (FCC) approved theuse of “211” for community information and referral nationwide. A number ofindividuals and organizations from across the country, including many from the agingnetwork, had been working towards this goal since 1997. At the time FCC approval wasgranted, a handful of states were well on their way to designing 211 service models whileothers were in various stages of the planning process.In 1999 the National Association of State Units on Aging (NASUA) joined theNational 211 Collaborative to ensure that aging network interests were represented. Atthe same time, NASUA encouraged state and area agencies on aging to take onleadership roles in the development of 211 in their respective geographic areas. It wasclear that the method of implementation of 211 in each state would be determined bythose involved in the early planning stages. Strong aging network involvement in theplanning stages would ensure that Older Americans Act I&R/A programs would beappropriately recognized and utilized.FCC approval was the impetus for a number of state units on aging to look moreclosely at their role, and the role of state government, in general, in planning andimplementing 211. To assist states in this effort, the National Aging I&R Support Centersponsored a teleconference panel discussion on state approaches to 211 development. Toaccommodate a high level of interest, the teleconference took place on October 11 th andwas repeated October 12 th .Each teleconference consisted of a 45 minute panel presentation followed byquestions and discussion. The panel consisted of three states, each representing adifferent approach to involvement in 211 planning and implementation. Following thepanel discussion, participants were given an opportunity to present on 211 activities intheir respective states.The following teleconference summary combines the proceedings from the twodays into one narrative. Please direct any questions you may have about the contents ofthis report, or materials referenced, to the National Aging I&R Support Center at 202-898-2578.
Aging Network Involvement in 211:A Teleconference Panel Discussion and Peer ExchangePANELISTS(In the order in which they presented)Christine Lewis, DirectorElderly Services DivisionConnecticut Department of Social ServicesMary Jo Iwan, AdministratorSpecial Services for Children and AdultsNebraska Department of Health and Human ServicesTina Hartley, Human Services Program CoordinatorAlabama Department of Senior ServicesSTATES REGISTERED TO PARTICIPATEOctober 11, 2000 October 12, 2000AlaskaArizonaArkansasColoradoCaliforniaFloridaIowaHawaiiIdahoKansasIllinoisKentuckyMassachusettsMarylandMaineMinnesotaMichiganMissouriMontanaNevadaNew JerseyNew YorkNorth DakotaNorth CarolinaOklahomaPennsylvaniaSouth CarolinaSouth DakotaTennesseeWashingtonVirginiaWyoming
Aging Network Involvement in 211:A Teleconference Panel Discussion and Peer ExchangePanel PresentationsChristine Lewis – Connecticut:211 began in Connecticut in February 1999 and is a public private partnershipbetween the United Way and the state of Connecticut. The beginnings of this partnershipdate back to 1976 when Connecticut began to plan for a statewide I&R system usingSocial Security Block Grant and state funds. The state contracted with the United WayInfoLine to provide I&R statewide. During the early years, some state departmentscontinued to have separate I&R programs. By the mid 80s, with the termination of theGovernor’s Information Line, InfoLine was operating 5 days a week from 9 to 5 andfunctioning as the state I&R service. In 1994, InfoLine began to offer services 7 days aweek, 24 hours a day. Today, InfoLine 211 has a $2.9 million budget with 34 full timeequivalent (FTE) staff, 18 of which work during the day Monday through Friday and theremainder work evenings, nights and weekends.Since 211 was initiated, there has been a 50% increase in the number of callsreceived by Infoline. While originally set up in several locations, InfoLine is nowoperated out of a single central location. They maintain an extensive I&R datebasecovering information for all ages and populations and offer a hard copy in directoryformat. They handle after hours calls for elderly protective services and are certified asa suicide hotline.In the early years of the program, prior to 211 implementation, the state mandatedthat area agencies on aging (AAA) fund InfoLine to handle all aging I&R. Eventually thestate unit on aging (SUA) removed that mandate and some AAAs began to do their ownI&R while others continued to fund InfoLine. AAAs that chose to start their ownprograms, began to keep separate databases and essentially cut ties with the InfoLineprogram. Recognizing the importance of collaboration in providing information andreferral, the SUA worked with the AAAs and United Way to encourage greatercoordination of services.Today, InfoLine’s database is shared with the AAAs utilizing Refer software.With the encouragement and support of the SUA, the aging network and United Way areworking together to improve their joint eligibility screening and client tracking programsas well as to establish an automatic call transfer system. One current issue which they areapproaching together is how to pay for call forwarding. In the future, they hope to builda Web link with access levels for professionals as well as for the public. While InfoLinedoes operate the adult protective services line, they now recognize the AAAs as theaging I&R specialists and refer to them at every opportunity.
Mary Jo Iwan – Nebraska: (Mary Jo was joined on October 11 by BeverlyGriffith, Director of the Eastern Nebraska Office on Aging)Though not yet implemented in Nebraska, the efforts to establish 211 actuallydate back to 1996 when a statewide task force was formed to examine the high rate ofinstitutionalization. The SUA and a number of AAAs were involved in this task force,along with many others representing diverse interests. The task force eventually dividedinto a number of smaller working groups as members recognized the breadth of theirmission. As a result of the task force efforts to date, there has been an increase inassisted living in Nebraska and a number of services have been added to their home andcommunity based services Medicaid Waiver.As task force members researched the issues, they often heard that access toservices could be difficult, particularly for those in crisis. As a result, a separate workinggroup was established to conceptualize a more accessible system. It was at this pointthat they began to consider and plan for 211. Today, a number of agencies andorganizations are involved in the 211 task force. They include the United Way, variousstate agencies, AAAs, the Nebraska AAA Association, the Red Cross, the Public ServicesCommission, Independent Living Centers and others.A steering committee was formed to direct 211 efforts. The Nebraska PublicServices Commission was invited to join the task force. A visit was made to Texaswhere a 211 model had already been developed. In order to examine the current I&Rsystem and consider how 211 could improve upon what already existed, the University ofNebraska Public Policy Center was funded to survey existing I&R and to conduct a 211system cost/benefit analysis. A total of 191 I&R services were identified and surveyed.The study indicated that 211 could be more efficient, even though no existing serviceswould need to be eliminated. Savings were estimated to be around $3.6 million annually.As a model begins to take shape in Nebraska, they are focusing on efforts toeliminate turf issues as well as to seek funding. The Nebraska model that is taking shapevalues all I&R programs and is integrating specialty I&Rs into the 211 plan. The AAAI&R programs currently use IRis software which can be easily integrated into a 211system. One statewide call center which would automatically transfer calls to theappropriate I&R program is planned. The call transfer system is being tested within therespite network I&R system.With funding seen as a crucial issue, the cost/benefit analysis was important inthat it provided the task force with information to take to the legislature showing that 211can be very cost effective in Nebraska. Task force members have also entered intodiscussions with Medicaid. They have discovered that 211, by improving access toservices as required under the Olmstead Decision, can tap into Medicaid administrativedollars based on a cost allocation system. These Medicaid funds are available on a 50/50match basis. The task force currently estimates that in Nebraska, 60% of 211 calls willqualify for these Medicaid funds.
Tina Hartley – Alabama:Aging network I&R systems improvement and statewide 211 planning effortswere launched separately, but at the same point in time in Alabama. In the fall of 1998,under the direction of the SUA, Alabama aging network I&R programs adopted theAtlanta Regional Commission’s Connect software program and began to build astatewide resource database and client tracking system. Though the database is not yetcompleted, the end is now in sight. In addition, the state has future plans to use the Webto allow public access to appropriate database resources. Another innovation came aboutin 1999 when the SUA initiated an 800 # which automatically routes calls to theappropriate AAA.It was also in 1998 when the Alabama Department of Senior Services learned atan AIRS affiliate meeting that statewide efforts, headed up by the United Way, werebeing launched to plan for 211 in Alabama. The Department of Senior Services quicklybecame involved and promoted the extensive aging network I&R systems modernizationbeing implemented. As a result, it was agreed that the 211 system would not attempt toduplicate the aging network efforts but would instead refer calls concerning the elderlydirectly to the existing aging network system.In 1999 the Alabama Public Utilities Commission was successfully petitioned forN11. Actual assignment of 211 will be achieved at the local level. The Alabama plancurrently calls for 5 regional centers operating 7 days a week, 24 hours per day. Theexact location of the regional centers has not been determined. The regional centers willstrive for multi-lingual and TDD capabilities. The plan is to pilot 211 in Montgomeryand then apply the resulting model to the rest of the state.Though the planning got off to a strong early start, the statewide steeringcommittee has not met recently. The SUA has continued, none-the-less, to maintainclose working contact with the United Way to ensure aging network presence as planningcontinues. There is apparently some skepticism among local I&R programs that 211 willbecome a reality in Alabama and this is partially responsible for lagging interest over thepast year. The aging network is the only specialty I&R system currently represented inthe planning process, with all other involved I&Rs representing the United Way. TheSUA has encouraged the Montgomery Area United Way to involve other specialtyprograms (i.e. other state agencies) in the planning process.
Questions to PanelistsHow will 211 affect the Eldercare Locator?While 211 will be effective in improving access to services in local calling areas,it will not initially assist callers in accessing services outside of the immediatecalling area. There are currently no future plans for 211 to develop a nationwidesystem, such as that now utilized by 411. With this in mind, the Eldercare Locatorwill continue to be the primary link for caregivers needing to access services longdistance.What software package does/will your 211 service use?Connecticut – ReferNebraska –IRisAlabama –IRisWill the 211 Collaborative be providing information on 211 models?AIRS currently posts some information on models on their Web site.(www.airs.org). The Collaborative hopes to offer regular updates on state plans andactivities on their Web site (www.211.org) in the future.Are the Medicaid funds mentioned in the Nebraska presentation available ongoing oronly for project start-up?Medicaid administrative dollars are available on a 50/50 match basis on anongoing basis. For more information contact your state or regional Medicaidoffice.Who pays for automatic call transfer? Is the caller aware of the transfer?The cost is absorbed by the agency not the caller. If the call is picked up by a callcenter and then routed to the appropriate I&R, the caller is aware. There are also“point of call” routing systems, however, which automatically route the caller tothe nearest center without the caller realizing this has occurred.How can we get a copy of the Nebraska study and cost/benefit analysis?Contact the National Aging I&R Support Center at (202) 898-2578 firstname.lastname@example.org.How receptive are seniors in Connecticut to using 211?There was extensive marketing when 211 was launched. While some seniorscontinue to call local numbers with which they are already familiar, in generalolder people and their caregivers are receptive to using 211.I’ve heard that 211 Connecticut will only give phone information and will not mailbrochures and other information out to callers. Is that true?Yes, that is the policy
State Reports:Arri izzoonnaaThe Arizona Aging and Adult Administration is currently working on a “nowrong door” program that will allow the public to access every state program bycontacting any one program. They are looking at how this program may be ableto incorporate 211.Haawaai iiiIn 1997 the United Way supported InfoLine program started statewide in Hawaii.It is known as “Ask 2000”. They work closely with the aging network and referaging related calls on to the AAAs. They will become the 211 provider inHawaii. The aging network will work with them in developing the system. Theyhope to get state funding for the initiative.IIddaahhooOne quarter of Idaho’s population is in the southwest corner of Idaho around theBoise area. The large mountainous geographic area of the state makes access toother population centers difficult. The original 211 efforts began under theleadership of the United Way about three years ago and focused only on thesouthwest corner of the state. The Idaho Commission on Aging became involvedand suggested a statewide approach. This statewide concept was later adopted.State government as a whole is not yet behind the effort and they have not yetsecured the Governor’s attention. A private hospital in Boise has volunteeredspace and staff if the other pieces fall into place.IIl llinnooiissThe United Way of Chicago has taken the lead and they have approached theGovernor. Meetings have been held with all state agencies and the telephonecompanies. Some state agencies are overwhelmed with the concept and are notnecessarily supportive at this time. The Department on Aging plans to convene ameeting to discuss aging network involvement. United Way currently states theywill not need to seek outside funding to establish 211. They intend to use onlyaccredited providers as call centers.KaannssaassCurrently United Way is looking at 211 statewide. The Wichita United Way isthe lead agency. Because they currently cover 70 of 105 counties, they alreadyhave an extensive database. The Kansas Department on Aging is involved andactive.Maarryyl laannddUnited Way of Central Maryland has provided the leadership to get things started.A number of state and local agencies are forming a task force. They have met
with the Public Utilities Commission to inform them of the intent. The Governorsoffice and legislative bodies have also been alerted. United Way has sent lettersto all County Executives. The aging network is working closely with the UnitedWay in developing the collaborative effort. Others involved include crisis lines,developmental disabilities, people with physical disabilities network, I&Rprovider council, MD Department of Human Resources and others.MaassssaacchhuusseettttssThe aging network has been upgrading their I&R capacity. They are establishinga single statewide 800 number that will be able to connect callers to theappropriate program such as SHIP, pharmacy assistance, homecare, APS, theMassachusetts Executive Office of Elder Affairs and others. They plan toincrease this capacity by initiating a messaging system with options that allowthe client to get information on the service they need without necessarily havingto speak with an operator. Massachusetts is initiating a new Web site with astatewide database for online access to information. The Office of Elder Affairsfeels these new systems put them in a good position to work with 211. They havebegun talks with the 211 task force which plans to refer appropriate calls to theaging network. The statewide task force is chaired by the United Way and theaging network is well represented. The task force has applied to the local publicservice commission for approval. The task force has received non-profit statusand has been able to secure two seed grants.MinnnneessoottaaThe Minnesota Board on Aging has taken the lead in organizing 211 for the state.Currently the United Way in Minneapolis/St. Paul provides comprehensive I&Rin the metropolitan area while FirstCall Minnesota provides services in 80 ruralcounties. The MN Board on Aging system will build on this existinginfrastructure for 211 and protocols will be established for referring to specialtyI&R programs. Much of the organizing around 211 has taken place through theMinnesota AIRS affiliate since a Board on Aging staff member is the currentpresident. All I&R providers will be invited to come together to develop thereferral protocols for 211. Minnesota is planning on utilizing Medicaid funds byimproving access to services as required under the Olmstead decision. Theyanticipate that this may provide as much as 50% of 211 funding.MissssoouurriiMissouri is just getting started in their 211 efforts. The aging network I&Rcoalition is currently considering their level of involvement. The result isanticipated to be the formation of a planning committee.NeevvaaddaaNevada is just beginning to consider 211. The University of Nevada hasexpressed an interest in working with the Nevada Division of Aging Services toinitiate planning efforts.
Neew JJeerrsseeyy211 collaboration activities began this past summer and two meetings have beenheld so far. A meeting has also been held with Verizon. The New Jersey Divisionon Aging is the only organization involved at this point in addition to the UnitedWay. However, the United Way is meeting with various concerned state leveldepartments to secure their support. The current concept is to develop a plan andthen seek input from local I&R providers.Noorrtthh Caarrool linnaaThe United Way of North Carolina was granted 211 in November of 1999. Theyare currently planning 4 demonstration projects across the state. It is anticipatedthat these will go live in 2001. The AAAs are involved to varying degrees on thelocal demonstration steering committees. The state has gotten involved in thestatewide steering committee in an effort to ensure aging network influence onthat level. They are currently the only group other than United Way representedon the statewide committee, but plan to encourage other specialty I&R to becomeinvolved. The current plan is to route aging related calls to the aging network.Okkl laahhoomaaThe United Way in Tulsa has taken the lead in Oklahoma and has hired a staffperson to coordinate the local campaign with some effort directed to the statelevel. They have applied for United Way Venture grant funds. In the Tulsa area,they have met with the local AAA and as well as others at the county level. Theyhave also begun meetings with Southwest Bell. The Oklahoma Aging ServicesDivision hopes to increase their involvement.Peennnnssyyl lvvaanni iaaAt this point southeast Pennsylvania, including Philadelphia, is the only area ofthe state that has begun to plan for 211. The Pennsylvania Department of Agingstaff have met with their director and are researching 211 at this time. They donot yet have concrete plans for any statewide effort.Waasshhi innggttoonnThey have begun collaborative efforts to organize in Washington and thereappears to be a number of agencies involved. On the state level, the Departmentof Social Services is involved, though the Aging and Adult ServicesAdministration is not yet active. They plan to become more involved and willencourage additional aging involvement.