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United We Stand

Texas officials discuss implementing a regional 211 information and referral system with neighboring states to better handle disasters.

by / September 7, 2006
Officials in the Texas Department of Information Resources (DIR) want the state to team with neighboring Gulf Coast states to create a regional 211 information and referral system.

If the project materializes, participating states -- such as Texas, Louisiana, Alabama, Georgia and Florida -- would interconnect their 211 call centers and train their phone representatives to serve citizens living in those partnering states.

Alabama, Georgia and Florida are still implementing their own 211 systems, which must be completed before they consider a regional system, according to Judy Windler, Texas DIR special projects director. The DIR, she said, has only had preliminary discussions about a regional system with Louisiana, whose system is complete, as is Mississippi's.

Give Me the 211
Several states have implemented 211 information and referral systems -- which offer citizens one number to call for information about health and human services in their area -- and many more are developing them. The 211 Texas Information and Referral Network program promises to deliver data on any benefits publicly or privately funded in a caller's area, said 211 Program Manager Beth Wick.

Texas' recently implemented 211 system is powered by voice over Internet protocol technology, and is widely viewed as a model for other states, said Mary Hogan, vice president of the United Way of Connecticut and former board president of the Alliance for Information and Referral Systems (AIRS).

Officials say the 211 system proved its worth during hurricanes Katrina and Rita -- it made directing the influx of Louisiana evacuees to health and human services dramatically easier, and let Texas effectively disperse the onslaught of frantic calls among its 25 call centers and avoid shutdowns.

Although the 211 system is beneficial, its referral process still needs improvement, Wick said. Disaster management is an ongoing reality of living on the Gulf Coast, she said, which means Texas and its neighbors should be instantly ready to transfer their 211 calling needs to call centers in other states where phone operators are trained to advise citizens during a crisis. "We had a tremendous amount of people who evacuated from Louisiana into Texas, [but] we didn't have any connectivity with Louisiana 211," Wick said. "We didn't know what sort of resources they might have had available to them, yet we were having to serve a lot of their people."

People stranded on rooftops in Louisiana called the Texas 211 system, as did those looking for family members, food, shelter, medicine and medical care. "You need to have people trained to handle that type of call," Wick said. "If the states were interconnected, that training is already available. If we have other storms this year, Texans may go to another state, and because we don't have connectivity with, say, Oklahoma or Louisiana, there's a gap there where we can't help them and they can't help us in the way we could if we were tied together."

Texas 211 phone operators reference a database to find any benefits available in a caller's area. If the Gulf Coast implements a regional system, participating states would feed their data into each other's databases for emergencies. States would still serve their own citizens during normal conditions.

Texas' 211 call volume increased by 300 percent during September 2005 -- a leap from its normal 80,000 calls per month to 267,000 calls. Costs rose by $1 million alone during September, Wick said.

"We ended up having to quickly bring up another center and try to staff it with state staff, and then extend everybody's hours," she said. "Everybody was working 12 hours or more."

A regional system's call dispersing capabilities would save states from hiring temporary phone operators during emergencies, keeping 211 referral assistance in the hands of nationally certified phone operators who provide that assistance for a living, she said. "In a time of disaster, they'd put their normal crisis hat aside -- helping people who are homeless or need medical care for their children -- and they'd put on a disaster hat," Wick said. "It's not a big leap for them, [and it's better] than having to hire people who aren't accustomed to your telephone and database systems."

Price of Admission
Windler said she doesn't know how long it would take to create a Gulf Coast regional 211 system, but states joining it would need to invest in expanding the Texas DIR's integrated network platform. That platform, which Windler calls the "brains" of the system, would route calls to all participating states. States would make regular payments to Texas for access to that platform, opening a new revenue stream for Texas, though the DIR hasn't yet projected its amount of revenue.

Assuming the participating states had compatible equipment with the Cisco-based platform in Texas, they wouldn't need to install any extra hardware at their own locations to connect.

Who's the Boss?
Windler said participating states would likely establish a commission to run the joint system. "I would see it as more of a collaborative, and they might choose a chairperson or something."

For example, the commission would establish protocols for authorizing a call center in one state to transfer call traffic to a call center in another state. She said the Texas DIR would likely have special expertise oversight over the integrated network platform because Texas owns it.

AIRS would also mandate several standards for how to run the regional system. One would be a standard each state's database vendor would meet for exporting its own data to the databases in other states, as well as importing data from those other states. AIRS is still developing that standard, Hogan said.

Coming Compromises
Many 211 systems aren't state funded. Most have a grass-roots origin, typically funded by the United Way and other local organizations, said Lucinda Nord, executive director of Indiana 211 Partnerships Inc. Nord helps coordinate Indiana, Ohio, Illinois, Michigan and Wisconsin's regional 211 systems.

The United Way introduced the country's first 211 in Atlanta in 1997. Since then, 211s have popped up in communities across the United States, and 13 states have 211 access statewide -- some state funded, some privately funded. That means a patchwork of financial backers would support a Gulf Coast regional 211 system. The problem is that different backers require 211 programs to have differing reporting focuses in exchange for their funding, said Nord, adding that some backers may base their funding on how well a 211 promotes self-sufficiency. Some backers may also require the 211's reporting to illustrate the outcomes of citizens using 211 services. Other funding sources may base their funding on simple call volume.

Nord said regional Gulf Coast system leaders should anticipate how they would persuade backers to compromise on funding requirements, and agree on what communications measures are needed where citizens in two neighboring states share a media market. The 211 in one state may publicize a new benefit exclusively available to that state. Citizens sharing a media market in a neighboring state may see that benefit publicized and assume it's available to them. Call volume would spike in that area of the neighboring state, Nord said. "We've tried to build out a communications plan that says, 'Whenever we're doing a big marketing push we're going to inform you, [the neighboring state], so you can staff up as well.'"

Making It Happen
Many say a state should implement its own 211 information and referral services before starting a multistate regional system. But Windler said multistate 211 systems offer states with small budgets a way to implement their own 211 services by sharing the routing infrastructure. "Capital costs for setting up this kind of a system are fairly expensive for small states."

Most agree that whether a state joins a regional multistate system or not, it should always place its 211 call centers near the areas those call centers serve.

Wick said call center phone operators should know their regions, and use landmarks to direct callers to services. "These area information centers, part of their responsibility is being intimately involved in the health and human service community in their region -- knowing somebody has a special program for children returning to school or there's a dental clinic open that will take a sliding scale," Wick said. "You don't have that detail if you are singly located in one place."

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Andy Opsahl

Andy Opsahl is a former staff writer and features editor for Government Technology magazine.

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