211 Human Services Strategy Report      

211 is a non-emergency phone line and database that provides callers with information and referrals only about human services and related community information. 211 was launched in Atlanta during 1997, sponsored by the United Way. The United Way Foundation and Alliance of Informational and Referral Organization are co-sponsors for 211 nationwide. 211 is the possibility of a communication network that could directly benefit emergency response during possible regional, state-wide, or national disasters. 211 can make a difference 365 days a year by making it easier for people to find human services in their communities when they are need.

As of 2008, Illinois was one of only 3 states with less than 20% coverage of a 211 system. Pilots are underway and there is opportunity for Illinois to participate in a nationwide network.

211 in Illinois

• Illinois passed the Human Services 211 Collaboration Act in 2003
• Illinois formed a governor appointed Collaboration Board for 211
• 211 pilots are in development

211 “In Action” 

• 211 reaches over 234 million Americans/ more than 75% of the population 
• In 2007, housing and shelter related inquiries were the most frequent 211 calls in the US, ~2 million calls

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Background

211 Service originated in Atlanta, Georgia and was launched by the United Way Atlanta just over a decade ago in 1997. Unlike 411 which provides directory assistance and can charge a fee for service, or 311 which provides information about non-emergency municipal services, 211 is a service line that provides callers with information and referrals only about human services and related community information. The United Way has categorized 211 referrals and they are listed in Table 1; the agencies that provide the human services are referral agencies. Throughout majority of the states, 211 services remain standard, with some variation.

The two leading sponsors for nationwide 211 services are United Way and AIRS (Alliance of Information & Referral Services). The United Way, a national network of nearly 1,300 local organizations, focuses on education, income, and health projects supporting their mission of community development (United Way). AIRS is a professional association for over 1,200 community information and referral providers (I&R) which specializes in creating and maintaining resource databases of programs and services that make information available through a variety of communication channels (AIRS). Additionally AIRS is the credentialing authority behind an accreditation program that measures an organization’s ability to meet the AIRS Standards, and a certification program that evaluates the competence of I&R practitioners (AIRS). Both organizations have partnered to promote 211 services which align with their organizational missions.

Table 1: Referral Categories

Legislation

Although individual states and counties manage the 211 service, this service has been deemed a federal priority, especially after September 11th, 2001 and severe and devastating natural disasters like Hurricane Katrina. After the terrorist attack on September, 11, 2001 (9/11) Congress saw the potential for the system in emergencies and in 2002 granted states permission to use federal money for 211 systems intended to prepare for potential bioterrorism attacks (Strom, NY Times, Nov 2005). Seeing an opportunity to create federal funding assistance, the 211 Calling Act, co-sponsored by Senators Elizabeth Dole (R-NC) and Hillary Clinton (D-NY), is legislation designed to authorize $150 million for years one and two of 211 implementation, and $100 million for years three through five through the U.S. Department of Health and Human Services (HHS) to help implement and sustain 211 nationwide (211 Calling Act, United Way). States would designate, if they have not already, a lead entity for 211 which would develop a statewide plan for implementation and administration of the funds. States would be required to provide a 50% match in order to draw down the federal dollars (211 Calling Act, United Way). This bill was re-introduced in January 2007 and was referred to the Senate Health, Education, Labor, and Pensions Committee and is still under consideration (GovTrack).

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National Status of 211

As of November 2008, of 50 states, 46 states and Washington DC and Puerto Rico were providing 211 service, although at various stages of implementation and activity as shown in Diagram 1. Of the 46 states, 27 states and Washington DC and Puerto Rico have fully implemented 211 service which means service is accessible to the entire population. Only four states are considered “in development”, including Illinois, Pennsylvania, Arizona, and Wyoming. The first statewide 211 service line was developed by Connecticut, Infoline 211, and the state provided the bulk of the funding for full implementation. However, funding has been one of the biggest challenges for many other states. As stated by the United Way, “211s have struggled to obtain sustainable funding.” Therefore, some states are forming private and public partnership models for funding; typical funding sources include local United Ways, community foundations, and federal and local governments.

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The Status of 211 in Illinois

The State of Illinois passed the Human Services 211 Collaboration Act in 2003. The Act recognizes 211 as a potential tool for collaborating human services into an information and referral network. When the legislation passed it created the Human Services 211 Collaboration Board which has nine members appointed by the Governor (ILGA). The following state agencies are represented on this collaborative board:

1) Office of the Governor
2) Illinois Commerce Commission
3) Department of Children and Family Services
4) Department of Healthcare and Family Services
5) Department of Human Services
6) Department of Public Health
7) Department on Aging
8) Department of Employment Security
9) Department of Human Rights

Furthermore, the Human Services 211 Collaboration Act identifies four important tasks that the Board must complete.

• One task is to implement 211 services within Illinois, which is a non-emergency telephone system that provides information and referrals for human services. The referrals may also be part of a web database.

• The second task is to establish standards for 211 deliveries in Illinois that are consistent with human referral service standards established by the National 211 Collaborative Board and the Alliance of Information and Referral Systems. These standards require suitable technology for delivering 211 calls as well as meeting the terms of the American Disabilities Act.

• The third task is to establish pilot projects within Illinois that will serve as operational examples of how to implement 211 as a human services information and referral number. The Board was given permission to select up to six pilots. In fact, three pilots were selected and endorsed.

• The fourth task is reporting, which is an annual requirement of the Board. The Board is to report to the Department of Human Services, the Governor, and the General Assembly on the use of 211 services in Illinois.

(Source: ILGA) 

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The 2040 Regional Vision

In 2008, the CMAP Board of Directors approved several vision statements for the 2040 Regional Comprehensive Plan reflecting the goals of the northeastern region of Illinois. 211 is an integral human services information and referral tool that aligns specifically with some vision statements. 211 can be considered one of many potential outcomes from working toward achieving these visions. The region can also consider how 211 could unify existing agencies with the purpose of streamlining the delivery of human service information and referrals to the public. The remainder of this strategy report will describe 211 within a national context.

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Operating 211

The 211 system involves both the county and state governments because in order for the system to be operational, the right model must be adopted and partnerships should be formed. There are three primary models that were created to describe how 211 service could operate throughout the country:

1) Centralized Administration/Single Call Center

2) Decentralized Administration/Multiple Call Centers

3) Centralized Administration/Multiple Call Centers

(Telecommunications and Information Policy Institute, Feb. 2002).

Each of these models has some unique qualities and participating states have selected the best models suited for their needs, but Model 2 has been selected as the best fit for majority of the states. Table 2 describes these models and their differences. Once a state decides that it wants to implement 211 services, a few key issues that require consideration are: telecommunication access through local and regional carriers, development of databases with human services resource information, operational staff and coordinators, sponsoring governmental and private agencies, and physical and web call centers.

Table 2: 211 Operational Models

As seen in Diagram 1, 211 services are being implemented at different rates across the country. Additionally with current technology, communication options are being maximized. In fact, based on 2006 data, forty states have a website available, eleven states have wireless accessibility, and thirty seven states, including DC and Puerto Rico, provide traditional land line accessibility (Public Policy Associates, June 2006).

211 Web Database

Development of an online web interface for 211 users is an important part of providing information and referral resources. On many 211 websites users can log on and search a statewide, regional, or city database for services by entering their zip code, city location, or type of service being requested. The web interface allows users to find quick referrals and information without contacting an operator.

Operational Challenges

During and after the process of implementing 211 services there are some common operational challenges that states have been facing. One challenge is whether or not the state will take the lead role in rolling out and standardizing 211 or decide to decentralize efforts, leaving it to individual local governments. Another challenge is determining whether or not call volume and budget justifies 24 hour coverage, despite AIRS 211 standards which require it (Public Policy Associates, June 2006). Of course, the most significant challenge is sustainable funding, as seen in the Ventura County, California example.

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Costs

A report released by the University of Texas at Austin emphasizes that the benefits could outweigh the costs for nationwide implementation of 211 services. However paying the costs of implementing and operating 211 for several states and counties is an obstacle. Some states have initiated 211 operations but have ceased operations or decreased capacity due to budget cutbacks. For instance, in New York, for FY 2007-08 $6.3 million was set aside in the state budget for 211 services. NY 211 has been operating statewide since 2007, covering more than 70% of the population (211 New York). One year later, in July 2008, a 92% budget cut was announced for 211 services leaving only $500k allocated to 211(Associated Press, July 2008).

Table 3 (p.15) shows a comparison between Connecticut, Texas, and Washington on funding sources and operating budgets that support 211. As seen in Table 3, costs can vary significantly between states based on cost drivers and therefore it is difficult to assign a nationwide standard cost of operations for 211. As an example, in Texas a cost-benefit analysis on the Texas I&R network (O’Shea, Kegler, King, 2000) shows the variation between budget assumptions made in 1998 vs. 2000, highlighting the more significant cost drivers (Diagram 2). The more significant drivers that increased costs by year 2000 were the change in call volume, telecommunication costs and the cost of operating the area information call centers.

Overall, 211 service costs vary based on population size of service area, maintenance costs of the telecommunication network, referral database development, operational staff, cost centers, and other inputs that affect annual operations. Additionally, when 211 services are dependent on annual budget allocations, availability of funding can fluctuate greatly for some states. The primary goal of the 211 Calling Act is to designate the federal government as a reliable funding source to ensure that each state has an opportunity to operate 211.

Diagram 2

Table 3

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Benefits

Emergencies strike at any time and any place and September 11th was a prime example of a national and an international state of emergency. Ambulances, police, firefighters, construction workers, doctors, teachers, and many more social and human service providers were called to duty. This terrorist attack was an awakening that 911 emergency services are not enough. 211 services were spotlighted as a potential communications solution soon after September 11. Also 211 could improve the way people connect everyday to human services in their communities. Some of the identified benefits of 211 for individuals, referral agencies, taxpayers, and society are: access to community information, shared data collection among communities, enhanced information for community planning and collaboration, reduced burden on 911 system, and better and more efficient response to human needs (Ray Marshall Center for the Study of Human Resources, Dec. 2004). The California Wildfires, Florida Hurricanes, and Hurricane Katrina are real cases of natural disasters when 211 services played a critical role in emergency services (Case Studies Section, pg. 16).

Why do people contact 211 operators or web call centers? 

Table 1 (p.2) describes the types of referrals made by 211, but depending upon the region where 211 offers services, the popularity of referrals vary. For instance, between two counties in Southeastern Michigan the top two service referrals in December 2007 were #1 Food Pantries and #2 Holiday Gifts & Toys in Wayne County vs. #1Rent Payment Assistance, and #2 Food Pantries in Oakland County (United Way for Southeastern Michigan, 12/2007). Table 4 displays an overall summary of the most popular referrals provided by 211 services based on selected state data.

As shown in Table 4, housing/shelter is the most frequently requested 211 referral, second is utility bill assistance and third is rental assistance. Although Table 4 only shows a sample of call data across the U.S., the ranking of referrals also follows a national trend in relation to housing affordability and skyrocketing energy costs. Within the top five categories there is consistency among selected states, but there is also deviation. For instance, in Vermont legal assistance and tax organizations and services are popular but not for any other state in the table. This deviation emphasizes the importance of varying needs based on location. Of course, a further profiling of callers would be required to better assess calling patterns.

Table 4: 211 Call Referrals by Categories and by Region (Selected Data)

This is helpful information in determining the needs of communities however generalizations or conclusions cannot be made. If 211 became a fully operational national system then collecting national data could be helpful in quantifying and measuring the benefits of referrals made by 211 around the country.

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Conclusion

The national status of 211 services is a positive indicator that the country has taken this type of service seriously. The purpose of the 211 service is to make information about community, local, and statewide human services available to everyone. Although the federal government has not passed the 211 Calling Act yet, many states have passed legislation that authorized the development of a 211 statewide system and some states have designated funding to support 211. The benefits of a 211 system at a national level are yet to be fully realized, but the benefits at local levels have already been accounted. On a daily basis across the U.S thousands of calls are made to 211 call centers to connect with public services and non-profit organizations that specialize in improving human conditions. Even though emphasis has been placed on 211 as an emergency response network, the benefit of a 211 system year-round is also important. Although the biggest obstacle of operating a 211 system has been sustainable funding, 46 states and Washington DC and Puerto Rico have found a way to work around this obstacle. Therefore, it is possible that in the future 211 may become a truly national network.

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National Examples of 211 as an Emergency Response System

In September 2008, Hurricane Ike caused significant rain in the Midwest over a period of days, which led to flooding along and around the river banks. In Illinois the amount of rain was considerable causing flash flood alerts all over the northeastern region and across Illinois. In a particularly hard-hit area, Wheaton (DuPage County) received 10.51 inches of rain in a two day period (Midwestern Regional Climate Center). Even rainfall near O’Hare International Airport amounted to 6.64 inches in one day, setting a record (Midwestern Regional Climate Center). This weather event is an example of when an entire region could benefit from an information and referral system like 211. For instance in New Orleans and in Corpus Christi, Texas, 211 assisted in evacuation procedures.

•  New Orleans, LA – Hurricane Gustav, a tropical cyclone, was a potential threat to Louisiana especially around the gulf coast in late August 2008. On the day before the Hurricane was anticipated to hit inland, the Department of Social Services urged citizens to dial 211 if they were seeking shelter within Louisiana. (Hurricane Gustav Resources)
• Corpus Christi, TX- Hurricane Ike was a destructive tropical storm throughout the Caribbean, mainly in Cuba and Haiti, and also caused significant damage along the coast of Texas. 211 was utilized by the State as a way to assist in evacuating special needs residents, pets, and all other residents who dialed 211 to identify themselves (MSNBC).

Additional examples of 211 being used as an emergency response tool are below.

211 Service during the California Wildfires, October 2007 

In late October 2007 twenty separate wildfires consumed the land, and six counties that were declared disaster areas in Southern California: Los Angeles, Riverside, Orange, San Bernardino, San Diego and Ventura. As of October 29, 2007, the fires had burned 518,000 acres in the seven southern counties, or two percent of the counties’ total land area, but 13.7% of San Diego County. 369,000 acres burned in San Diego County, accounting for 71.4 percent of the burned acreage in the counties eligible for federal aid. (Source: Bureau of Labor Statistics).

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2004 Florida Hurricanes

The Florida Senate Bill 1276, state legislature passed in 2002, authorizing the implementation of a statewide 211 network. In 2004, Florida was hit by five “tropical cyclones” in a single year. This was devastating to residents and their property, the economy, and the landscape of Florida.

The Five Storms 

1) Tropical Storm Bonnie- a tropical storm but no casualties or damage recorded
2) Hurricane Charley- Category 4 hurricane, hit southwest coast of FL and central FL peninsula, 9 deaths, storm damage estimated at $15 billion
3) Hurricane Frances- Category 2 hurricane, hit the east coast of FL, caused a lot of flooding; responsible for 20 deaths and approximately $16 billion in damages.
4) Hurricane Ivan-Category 5, hit southwest of Pensacola, FL; responsible for 52 deaths in the U.S. The Carribbean was damaged most; estimated damages of $20 bil.
5) Hurricane Jeanne- most devastating in Haiti and the Caribbean causing approximately 4,500 death. Hit Central FL, caused 11 deaths in US and estimated $12 billion in damages.
(Data Source: Trial by Fire: How 2-1-1’s Regional Response to the2007 Southern California Wildfires Underscored the Need for a Statewide Network, United Way & CAIRS, February 2008)

In Florida, a state that has encountered numerous natural disasters, there is strong support for a 211 statewide system. Currently, Florida does not have full coverage across the state but instead has more than 80% coverage operating with a decentralized model. One major issue that has been encountered is that 211 is not an established statewide number so during emergencies statewide coordination was limited. Additionally, eligibility for funding from FEMA requires 211 to act as a major emergency system which has to be coordinated at the state level.

Key benefits of 211 services as an Emergency Service Response 

A key benefit of 211 services is the fact that it provides response to callers; additionally data collected can be useful in identifying unmet needs and gaps in services. Also, the intensity of calls usually does not end after a disaster but instead increase or remain high which shows that callers are in need even after an emergency. 211 service can provide an intake service for the public sector for human service agencies by conducting initial screenings. Finally, 211 service not only serves as a referral and emergency system but also works with local volunteer agencies. For instance, 8800 volunteers were mobilized two weeks after Hurricane Charley in DeSoto County, Florida. 

Bibliography: 

“Trial By Fire: How 2-1-1’s Regional Response to the 2007 Southern California Wildfires Underscored the Need for a Statewide Network”, United Way, 211 California & AIRS, February 2008 

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Hurricane Katrina & Hurricane Rita benefit from 211

Hurricane Katrina, one of the most devastating hurricanes in history, followed a couple of weeks by Hurricane Rita were both very disastrous for the people of Louisiana, Mississippi and in Alabama and Texas. Due to the level of displacement that the storms caused, all surrounding states were affected. Three years later, in 2008, Louisiana is still in recovery. One very critical factor that was pushed beyond its limits was emergency response- the 911 system was overwhelmed and was not available to thousands of people.

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APPENDIX: Call Statistics 

Denver, Colorado 

Source: United Way Denver

211 Statistics, 2007 Annual

Total Calls=109,900
http://www.unitedwaydenver.org/site/c.rwL8KjNULrH/b.4119499/k.8D4F/211_Metro_Denver_Colorado__Mile_High_United_Way.htm 

State of Vermont 

Source: 211 Vermont

211 Statistics, January to June 2008

Total Calls=10,646
http://www.vermont211.org/images/stories/Documents/monthly2008.pdf 

State of Connecticut 

Source: 211 Connecticut

211 Statistics, 2007 Annual

Total Calls= 338,685
http://www.infoline.org/Professionals/Statistics/stats07.asp 

San Bernardino County, California 

Source: 211 San Bernardino County, Inland Empire United Way

211 Statistics, October to December 2007

Total Calls= 13,243

http://www.211sb.com/publications.htm 

Southeastern Michigan, Region coverage includes Detroit, MI

Source: United Way of Southeastern Michigan

211 Statistics, June-December 2007

2007 Total Calls=163,659

http://www.uwsem.org/research/index_211.html

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APPENDIX: 211 Cost/Benefit Model Detail 

The detail in this appendix section supports the costs and benefits dollar figures described within the report. All of the data and information comes from a 211 Cost/Benefit Analysis researched and completed by the Ray Marshall Center for the Study of Human Resources at the University of Texas at Austin. The report is the “National Benefit/Cost Analysis of Three Digit-Accessed Telephone Information and Referral Services”, December 2004. http://www.211.org/documents/costbenefitanalysis.pdf

Costs 

Cost Estimate Calculations 

Cost per call and anticipated call volume form the basis of the total national cost estimate.

Costs are totaled from:

1. Cost per call associated with each site

2. Cost per call associated with each model

3. Total costs under four national cost estimation approaches

A unit cost for each model was calculated by aggregating call volume and total costs for the sites that represent each model. Estimated costs for each model include all operating expenses for a call center.National call volume multiplied by the cost per call provides the national cost estimate. 

There were three primary perspectives used for analyzing both benefits and costs in the Cost Benefit Analysis conducted at the University of Texas at Austin.

1. Participants, include individuals and families, employers, and local information and referral centers, as well as health and human services providers;

2. Taxpayers (or government), are primarily state and local public funds, but including federal, as well; and

3. Society as a whole is simply the sum of participants and taxpayers, net of any taxes and/or transfers between them.

Cost by Perspectives 

Participants incur costs burdened by all non-profit entities that operate the 2-1-1 call centers and organizations that contract with them and the donors who support them.

Taxpayers incur costs through public contracts, grants, and investments, as well as direct services that the public sector provides to the 2-1-1 network.

Society incurs the sum of costs burdened by participants and taxpayers net any taxes or transfers between them.

Benefits 

Benefits were estimated by modeling anticipated national call volumes as a function of call volume to population rates in more mature 211 sites which included the following cities and states, Hawaii, Connecticut, Houston, TX, Minnesota, Salt Lake City, Utah, Albuquerque, New Mexico, Grand Rapids, MI, Atlanta, GA, Sioux Falls, SD, and Jacksonville, FL. The major assumption for the model was that the penetration rate would be equivalent in a fully operational national 2-1-1 network.

Beneficiaries by Category 

1) Participants/Individuals & Families: Value of Time Saved Value of Tax Assistance, Value of Taxes Recovered, Value of 24/7 Access

2) Organizations: Volunteer recruitment, Value of 24/7 Access, Participants Subtotal, Taxpayers

3) Planning and Management: Misdirected calls (time saved), Certification Readiness, Value of 24/7 Access, Eliminated I&R Duplication, Non-Reimbursed Services, 911 Redirection Benefit

Net Value 

Net Value is the difference between costs and benefits and is the preferred evaluation for policy makers. All models except for the decentralized model create a positive net value and therefore a positive Cost/Benefit ratio (a ratio greater than 1).

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References

211 Calling Act, GovTrack http://www.govtrack.us/congress/bill.xpd?bill=s110-211

211 Calling Act, United Way http://www.211.org/documents/211CallingAct.pdf 

211 New York, http://www.211ny.org/history.html

211 San Bernardino County, Monthly Report 06/2008, http://www.211sb.com/publications.html 

Alliance of Information and Referral Systems

Associated Press, “NY slashes services hot line budget”, July 8, 2008, http://www.nysun.com/new-york/state-slashes-211-hot-line-budget/81271/ 

CMAP Regional Vision for Metropolitan Chicago, http://goto2040.net/ideazone/default.aspx?id=9208 

Hurricane Gustav Resources, http://hurricanegustavresources.org/2008/08/31/louisiana-evacuees-urged-to-use-211-and-toll-free-number-to-find-shelters/ 

Illinois General Assembly, Executive Branch (20ILCS3956/) Human Services 211 Collaboration Board Act, http://www.ilga.gov/legislation/ 

Midwestern Regional Climate Center, http://mcc.sws.uiuc.edu/cliwatch/0809/080916.htm 

MSNBC, “City and County prepare for Hurricane Ike’s Arrival”, September 9, 2008, KRIS-TV http://www.msnbc.msn.com/id/26630396/ 

O’Shea, Kegler, King, Ray Marshall Center for the Study of Human Resources, The University of Texas at Austin, “The Value of a Comprehensive Texas Information and Referral Network:

August 2000 Update”, August 2000 http://www.utexas.edu/research/cshr/pubs/html/INR2000Fnl_Rev.htm 

Public Policy Associates, Incorporated, “State of Michigan 2-1-1 Study: Interim Report”, June 2006, p.11)

Public Policy Associates, Incorporated, “State of Michigan 2-1-1 Study: Interim Report”, June 2006, p.14)

Ray Marshall Center for the Study of Human Resources, The University of Texas at Austin, “National Benefit/Cost Analysis of Three Digit-Accessed Telephone Information and Referral Services”,              December 2004, http://www.211.org/documents/costbenefitanalysis.pdf 

San Bernardino County 2007-08 Budget in Brief, http://www.sbcounty.gov/content/20080107_cao_budget_in_brief.pdf 

Southeastern Michigan Council of Government, Annual Report, http://www.semcog.org/Population.aspx 

Strom, Stephanie, “After Hurricanes, Growing Support for 211 Call Service” New York Times, November 20, 2005, http://www.nytimes.com/2005/11/20/national/nationalspecial/20phone.html 

Telecommunications and Information Policy Institute, University of Texas at Austin, “211 State by State: A Periodic Report on the National Implementation of Three Digit-Accessed Telephone

Information and Referral Services”, February 2002, http://www.211.org/documents/costbenefitanalysis.pdf 

United Way for Southeastern Michigan, Monthly Report 06/2008, http://www.uwsem.org/research/index_211.html 

United Way, http://www.liveunited.org/about/

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