Thinking Outside the Box

1. Thinking Outside the Box Creative Resource Ideas for Return Callers Angela Brown, MSW, CIRS-A Ashley Morris, MSW

2. Presentation Goals Attendees will leave this presentation with the ability to: • Empower return callers to think outside the box and utilize other resources • Effectively end calls when resources have been provided • Identify differences between I&R and case management • Distinguish between callers who have exhausted all resources and those whose challenges extend beyond the mere availability of resources

3. About the Eldercare Locator • A free, public service of the U.S. Administration on Aging that connects older adults, families, caregivers, and adults with disabilities, to resources in their local community. • I&R for this population when they inquire about available programs and services. • Education for callers on questions to ask when speaking with local providers. • I&R and education services are provided via telephone, chat, e-mail and mail.

4. Types of Calls • Number of Contacts (2012): 216,670 • Top 5 Purposes of Calls: • 33% Transportation • 20% Financial Assistance • 10% In-home Services • 8% Medical Services (includes dental, vision and hearing) • 4% Interest in Available Programs and Services

5. Resources We Use • Local Aging Service Providers: AAA, CIL, ADRC • State Offices: State Units on Aging, Health Insurance Counseling Programs • Elder Abuse Prevention: Long-Term Care Ombudsman, APS • National Organizations that help in the areas of: Housing, Home Repair/Modification, Food and Shelter, Taxes, Employment, Caregiving, LTC

6. Escalated Calls

7. What are Escalated Calls? • Cannot be handled on the frontline due the complexity of the circumstance and/or the characteristics of the caller. • Found in every establishment and is not necessarily indicative of staff performance or capability.

8. Eldercare Locator Escalated Calls • Distressed: caller whose emotional state requires more time than usual, and the expertise of a specialist. • Skilled: call topics that are too complex to be handled at the front end; require more time, education and resources. • Return Callers: those who utilize all referrals and need additional resources.

9. Case Scenario A: Elder Abuse • Caller felt mother was being abused in a long-term care facility. • Unable to get satisfactory help from the relevant agencies. • Contacted: LTC Ombudsman, APS, AAA, State Agency & Police

10. Case Scenario A: Resources Used • Caller was told that her U.S. Senators and Representatives could maybe look into the situation and advocate for her. • As the conversation progressed, the caller began to think outside the box and decided to look into reporting the situation to the media.

11. Creative Resource: Elected Officials • U.S. Senators and Representatives regularly advocate for their constituents. • State Senators and Representatives are also good resources. • Try to give local representatives to callers first, and use federal representatives as a back-up.

12. Creative Resource: The Media • A conduit for getting information to the community. • Able to ignite grassroots action and attract the attention of those in power. • Provide the media as a resource only to callers who feel that they are not being heard, and/or are looking to make lasting change.

13. Case Scenario B: Medical Bills • Caller had a number of medical bills that he could not afford to pay. • The local agencies stated that there were no financial resources available in the state to help him. • He did not have a chronic or terminal illness that would have attracted the assistance of a foundation. • Contacted: AAA and State

14. Case Scenario B: Resources Used • Research was conducted on ways to pay medical bills, and Medical Billing Advocates were seen as a potential resource. • The caller was referred back to the AAA for medical billing advocacy services.

15. Creative Resources: Exploring Other Options • The caller was encouraged to also inquire as to whether there were any other organizations or programs that could assist him in having his bill reduced as much as possible. • The client was motivated to think outside the box of getting money to pay the bill, and instead, shift his thinking to reducing the bill.

16. Creative Resources: Exploring Other Options • When speaking with return callers in need of financial assistance, it is important to help them think outside of the box of getting money. • Exploring different avenues may help the caller to improve their situation by other means.

17. Tips When Using Creative Resources • Always equip the caller with appropriate questions to ask the referrals. • Remain aware of the protocols of your organization.

18. Case Scenario C: Transportation • Caller needed transportation from a rural area to a medical appointment in the city (30 miles). • No private resources (family, neighbors, or religious community) were able to assist. • Contacted all relevant agencies.

19. What To Do When… …There Are No Resources

20. No More Resources • Distinguish between callers who have exhausted all resources and those whose communication and attitude are preventing them from receiving help. • Three Key Characteristics: • Caller has trouble receiving information from others • Caller has an “opposed” mindset • Caller is not actually facing a problem • Discerning what type of caller you are speaking with may give you a clue as to whether you even need to think outside of the box. For some, no amount of creative thinking or investigation will be of assistance.

21. Helpful Things to Say • Reiterate what your service does • Give tips for future action • Inform the caller that you will get back to them if you find additional resources

22. Know the Differences… I&R vs. Case Management

23. I&R vs. Case Management • I&R: The practice of providing “people…with information about a broad range of…services that might otherwise be unknown to them. [I&R] opens the door to the human service delivery system and helps people obtain access to the services they need.” (The ABCs of I&R, 2013) • Case Management: “a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual’s and family’s comprehensive health needs…” (CMSA, 2013)

24. I&R v. Case Management • Differences between I&R and Case Management: • Resource Connection vs. Theory & Evidence-Based Practice • Distinctive Assessment Types & Purposes • Advocacy & Follow-up vs. Care Coordination • Do not become the caller’s case manager unless you are designated by your organization to provide such services.

25. Summary When engaging with return callers, remember to: • Empower them to consider and pursue every option available. • Politely close out calls when a person has truly exhausted all options. Leave the caller with a sense of hope and give them instructions for further action. • Draw appropriate boundaries and remain in the role of I&R Specialist. • Differentiate between callers who have exhausted all resources and those whose challenges extend beyond the mere availability of resources.

26. Questions or Ideas?

27. Contact Information Angela Brown, MSW, CIRS-A Transportation Specialist abrown@n4a.org Ashley Morris, MSW LTSS Specialist amorris@n4a.org