Inclusion/Exclusion Policy: The Most Important Document You’ll Create

Inclusion/Exclusion Policy: The Most Important Document You’ll Create

Steve Eastwood, Community Information and Referral Services/2-1-1 Arizona

Dave Erlandson, United Way 2-1-1/Ceridian

AIRS Standard 7

“To ensure that the needs of the community are met, the I&R service develops criteria for the inclusion or exclusion of agencies and programs in the resource database. The criteria are uniformly applied and published so that staff and the public are aware of the scope and limitations of the database.”

Standard 7 Quality Indicators

The Policy describes the criteria for the database

Comprehensive/specialized split, balance when it comes to politics and issues.

The policy is reviewed at least once every two years

If the I&R charges a fee for inclusion, this practice is published as one of the criteria

Appears in other Standards QI’s

Standard 9, Classification System/Taxonomy

Quality Indicator 3: The taxonomy should be reviewed once per year, ideally with the inclusion/exclusion

Standard 10, Content Management and Indexing

Quality Indicator 2: An adequate number of resource specialists must be on staff to properly maintain the data

Current Literature

Dick

Manikowski

, “Setting Inclusion/Exclusion Criteria: Determining the Scope of the Resource File,”

Information and Referral, the Journal of the Alliance of Information and Referral Systems

22 (2000): 111-138.

Decision making document meant to ensure consistency, easy application to potential resources, and supports decisions when contested

A very important aspect of the above three is that this removes personal preferences from the decision

Specific steps to writing policy

A 3-step guide to writing inclusion/exclusion policy does not exist; we can talk about clauses that tend to work well and others that don’t but…

Because there are so many variables between I&R agencies we need to take a moment to think in the abstract

A great starting point is your own agency’s mission

Why is your agency around in the first place and how can the inclusion/exclusion policy reflect and support the mission statement?

Beyond the mission

The needs of your population should come first

You may not have a good grasp on this when first writing the policy, but during reviews use reports to narrow down what is needed and what is not

This is not necessarily the needs of your I&R staff; try to go beyond anecdotes

Avoid duplication of existing information systems

We don’t exist as the only source of information for people; if a specialized I&R exists there is no need to reinvent the wheel that’s already rolling

Comprehensive/Specialized I&R

Specialized I&R agencies have things easier here

While this sounds pretty straightforward it’s actually tough to achieve a

zen

-like state of “complete comprehensive-

ness

”

Comprehensive should not be a code word for “anything goes;” this will undermine other policy clauses

A great way of thinking of comprehensive is simply a shorthand way to note that your agency is not specialized

Specific Considerations

Subject Area Considerations

If specialized I&R agencies are out there consider meeting the right people to discuss overlapping effort

With websites improving it may a good idea to avoid duplicating information that is easily accessed online

Target Group Considerations

Consider what your target population needs, and avoid simply stating the population type in your policy. Humans have common needs, so stating a target group doesn’t convey whether those common needs are in or out

Specific Considerations

Eligibility Considerations

Membership organizations may provide some amazing services if you can get through the initial payment barrier; can your population afford that?

Geographic Considerations

This is pretty straightforward but consider service area

vs

service location, further restrictions may want to be placed on national agencies

Specific Considerations

Tax Status

For profits/nonprofits make for a great starting point when considering inclusion/exclusion; however what about a for profit that offers discounts to your population?

Private Practitioners

Including them can quickly grow your database to a point where it’s unmanageable. State governing boards or professional societies may keep up their own directories on these.

Specific Considerations

Stability

If an agency has erratic downtime/uptime for whatever reason it may be better to avoid referring to it; and instead focus on more stabile organizations that you know your callers will be able to access; consider business viability

Political Groups

Strive for balance if they are included; this means you may be updating things you do not personally like

Related documents

Disclaimers of Responsibility

Often times it’s the I&R staff who are reminding people that these are referrals and not endorsements

May be good to have it codified somewhere

Complaint Handling Procedures

How can agencies appeal an inclusion/exclusion decision?

Don’t be afraid to say no to an agency; the services (and the records you’re updating) need to work for your population

“Get Out of Jail Free” Clause

Be extremely careful in how you implement this: while a level of flexibility is needed, all of your previous policy work can be undone by this clause

Resource staff should carefully document why they invoke this clause to include/exclude an agency

Keep that documentation until the next policy review and then look for commonalities

If something is common enough, codify it in its own policy clause

Information Systems Over Time

Libraries: generally “copy cataloging” allows librarians to import a record into their system; often accused of preservation through “benign neglect”

Archives: generally have to create unique records called finding aids; larger time investment than libraries, but it’s also rare that they will change

Records Management: generally support business objectives that will be met; once the objective is complete, records are retained for a time and then sent to an archive or destroyed

I&R Over Time

I&R work hopes to address conditions such as disease, disability, aging, homelessness, etc.

Until there is a cure for these things, our objective will continue into perpetuity

The time and effort of resource work has a monetary cost

When you are including something in the database you are making a financial decision

Costs Over Time

Consider what one hour of your resource time is worth

Then think about how current average time quoted for maintenance on a simple agency is two and a half hours

Since maintenance work is ongoing, multiply that number by a few decades

Framing it this way demonstrates costs can get into the thousands for records that are not often used

Aim for

curated

content!

Inclusion/Exclusion Review

Practical steps to include in your biannual review:

AIRS Problem/Needs Categories: can give you a high level view of what your population needs

Special Referrals Report: have a method of recording referrals outside of your information system

Inclusion/Exclusion Review

Review your taxonomy at the same time as your Inclusion/Exclusion review this can clue you in on a few things:

Are there terms/service that receive so few referrals that you can inactivate them? Would you also be able to codify them as excluded from the database?

Are there terms that when rolled up to the next highest level have enough referrals to stay?

Do you have terms that aren’t attached to any services?

Low Referrals Report Example

Examples of Interest

Two policies attempted to define “Health and Human Service Providers” into more specific categories as a starting point

One included using the Better Business Bureau as a mechanism to review included for profit agencies

A few make specific provisions for 800 numbers if they’re accessible to their populations

Questions/Discussion

Have you found a particular criteria works well for your agency?

How did your last review go? Was it simply a “rubber stamp” affair of changing the dates? Did you have to work hard to convince your stakeholders to open up or further limit your policy?

Do you track your inclusion/exclusion updates throughout your agencies life?

Contact Information

Steve Eastwood, seastwood@cir.org

Dave Erlandson, david.erlandson@ceridian.org