Champion of '211' Call Centers Set to Lead National Counties Group

NASHVILLE — San Diego County’s 211 call center has come a long way from its somewhat humble beginnings over a decade ago.

It started off around 2005 with the county convincing local nonprofits that it would be wise to have one simple number people could call to get connected with health and social services.

Later, workers staffing the phone line began fielding non-emergency calls during disasters.

County Supervisor Greg Cox recalls the 211 outfit in its early days as a “podunk, little operation that was in a crappy little shopping center.”

About 20 operators handled around 300 calls on a typical day. That is until the wildfires that hit the county in 2007. Cox says one of his staff checked in on the center a day after the fires started, and found that calls had surged tenfold and that around 9,000 had been dropped.

What happened next, the county supervisor describes as “one of those experiences sometimes you get to have in government where it’s just like everybody rose to the occasion.”

Phone lines were quickly upgraded, a hole was cut in the wall so the center could be expanded into the vacant space next door (“we didn’t even ask the landlord,” Cox said), additional tables and computers were brought in. About 1,200 volunteers manned the phones.

The call center, according to Cox, took roughly 160,000 calls, in about a week’s time, as the county of about 3 million residents evacuated around a half-million people out of the path of the fires.

After the wildfires subsided, San Diego County officials came to see 211 as useful for something more than health and human services.

“During a disaster it’s absolutely indispensable,” Cox said.

NACo President’s Initiative

On Monday, Cox is slated to succeed Tarrant County, Texas Commissioner Roy Charles Brooks as president of the National Association of Counties. Each president of the organization typically has a leadership initiative that they focus on during their one-year tenure.

NACo has gathered in Nashville in recent days for its annual conference.

Cox’s initiative, known as “Connecting the Unconnected,” is driven in part by his belief in the usefulness of call services like the 211 operation in his county. “I’ve become, maybe, a fanatic about 211,” he told Route Fifty last week during an interview about the initiative.

The call center in San Diego County is no longer housed in the shopping complex. It’s now in a more state-of-the-art facility.

When a person in the county calls in for help gaining access to health or social services, Cox said that they may end up speaking to a staff member for 20 minutes or so about a range of programs.

“What you’re getting here is a real live person dealing with your real live problem and hopefully coming up with real solutions,” he said.

He offers this example: Someone calls in because they are short on food. The call center operator can direct them to a food bank, but can also collect information to get the person enrolled for food stamps and forward it to the county staff that determine eligibility.

Beyond that, they can ask if the person needs assistance locating a health clinic in their area, or if they’re aware that their children might qualify for free or reduced-price school lunch.

Additionally, the call center has a contract with the local utility, San Diego Gas & Electric, to enroll people in an assistance program that provides reduced rates for low-income residents.

Nonprofits that provide health and human services in the county have been intertwined with the call center since its early days.

There are about 1,200 area nonprofits in San Diego County running about 6,000 different programs. The call center has a database to search these, not just for the poor but also for people who might be seeking help for something like a family member who has dementia.

On the emergency management front, the county has relied on 211 service during outbreaks of H1N1 flu virus, and Hepatitis A, letting people know where to get vaccinations. And after a less severe wildfire last week people called in to get information about assistance.

“What we’ve been able to do with 211 is really tear down all of these silos,” Cox said.

He’d like to see other counties go down a similar path.

In California, the supervisor says that 20 of the 58 counties don’t have 211 networks established. A recent grant from the state’s public utilities commission will help get them set up. South Dakota has 66 counties but only one or two with 211 systems, he said.

“I’m convinced, that if we do this right, this will actually save counties money,” Cox added.

Next Phase of San Diego County's Call Center

Going forward, San Diego is looking to ingrain a more advanced data platform into its 211 system. The idea is that the center will act as a hub for this data, sharing the information, in compliance with privacy laws, with clinics, hospitals, nonprofits and other service providers.

“You can kind of capture and get a good profile of that household, or that individual, or that client and ensure they’re not duplicating services,” explained Danny Melgoza, chief of staff for Cox.

The vision is for a system where it’s possible to punch a person’s name into a computer and see information about all of the services they’re accessing across the organizations in the database.

It’s expected the system, which is still being discussed, will have predictive elements as well. For instance, knowing a household’s food stamp benefits might not stretch to the end of the month, an agency or a nonprofit might preemptively direct them to a food bank.

In the meantime, Cox will kick of his NACo presidency as an evangelist for more robust 211-like systems. “We’re not trying to reinvent the wheel. And a lot of communities have 211s,” he said. “A lot of it is just taking what is already there and trying to maximize the use of it.”