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ALLIANCE OF INFORMATION AND REFERRAL SYSTEMS

CERTIFIED INFORMATION AND REFERRAL SPECIALIST-AGING/DISABILITY (CIRS-A/D)

PRACTICE (JOB) ANALYSIS DEVELOPMENT & VALIDATION

Michael Hamm & AssociatesDr. Gerald A. Rosen, Consulting Psychometrician

December 23, 2013

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The Alliance of Information and Referral Specialties (AIRS) has undertaken the task of updating and expanding the scope of its Certified Information and Referral Specialist-Aging (CIRS-A) examination to more formally include practice related to disabilities. The product of this effort will be a revised designation called Certified Information and Referral Specialist-Aging/Disabilities (CIRS-A/D). A necessary first step in this process is to update the CIRS-A practice (job) analysis, identifying the domains of practice, tasks performed, and knowledge and skills required for safe and effective performance in this expanded scope. Once in place, these domains, tasks and knowledge and skill statements will form the basis of examination construction in accordance with the weights specified in this report.

On November 21& 22, 2013, a workshop was conducted in Arlington, VA wherein a diverse group of 13 certified subject-matter experts (SMEs) selected by and representing AIRS met to conduct the practice analysis for the CIRS-A/D examination program. (The roster of workshop participants can be found in Table 1.) The workshop facilitators were Michael Hamm and Dr. Gerald A. Rosen of Michael Hamm and Associates. Specifically, the purpose of this meeting was to: 1) produce a document delineating the knowledge required for the safe and effective performance of the tasks carried out by the certification-level I&R aging/disability specialist; 2) identify for each domain and task weighting factors for examination development representing the pooled judgments of the SMEs of their relative importance and frequency of performance; and 3) produce a list of performance domains and associated skills to be used as an adjunct to the process of examination item (question) writing and test construction.

The product of the role delineation workshop was a draft practice analysis/set of test specifications that was subsequently returned to AIRS for further review and comment by the Committee. As a result, several corrections and clarifications were made to the draft.

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Table 1

Practice Analysis Workshop Participants, November 21-22, 2013 - Arlington VA

Name Credentials City State/ Province

Organization Position Yrs Exp

Amala, Raquel CIRS-A Portland OR United Way I&A Specialist 20+

Anderson, Holly CIRS-A Jasper TX Area Agency on Agency

Director 29

Brown, Angela MSW, CIRS-A

Washington DC National Assoc. Area Agencies on Aging

Program Assistant 3

Danner-Gulley, Deborah

RN, CM-C, CIRS-A

Williamsburg OH Area Agency on Aging, District 7

LTC Programs Director

21

Gipson, Ronnie BAT, MURP College Station

TX Brazos Valley Council of Governments AAA

Program Manager 28

Gorman, Bob BS, CIRS-A Naugatuck CT Community Choices

I&R Coordinator

16

Harvey, Olivia Marlow

BS, QIDP, QMHP, CIRS-A

Wise VA Junction Center for Ind. Living

Options Counselor Coordinator

7

Osborne, Mary MSW, Gerontology, CIRS-A

Washington DC National Assoc. Area Agencies on Aging

Manager Eldercare Locator

15

Tribe, Sara BA, MSW, LCSW, CIRS-A

Washington DC National Assoc. of States United for Aging & Disabilities

Director, National I&R Support Center

9

Welton, Christine AS, CRS, CIRS-A

Fort Myers FL Area Agency on Aging for SW FL

Client Services Director

8

Wildman, Anne G. BSW, LSW, CRS

Florence KY Northern KY Area Development District

Director 15

Williamson, Sharon BSW, MPH, Cert. Health Educ Spec, CIRS-A

Savannah GA GA Dept. of Behavioral Health & Developmental Disability

Aging and Disability Program Specialist

25

Yee, Matthew MHA, MBA, CIRS-A

Peoria IL Central Illinois Agency on Aging

Director, Information Resources and Supportive Services

10

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Because the product of this workshop represented the work of a limited number of individuals working at a single, two-day meeting, the decision was made to validate the practice analysis. (The practice analysis document can be found in Table 2.) The practice analysis validation process consisted of a survey of practitioners from the various regions of the United States. The database for the survey was the complete list of 2,100 certified I&R specialists maintained by AIRS. All of the individuals listed in the database were invited to participate in the survey. Thus, no sampling of the database was undertaken. In addition to the draft practice analysis document, participants were provided with instructions for logging on to a website and a set of detailed instructions for reviewing and commenting on the practice analysis and skills set documents. The respondents recorded their responses to the survey questions on the host website. They were asked to review the practice analysis document and: (1) identify those domains, tasks, knowledge or skill statements they would like to remove, reword, or revise; (2) suggest any new domains, tasks, knowledge or skill statements that they would like to add to the practice analysis; and (3) confirm or suggest changes to the domain weights. (The complete survey results including the demographic characteristics of the survey respondents can be found in Appendix A.)

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TABLE 2 CERTIFIED INFORMATION AND REFERRAL SPECIALIST - AGING/DISABILITIES

JOB TASK ANALYSIS

This Document represents a delineation of the tasks (T) performed together with the knowledge (K) and skills (S) applied by Certified Information and Referral Specialists -Aging/Disabilities in the practice of their profession. Information and Referral Specialists – Aging/Disabilities are human service professionals whose communication skills, creative thinking and problem-solving skills provide the critical link between client needs and community, health and social services. They respect and support client rights to self-determination as they provide person-centered information, assistance and advocacy for older adults, persons of all ages with disabilities, and their caregivers.

Domain I – Rapport (18%*)

T-1 Establish and maintain rapport by welcoming clients according to their preferred mode of communication, explaining your role as an I&R Specialist, actively listening, and responding in a manner and tone appropriate to the situation.

The safe and effective performance of this task requires knowledge of:

K-1 Techniques for establishing and maintaining rapport (e.g., empathy, validation, sensitivity, receptivity/leadership)

K-2 Active listening techniques (e.g. patience, responsiveness, paraphrasing, supportive silence)

K-3 Techniques for recognizing and appropriately responding to cultural, ethnic, aging, disability, and other demographic differences

K-4 Techniques for responding to emotional states of clients (e.g., empathy, de-escalation, reassurance, support)

K-5 Techniques for working with challenging behaviorsK-6 Diverse modes of communication (e.g. social media, interpreters, assistive

technology)

Domain II - Screening/Assessment (20%*)

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T-1 Determine the nature of the call (e.g., information provision, information and referral/assistance, eligibility screening, crisis), problem/need(s), and the emotional state of the client.




K-6 Diverse modes of communication (e.g. social media, interpreters, assistive technology)

K-7 Techniques for effective questioning (e.g., open-ended and clarifying questions)

K-8 Interviewing techniques, including motivational interviewing when applicable

K-9 Signs and symptoms of crisis situations and abuse/neglect

T-2 Explain the need for and obtain demographic and other information relevant to the client’s situation and presenting problem.






K-10 Available services and their key information elements (e.g. eligibility, documentation required, application method, location, hours of operation, languages of service, transportation access, private payment options)

K-11 Principles associated with client confidentialityK-12 Basic knowledge of government programs and services (e.g. Medicare,

Medicaid, veterans, state, local)

T-3 Determine the need for additional information gathering and service provision (e.g. home visit, evidence-based risk screening, Options Counseling).


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K-13 Basic knowledge of surrogate decision makers (e.g. power of attorney, guardianship, advance medical directives) and associated processes/documentation

T-4 Determine the actions previously taken, if any, assistance previously received, and the results of the actions and assistance in order to refine the list of possible resources and the assistance that may be needed.










T-5 Evaluate the client’s resources (e.g., personal, family, financial), strengths, limitations, potential barriers (e.g., disabilities, language, communication skills), preferences, and coping skills (i.e., ability to effectively act on referrals) in order to facilitate self-advocacy and determine the need for additional assistance and advocacy.


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K-12 Basic knowledge of government programs and services (e.g. Medicare, Medicaid, veterans, state, local)

K-14 General characteristics of older adults, individuals with disabilities, and caregivers and the risks/challenges they face

K-15 Characteristics of and risks/challenges associated with chronic diseases and disabilities

K-16 Techniques for obtaining additional information on older adults, individuals with disabilities, caregivers, chronic diseases, disabilities, etc.

K-17 Techniques for assessing client readiness and ability to actK-18 Techniques for empowering individuals to take action for themselves

T-6 Review, clarify and confirm the assessment information with the client and make changes as necessary.







K-17 Techniques for assessing client readiness and ability to act

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Domain III - Identification of Resources and Preferences (17%*)

T-1 Work with the client to prioritize needs, and identify appropriate resources based on the previous evaluation of personal strengths, resources and preferences.











K-17 Techniques for assessing client readiness and ability to actK-18 Techniques for empowering individuals to take action for themselves

K-19 Techniques of person-centered planningK-20 Techniques for effectively searching community resources

Domain IV –Information, Assistance, Referral and Advocacy (19%*)

T-1 Describe and explain to the client the available options and their associated requirements and responsibilities in terms of the client’s priorities and preferences.




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technology)K-7 Techniques for effective questioning (e.g. open-ended and clarifying

questions)K-10 Available services and their key information elements (e.g. eligibility,

documentation required, application method, location, hours of operation, languages of service, transportation access, private payment options)


K-18 Techniques for empowering individuals to take action for themselvesK-19 Techniques of person-centered planningK-21 Techniques for helping clients explore options, including the concepts

within Options CounselingK-22 Principles of self-direction

T-2 Determine the level of assistance and advocacy needed in order to help the client act on the selected options.









K-17 Techniques for assessing client readiness and ability to actK-18 Techniques for empowering individuals to take action for themselvesK-19 Techniques of person-centered planningK-22 Principles of self-directionK-23 I&R agency policies and codes of ethics

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T-3 Obtain client agreement on roles, permission to assist and advocate as needed, release of information if required, etc. in order to permit action on selected options.




K-7 Techniques for effective questioning (e.g. open-ended and clarifying questions)



K-11 Principles associated with client confidentialityK-13 Basic knowledge of surrogate decision makers (e.g. power of attorney,

guardianship, advance medical directives) and associated processes/documentation

K-17 Techniques for assessing client readiness and ability to actK-18 Techniques for empowering individuals to take action for themselvesK-19 Techniques of person-centered planningK-21 Techniques for helping clients explore options, including the concepts

within Options CounselingK-22 Principles of self-directionK-23 I&R agency policies and codes of ethics

T-4 Implement assistance and advocacy decisions in collaboration with the client, family, caregivers, providers, etc. in order to obtain needed services.






technology)

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K-17 Techniques for assessing client readiness and ability to actK-18 Techniques for empowering individuals to take action for themselvesK-19 Techniques of person-centered planningK-22 Principles of self-directionK-23 I&R agency policies and codes of ethics

T-5 Complete the contact by reviewing and summarizing with the client the information given, options selected, action plan, and follow-up plans, if applicable. (The continuation of the original rapport should ensure the client will re-contact your service if future help is required.)




K-5 Techniques for working with challenging behaviorsK-18 Techniques for empowering individuals to take action for themselves

Domain V - Documentation (11%*)

T-1 Complete the record of the current contact, and contacts made on behalf of the client by obtaining additional information, if necessary, and documenting assessment and demographic information, and any required outcomes, client notes, follow-up notes, etc.The safe and effective performance of this task requires knowledge of:



K-23 I&R agency policies and codes of ethics

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K-24 Documentation techniquesK-25 The nature and uses of I&R data and data reportingK-26 Mandatory reporting requirements

Domain VI - Follow-up (10%*)

T-1 Contact the client as appropriate to determine current status of situation, if the referrals were contacted and proved appropriate, and/or if additional assistance and referral is required (i.e., what happened, what didn’t happen, what changed, if needs still remain, if new needs have arisen, and agreed upon next steps).


K-1 Techniques for establishing and maintaining rapport (e.g. empathy, validation, sensitivity, receptivity/leadership)





technology)K-6 Diverse modes of communication (e.g. social media, interpreters, assistive

technology)K-7 Techniques for effective questioning (e.g., open-ended and clarifying

questions)K-8 Interviewing techniques, including motivational interviewing when

applicableK-9 Signs and symptoms of crisis situations and abuse/neglectK-10 Available services and their key information elements (e.g. eligibility,



Medicaid, veterans, state, local)K-13 Basic knowledge of surrogate decision makers (e.g. power of attorney,


K-14 General characteristics of older adults, individuals with disabilities and caregivers and the risks/challenges they face


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K-17 Techniques for assessing client readiness and ability to actK-18 Techniques for empowering individuals to take action for themselvesK-19 Techniques of person-centered planningK-21 Techniques for helping clients explore options, including the concepts

within Options CounselingK-22 Principles of self-direction K-23 I&R agency policies and codes of ethicsK-24 Documentation techniquesK-26 Mandatory reporting requirements

Domain VII - Ethics, Professional, and Legal Issues (5%*)

T-1 Certified Information and Referral Specialists - Aging/Disabilities provide services in a manner consistent with the AIRS Standards and Quality Indicators for Professional Information and Referral, the Older Americans Act, the Rehabilitation Act, and the Americans with Disabilities Act.


K-11 Principles associated with client confidentialityK-23 I&R agency policies and codes of ethicsK-27 The AIRS Standards and Quality Indicators for Professional Information

and ReferralK-28 The Older Americans ActK-29 The Americans with Disabilities ActK-30 The Rehabilitation Act

T-2 Certified Information and Referral Specialists – Aging/Disabilities follow the requirements of mandatory reporting laws and ethical responsibilities (e.g., elder and child abuse, domestic violence, suicidal/homicidal ideation), and other legal and ethical requirements (e.g., privacy legislation, client confidentiality, conflict of interest, surrogate decision making, ADA).




K-23 I&R agency policies and codes of ethicsK-26 Mandatory reporting requirementsK-29 The Americans with Disabilities Act

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T-3 Certified Information and Referral Specialists - Aging/Disabilities engage in professional development activities to continuously improve the quality of the services they provide, manage personal stress, and perform their responsibilities with a positive attitude and a consistently high quality of service.


K-23 I&R agency policies and codes of ethicsK-27 The AIRS Standards and Quality Indicators for Professional Information

and ReferralK-31 Professional development and continuing education activitiesK-32 Stress management techniques

__________________________________________________________________________________*(+/- 3%)

Knowledge Summary






technology)K-7 Techniques for effective questioning (e.g., open-ended and clarifying

questions)K-8 Interviewing techniques, including motivational interviewing when

applicableK-9 Signs and symptoms of crisis situations and abuse/neglectK-10 Available services and their key information elements (e.g. eligibility,


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Medicaid, veterans, state, local)K-13 Basic knowledge of surrogate decision makers (e.g. power of attorney,





K-17 Techniques for assessing client readiness and ability to actK-18 Techniques for empowering individuals to take action for themselvesK-19 Techniques of person-centered planningK-20 Techniques for effectively searching community resourcesK-21 Techniques for helping clients explore options, including the concepts

within Options CounselingK-22 Principles of self-directionK-23 I&R agency policies and codes of ethicsK-24 Documentation techniquesK-25 The nature and uses of I&R data and data reportingK-26 Mandatory reporting requirementsK-27 The AIRS Standards and Quality Indicators for Professional Information

and ReferralK-28 The Older Americans ActK-29 The Americans with Disabilities ActK-30 The Rehabilitation ActK-31 Professional development and continuing education activitiesK-32 Stress management techniques

Skills Summary

S-1 Establishing and maintaining rapportS-2 InterviewingS-3 Active listeningS-4 Effective questioningS-5 Call managementS-6 Identifying crisis situationsS-7 Understanding and appropriately responding to cultural/ethnic differencesS-8 Communicating effectivelyS-9 Ability to concentrate fully on one task and then switch quickly with full

focus to another

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S-10 Use of technologyS-11 Problem solvingS-12 Identifying needsS-13 Research and resource searching/retrieval (for example, use of AIRS

211/LA County Taxonomy of Human Services)S-14 Guiding and supportingS-15 Education and coachingS-16 AssistingS-17 AdvocacyS-18 EmpowermentS-20 Recognizing conflicts of interestS-21 Self-awarenessS-22 Recognizing limitationsS-23 Setting boundariesS-24 Stress Management

On December 19, 2013 the JTA Committee met via conference call to consider and discuss the findings of the survey. As a result of that meeting it was determined that the weights for Domains IV and V would be adjusted per their survey-based recalculations (-1% for Domain IV and +1% for Domain V), K-13 would be reworded to begin “Basic knowledge of” and all knowledge statements would be reviewed by AIRS staff to ensure that “common disabilities” and “LGBT” are included within the knowledge statements as currently worded. If not, AIRS staff has leave to make any necessary revisions or add knowledge statements as appropriate. (NOTE: The practice analysis presented in Table 2 includes the Committee’s changes.)

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APPENDIX A

CIRS-AGING/DISABILITIES JOB TASK ANALYSIS SURVEY RESULTS

The survey, along with a copy of the draft CIRS-A/D JTA, was distributed to 2,100 existing Certified Information and Referral Specialists – Aging (CIRS-A), opening on Tuesday, December 10, 2013 and closing Friday, December 13, 2013. There were 265 responses reflecting the diversity of CIRS-A holders (about 12% of those contacted). This suggests that after accounting for messages trapped in Internet filters, trapped in personal spam filters, sent to no longer current email addresses or deleted unread, the actual response rate may be closer to 20%.

What profession credentials do you currently hold? (Check all that apply)

Answer Options Response Percent

Response Count

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CIRS-A 98.5% 259CIRS 5.7% 15CRS 2.7% 7Professional license (Specify below) 7.2% 19Other Certification (Specify below) 9.1% 24Other (please specify) 47

answered question 263skipped question 2

The “Other” credentials referred to included:Dementia Specialist, Tcare CertifiedLICSWOptions Counsellor (2)NavigatorRegistered nurseMSW (3)Social Work (2)Long Term Care OmbudsmanCertified Advance Practice Social WorkerOSHIIP volunteer, ODA Certified, LSWM.A. (3)Registered Nurse, ACLS, BLSOmbudsmanTailored Caregiver Assessment and Referral; Care Transitions Intervention CoachLTCFSAttorney licensed by California State Bar

LSW, Options Counselor, Care Transitions

Masters Degree Special EducationLicensed Masters Level PsychologistLSW (10)Case Manager (BA in Sociology)SMP, CLAIMCHOICES (SHIP), Certified Application AssistanceQualified Mental Health Associate/VR Counselor 3LSW; OSHIIP Counselor CertificationNC Options CounselingBSW, Options Counseling trainingCertification in Aging Boston UniversityB.S. QDDP, QMHP, CTIGerontology CertificateHigher National Certification (Engineering)

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Which of the following best describes the type of I&R that you work for?


Response Count

AAA 41.5% 110ADRC 37.0% 98CIL 0.8% 2State Unit on Aging 6.8% 182-1-1 2.6% 7Comprehensive I&R (non 2-1-1) 4.9% 13Blended Aging/2-1-1 1.9% 5Blended Crisis/I&R 0.4% 1Other Specialized I&R 4.2% 11

How many years of I&R experience do you have?


Response Count

Less than 2 years 7.2% 19Between 2 and 5 years 24.6% 65Between 6 and 10 years 27.3% 72Between 11 and 15 years 17.0% 45Between 16 and 20 years 13.6% 3621 years and over 10.2% 27

How old are you?


Response Count

19 years or younger 0.0% 0Between 20 and 29 years 6.8% 18Between 30 and 39 years 14.8% 39Between 40 and 49 years 23.1% 61Between 50 and 59 years 30.7% 8160 years and over 24.6% 65

What is your highest level of Education?


Response Count

High School Diploma/GED 8.7% 23Associates/Community College Degree 12.1% 32Bachelor's Degree 50.2% 133

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Master's Degree 22.3% 59Doctorate 0.4% 1Other 6.4% 17

Do you support the idea of having a single Certification that covers the work of I&R/Specialists serving both older adults and persons with disabilities (and their families and caregivers)?


Response Count

Yes 91.9% 239No 8.1% 21

Which region/country best describes where you live and work?


Response Count

South (AL, AR, LA, MS, TN) 6.0% 16SouthEast (FL, GA, NC, SC, VA, WV, PR) 14.7% 39SouthWest (TX, OK, NM, CO) 3.4% 9MidWest (OH, MI, IN, KY, ND, SD, WI, IL, MO, MN, IA, KS, NE) 42.6% 113West (AZ, UT, WY, MT, ID, WA, OR, NV, CA, AK, HI) 17.7% 47East (NY, PA, NJ, DE, MD, DC) 7.5% 20NorthEast (ME, NH, VT, MA, CT, RI) 7.9% 21

The draft Practice Analysis identified "Domains" (or areas) that are central to the profession. Are there any of these Domains that you would like to eliminate from the Job Task Analysis document? Briefly state your reason(s) for the deletion(s).

Answer Options Response Response

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Percent CountKeep all Domains 96.2% 230Remove Domain I - Rapport 0.8% 2Remove Domain II - Screening/Assessment 0.4% 1Remove Domain III - Identification of Resources and Preferences 0.8% 2Remove Domain IV - Information, Assistance, Referral and Advocacy 0.4% 1Remove Domain V - Documentation 0.4% 1Remove Domain VI - Follow-up 1.3% 3Remove Domain VII - Ethics, Professional & Legal Issues 0.4% 1Briefly state your reason(s) for any deletion(s 10

o I think they all are very important Domains.o Too hard to measure.o D/t the variety of what we do sometimes we do not have the information needed to

follow up.o T 3, very time consumingo 4 and 5 look and could be sameo Screening ongoing, but assessments are duplicated by other assessment processes

for various programs.o Usually there is not manpower big enough to follow up with every caller.o All are appropriate to I&As.o We're not always able to follow up, due to time restrictions, but when we can, it is

helpful, otherwise keep all domainso same techniques applies w/ Aging populations

Indicate any Domains that you would like to reword or revise and provide your preferred wording. Briefly state your reason(s) for the change(s).


Response Count

No rewording/revision of Domains needed 95.3% 222Reword/revise Domain I - Rapport 1.7% 4Reword/revise Domain II - Screening/Assessment 1.7% 4Reword/revise Domain III - Identification of Resources and Preferences 1.3% 3Reword/revise Domain IV - Information, Assistance, Referral and Advocacy 1.3% 3Reword/revise Domain V - Documentation 0.4% 1Reword/revise Domain VI - Follow-up 1.3% 3Reword/revise Domain VII - Ethics, Professional & Legal Issues 0.4% 1Briefly state your reason(s) for any change(s). And provide your preferred wording. 13

o I don't believe there is any change necessary. I think they are all very clear.

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o Rapport needs to be maintained throughout the interaction. Therefore another word might fit better for Domain 1. Maybe something that speaks to the introduction of the I&R service as well as learning the callers intent for the communication. Also in Domain I there should be a reference to confidentiality (K-12) and learning from the customer a willingness to proceed with the call (K-8). Please consider removing the word "screening" from Domain II. This section speaks to learning the customer's concerns and gathering enough information about the customer's needs to be helpful. Discovery might be a better word, it goes beyond assessment and screening and encompasses the customer's goal for the conversation.

o I think there is a lot of redundancy by listing all the knowledge/skills needed for each domain. I think it would be better to list all the knowledge/skills that the CIRS-A/D holder needs to have and then list all the domains.

o Not familiar enough to commento Sameo To have 10% follow-up I think might prove to be difficult in certain areas. It has

been my experience thus far, that a majority of follow-ups that I do, I never receive a phone call back or nobody answers unless they need other services.

o "Screening" only (see # 8)o Establishing Trust and rapport.o Follow up when appropriateo I would rename Domain III: Identification of Options, Resources and Customer

Preferences.o “Building Rapport" or "Establishing Rapport"o None of the descriptions are measureable.o It should be made plain that advocacy begins with providing resources. It seems

self-determination gets muddled with when advocacy should begin. The CIRS (A) should always be aware that advocacy begins when we answer the phone. The first step is when a person makes the call.

Are there any additional Domains that you would like to add to the Practice Analysis. Briefly state your reason(s) for the addition(s).


Response Count

No additional Domains are needed 97.9% 237One or more additional Domains are needed (listed below) 2.1% 5

Which additional Domain(s) need to be added? Briefly state your reason(s) for the addition(s).

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o Use of technology in providing info to clients: e-mail, texting, assistive deviceso Basic understanding of the most common disabilities!o Perhaps more information/training could be added regarding working with

customers who have different communication needs (for example, aphasia or slurred speech as the result of a stroke), or best practices for working with customers who use assistive/communication devices. I'm not sure if this would be

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additional domain, or could be included in the "building rapport" or "assessment" domains.

o Would person centered options counseling fit well as a domain?o Maybe you could have two different versions of the test - one more focused on

aging for those in the aging field, and one that is more focused on disabilities for those that work in the disability field.

o I cannot say no additional domains are necessary, because the community is always transitioning. I do think there should be an awareness or sensitivity domain for diverse subcultures, i.e. aging GLBT, more cultural and ethnic awareness, etc. ..

DOMAIN WEIGHTS The Job Task Analysis process identified seven Domains and attached a provisional “weight” (or value) to each one. These numbers are intended to identify their relative importance in a CIRS-A examination - "importance" being a combination of both the critical nature of a particular task and the amount of time required to perform it. For example, the 20% listed next to “Domain II – Screening/Assessment” means that for a 100 question examination, 20 of the questions should deal with Screening/Assessment issues. Here's the proposed weights: 18% = Domain I - Rapport 20% = Domain II - Screening/Assessment 17% = Domain III - Identification of Resources and Preferences 20% = Domain IV - Information, Assistance, Referral and Advocacy 10% = Domain V - Documentation 10% = Domain VI - Follow-up 5% = Domain VII - Ethics, Professional & Legal Issues


Response Count

I agree with the proposed weighting 87.7% 222I would like to adjust the proposed weighting 12.3% 31

DOMAIN WEIGHT ADJUSTMENTS If you believe that the Domain weightings should be altered, indicate your preferred adjustment. The most important Domains should have the highest weights. If two Domains are equally important or very close in importance, than the one which involves the greater amount of time spent would be assigned a higher weight. However, if you chose to make changes, the percentages for the seven Domains must still add up to 100. (Please just enter numbers, such as 25, and not 25%) Here's the proposed weights: 18% = Domain I - Rapport 20% = Domain II - Screening/Assessment 17% = Domain III - Identification of Resources and Preferences 20% = Domain IV - Information, Assistance, Referral and Advocacy 10% = Domain V - Documentation 10% = Domain VI - Follow-up 5% = Domain VII - Ethics, Professional & Legal Issues

Answer Options Response Average

Response Total

Response Count

Domain Rapport 15.83 570 36Domain Screening/Assessment 19.58 705 36Domain Identification of Resources and Preferences 17.42 627 36Domain Information, Assistance, Referral and Advocacy 20.00 720 36

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Domain Documentation 10.67 384 36Domain Follow-up 9.69 349 36Domain Ethics, Professional & Legal Issues 6.81 245 36

TASK (T) STATEMENT COMMENTS Within each Domain, which specific Tasks would you like to eliminate from the Practice Analysis or to revise/reword. Briefly state your reason(s) for your suggestion(s).


Response Count

(Rapport, T-1) Establish and maintain rapport by welcoming clients according to their preferred mode of communication, explaining the role of an I&R Specialist, actively listening, and responding in a manner and tone appropriate to the situation.

35.7% 5

(Screening/Assessment T-1) Determine the nature of the call (e.g., information provision, information and referral/assistance, eligibility screening, crisis), problem/need(s), and the emotional state of the client.

0.0% 0

(Screening/Assessment T-2) Explain the need for and obtain demographic and other information relevant to the client’s situation and presenting problem.

7.1% 1

(Screening/Assessment T-3) Determine the need for additional information gathering and service provision (e.g. home visit, evidence-based risk screening, Options Counseling).

0.0% 0

(Screening/Assessment T-4) Determine the actions previously taken, if any, assistance previously received, and the results of the actions and assistance in order to refine the list of possible resources and the assistance that may be needed.

7.1% 1

(Screening/Assessment T-5) Evaluate the client’s resources (e.g., personal, family, financial), strengths, limitations, potential barriers (e.g., disabilities, language, communication skills), preferences, and coping skills (i.e., ability to effectively act on referrals) in order to facilitate self-advocacy and determine the need for additional assistance and advocacy.

7.1% 1

(Screening/Assessment T-6) Review, clarify and confirm the assessment information with the client and make changes as necessary.

7.1% 1

(Identification of Resources and Preferences T-1) Work with the client to prioritize needs, and identify appropriate resources based on the previous evaluation of personal strengths, resources and preferences.

14.3% 2

(Information, Assistance, Referral and Advocacy T-1) Describe and explain to the client the available options and their associated requirements and responsibilities in terms of the client’s priorities and preferences.

7.1% 1

(Information, Assistance, Referral and Advocacy T-2) Determine the level of 14.3% 2

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assistance and advocacy needed in order to help the client act on the selected options.(Information, Assistance, Referral and Advocacy T-3) Obtain client agreement on roles, permission to assist and advocate as needed, release of information if required, etc. in order to permit action on selected options.

0.0% 0

(Information, Assistance, Referral and Advocacy T-4) Implement assistance and advocacy decisions in collaboration with the client, family, caregivers, providers, etc. in order to obtain needed services.

14.3% 2

(Information, Assistance, Referral and Advocacy T-5) Complete the contact by reviewing and summarizing with the client the information given, options selected, action plan, and follow-up plans, if applicable. (The continuation of the original rapport should ensure the client will re-contact the I&R service if future help is required.)

7.1% 1

(Documentation T-1) Complete the record of the current contact, and contacts made on behalf of the client by obtaining additional information, if necessary, and documenting assessment and demographic information, and any required outcomes, client notes, follow-up notes, etc.

7.1% 1

(Follow-up T-1) Contact the client as appropriate to determine current status of situation, if the referrals were contacted and proved appropriate, and/or if additional assistance and referral is required (i.e., what happened, what didn’t happen, what changed, if needs still remain, if new needs have arisen, and agreed upon next steps).

0.0% 0

(Ethics, Professional and Legal Issues T-1) Certified Information and Referral Specialists - Aging/Disabilities provide services in a manner consistent with the AIRS Standards and Quality Indicators for Professional Information and Referral, the Older Americans Act, the Rehabilitation Act, and the Americans with Disabilities Act.

0.0% 0

(Ethics, Professional and Legal Issues T-2) Certified Information and Referral Specialists – Aging/Disabilities follow the requirements of mandatory reporting laws and ethical responsibilities (e.g., elder and child abuse, domestic violence, suicidal/homicidal ideation), and other legal and ethical requirements (e.g., privacy legislation, client confidentiality, conflict of interest, surrogate decision making, ADA).

7.1% 1

(Ethics, Professional and Legal Issues T-3) Certified Information and Referral Specialists - Aging/Disabilities engage in professional development activities to continuously improve the quality of the services they provide, manage personal stress, and perform their responsibilities with a positive attitude and a consistently high quality of service.

7.1% 1

Briefly state the changes you would like to make to any of the Tasks (make sure you clearly indicate which Task you are referring to)

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o Add trust.o Again, don't always have time for follow-up. I find it helpful when it occurs, but isn't

always able to occur unless caller calls back to say referral no longer exists or resource

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wasn't helpful. We do QA surveys though.o Already covered. Duplicative with intake and T-4o Don't see the need for explaining the role of I & R Specialist.o I don't think any of them need to be eliminated, but they can be condensed.o I would make no changes. The draft, as it is, is very detailed and correct. I have no

issues with any of it.o Not certain what changes I would make without close scrutiny. It does appear that

there is a lot of redundancy in many of the domains as I first read it .o Our aging department serves as an ADRC by partnering with a disability partner (CIL).

They are the experts in the field, and we strictly refer to them for clients in their demographic. We are not as advanced in regards to what is available - leaving the expertise up to them.

o Remove this and include these ideas: The Ethics of providing services to people near the end of their life, how to maintain their autonomy in decision making - enforcement of the patients right to refuse, or to request withdrawal of any medical treatment. The ethics required of hospitals, discharge planners, hospitals exiting patients in order to please Medicare or insurance agencies rather than providing needed care. All your certification standards should address the people you are serving first - If you want people to manage personal stress teach them not to accept arbitrary standards and to question the increase in documentation over quality of care.

o Screening/Assessment T-5) tasks seems to fall more under the responsibilities of an Options Counselor. For the purposes of Information and Assistance these topics would likely be addressed under (Identification of Resources and Preferences T-1)

o T-2,(Rapport) It might be helpful to add something that supports/respects the autonomy of the customer. T-2 (I, A, R, A) Determining the level of assistance and advocacy needed involves seeking agreement from the person regarding the assistance or advocacy. The statement of the tasks needs to reflect partnership between the person and the I&R staff, like T-3.

o T-4 not really a function of I & R Specialists - they are NOT case managers. This function would be more appropriate for a Benefits or Options Counselor. I understand the CIRS-A/D may be applied to both I & R Specialists and Benefits/Options Counselors, but implementing assistance is more of a case management function, not I & R.

o (Note that the remainder of the comments were saying that no changes were needed)

List any additional Tasks that you would like to add to the Practice Analysis under any of the Domains. Briefly state your reason(s) for the addition(s).

o "(Identification of Resources and Preferences T-2) Identify and explore any unmet needs based on available resources or client's preferences. Explain and address with client."

o Accurate documentation needs more emphasis from AIRS. In order to obtain, maintain and/or justify increased funding due to the needs of our consumer populations, data must be gathered and accurate. With the aging/disability community, it is increasingly important to gather demographics that include age and types of disabilities, as well as resources (or lack of resources) in the communities we serve. Maybe this should be broken into two items, to emphasize the documentation of the initial call as well as related calls?(Documentation T-1) Complete the record of the current contact, documenting demographic information including age groups and disability types, topics covered,

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assessments and referrals given, client notes, etc.(Documentation T-2) Record additional or advocacy contacts made on behalf of the client, as well as documenting any required outcomes, referrals, client notes, follow-up notes, etc.

KNOWLEDGE (K) STATEMENT COMMENTS Below are the Knowledge Statements that are attributed to various Domains and Tasks. Do you wish to remove any of these statements or to revise/reword any of them?


Response Count


25.0% 3


0.0% 0


0.0% 0


0.0% 0

K-5 Techniques for working with challenging behaviors 0.0% 0K-6 Diverse modes of communication (e.g. social media, interpreters, assistive technology)

8.3% 1

K-7 Techniques for effective questioning (e.g., open-ended and clarifying questions) 0.0% 0K-8 Interviewing techniques, including motivational interviewing when applicable 16.7% 2K-9 Signs and symptoms of crisis situations and abuse/neglect 0.0% 0K-10 Available services and their key information elements (e.g. eligibility, documentation required, application method, location, hours of operation, languages of service, transportation access, private payment options)

0.0% 0

K-11 Principles associated with client confidentiality 0.0% 0K-12 Basic knowledge of government programs and services (e.g. Medicare, Medicaid, veterans, state, local)

8.3% 1

K-13 Surrogate decision makers (e.g. power of attorney, guardianship, advance medical

8.3% 1

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directives) and associated processes/documentationK-14 General characteristics of older adults, individuals with disabilities, and caregivers and the risks/challenges they face

8.3% 1


0.0% 0


0.0% 0

K-17 Techniques for assessing client readiness and ability to act 25.0% 3K-18 Techniques for empowering individuals to take action for themselves 8.3% 1K-19 Techniques of person-centered planning 0.0% 0K-20 Techniques for effectively searching community resources 8.3% 1K-21 Techniques for helping clients explore options, including the concepts within Options Counseling

8.3% 1

K-22 Principles of self-direction 0.0% 0K-23 I&R agency policies and codes of ethics 0.0% 0K-24 Documentation techniques 0.0% 0K-25 The nature and uses of I&R data and data reporting 0.0% 0K-26 Mandatory reporting requirements 8.3% 1K-27 The AIRS Standards and Quality Indicators for Professional Information and Referral

0.0% 0

K-28 The Older Americans Act 0.0% 0K-29 The Americans with Disabilities Act 0.0% 0K-30 The Rehabilitation Act 0.0% 0K-31 Professional development and continuing education activities 0.0% 0K-32 Stress management techniques 0.0% 0Briefly state your reason(s) for any suggested changes. Please make it clear which Knowledge Statement you are referring to!

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o Asking a lot of I&A specialists. Education and ongoing (free) training is mandatory.o I like the concepts of motivational interviewing but not the jargon!o If by social media you are referring to twitter and Facebook, i don't see them being

used with individual clients as assistive technology and interpreters would be used. I could see email being used for an individual to receive referrals or general information. It would seem that technology would be a better term if the purpose is to provide individual I&A/R.

o If by using social media you are referring to making general announcements - i.e. Medicare Open Enrollment will end on such and such a date, such and such a scam

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has been reported, LIHEAP enrollment is beginning etc. that is very different from providing I&A/R to a specific individual and would fall under outreach.

o K-13 - do you mean basic knowledge of?o K-18 and establishing healthy boundaries with consumers and caregivers.o K-2 Add Social Securityo K- 19 Add person centered thinking/planningo Add an additional knowledge areas that includes the Social Security Act (SSI &

SSDI)o K-17 add "eliciting person's desire" to take next steps or proceedo K-12 Clarity if this means the I&R Specialist would refer a person to options

counseling service or provide options counselingo Make clear that there is a difference of characteristics between these populations.

They are not all the same.o Rapport- again too hard to measure.o Trusto We need a universal report not 3 or 4 reports of the same thing to different

masters. It takes too much time away from client services!

List any additional Knowledge Statements that you would like to add to the Practice Analysis under any of the Domains and Tasks. Briefly state your reason(s) for the addition(s) and which Domain/Task do they belong to.

o Consider adding a statement that addresses the I&R Specialists ability to address situations where the customers requests or needs are outside of the I&R Specialist's role.\

o Complaint resolutiono DSMIV knowledgeable about the mental health population to some degree.o "Knowledge of Aging Chronic Health Condition - stages of progressiono Grief - stages how to assist with grief & loneliness"o Mediating when client and family are at odds as to services consumer needs. K-1o "Rapport Domain : Basic Etiquette: when working with people with disabilities, use

People First Language. A person’s self-image is tied to the words used about him. People First language reflects good manners. go to www.disabilityisnatural.com for more information."

SKILL (S) STATEMENT COMMENTS Below are the Skill Statements that are attributed to various Domains and Tasks. Do you wish to remove any of these statements or to revise/reword any of them?


Response Count

S-1 Establishing and maintaining rapport 22.2% 2S-2 Interviewing 11.1% 1S-3 Active listening 11.1% 1S-4 Effective questioning 11.1% 1S-5 Call management 11.1% 1

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S-6 Identifying crisis situations 0.0% 0S-7 Understanding and appropriately responding to cultural/ethnic differences 0.0% 0S-8 Communicating effectively 0.0% 0S-9 Ability to concentrate fully on one task and then switch quickly with full focus to another

33.3% 3

S-10 Use of technology 0.0% 0S-11 Problem solving 0.0% 0S-12 Identifying needs 0.0% 0S-13 Research and resource searching/retrieval (for example, use of AIRS 211/LA County Taxonomy of Human Services)

11.1% 1

S-14 Guiding and supporting 22.2% 2S-15 Education and coaching 11.1% 1S-16 Assisting 11.1% 1S-17 Advocacy 0.0% 0S-18 Empowerment 0.0% 0S-20 Recognizing conflicts of interest 0.0% 0S-21 Self-awareness 11.1% 1S-22 Recognizing limitations 0.0% 0S-23 Setting boundaries 11.1% 1S-24 Stress Management 11.1% 1Briefly state your reason(s) for any suggested changes. Please make it clear which Knowledge Statement you are referring to!

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o Add trust.o Combine S23 and S24o Consider including Motivational Interviewing also adding information that

recognizes autonomy.o I do not see a need to change ny of these steps.o Is duplicative, covered by other skillso S-21 - what does that mean?

S-14 and S-15 probably can be combined.o S-9 has been researched and established by respected researchers to be

impossible. Please stop trying to justify multi tasking as possible or advantageous to people.

List any additional Skills that you would like to add to the Practice Analysis under any of the Domains. Briefly state your reason(s) for the addition(s).

o - Add Motivational Interviewing as a skill or list as a communication strategy like active listening

o cultural competency-aging also does have its own culture too.o Grief - stages how to assist with grief & lonelinesso I would add skill at accurate and complete documentation of client records and notes.

This is mainly important for future contacts with that client, but also for reporting purposes.

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