Why our advocacy
is still important

Christina Clayton – DESC

Rhonda Hauff – Yakima Neighborhood
Health Services

Kate Budd – Clark County DCS

Sue Chance -- DSHS
2

The Essential SOAR Process

ACA & Implications

SOAR Initiatives & Action Planning

Community Efforts

Practical Tips

Q&A
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4

National program focused on expediting access to
SSI/SSDI for:
◦
◦
◦
◦
Adults with
Serious mental illness and/or co-occurring disorders
Homeless or at risk of homelessness
In WA, also includes focus on veterans and tribes

Recovery from homelessness and mental and physical
health problems is goal

Sponsored by the Substance Abuse and Mental Health
Services Administration (SAMHSA) in collaboration with
SSA since 2005

All 50 states currently participate; no direct funding
provided to states
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
Includes training of staff focusing on:
◦ Eligibility criteria for SSI/SSDI
◦ Development of claims
◦ Collection and development of relevant clinical
information
◦ Sharing (with appropriate releases) of individual
information to facilitate service delivery and planning

SOAR trained staff typically are experts in mental
health/mental illness and/or homelessness
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

SSI and SSDI: Social Security Administration disability
benefits
Often only income source for people with disabilities
SSI: Supplemental Security Income
◦ Provides Medicaid in WA once eligible
◦ Low-income individuals who have a disability, are blind, or
who are age 65 or over
◦ Maximum Federal benefit changes each year

SSDI: Social Security Disability Insurance
◦ Income based on earnings
◦ Medicare after two years of receipt of payments for most
individuals
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 3-part
initiative:
◦ Systems change planning
through local and state
planning groups
 Collaboration
 Process changes
◦ Training: Stepping to Stones
to Recovery: 2-day and/or
online
◦ Technical assistance
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
SSA disability benefits can provide access to:
◦
◦
◦
◦
◦

Income
Housing
Health Insurance
Treatment
Other supportive services
For people with disabilities, SSI/SSDI can be a critical
step towards ending homelessness and promoting
recovery
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
People experiencing homelessness are frequent users of
expensive uncompensated health care

Can recoup cost of this care from Medicaid for up to 90 days
retroactive to date of SSI eligibility

States and localities can recoup from SSA the cost of public
assistance provided during the application process

SSI, SSDI and Medicaid bring federal dollars into states,
localities and community programs
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


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

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Initial application approval rates for people who are
homeless: 10-15%
General initial application approval rates: 37%
Complicated application process
Extensive need for documentation
Lack of understanding of criteria and their
documentation requirements
Takes several months
SOAR: Addresses all these
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
19,008 persons experiencing or at risk for homelessness have been
approved on initial application

65 percent approval rate overall

Compares to 10-15 percent for unassisted applications from
people who are homeless and 29 percent for all applicants

Approvals were received in an average of 100 days in 2013

Appeals can take a year or more; many people give up and do not
appeal
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



Expedited process approved by SSA Regional Office
Close collaboration to serve veterans through SOAR
◦ Only state to establish such extensive collaboration
for veterans who are homeless or at risk of
homelessness
Extensive collaboration with PATH/use of PATH staff
to do applications
Planning groups begun through several areas in state
State planning group active since 2010
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Signed into law in March 2010
Health Insurance Marketplace
◦ Qualified Health Plans
Medicaid
Medicare
benefits
◦ Preventative care coverage at no-cost
◦ Addresses the prescription drug “donut-hole”
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Exchange open
enrollment
Exchange open
enrollment
Medicaid enrollment


Oct 1 2013 Jan 1 2014


March 31 2014 Oct 15, 2014

Dec 7 2014
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
Begin with trusted
sources

◦ Case workers, community
providers


Peers are crucial
Deliver positive
messages
◦ Can stay independent and in
control
◦ Be more financially secure
◦ Improve and maintain health
and well-being

Emphasize availability,
ease of enrollment,
affordability
Consolidated Homeless Grants
(CHG)
◦ State support to Counties / CACs

Emergency Solutions Grants
(ESG)
◦ State support to Counties / CACs

Housing & Essential Needs (HEN)
◦ Dept of Commerce to Counties
◦ Clients already on Medicaid- but
often attached to uninsured

Low Income Energy Assistance
Program (LIHEAP)




ACA brings expanded access to Medicaid for
States participating
SSI/SSDI remain crucial income supports
SOAR providers can continue their work and help
with outreach for the Medicaid Expansion
population
Medicaid enrollment workers can also help screen
and refer people to SOAR providers and/or
additional resources if seem eligible for SSI/SSDI
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



Enrollment is not automatic. Individuals still need to apply for
Medicaid, and assistance for this is variable.
Individuals who experience homelessness with serious mental
health issues and/or co-occurring substance use unlikely to
access ACA without significant outreach
SOAR workers will be especially poised to help those who are
still experiencing homelessness, to connect to insurance as well
as essential services and health care
Look at ways current systems can be modified to address
Medicaid expansion efforts
ACA & Medicaid provides eligibility for health coverage, not
actual health care access per se
Income supports like SSI & SSDI are critical for safe and stable
housing, which in turn lead to better health outcome and
recovery
22

Access to SSI/SSDI income support remains
essential
◦ Housing
◦ Living expenses


Consumer should enroll in health coverage as
soon as possible
Once approved for SSI they can change their
Medicaid coverage based on their SSI eligibility
◦ Indicate they are disabled on original application
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



SOAR Case Managers can improve client health
outcomes and be a part of Health Homes
CMHCs can and should be key players in
community SOAR efforts and ACA implementation
Talk to State legislators and Medicaid agency staff
about how SOAR can be a partner in health care
reform efforts
The National SAMHSA SOAR TA Center is
prepared to help address the expanding need
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

Establish local planning groups
Determine staffing model:
◦ Training of staff in multiple agencies
◦ Team of staff in one agency serves community
◦ Pooling of funds from multiple agencies to create team that
develops expertise


Inform atypical partners of benefits to community:
Chambers of Commerce, large corporations, police,
judges, local governments
Use data to illustrate funds brought in and spent in
communities
25
 Completing
Applications
 Collaborations
 Training,
(SSA, DDS, Medical providers, other)
Tracking Outcomes and
Sustainability
 Local
Leadership Team
26

Establish leads

Identify existing resources

Introduce SOAR

Collaborate

Train & support staff who do applications

Quality review

Track & report outcomes

Fund & Sustain
27
 DESC
& partners in Seattle-King County
SOAR Steering Committee
 Background
 Mission
 Strategy
 Outcomes
 Lessons
28

Get the right people!

Survey of staff

Staff informational groups

Engaging & observing

Focus on choice & respect

Ask in a new way

Underpromise & overdeliver

Helpful things to do:
◦ Authorized Representative
forms
◦ SOAR Fax Sheet
◦ SSIF & Adjudicator Contact
◦ Medical/Job Worksheet (SSA3381)
◦ Medicare Savings Program
◦ Understand the Listings for
disability reports
◦ Get information after denial
(CD-ROM)
◦ Spenddown—getting
information
◦ Apply for ABD online
29
 DSHS
role in Washington & SOAR
Training
 History
 Collaboration
 Recommendations
30
 Washington
Department of
Veterans Affairs
 Giving
voice to those who struggle
 Partnerships
 Outcomes
 Sustainability
 Commitments
 Opportunities
31
 Clark
County Department of
Community Services
 Systems
approach
 Funders and providers working together
 Staffing model
 Outcomes
 Hopes for the future
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33
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
http://www.prainc.com/soar/ and NEWER site http://soarworks.prainc.com/ (SOAR Technical Assistance Website)

http://www.prainc.com/SOAR/tools/manual.asp (manual for Stepping Stones to Recovery, SOAR binder from training)

http://soarworks.prainc.com/course/ssissdi-outreach-access-and-recovery-soar-online-training (online SOAR training, at own pace)

www.pathprogram.samhsa.gov/SOAR (PATH program site)

http://www.nhchc.org/policy-advocacy/issue/disability/ (National Health Care for the Homeless Council)

http://www.ssa.gov/

http://www.hca.wa.gov/hcr/me/Pages/training_education.aspx (online training for HCA Medicaid)

http://youtu.be/fd6e5ORJ8i0 (training video from HCA, 15”)

http://www.wahbexchange.org/info-you/partners/ (tip sheets, etc. from WA health exchange)

http://www.dshs.wa.gov/

http://pathprogram.samhsa.gov/super/path/Grantees.aspx (site to find out where PATH programs are by area/state)

http://www.dva.wa.gov/

http://www.co.clark.wa.us/community-action/soar.html

http://www.desc.org/

http://www.ynhs.org
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
Christina Clayton: [email protected]

Rhonda Hauff: [email protected]

Kate Budd: [email protected]

Sue Chance: [email protected]

Yvonne Perret, founder of SOAR, Exec. Dir., Advocacy and
Training Center, Maryland: 301-777-7987;
[email protected] CALL OR WRITE ANY TIME!
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Slideshow - Washington Low Income Housing Alliance