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SOAR and Veterans

SOAR and Veterans. Please stay on the line. AUDIO: Phone: 1-888-942-8392 Passcode: 2011068 PIN: Provided in your confirmation email (Contact ssodergren@prainc.com if you can’t find your PIN) The webinar will begin shortly. SOAR and Veterans. Presented by:

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SOAR and Veterans

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  1. SOAR and Veterans Please stay on the line. AUDIO: Phone: 1-888-942-8392 Passcode: 2011068 PIN: Provided in your confirmation email (Contact ssodergren@prainc.com if you can’t find your PIN) The webinar will begin shortly.

  2. SOAR and Veterans Presented by: SAMHSA SOAR Technical Assistance Center Policy Research Associates, Inc. Under contract to: Substance Abuse and Mental Health Services Administration U.S. Department of Health and Human Services

  3. Webinar Instructions • Question instructions • Muting • Recording availability • Downloading documents • Evaluation

  4. SOAR Training • 2-day Stepping Stones to Recovery training • www.prainc.com/soar • Find your State

  5. Agenda • Building Collaborations to Serve Veterans • Pam Heine, SAMHSA SOAR Technical Assistance Center • Veterans Benefits Administration • Christi Greenwell, Assistant Director, Client Services and Outreach, Benefits Assistance Service, Veterans Benefits Administration • SOAR and Veterans • Nancy Campbell, National Director, HUD-VASH Program • Serving Veterans: Employment and SOAR • Anthony Foster, Incarcerated Veterans Transitional Program • Questions and Answers

  6. Building Collaborations to Serve Veterans Pam Heine SAMHSA SOAR Technical Assistance Center Policy Research Associates, Inc.

  7. Homelessness Among Veterans • HUD’s 2011 Point-in-Time Estimate of Homelessness indicates a 12% decrease in the number of homeless Veterans from 76,329 to 67,495 since 2009 • Nearly twice that number are estimated to be homeless over the course of a year • The majority are in shelters, with many living on the streets • 95% of homeless vets have honorable discharges • Like the overall homeless population, almost half of homeless veterans are in 4 states: CA, FL, TX, NY

  8. Veterans At-Risk for Homelessness • NAEH estimates that 90,000 to 470,000 veterans are at risk for homelessness where “at risk” is defined by NAEH as one or more of the following: • Below poverty level income • Paying more than 50% of income for rent • Having a disabled member of the household • Households that are not in the labor force

  9. New VA Office of Inspector General Report • OEF/OIF veterans experienced higher homeless incidences after military separation • Veterans who experienced homelessness after military separation were younger, enlisted with lower pay grades, and were more likely to be diagnosed with mental disorders and/or traumatic brain injury (TBI) at time of separation from active duty • Presence of mental disorder (substance-related disorder and/or mental illness) is the strongest predictor of becoming homeless after discharge from active duty • Nearly 65% of homeless veterans utilized the VA’s Health Care for Homeless Veterans(HCHV), Homeless Chronically Mentally Ill (HCNI) Program and HUD/VASH Source: Homeless Incidence and Risk Factors for Becoming Homeless in Veterans: VA office of Inspector General Report No.11-034128-173, May 4, 2012.

  10. Prioritizing Preventing and Ending Homelessness Among Veterans • 2010 – US Interagency Council on Homelessness Federal Strategic Action Plan to Prevent and End Homelessness • Second of 4 goals is to prevent and end homelessness among veterans in five years • 2010 –2015 VA Five-Year Plan to Prevent and End Homelessness Among Veterans

  11. Income Housing Health insurance and treatment Employment and supports Why is Access to SSI and SSDI Important for Veterans?

  12. Increase in Disability Applications • 45% of the 1.6 million veterans from the wars in Iraq and Afghanistan applying due to service-related injuries • Double the 21% from the Gulf War (1990’s) • Why the increase? • Weak economy • Surviving wounds • More awareness of TBI, PTSD

  13. Veterans who receive partial disability can also receive SSA disability benefits Veterans can access SSA benefits while they are waiting for VA benefits Health insurance associated with SSA benefits can be important for vets without VA health care Younger veterans with limited work history may be eligible for SSDI Veterans with “active duty” status and in treatment for a severe impairment, receiving pay, may still be eligible for SSA benefits SSA has special provisions for veterans who entered the service as legal immigrants SSA has special provisions for expediting disability applications for Wounded Warriors, which also applies to appeals Veterans and SSA Benefits

  14. SOAR and Veterans: Right Now! • SOAR providers serve veterans • Some VA staff have been SOAR trained (GA, KS, NC, NM, SC, VA, WA) • SOAR brings hope to veterans by integrating: outreach, access and recovery (consistent with VA’s 6 key pillars) • SOAR promotes expediting claims through well established partnerships: • SSA and DDS • HUD/PATH/Continua of Care • Medical Records Departments • Community Based Service Providers

  15. POMS DI 31001.015 -- Conflict of Interest in Claimant Representation rule** restricts federal employees from representing SSA applicants VA Case Managers -- Restricted from representing veteran with SSA using the SSA-1696 Appointment of Representative form VA is working with US Interagency Council on Homelessness (USICH) to see there are any potential exceptions to reduce this barrier ** http://policy.ssa.gov/poms.nsf/lnx/0431001015 Issue: Federal Conflict of Interest Rule

  16. Allowed activities will be covered by Nancy Campbell, National Director of the HUD-VASH program Think Positive!

  17. Washington State Department of Veterans’ Affairs SOAR Project in Retsil, Washington Building 9 for Veterans – 60-bed transitional housing provides safe, stable housing for male and female veterans who are homeless and committed to employment or living independently Funding: VA Grant and Per Diem (GPD) Program provides benefits screening and assistance from SOAR trained staff Existing SOAR/VA Collaborations: Washington

  18. Existing SOAR/VA Collaborations: Georgia • Atlanta VA Medical Center • OEF/OIF Transition Patient Advocate, Ron Hackney • Refers many veterans to community-based SOAR providers

  19. SOAR in VA Action Plans • Community Homelessness Assessment, Local Education and Networking Groups (CHALENG) for Veterans [FY2010 action plan, needs survey results; SSI/SSDI ] • Albuquerque, NM • Charleston, SC • Topeka, KS • Little Rock, AR • http://www1.va.gov/HOMELESS/chaleng.asp

  20. SSA Wounded Warriors program – since 2009 http://www.socialsecurity.gov/woundedwarriors/ Medical Records (2012)- VA released new procedures for expediting the handling of military record requests associated with homeless Veterans claims processing Outreach: SSA and VA staff both perform outreach to VA Medical Centers, DOD, shelters, streets, community events such as, Stand Downs, Service Organizations Other Collaborations You Should Know About

  21. Veterans Benefits Administration Christi Greenwell Assistant Director, Client Services and Outreach, Benefits Assistance Service, Veterans Benefits Administration

  22. VBA Offices Anchorage Honolulu Manchester Togus Seattle White River Jct. Ft. Harrison Fargo Portland St. Paul Boston Milwaukee Boise Sioux Falls Buffalo Providence Detroit Hartford Cheyenne Des Moines Pittsburgh New York Lincoln Cleveland Newark Chicago Reno Philadelphia Indianapolis Salt Lake City Wilmington Huntington Oakland Denver St. Louis Baltimore Wichita DC Louisville Roanoke Los Angeles Nashville Winston Salem Little Rock Albuquerque Muskogee Columbia Atlanta Phoenix San Diego Montgomery Waco Jackson New Orleans Houston St. Petersburg San Juan Regional Office (RO) RO & Education Regional Processing Center (RPO) RO & Regional Loan Center (RLC) RO, RPO & RLC RO & Insurance Center

  23. Compensation & Pension Benefits Disability Compensation Dependency and Indemnity Compensation Disability Pension (Death Pension)

  24. DisabilityCompensation Disability resulting from injury or disease incurred in or aggravated by active service. Disability may be rated from 0% to 100%, Payments made for 10% to 100%. Special Monthly Compensation (such as aid & attendance, loss of limb, eyesight). Payments are tax free.

  25. Granted to those with wartime service Age 65 or older, OR Totally and permanently disabled, OR Patients in a nursing home receiving skilled nursing care, OR Receiving Social Security Disability Insurance Needs-based Special Monthly Pension (such as aid & attendance, loss of limb, eyesight) Payments are tax free Disability Pension 25

  26. Dependency and Indemnity Compensation (DIC) A monthly benefit paid to eligible military service survivors of a member who died while on active duty, active duty for training, inactive duty training, or Veteran whose death resulted from a service-related injury or disease. Payments may also be awarded for non service-related injury or disease resulting in death under certain circumstances Payments are tax free.

  27. SSA and Department of Veterans Affairs • Verifying SSA benefits through Federal On-Line Query (FOLQ) • Completing VA Form 21-4180, Request for Certification by Social Security Administration • Establishing Relationship and Dependency for REPS Benefits • Using Administration Determinations made by SSA • Processing of SSA Form-24 • Matching Programs

  28. Veterans and SOAR Nancy Campbell, MSW, LISW National Director, HUD-VASH Program

  29. Health Care for Homeless Veterans (HCHV) • The central goal of HCHV programs are to reduce homelessness among Veterans by conducting outreach to those who are the most vulnerable and are not currently receiving services and engaging them in treatment and rehabilitative programs. • The Contract Residential Treatment Program ensures that Veterans with serious mental health diagnoses can be placed in community-based programs which provide quality housing and services. • 42,275 intake assessments with 88,244 Veterans treated by HCHV staff (12% increase from FY 09) • Introduced the Low Demand/Safe Haven demonstration model • 217 Stand Downs (12.5% from FY 09) • 174 community-based programs • 1,583 operational beds; including 927 residential treatment beds; 636 beds for Emergency Housing, and 20 beds in the Safe Haven pilot program.

  30. Health Care for Reentry Veterans Services and Resources (HCRV) • The HCRV program is designed to address the community re-entry needs of incarcerated Veterans. • The HCRV's goals are to prevent homelessness, reduce the impact of medical, psychiatric, and substance abuse problems upon community re-adjustment, and decrease the likelihood of re-incarceration for those leaving prison. • 40,000 veterans come out of prison each year • 44 full- time re-entry specialists seeing Veterans in 1066 state and Federal prisons across the country • From Aug. 2007-Oct. 2010 approximately 24,925 Re-Entry Veterans have been seen, with 9,326 seen in FY10 alone

  31. Veterans Justice Outreach • The purpose of the Veteran Justice Outreach Initiative (VJO) initiative is to avoid the unnecessary criminalization of mental illness and extended incarceration among Veterans by ensuring that eligible justice-involved Veterans have timely access to VHA mental health and substance abuse services when clinically indicated, and other VA services and benefits as appropriate. • Justice Outreach (law enforcement, jails, courts) • 6,451 Veterans seen in VJO • FY 10: 46 full-time specialists funded • FY11: Additional 79 full-time specialists funded • There are approximately 50 operational Veteran Courts (more than double the number for FY 2010) that VA VJO Staff participate with

  32. Supportive Services Grants for Low Income Veterans and Families (SSVF) • This program was authorized by Public Law 110-387 and will provide supportive services to very low-income Veteran families in or transitioning to permanent housing. Funds will be granted to private non-profit organizations and consumer cooperatives who will assist very low-income Veteran families by providing a range of supportive services designed to promote housing stability. • 85 Grants awarded Summer 2011 • Announcement of new awardees expected in July 2012

  33. Domiciliary Care for Homeless Veterans (DCHV) • Program that provides time-limited residential treatment to homeless Veterans with health care and social-vocational deficits. • DCHV programs provide homeless Veterans access to medical, psychiatric, and substance use disorder treatment in addition to social and vocational rehabilitation programs. • 2,400 beds for homeless Veterans • Provided residential rehabilitation treatment to over 6,000 homeless Veterans with almost 40 percent of those returning back to work In FY 11 • $33M to develop 5 new sites • 5 Sites (Denver, Philadelphia, Atlanta, San Diego, Miami)

  34. Income and Benefits • Many homeless people are unable to work due to a disability, or are unable to quickly earn enough to afford rent. The sooner a minimal income is obtained, the sooner a new home is possible. • This strategy includes a multi-pronged effort aimed at improving financial opportunities for Veterans, including, at minimum, vocational training and enhanced access to benefits. • Veterans Benefits Administration (VBA) provides services for homeless Veterans at all 56 regional offices. The number of homeless Veterans claims’ received during FY 2009 (6,285) increased by 9.06% from FY 2008 (5,715). Assistance is also provided to Veteran homeowners who may be in foreclosure. • VA continues to partner with the Social Security Administration (SSA) to expedite claims for Social Security Disability and with state and local governments for other types of economic assistance to Veterans

  35. Homeless Providers Grant and Per Diem Program (GPD) • Allows VA to award grants to community-based agencies to create transitional housing programs and offer per diem payments. The purpose is to promote the development and provision of supportive housing and/or supportive services with the goal of helping homeless Veterans achieve residential stability, increase their skill levels and/or income, and obtain greater self-determination. GPD-funded projects offer communities a way to help homeless Veterans with housing and services while assisting VA medical Centers by augmenting or supplementing care. • GPD offered both Capital and “Per Diem Only” grant awards • $41 million awarded to community-based agencies • $26 million in Capital funds • $15 million in “Per Diem Only” awards • Approximately 12,000 beds • Operationalized 971 additional transitional housing beds in FY10 • New FY 12 NOFA recently issued. Focus on “transition in place”

  36. HUD-VASH Program • A collaborative program between HUD and VA where eligible homeless Veterans receive VA provided case management and supportive services to support stability and recovery from physical and mental health, substance use, and functional concerns contributing to or resulting from of homelessness. The program goals include promoting maximal Veteran recovery and independence to sustain permanent housing in the community for the Veteran and the Veteran’s family. • Approximately 48,000 Housing Choice Vouchers currently in use • As of March 28, 2012, 31,197 Veterans have been housed • Over 300 participating PHAs • VA has now funded over 1900 case managers/other staff across the country • This includes 101 Substance Use Disorder Specialists to enhance VA case management and supportive services

  37. Community Partnerships • There has been a great deal of emphasis placed on building partnerships. This strategy is a cornerstone of the entire Plan to End Homelessness Among Veterans, and includes substantial new efforts to create partnerships with community and local governmental agencies to enhance opportunities and services for homeless Veterans. • VA has strengthened their partnerships with community service providers: • Nationwide, there are now nearly 4,000 interagency collaboration agreements in place. • These agreements have aided the VA in extending outreach services to sites such as shelters, soup kitchens, safe havens, welfare offices or other locations where homeless persons may be located and have spurred the development of additional housing resources. • This has led to improved coordination of services and the development of innovative strategies to address the needs of homeless Veterans. • GPD partners with over 500 agencies to provide transitional housing services. • VA continues to foster interagency collaboration with: United States Interagency Council on Homelessness (USICH), HUD, SAMSHA, DoL, Education, Health & Human Services (HHS), Department of Justice (DoJ), and others.

  38. Role of HUD-VASH Case Manager • Once accepted, a Housing Recovery Plan is developed by the case manager and the Veteran. It is an integrated part of the overall treatment plan, and reflects the recovery goals of the Veteran which may include: • Establishing Housing stability (paying rent, following rules, etc) • Meeting employment and income needs • Resolving legal and financial issues (credit history) • Supporting physical, mental, social health • Fostering community integration and independence • Process to monitor the progress of the plan is jointly agreed upon • Main Goal: Sustaining Veteran in permanent housing

  39. Prohibitions Re: SOAR • Federal employees are not allowed to represent veterans in their claims for Social Security benefits. It’s a criminal conflict on interest violation (18 U.S.C. 203, 205) • This “representational duty” of being a claims representative is outside the scope and course of the routine work of VA employees. Could find themselves outside the umbrella of coverage of the Federal Tort Claims Act and staff could be personally held liable • Cannot sign SSA Form 1696 –Appointment of a Representative • Cannot discuss the status of a veteran’s claim with SSA whether the discussion takes place at a hearing or not; can be construed as advocacy

  40. Allowable Activities Re: SOAR • Staff can attend trainings to become familiar with the process • Can disclose VA records to SSA (Form 827) if veteran signs the appropriate release • Can complete the Disability Report-Adult (Form 3368) and be listed as a contact who knows the veteran • Can assist in completing the application forms and referring the veteran to an appropriate advocate/ representative • Can provide support and encouragement while Veteran is going through the process • OK to work “behind the scenes”

  41. Other Options/Possibilities • SSVF grantees • State veteran employees • Veterans Service Organizations • Other state, city or non-profit employees • Pro bono private sector attorneys • Legal services referral resources • VA Staff must follow VHA Directive 2011-034 Homeless Veterans Legal Referral Process

  42. Serving Veterans: Employment and SOAR Anthony Foster, Service Coordinator Incarcerated Veterans Transitional Program (IVTP) Goodwill Industries of the Inland Northwest Spokane, Washington

  43. Incarcerated Veterans Transition Program (IVTP) • For veterans who have any discharge other than dishonorable • Veteran must have been incarcerated within the past 6 months • Veteran must be homeless, unemployed, and have a STRONG desire to obtain employment

  44. IVTP Benefits • Job readiness assistance from employment specialist • Housing assistance from housing specialist (i.e., housing plan, landlord referral) • Employment Readiness and Responsible Renter’s classes • Participation in weekly job club • Transportation assistance • Clothing assistance • Referral to VA for other relevant services

  45. Challenges We’ve Faced • Some veterans may not be ready for work • Some are experiencing chronic homelessness • May lose contact for months at a time • Veteran may have limited work history and/or training

  46. More Challenges… • Conviction record may make finding a job difficult (i.e., type of offense vs job availability) • If in substance abuse treatment, work search is postponed until treatment cycle is completed (intensive outpatient)

  47. SOAR as an Option for Veterans • Schedule meeting with veteran and request all relevant records (i.e., military, department of corrections, other medical facilities) • Meet with vet and complete application and disability report • Fax over all records to local Social Security Administration Office • Follow-up with veteran upon notice of decision • Help file appeal if necessary • Refer to community legal resources for assistance once all appeal process have been exhausted

  48. For More Information Anthony FosterService Coordinatoranthonyf@giin.org(509) 232-1125

  49. Questions and Answers Facilitators:SAMHSA SOAR Technical Assistance Center Policy Research Associates, Inc.

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