Florida Peer Network Annual Consumer Conference May 2011

1. Florida Peer Network Annual Consumer Conference May 2011

2. What is SOAR? SOAR is a two-part process: 1. Building A Community Initiative 2. Two-Day Trainings 2

3. What is SOAR? SSI/SSDI Outreach Access Recovery Strategy to help states and communities increase access to SSI and SSDI for the individuals they serve through training, technical assistance, and strategic planning Includes the use of SAMHSA�s Stepping Stones to Recovery training curriculum 3

4. Building a Community Initiative Florida is in the early stages of this piece Initiative is being developed and led by local circuit SAMH offices, with TA provided by the State Team Leader (STL) in the Mental Health Program Office All stakeholders are included in building the initiative � DCF SAMH, providers, consumers, stakeholders, local SSA and DDS staff 4

5. Building a Community Initiative Suggested Roles and Responsibilities Establish a local planning team Chairperson to convene meetings and disseminate minutes and other relevant information, coordinate local implementation with STL, communicate TA needs to the STL Local Work Group collects and reports outcomes, works with local SSA and DDS offices, provides logistical support to trainers, provides education on the benefits of SOAR, identifies and addresses TA needs 5

6. Components of SOAR Planning and Collaboration Ongoing planning and implementation meetings involving all stakeholders, including SSA and DDS SOAR staff facilitates first meeting Action plan for SOAR implementation Leader to �champion� SOAR in communities Tracking outcome information 6

7. Components of SOAR Ongoing technical assistance Designated SOAR team primary contact for each state (STL = Denise Barber) On-site assistance possible Conference calls Webinars Written products Continued advocacy with SSA and DDS 7

8. Components of SOAR Training Four Day Train-the-Trainers program to give each state the capacity to provide on-going training using the Stepping Stones to Recovery curriculum Two Day SOAR Trainings for front line staff TA Center @ Policy Research Associates (PRA) provides ongoing support 8

9. SOAR Two-Day Training Training is for case managers and other front line staff who work directly with the individuals we serve and will help them complete the SSA applications Staff who have been trained in SOAR and are completing SOAR applications need to submit data on each application to local SAMH office 9

10. What We Know is Possible Through SOAR Approval rates of 65-90% on initial application Based on success of University of Maryland Medical System Baltimore SSI Outreach Project Over a 10 year period, achieved success rate on applications of 96% of those eligible Comprehensive approach to individual�s needs with income as the �hook� Engagement, relationship, assessment are integral parts of project and curriculum 10

11. SSA Disability Benefits Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) SSI: Based on need People who have disability, blindness or age 65/over Limited maximum federal benefit Limit on resources Provides Medicaid 11

12. SSA Disability Benefits SSDI: Benefit based on earnings paid into SSA through FICA taxes Individual and family benefits No limits on resources Medicare after two years of eligibility 12

13. SSA Disability Benefits Application Process Both SSI and SSDI: non-medical criteria SSA processes non-medical criteria; must meet criteria to be processed further Apply for both at the same time Once non-medical criteria are met, disability determination completed at DDS (in Florida Division of Disability Determination within Dept. of Health) 13

14. SSA Disability Criteria To be eligible for SSI or SSDI, an individual must meet three criteria: Have a medically determinable physical or mental impairment (or combination) that either meets or is equivalent to the listing of impairments that DDS considers Duration of the impairment(s) must have lasted or be expected to last 12 months or more, or result in death Individual must show significant FUNCTIONAL PROBLEMS caused by the MEDICAL IMPAIRMENT(S) 14

15. Facts on SSI and SSDI SSI: Supplemental Security Income; currently federal benefit rate is $674/month; provides Medicaid SSDI: Social Security Disability Insurance; amount of benefits depends on earnings paid into SSA (FICA) system; Medicare provided after TWO years of eligibility DDD: Division of Disability Determination: the process for both programs is the same; when one applies for SSI, the application is usually reviewed for SSDI as well 15

16. Access Access to SSI and SSDI is Important SSA disability benefits can provide access to: Housing Income Health Insurance 16

17. Why is Access to SSI so Difficult? People need adequate assessment and documentation regarding how their disabling conditions limit their ability to work Providers who assist SSI applicants need staff who understand the disability determination process and who have time to assist in all aspects of developing the application Relationships with SSA, the State Division of Disability Determination (within the Department of Health), community medical providers, and others are essential to changing the outcomes of SSI/SSDI applications 17

18. Benefits and Recovery What does recovery from mental illnesses (and homelessness) involve? Living stability � housing, treatment and supportive services Helps encourage return to/beginning of employment Ongoing human relationships Successful community living Hope for reaching life goals Income facilitates community success 18

19. Challenges Complicated process that requires comprehensive documentation Approximately 37% of individuals approved on initial application Individuals often have intermittent treatment history Cognitive impairment interferes with provision of information Homeless individuals have additional challenges such as follow-up, receiving communication via mail Medical records rarely address FUNCTIONAL difficulties 19

20. How is This Model Different? Case managers/other staff actively assist people with completing applications Training offers a step-by-step explanation of SSI/SSDI applications and the disability determination process SOAR focuses on the initial application � Get it right the first time! Focuses on documenting the disability & how it effects the inability to work and earn SGA 20

21. What Does It Take? Use the SOAR Critical Components Focus on the initial application Become the applicant�s representative (using SSA Form 1696) � NOT the same as the Representative Payee Providers need to ensure adequate staffing Providers need to attend trainings and supervise staff completing SOAR applications for quality control Collect and report data on outcomes to DCF � data is then submitted to PRA 21

22. Pre-Release Agreements People leaving SMHTFs/jails/prisons can apply for benefits 60 days prior to release Pre-release agreements allow for applications up to 120 days or more Decision on disability made prior to release Includes linkage with community provider after release 22

23. Help Spread the Word! Ask your peers and coworkers if they have heard of SOAR Explain how it can help them, their agencies, and the individuals being served Ask your coworkers how you can help them gather and expedite information from applicants in the SOAR process Encourage consumers and peers to inquire about SOAR This reinforces personal responsibility and self-advocacy! 23

24. Conclusion Focusing on expediting benefits works! It�s a win-win for the individuals served, for states and localities, and for community programs It is a MAJOR tool in Recovery This process: Does work Is possible Can be done Convey hope! Encourage the Possibilities! 24

25. On-Line Resources SOAR - www.prainc.com/SOAR Social Security Administration � www.socialsecurity.gov Disability Info � www.disabilityinfo.gov DCF � denise_barber@dcf.state.fl.us, 850-717-4329 25