SOAR Works...in Arizona

2  

SSI & SSDI 2 Different Programs!

2016

Reaching  across  Arizona  to  provide  comprehensive    quality  health  care  for  those  in  need  

Supplemental Security Income (SSI)

Social Security Disability Insurance (SSDI)

●  Based on financial need. ●  FBR=$733 (individual) and

$1,100 (couple). ●  $2,000 resource limit

($3,000 for couples) ●  Medicaid (AHCCCS)

●  Based on work history & amount paid into the system.

●  Medicare

Non-medical factors of entitlement for SSI and SSDI are completely different

3  

Applying for Social Security Benefits

Reaching  across  Arizona  to  provide  comprehensive    quality  health  care  for  those  in  need  

How many have ever tried to assist someone with applying for SSI and/or SSDI?

What is SOAR? SOAR stands for: SSI/SSDI Outreach, Access and Recovery

•  An approach that increases access to the Social Security Administration’s (SSA) disability programs. o  Supplemental Security Income (SSI) o  Social Security Disability Insurance (SSDI)

•  For people who are homeless or at risk of homelessness, have a serious mental illness (or exhibit symptoms), and/or have serious physical illnesses that affect their ability to work at a substantial gainful level

See Handout

5  

SOAR Success Story from Lodestar Day Resource Center (LDRC)

Reaching  across  Arizona  to  provide  comprehensive    quality  health  care  for  those  in  need  

How is the SOAR Model different?

•  Evidence-based best practice implemented in all 50 states •  Case managers actively assist applicants, maintaining

contact and serving as their Appointed Representative •  Emphasis on obtaining approval on initial

application and avoiding appeals •  Collaboration with local agencies, medical providers, and

SSA/DDS •  Focus on thoroughly documenting the disability and its

effect on functioning, reducing the need for consultative exams

Identifying SOAR Clients

Pre-Screen Assessment & Eligibility q  Non-Medical Eligibility q  Major Impairments q  Psychiatric Treatment History q  Medical Conditions q  Current Psychiatric Symptoms q  Functional Impairment q  Education, Skills, Certifications q  Work History

SOAR Partners

Social Security Administration (SSA) Ø  Federal agency that administers SSI/SSDI Ø  Makes the non-medical decision

Disability Determination Services (DDS) Ø  State agency under contract to SSA Ø  Makes the medical/disability determination

Medical/treatment providers Ø  Assessments/evaluations Ø  Medical records

You!

Importance of SOAR / SSA / DDS Collaboration

•  SOAR applicants are flagged to SSA & DDS to expedite

processing

•  SOAR helps “paint a picture” of the individual to be able to

assist 2 different entities, who have never even seen the

individual, make a determination that benefits are necessary.

•  SSA and DDS representatives believe

in SOAR and are very receptive to

addressing any challenges that may arise.

More Collaboration with SSA and DDS

•  The Phoenix downtown SSA office assigns a specific claims representative to assist with all SOAR applications.

•  In collaboration with DDS on a pilot basis, DDS has evaluators assigned to the Lodestar Day Resource Center processing SOAR claims.

•  DDS and SOAR work together to ensure the applicants attend any medical/psychological consultative examinations, when necessary.

What Is A Complete SOAR Application?

Ø  SSA 8000 (SSI Application)

Ø  SSA 827 (Authorization to Disclose Medical Records)

Ø  SSA 1696 (Appointment of Representative)

Ø  SSA 3373 (Function Report)

Ø  SSA 3380 (Function Report Third Party)

Ø  SSA 3369 (Work History Report)

Ø  SSA 3368 (Online Adult Disability Report)

Ø  SSA 16 (Online SSDI Application)

Ø  Medical Summary Report

Ø  Medical Records

 

Medical Summary Report (MSR)

The MSR is a letter which describes the individual and his/her functional limitations and struggles

ü  Critical component of the SOAR model ü  Paints a vivid picture of the individual for the DDS

examiner who never sees them ü  Provides a clear link to the functional impairment ü  Answers the question: “Why can’t the applicant work?”

SOAR Across the State

SOAR Local Leads Across the State

ü Southern AZ (Cristina “Tina” Benitez) ü Northern AZ (Jacqueline “Jackie” Nairn) ü Maricopa County (Loren Gallegly)

13  Reaching  across  Arizona  to  provide  comprehensive    quality  health  care  for  those  in  need  

SOAR Local Leads Across the State Southern Arizona

Cristina “Tina” Benitez Cenpatico Integrated Care (based out of Tucson)

SOAR expansion in Southern Arizona o  Pima, Pinal, Cochise, Yuma, La Paz, Graham, Greenlee, Santa Cruz

Ø  Where we started Ø  Expansion efforts Ø  Where we are now Ø  Where we are headed

15  

Where We Started SOAR Local Lead:

v  Tina has been the Local Lead for the southern region of Arizona since March, 2015 and, spanning 8 counties.)

v  Before March, 2015, there were only a few SOAR-trained individuals and very limited knowledge of SOAR within the communities

No local steering committee

SOAR initiative v  Comes under CIC Housing

Department, which includes: Ø  Supportive Housing Ø  HUD Grant partners through CoC/BoS

Expansion efforts

SOAR Presentations v  8 trainings to over 240 people

between 11/2015 to 4/2016 v  SOAR overview sessions to approx.

76 people between July and August, 2016

Southern Arizona SOAR Local Steering Committee

v  Re-launch on 8/30/2016

Future SOAR Overview Sessions v  Pima, Cochise (SE Arizona), Pinal,

Yuma/La Paz Counties v  Starting 9/26/2016, ending

11/27/2016 v  Contact Tina for specific dates

Southern Arizona Local Lead

Reaching  across  Arizona  to  provide  comprehensive    quality  health  care  for  those  in  need  

16  

Where We Are Now

SOAR Local Steering committee Re-launch:

v  In attendance: SSA, RBHA Providers, PATH Team, and more

SOAR-Certified Staff: v  Pima (31), Cochise (5), Yuma (1) v  None in La Paz, Graham, Greenlee,

& Santa Cruz v  Pasqua Yaqui Tribe (1)

Continually working on expanding SOAR

Where We Are Headed

SOAR-Certified staff in all 8 Counties

v  Including having all Behavioral Health agencies with SOAR-Certified staff

v  Including HUD Grant Housing partners

Multiple Steering Committees across Southern AZ

v  Having 1 Regional Lead

CIC Behavioral Health agencies entering SOAR outcomes into HMIS

Expand SOAR in La Paz, Graham, Greenlee, & Santa Cruz

Southern Arizona Local Lead

Reaching  across  Arizona  to  provide  comprehensive    quality  health  care  for  those  in  need  

SOAR Local Leads Across the State Northern Arizona

Jacqueline “Jackie” Nairn Catholic Charities (based out of Cottonwood)

SOAR expansion in Northern Arizona o  Coconino, Mohave, Yavapai, Navajo, Apache, Gila Counties

Ø  Where we started Ø  Expansion efforts Ø  Where we are now Ø  Where we are headed

18  

Where We Started (March 2015)

SOAR certified case managers: v  3 (2 in Yavapai and 1 in Coconino)

Full time SOAR benefits specialists:

v  1 (Coconino)

Individuals enrolled in SOAR online course:

v  5 (Yavapai/Coconino)

No local steering committee

Expansion efforts

Northern Arizona SOAR Local Steering Committee

v  Formed (July 2015)

SSA liaisons identified: v  Prescott, Needles, Flagstaff, Show

Low Offices

Letters sent to agencies/medical providers

Presentations

Northern Arizona Local Lead

Reaching  across  Arizona  to  provide  comprehensive    quality  health  care  for  those  in  need  

19  

Where We Are Now

SOAR certified case managers: v  15 (5 in Yavapai, 3 in Coconino, 5

in Mohave, 1 in Gila)

Full time SOAR benefits specialists:

v  1 (Coconino)

Individuals enrolled in SOAR online course:

v  38 (Yavapai, Coconino, Mohave, Navajo, Apache)

Local Steering Committee v  Meetings quarterly

Where We Are Headed

SOAR forum (9/12/2016)

Local Steering Committees in each county

v  Having 1 Regional Lead

Expand SOAR in Apache & Navajo Counties

Northern Arizona Local Lead

Reaching  across  Arizona  to  provide  comprehensive    quality  health  care  for  those  in  need  

SOAR Local Leads Across the State Maricopa County

Loren Gallegly Lodestar Day Resource Center (LDRC)

Implemented October 1, 2013

§  65 Approvals §  70% Approval Rate

v  Arizona approval rate for all claims is only 26%

Maricopa County Local Lead

LDRC SOAR Program Data 2015 SOAR Data: §  Approval Rate: 74% §  Date to Decision: 66 days §  Over $167,000 in back-payments

What is the SOAR Online Course? Consists of 7 classes (or sections), each of which has a series of articles & short quizzes, with an overall practice case.

o  This practice case provides an opportunity for Case Managers to apply what they have learned by completing an SSI/SSDI application packet for a fictitious applicant using SOAR techniques.

Estimated 16 hours to complete (CEUs upon successful completion)

Participants work at their own pace, starting and stopping as they wish. However, it is strongly encouraged that students complete the course within 4-5 weeks to retain the information learned.

Go to http://soarworks.prainc.com, click the “Online Course” tab, and enroll into the course. Please keep in mind that you will need to create a FREE account on the website prior to taking the course.

SOAR Online Course Trainings March, 2014 – September, 2016

Number of AZ Staff Who Have Completed the Online Course

10  

41  50  

82  

113  

139  155  

0  

20  

40  

60  

80  

100  

120  

140  

160  

Mar  '14   Dec  '14   Apr  '15   Sept  '15   Mar  '16   Jul  '16   Sept  '16  

SOAR-Trained? Now What?

There are only 2 expectations for those who become SOAR-trained:

1)  Use the SOAR process when assisting individuals apply for SSI/SSDI

2)  Track cases in a web-based tracking system called OAT (Online Application Tracking), which is a very quick and easy system to track successes.

That's it!! There are no expectations like "X" amount of applications or "X" amount of successes, etc... HMIS is also an acceptable way to gather data

25  

SOAR Success Story from Lodestar Day Resource Center (LDRC)

Reaching  across  Arizona  to  provide  comprehensive    quality  health  care  for  those  in  need  

Q & A from Audience

27  

Adam Robson Employment Administrator AHCCCS (602) 364-4622 Adam.Robson@azahcccs.gov Loren Gallegly SOAR Case Manager Lodestar Day Resource Center (602) 527-1978 LGallegly@hsc-az.org Cristina “Tina” Benitez Housing Management Specialist Cenpatico Integrated Care (866) 495-6738 x84579 CBENITEZ@cenpatico.com

Amber Allery Claims Representative Social Security Administration (866) 964-0203 x12821 Amber.Allery@ssa.gov Jacqueline “Jackie” Nairn CABHI Supervisor Catholic Charities (928) 202-6256 jnairn@cc-az.orgg

Thank You!!

Reaching  across  Arizona  to  provide  comprehensive    quality  health  care  for  those  in  need