SOAR Works...in Arizona

Transcription

1 SOAR Works...in Arizona

2 Supplemental Security Income (SSI) SSI & SSDI 2 Different Programs! 2016 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 Reaching across Arizona to provide comprehensive quality health care for those in need 2

3 Applying for Social Security Benefits How many have ever tried to assist someone with applying for SSI and/or SSDI? Reaching across Arizona to provide comprehensive quality health care for those in need 3

4 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 5

6 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

7 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

8 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!

9 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.

10 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.

11 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 3368 (Online Adult Disability Report) Ø SSA 16 (Online SSDI Application) Ø Medical Summary Report Ø Medical Records Ø SSA 3369 (Work History Report)

12 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?

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

14 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 Southern Arizona Local Lead 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 v Starting 9/26/2016, ending 11/27/2016 Contact Tina for specific dates Reaching across Arizona to provide comprehensive quality health care for those in need 15

16 Southern Arizona Local Lead 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 v Including having all Behavioral Health agencies with SOAR-Certified staff 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 Reaching across Arizona to provide comprehensive quality health care for those in need 16

17 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 Northern Arizona Local Lead Where We Started (March 2015) Expansion efforts 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 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 Reaching across Arizona to provide comprehensive quality health care for those in need 18

19 Northern Arizona Local Lead Where We Are Now Where We Are Headed 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) SOAR forum (9/12/2016) Local Steering Committees in each county v Having 1 Regional Lead Expand SOAR in Apache & Navajo Counties Local Steering Committee v Meetings quarterly Reaching across Arizona to provide comprehensive quality health care for those in need 19

20 SOAR Local Leads Across the State Maricopa County Loren Gallegly Lodestar Day Resource Center (LDRC) Implemented October 1, Approvals 70% Approval Rate v Arizona approval rate for all claims is only 26%

21 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

22 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 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.

23 SOAR Online Course Trainings March, 2014 September, 2016 Number of AZ Staff Who Have Completed the Online Course Mar '14 Dec '14 Apr '15 Sept '15 Mar '16 Jul '16 Sept '16

24 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 25

26 Q & A from Audience

27 Thank You!! Adam Robson Employment Administrator AHCCCS (602) Loren Gallegly SOAR Case Manager Lodestar Day Resource Center (602) Amber Allery Claims Representative Social Security Administration (866) x12821 Jacqueline Jackie Nairn CABHI Supervisor Catholic Charities (928) Cristina Tina Benitez Housing Management Specialist Cenpatico Integrated Care (866) x84579 Reaching across Arizona to provide comprehensive quality health care for those in need 27