Accessing Entitlements

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Accessing Entitlements Utilizing SOAR

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Accessing Entitlements

  1. 1. Accessing Entitlements Utilizing SOAR <ul><li>Cindy A. Schwartz, MS, MBA </li></ul><ul><li>Project Director, Eleventh Judicial Criminal Mental Health Project, Jail Diversion Program </li></ul><ul><li>Miami, Florida </li></ul>
  2. 2. Why is access to SSI and SSDI important for people re-entering the community from institutional settings ? <ul><li>SSA disability benefits can provide access to: </li></ul><ul><ul><li>Housing </li></ul></ul><ul><ul><li>Income </li></ul></ul><ul><ul><li>Health insurance </li></ul></ul>
  3. 3. Eligibility <ul><li>Legal documentation or citizenship </li></ul><ul><li>Disability </li></ul><ul><li>Unable to work </li></ul>
  4. 4. SSI and SSDI <ul><li>SSI: Supplemental Security Income; federal benefit rate is $674 per month and will provide Medicaid in Florida </li></ul><ul><li>SSDI: Social Security Disability Insurance; amount of benefit dependent on earnings put into SSA system; Medicare provided after two years of eligibility in most instances </li></ul><ul><li>The disability determination process for both programs is the same; when one applies for SSI, they are usually review by SSA for their eligibility for SSDI as well. </li></ul>
  5. 5. The Problem <ul><li>The application process is difficult for most people but especially for individuals who have mental illnesses and co-occurring substance use disorders </li></ul><ul><li>Only about 37 percent of all those who apply (all disability groups) are typically approved on initial application </li></ul><ul><li>People that are homeless have a lower percentage of approval on the initial application (10-15%) </li></ul><ul><li>Appeals take years and many potentially eligible people give up and do not appeal </li></ul>
  6. 6. Why Is Access To SSI So Difficult? <ul><li>People who re-entering the community need assistance to apply for Social Security benefits </li></ul><ul><li>They need adequate assessment and documentation of how their disabling conditions limit their ability to work </li></ul><ul><li>Providers who assist applicants need staff who understand the disability determination process and who have time to assist in all aspects of developing the application </li></ul><ul><li>Relationships with SSA, the state Disability Determination Service (DDS), community medical providers and others are essential to changing the outcomes of SSI/SSDI applications </li></ul>
  7. 7. What We Know Is Possible… <ul><li>Approval rates of 90% </li></ul><ul><li>on initial application </li></ul><ul><li>for Jail Diversion Participants </li></ul><ul><li>In Miami-Dade County </li></ul>
  8. 8. SOAR Technical Assistance Initiative <ul><li>SOAR stands for “SSI/SSDI Outreach, Access and Recovery” </li></ul><ul><li>Strategy to help States and communities increase access to SSI and SSDI for people who are homeless through training, technical assistance and strategic planning </li></ul><ul><li>Includes use of SAMHSA’s Stepping Stones to Recovery training curriculum </li></ul>
  9. 9. How Is This Model Different? <ul><li>Case managers actively assist applicants </li></ul><ul><li>Step-by-step explanation of SSI application and disability determination process </li></ul><ul><li>Focuses on the initial application – “Get it right the first time!” </li></ul><ul><li>Avoids appeals whenever possible </li></ul><ul><li>Focuses on documenting the disability </li></ul>
  10. 10. What Does It Take? <ul><li>Use the SOAR Critical Components ( www.prainc.com/SOAR/about/CriticalComponentsChart.pdf ) </li></ul><ul><ul><li>Focus on the initial application </li></ul></ul><ul><ul><li>Become an applicant’s representative (SSA Form 1696) </li></ul></ul><ul><ul><li>Work closely with community medical providers </li></ul></ul><ul><ul><li>Reach out to hospital and clinic medical records departments </li></ul></ul><ul><ul><li>Reduce the need for consultative exams </li></ul></ul><ul><ul><li>Develop medical summary reports signed by a physician or psychologist </li></ul></ul>
  11. 11. What Does it Take? <ul><li>Ensure adequate staffing </li></ul><ul><li>Provide training and quality control </li></ul><ul><li>Collaborate with SSA and DDS </li></ul><ul><li>Collect and report on outcomes </li></ul>
  12. 12. Miami-Dade County GAP Funding <ul><li>Provides Interim Assistance for individuals applying for federal entitlements (SSI/SSDI) during the period between application and approval of benefits </li></ul><ul><li>Funding for Housing is reimbursed to the County </li></ul><ul><li>Effective and cost efficient method to improve re-entry to the community </li></ul>
  13. 13. How Do You Make This Happen? <ul><li>Look for partners that stand to benefit from increased access to SSI, SSDI and Medicaid: </li></ul><ul><ul><li>Mental health centers and primary care clinics </li></ul></ul><ul><ul><li>Hospitals – public or private </li></ul></ul><ul><ul><li>Jails or prisons that are focused on reentry </li></ul></ul><ul><ul><li>State or County general assistance programs </li></ul></ul><ul><ul><li>Housing programs – public and private </li></ul></ul><ul><ul><li>Local 10-year plans to address homelessness </li></ul></ul>
  14. 14. Conclusion <ul><li>Focus on expediting benefits works! </li></ul><ul><li>Its a win-win for the individual, for states and localities, and for community programs </li></ul><ul><li>A major tool in recovery and </li></ul><ul><li>re-entry to the community </li></ul>
  15. 15. For More Information on SOAR and Stepping Stones to Recovery <ul><li>Visit the SOAR website at </li></ul><ul><li>www.prainc.com /soar </li></ul><ul><li>Or contact: </li></ul>Cindy A. Schwartz, MS, MBA [email_address]

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