soar worksin arizona€¦ · see handout . 5 soar success story from lodestar day resource center...
TRANSCRIPT
SOAR Works...in Arizona
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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
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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
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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
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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
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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
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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
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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
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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
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Adam Robson Employment Administrator AHCCCS (602) 364-4622 [email protected] Loren Gallegly SOAR Case Manager Lodestar Day Resource Center (602) 527-1978 [email protected] Cristina “Tina” Benitez Housing Management Specialist Cenpatico Integrated Care (866) 495-6738 x84579 [email protected]
Amber Allery Claims Representative Social Security Administration (866) 964-0203 x12821 [email protected] Jacqueline “Jackie” Nairn CABHI Supervisor Catholic Charities (928) 202-6256 [email protected]
Thank You!!
Reaching across Arizona to provide comprehensive quality health care for those in need