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									   National SOAR Update
    Yvonne M. Perret, MA, MSW, LCSW-C
Advocacy and Training Center, Cumberland, MD
            Deborah, Dennis, MA
   Policy Research Associates, Delmar, NY

             November 8, 2008
                      SOAR States
                                         North Carolina
    Alabama          Kentucky
                                         Ohio
    Alaska           Los Angeles*
                                         Oklahoma
    Arizona          Louisiana
                                         Oregon
    Colorado         Maryland
                                         Pennsylvania
    Connecticut      Massachusetts
                                         Rhode Island
    DC               Michigan
                                         Tennessee
    Delaware         Minnesota
                                         Texas
    Florida          Montana
                                         Utah
    Georgia          Nevada
                                         Virginia
    Hawaii           New York
                                         Washington
    Indiana          New Hampshire
                                         West Virginia
                     New Jersey

                                                           TTT 4a
         Update from SOAR States
   34 Federally funded states
   Nashville -- 98% of first 87 applications approved on
    average in 56 days
   NY’s Sing Sing prison -- 89% of 100 pre-release SSI
    applications approved in 59 days on average
   As of May, 2008, across 19 states reporting thus far –
    1,510 SSI applications (70% of all assisted) have been
    approved in an average of 93 days
   In 2008 alone, SSI brought $11.5 million into the state
    and local economies of these 19 states
                   Process Update
   Developed in MD in 2007
   Implemented in MD, MI, WI, PA, TX, and WV
   Allows for:
       Faxed consent form sets up protective filing date so
        that there is documentation for this
       Case held at SSA for up to 60 days after protective
        filing date
       Case managers collect medical information without
        replication by DDS
       Assigned contact staff at local SSA office
             Successful Models:
           Staffing Incorporates…
   Serving as appointed representatives and doing
   Ensuring collection of all medical information
   Collaboration with community medical providers
   Writing of the medical summary report
   Ongoing communication/collaboration with SSA & DDS
   Conducting evaluations as needed
   Tracking of outcomes
       Successful Models: Staffing
        and Funding - Nashville
   Nashville’s 10-year plan: Started with
    funding one position in comprehensive
    mental health center
   Now funds 3 staff—two case managers
    and program manager; also have funding
    for outreach worker; incorporates all
    critical components outlined above
       Successful Models: Staffing
        and Funding - Nashville
   98% of first 87 applications approved on
    average in 56 days
   Close working together with health provider
    medical records staff
   Outreach ensures ongoing contact with
   Treatment provided in agency in which SSI
    project is housed
   Recently added VISTA worker to assist with
    administrative work and to develop further
           Successful Models:
      Staffing and Funding - Utah
   Bases SOAR project within Department of
    Workforce Services, Department of Human
    Services (public assistance agency)
   Medicaid unit and SOAR merged under same
    supervisor and leadership and share medical
    information for eligibility
   Serves folks who come into agency for income
    supports and services
   Connects folks with vocational services who are
    not SSI/SSDI eligible
            Successful Models:
       Staffing and Funding - Utah
   Rolled out in Salt Lake City initially
   Rolled out in rest of state 9/08
   Tracks recoupment of GA expenses
   In Salt Lake alone, estimates recovery of state
    funds to be around $2 million
   Works collaboratively to get health providers
    involved in doing needed assessments
   Has done highest number of SOAR applications
    of any state: Approval rate of 82% in 116 days
      Successful Models: Staffing
      and Funding - Portland, OR
   Funded SSI team through collaboration
    with a hospital and a foundation grant
   Benefits Entitlement Specialty Team
    (BEST) has supervisor, 4 case managers,
    and data entry staff person
   Based in Central City Concern—a
    comprehensive health care provider that
    offers physical and mental health care
      Successful Models: Staffing
      and Funding - Portland, OR
   Strongly linked to ensuring provision of housing
   Tracking Medicaid/Medicare reimbursement for
    hospital that provides funding
   $111,000 of past medical bills became
    reimbursable through retro Medicaid for only 3
    applicants to date
   Approval rate of 90% within 25 days as of
    summer, 2008; only started in January, 2008
     Successful Models: Staffing and
       Funding - RI, Covington, KY
   Both locations have hospital funding of
    staff positions
   Rhode Island’s hospital’s initial investment
    was $30,000 for staff person located in
    Mental Health Association to do SSI/SSDI
   Hospital recouped $197,000—a return of
    over 6:1 on initial investment
   Approval rate: 71% in average of 64 days
     Successful Models: Staffing and
       Funding - RI, Covington, KY
   Covington, KY: Rural area
   Hospital initially funded 0.5 FTE position
    in amount of $18,000
   Hospital recouped $255,000 in uncompensated
    care through approval of benefits and Medicaid
   Since initial investment, has increased funding
    to full-time position
             Successful Models:
      Staffing and Funding - Georgia
   State team lead and trainer housed in State
    Mental Health Agency
   PATH funded: team lead and social worker in
    same agency
   Provides direct services and coordinates SOAR
    across state
   Publishes monthly SOAR newsletter and
    coordinates Southeast SOAR Consortium of
    SOAR states in southeast area
            Successful Models:
     Staffing and Funding - Georgia
   Have rolled out effort in all state hospitals
    in Georgia
   Did Train-the-Trainer in Georgia of
    trainers to be based in each state hospital
   Incorporates SOAR into discharge
    planning from state hospitals
   Approval rate of 67% in average of 75
            Successful Models:
     Staffing and Funding - Michigan
   Only state to have rolled out SOAR in entire state at once
   Special process developed for hearings
   SSA and DDS have contact designees in all offices throughout state
   State divided into 8 regions
   Train-the-Trainer held within MI so trainers exist in each region
   Tracking outcomes through HMIS
   PATH state team lead serves as SOAR statewide coordinator
   Focused effort with Michigan Department of Corrections starting
   Approval rate: 78% within an average of 53 days
        Successful Models: Staffing
        and Funding - Philadelphia
   PA decided to focus effort on Philadelphia
   Funding provided through state
   Contract with Homeless Advocacy Project (HAP), a
    program of attorneys and paralegals
   Have two SOAR trainers at HAP who train community
    social workers and track outcomes
   HAP does quality review for all applications
   100% of applications approved within average of 30
    Successful Models: Staffing and
    Funding - Sing Sing Prison, NY
   Pre-release and re-entry benefits applications
    done prior to release from Sing Sing prison
   Coordinated through CUCS, a community
    services agency in NYC
   Same staff who does applications follow folks in
    community and access housing for them
   89% of 100 pre-release SSI applications
    approved in 59 days on average
   Expanding to four other prisons in NY
      Successful Models: Evaluations
              West Virginia
   Just started in late 2007
   SOAR trainer had innovative idea
   Contacted retired licensed physicians for pro
    bono evaluation possibilities
   Great response
   Now has cadre of physicians who do physical
    and mental health evaluations at no cost
  Successful Model: Overall
Coordination of SOAR Efforts
   Rhode Island: United Way funded
    statewide SOAR coordinator based
    through Rhode Island through Rhode
    Island Coalition for the Homeless
   Palm Beach, FL: United Way and
    state human services agency pooled
    funds to begin SOAR initiative; just
    started in 2008
           Federal Policy Advocacy
   Expansion of acceptable medical sources to include
    physician’s assistants, nurse practitioners, and licensed
    clinical social workers
   Expansion of presumptive disability to include homeless
    adults who have schizophrenia
   Tracking by SSA of outcomes for homeless applicants
   Treatment of individuals with substance use disorders
   Advocacy for additional funding for SOAR
   Update on SSA’s homelessness plan and its
        Growing and Sustaining SOAR
   State or local plans to address homelessness (TN, PA, MN)
   Collaborations with hospitals (KY, RI, TN, GA, OR)
   State PATH programs (MI, GA, AL, VA, WI, NC)
   Foundations, United Way and other non-governmental funders (OR, RI,
    Palm Beach, FL; CA
   Applying for Vista or Americorp volunteers (TN, MI, NC)
   State or county general assistance programs (UT, NY, WA, FL, MN)
   Working with corrections on re-entry (NY, MI, Miami, Contra Costa, CA)
   Using outcomes to argue for additional resources (UT, PA, KY, TN)
   Partnering with schools of Social Work for internships (MI)
   Asking state medical association for retired physicians to do pro bono
    assessments (WV)
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