SOAR in Arizona: Increasing Access to SSI/SSDI for Eligible Adults

1. SOAR in Arizona

2. Soar across the state • Southern Arizona – Cristina Benitez • Northern Arizona – currently vacant and looking • Maricopa County – Jeremy Huntoon • State Lead – Joy Johnson • SSA Phoenix – Amber Allery

3. Soar local leads across the stateSouthern Arizona Cristina Benitez, Arizona Complete Health • Covers 8 counties • Pima, Pinal, Cochise, Yuma, La Paz, Graham, Greenlee, Santa Cruz • Southern Arizona is re-starting SOAR in the Southern part of the state and working with Social Security Administration in Tucson which serves Southern Arizona • Pinal County Lead- Elizabeth Flores- Pinal Hispanic Council • South Eastern Arizona- Annette Eastman-Community Partners Integrated Health

4. Soar local leads across the stateMaricopa County Jeremy Huntoon, Community Bridges • Covers Maricopa County

5. Soar local leads across the statebalance of state Joy Johnson, Arizona Department of Housing • Covers the 13 “rural” counties (Balance of State) • Administers homeless programs funding • COC and/or HTF funds in every “rural” county • SOAR goals • Lead in every “rural’ county

6. Social Security Disability Insurance (SSDI) • What is it? • SSDI is a program to provide income supplements to people who are no longer able to work because of a significant disability. • Who is it for? • People who are no longer able to perform substantial work activity may qualify if they: • have a medical condition that’s expected to last at least one year or result in death, • are younger than full retirement age (FRA) and earn less than the substantial gainful activity (SGA) limit, • are blind and at least age 55 for certain individuals, and have • earned a certain number of work credits.

7. Supplemental Security Income (SSI) What is it? SSI is a federal program that provides monthly payments to people who have limited income and few resources. Who is it for? People who are 65 or older, as well as for those of any age, including children, who are blind or who have disabilities.

8. SSDI vs. SSI

9. What’s New in 2019? • The Substantial Gainful Activity (SGA) amount for individuals with disabilities, other than blindness, increased from $1,180 to $1,220. • The SGA amount for individuals who are blind increased from $1,970 to $2,040 for 2019. • The monthly earnings amount that we use to determine if a month counts for the Trial Work Period month is $880 per month in 2019. • The Supplemental Security Income (SSI) Federal Benefit Rate (FBR) is $771.00 per month for an eligible individual (was $750) and $1,157 per month for an eligible couple. (was $1125.00)

10. What is SOAR?SOAR stands for: SSI/SSDI Outreach, Access and Recovery • A process designed to help states increase access to SSI/SSDI for eligible adults 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 ($1180 per month or $1970 for blind people) • Encourages a collaborative process between SSA and DDS • Offers training for case managers • Provides individualized TA for support

11. SOAR Partners Social Security Administration (SSA) • Federal agency that administers SSI/SSDI • Makes the non-medical decision Disability Determination Services (DDS) • State agency under contract to SSA • Makes the medical/disability determination Medical/treatment providers • Assessments/evaluations • Medical records

12. Collaborating with SSA and DDS • The Phoenix downtown SSA office assigns a specific claims representative to assist with all SOAR applications. • SSA flags all homeless applicants to expedite processing. • DDS and SOAR work together to ensure the applicants attend any medical/psychological consultative examinations. • SSA offices in the BOS

13. The soar applicantfunctional impairments

14. The soar applicantfunctional impairments • Neglects to attend to basic needs including medical, nutrition, hygiene and grooming • Needs assistance in caring for self in a safe or sanitary manner • Housing, food, clothing must be provided or arranged for by others • Unwilling to seek care for serious medical conditions or refuses treatment for life threatening illnesses due to mental illness

15. The soar applicantfunctional impairments Risk of serious harm to self or others • Seriously disruptive to family and/or community • Regularly engages in assaultive behavior • Has been institutionalized due to dangerous behavior • Currently displays, or has a history of abusive behavior towards others in the persons care i.e. children caretakers caseworkers

16. The soar applicantfunctional impairments Risk of Deterioration • A qualifying diagnosis with probable chronic, relapsing and remitting course • Co-morbidities (mental retardation, substance dependence, personality disorders) • Persistent or chronic factors such as social isolation poverty • Extreme chronic stressors such as life threatening medical illness victimization

17. The soar applicantfunctional impairments Dysfunction in Role Performance • Frequently disruptive or in trouble at work or school • Unable to maintain employment or requires high level of supervision at work or school • Meet other developmentally appropriate responsibilities

18. Soar has broader goals

19. How is the SOAR Model different? • Case managers actively assist applicants, maintaining contact and acting as their 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

20. Critical Components • Serving as the appointed representative • Collecting and submitting medical records • Electronically submitting applications and medical evidence whenever possible • Collaborating with physicians for assessments and medical information • Collaborating with SSA and DDS • Submitting a Medical Summary Report

21. Medical Summary Report(MSR) The MSR is a letter which describes the individual and his/her functional limitations and struggles • Critical component of the SOAR model • Paints a vivid picture of the individual for the DDS examiner who never sees them • Provides a clear link to the functional impairment which links directly to; • “Why can’t the applicant work?”

22. Serving as the Appointed Representative SSA-1696: Appointment of Representative • Permits communication with SSA and DDS about the applicant’s file • Case Manager receives copies of all applicant communication from SSA and DDS • The most important tool for working with someone who is experiencing homelessness • Neither the agency or the Case Manager is liable for the decision made by DDS • It is NOT the same as the Representative Payee • SOAR providers should check “waiving fees from all sources”

23. Electronically Submitting Applications and Medical Evidence • Saves Social Security Administration (SSA) and the Disability Determination Services (DDS) time, effort, and money during the disability process. • Helps expedite the claim.

24. Activity:Reasons for the work we do • This program is about: • Ending homelessness • Promoting recovery • Transforming lives • Discussion: • What brought you to this work? • How do you see this program helping your clients?

25. activity continueddiscussion • Besides having that collaboration with SSA, what is the biggest difference you’ve witnessed when assisting individuals apply for SSA benefits with and without SOAR? • Have there been any barriers that you have needed to overcome since you’ve been SOAR-trained? If so, have those barriers been resolved? • What are some success stories you have to share with the audience?

26. How to get SOAR-Trained SOAR Online Course • 16 hours of Continuing Education Unit (CEUs) upon successful completion • You get 4-5 weeks to complete the overall training • In-depth, step-by-step explanation of SSA’s disability determination process and SSI/SSDI application forms

27. How to get SOAR-Trained SOAR Online Course • Self-directed learning, work at your own pace • Sample reports, letters, forms and other tools • Completion of a SOAR SSI/SSDI application packet, submitted to the SOAR T/A Center for review and feedback

28. New: Online coursefor child curriculum • For children and youth experiencing or at risk of homelessness with a permanent disability (same as the adults) • Seven classes with articles, videos and short quizzes • Estimated time of completion is about 20 hours • For more information enroll in SOAR 101; Class 1, no obligation to complete the entire course

29. SOAR Outcomes Approvals • Over the past 12 years, SOAR has been used to assist over 63,861 people • Of those applications, 65%, representing 34,919 persons, have been approved for SSI/SSDI on the initial application • An additional 5,392 applications that were denied initially, approved on reconsideration or appeal • Since 2006, SOAR is responsible for assisting 40,311 persons experiencing or at risk of homelessness

30. SOAR Outcomes 2017 • 3,563 approvals on initial applications • Decisions on initial applications on average was 96 days • Which equals 64% approval rate • This compares to allowance rate of 28.5% for all persons 18 to 64 who applied for SSI or SSDI in 2015 • The National approval rate is 65% • Arizona’s approval rate is 65% in 115 days on average

31. SOAR OutcomesTop 10 States • Have a cumulative approval rate of 84% • At least 200 cumulative decisions • Combined, these states had 10,416 decisions • Average back pay received $5,520 from 1,677 cases • Average Medicaid reimbursement $5,929 from 85 cases • $356 million brought into the economy nationally It’s time AZ joined this grouping!!!!

32. SOAR Outcomes • Online Application Tracking (OAT) • Web-based program that allows case managers to keep track of their outcomes • Free • Easy to use • Accessible from any web browser • Nothing to download • HIPAA compliant • No personal identifying information is collected

33. How to get started • Below is the link to the website • The course is explained on this page • There is Q and A • And a link to take you to the registration page • Set up your account • Class begins! • https://soarworks.prainc.com/course/ssissdi-outreach-access-and-recovery-soar-online-training

34. How to stay involved in SOAR AZ SOAR State Steering Committee • Contact the state lead or your local lead if interested in becoming a member AZ SOAR Local Steering Committee • Contact state lead or your local lead if interested in becoming a member SOAR Refresher Trainings • For those who have completed the Online Course (coming) SOAR T/A Center • The Arizona SOAR contact is Pam Heine (pheine@prainc.com) • Anyone can contact the SOAR T/A Center for any SOAR-related questions or concerns

35. Social Security Work Incentives Disability Benefits 101 (DB101) • A user-friendly online tool that helps work through the myths and confusion of Social Security benefits, healthcare, and employment • az.db101.org/ • Other states need to know and understand Social Security Work Incentives…we have DB101 to do the work for us

36. Q & A from Audience

37. Thank you • Joy Johnson, State Lead, Arizona Department of Housing • Joy.Johnson@azhousing.gov • Cristina Benitez, Southern Arizona Lead (8 Counties), Arizona Complete Health • cbenite@azcompletehealth.com • Jeremy Huntoon, Maricopa County Lead, Community Bridges • jhuntoon@cbridges.com • Amber Allery, Claims Representative, Social Security Administration • Amber.allery@ssa.gov