SSI/SSDI Outreach, Access and
Recovery: An Overview
Supplemental Security Income
(
)
SSI
and Social Security Disability Insurance
income benefits administered by the Social Security Administration
/
.
and or Medicare health insurance to eligible individuals
.
complicated and difficult to navigate
,
Nationally
about
(
)
SSA
)
SSDI
are disability
that also provide Medicaid
/
The application process for SSI SSDI is
29
percent of individuals who apply for these
benefits are approved on initial application and appeals take an average of
The Issue
(
1
.
year to complete
For people who are homeless or who are returning to the community from institutions
),
hospitals
.
access to these programs can be extremely challenging
people who are homeless and who have no one to assist them is about
,
,
have a mental illness
substance use issues
application process is even more difficult
–
(
,
,
jails
prisons
or
Approval on initial application for
10-15
.
percent
For those who
-
,
or co occurring disorders that impair cognition
the
yet accessing these benefits is often a critical first step in
.
recovery
Strategic
Planning
Training
Leaders
Technical
Assistance
Strategic planning meetings bring
Training of case managers
Individualized technical
/
key state local stakeholders
( . .,
e g
SSA and Disability Determination
A Solution
Services
(
);
DDS
State Mental Health
;
,
community homeless
-
Available in person
this training includes
.
application process
agree upon
a SOAR Process for the submission
,
sustainability
developing
,
quality review procedures
A
and assisting with tracking
Leadership Academy program
outcomes to document
creates strong local leaders to
success and identify areas for
-
/
.
support SOAR trained case
and processing of SSI SSDI
identifying funding
opportunities for
/
)
,
.
curriculum
,
an improved SSI SSDI
behavioral health providers
applications
action plan implementation
a step by step explanation of
health and
,
Stones to Recovery
,
- -
and
together to collaborate
assistance for supporting
or online
Agency and Department of
Corrections leadership
’
using SAMHSA s Stepping
improvement and expansion
managers and coordinate
and develop
.
local SOAR programs
an action plan to
implement their
.
SOAR Program
Since
Outcomes
22,863
2006,
In
The allowance or approval
over
/
applications averages
SSI SSDI applications
.
percent in an average of
have been approved
days
65
94
,
alone
local economies of the
(
.
outcomes
).
@
e mail us at soar
.
://
prainc com or visit http
48
states reporting
from date of
date of decision
, -
$227
million into the state and
application submission to
For more information
/
SSI SSDI
brought at least
rate on initial SOAR
initial SOAR
2014
.
.
/
soarworks prainc com
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of
Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
TOTALS
Locality
Birmingham
Multiple sites
Maricopa County
State
Multiple sites
Sacramento (SMART)*
HOPE San Diego
Santa Clara*
Ventura Co
State
State
State
District
State
State
State
State
State
State
State
Multiple sites
Multiple sites
Multiple sites
State
Multiple sites
Boston
State
State
Multiple sites
Multiple sites
Multiple sites
Multiple sites
State
Nashua
Multiple sites
State
Multiple sites
State
State
State
BEST Portland
Multiple sites
Multiple sites
Philadelphia (HAP)
State
State
Rapid City
Multiple sites
Nashville
State
State
State
State
Vancouver provider
Veterans
Multiple sites
Multiple sites
State
2014
Decisions
8
19
15
124
7
382
48
66
105
80
55
2014
Appr
7
6
9
85
4
287
36
57
51
58
30
2014
Allowance
88%
32%
60%
69%
57%
75%
75%
86%
49%
73%
55%
2014 Av
Days
88
176
108
42
103
70
84
na
132
97
127
Years of
Data
6
6
4
6
various
4
3
4
4
various
5
6
New Cum
Decisions
111
93
127
590
15
1706
127
141
202
491
184
293
31
492
89
5
20
23
25
369
80
5
13
19
81%
75%
90%
100%
65%
83%
119
58
78
135
88
75
17
41
98
93
11
36
39
80
65%
88%
40%
86%
126
130
139
140
155
2
255
86
50
42
10
166
13
135
0
153
32
30
16
5
101
11
87%
0%
60%
37%
60%
38%
50%
61%
85%
73
85
99
167
30
107
90
64
185
66
81
81
317
863
79
209
38
55
69
264
412
70
146
58%
68%
85%
83%
48%
89%
70%
137
105
68
106
54
na
74
47
158
34
150
72%
95%
51
43
38
21
55%
81
100
170
20
675
4
206
29
27
18
83
37
5,905
90
170
13
228
1
149
17
22
9
45
25
3,818
90%
100%
65%
34%
25%
72%
59%
81%
50%
54%
68%
65%
80
37
128
184
45
141
150
97
61
113
114
94
4
various
6
3
3
4
6
4
5
7
5
3
5
5
6
7
4
4
3
6
6
3
6
6
various
8
7
7
7
5
5
7
7
4
2
7
8
6
7
<1
7
3
3
6
5
4
66
3155
2032
29
98
118
20
56
549
750
247
5
515
464
2204
1875
70
79
98
706
270
7
350
372
908
1130
3709
661
1054
182
132
1343
200
92
71
444
692
325
3835
4
873
60
227
52
777
138
35,124
New Cum
Cum
Appr
Allowance
83
66%
61
66%
69
54%
457
77%
9
60%
994
58%
87
69%
124
88%
111
55%
324
66%
119
65%
212
72%
56
2124
1144
25
52
85
18
41
443
480
156
5
443
267
1317
1266
38
40
38
407
191
6
199
238
634
917
1900
477
820
92
86
1330
154
55
63
353
678
219
1828
1
625
29
212
31
530
100
22,863
85%
67%
56%
86%
53%
72%
90%
73%
81%
64%
63%
100%
86%
58%
60%
68%
54%
51%
39%
58%
71%
86%
57%
64%
70%
81%
51%
72%
78%
51%
65%
99%
77%
60%
89%
80%
98%
67%
48%
25%
72%
48%
93%
60%
68%
72%
65%
Best Practices for Implementing State and Local SSI/SSDI Outreach Initiatives
for People Experiencing Homelessness
1. Establish leads. Identify state and local leadership and establish a steering committee.
2. Identify existing resources. Identify programs/staff that are currently assisting individuals
experiencing or at-risk of homelessness with Supplemental Security Income/Social Security
Disability Insurance (SSI/SSDI) applications.
 What are your existing resources?
 How are you currently assisting with benefits acquisition?
 What is your success rate?
 What needs to be changed?
3. Introduce SOAR. Identify agencies that will participate in your SOAR project and get their buy-in.
Engage agency administrators so they understand the purpose and benefits of SOAR. Establish a
pilot site and create an action plan.
4. Collaborate. Negotiate a specific referral process with the Social Security Administration (SSA) and
Disability Determination Services (DDS) so that expectations and commitments are clear (c.f., Best
Practices for Collaborating with SSA and DDS on SSI Outreach for People Experiencing
Homelessness). Establish a process to obtain medical records from providers that treat people who
are homeless in the community. Identify staff who can be fully or partially dedicated to assisting
with benefits applications. Realign or combine existing resources, identify new funds. Is there an
opportunity to benefit from retroactive recovery of uncompensated care?
5. Train and support staff that assist SSI/SSDI applicants. Have staff complete SOAR training, either
online or in person. Identify mentors who can assist new trainees with their first few applications.
Inform trainees of the expectations for participation in SOAR in your state and any state-specific
processes. Establish mechanisms for on-going communication and support, i.e. refresher trainings,
conference calls, newsletters, monthly meetings of trainees, SSA and DDS.
6. Quality review. Ensure that applications submitted to SSA are complete and high quality. Use the
SOAR Quality Review Checklist for SSI/SSDI or establish your own quality review procedures (e.g.
mentoring, supervisory reviews, reviewing Medical Summary Reports). Review the Best Practices
for Assisting SSI/SSDI Applicants Experiencing Homelessness to assess fidelity to the SOAR model.
Hold regular steering committee meetings to identify and resolve any challenges.
7. Track and report outcomes. Use the SOAR Online Application Tracking (OAT) program to collect
and report outcomes. It’s free, web-based (https://soartrack.prainc.com/), and easy to use.
8. Fund and sustain. Use your outcomes to expand or sustain your SOAR project. Analyze data and
report the cost savings associated with SOAR. Share success stories; give presentations to
influential leaders and potential funders. High reimbursement and recoupment totals can be used
to attract additional resources and supplemental funding.
SSI/SSDI Outreach, Access and Recovery (SOAR) Technical Assistance Center
December 4, 2014
State Team Lead and Planning Team
Suggested Roles and Responsibilities
State Team Lead (STL) Roles and Responsibilities
 Identify state planning team members, including SSA and DDS representatives.
 Convene regular meetings of the state planning team.
 Disseminate minutes of meetings to the state planning team and local planning team(s).
 Create a distribution list for ongoing communication.
 Serve as liaison between SOAR state planning team and local planning teams to problem-solve
and coordinate data collection.
 Coordinate and follow up on the implementation of the state action plan and SOAR Process.
State Planning Team Roles and Responsibilities
 Collaborate with SSA and DDS (regional, area, district or local offices) to establish the SOAR
Process. Determine SSA office liaisons (if possible) and disseminate this information to SOARtrained community staff.
 Provide support to SOAR-trained staff and Trainers, working closely with local/regional planning
teams. Work with local planning groups to identify experienced mentors who can assist new
trainees with their first few applications. Identify individuals for the Train-the-Trainer program
offered by the SAMHSA SOAR TA Center.
 Identify strategies for ongoing funding and sustainability. Create buy-in by educating
stakeholders about the impact SOAR has in your state. Use outcomes to highlight the benefit of
SOAR in reimbursed care and income.
o Explore various funding sources. Consider use of federal funds (e.g. PATH); pool and/or
realign existing resources; explore local foundations, United Way, corporations, and
hospital collaborations; and investigate criminal justice funding to implement SOAR in
jails or prisons.
 Collect and report outcomes. Identify tracking mechanism to be used (e.g., SOAR Online
Application Tracking (OAT) or HMIS). Ensure the collection and reporting of outcomes by
communities and SOAR-trained staff; report outcomes to the SAMHSA SOAR TA Center as
requested.
 Identify and address technical assistance needs. Hold regular calls and/or meetings with Local
Planning Team Leads to identify issues and problem solve. Request TA as needed from the
SAMHSA SOAR TA Center.
 Expand SOAR to other areas of the state and to other populations at risk for homelessness (e.g.,
jails/prisons, general assistance/TANF recipients, state hospital discharges, etc.).
 Attend meetings.
SSI/SSDI Outreach, Access and Recovery (SOAR) Technical Assistance Center
December 17, 2014
Local Team Lead and Planning Team
Suggested Roles and Responsibilities
Local Team Lead Roles and Responsibilities
 Identify local planning team members, including SSA and DDS representatives and your State
Team Lead (STL).
 Convene regular meetings of the local planning team.
 Disseminate minutes of meetings to the local planning team and the STL.
 Create a distribution list for ongoing communication.
 Hold regular calls with the STL to report progress and challenges.
 Coordinate and follow up on the implementation of the local action plan and SOAR Process.
 Collaborate with STL to ensure local implementation is consistent with the State plan.
 Report data and outcomes to the STL according to the State plan.
Local Planning Team Roles and Responsibilities
 Collaborate with local SSA and DDS offices to establish working agreements based on the SOAR
Process agreed upon by your state.
 Provide logistical support to Trainers to plan and conduct local trainings. If necessary, discuss
with the Trainers charging a minimal fee to cover incidental costs, e.g., $25-30/person for the 2day training.
 Identify and explore strategies for ongoing funding and sustainability. Create buy-in by
educating local stakeholders about the impact that SOAR has in your community. Use outcomes
to highlight the benefit of SOAR in reimbursed care and income.
 Collect and report outcomes. Work closely with your State Team Lead to ensure the collection
and reporting of outcomes using whatever mechanism the State determines, such as HMIS or
the SOAR Online Application Tracking (OAT).
 Identify and address technical assistance needs. Hold regular calls and/or meetings with SOAR
providers/trainees and SSA and DDS to discuss strategies and brainstorm solutions to challenges
that arise. Request TA as needed from the SAMHSA SOAR TA Center.
 Attend meetings.
SSI/SSDI Outreach, Access and Recovery (SOAR) Technical Assistance Center
December 17, 2014
SOAR Leadership Academy
What is a SOAR Leadership Academy?
The SOAR Leadership Academy is a three-day training program presented by the SAMHSA SOAR
Technical Assistance (TA) Center designed to prepare individuals to serve as local leads within their
communities, guide the SOAR initiative and support individuals who complete the SOAR online course.
Topics Covered:
 Creating & Leading a Local Steering Committee
 Facilitating Effective Meetings
 Using the Online Application Tracking (OAT) system
 Funding & Sustaining SOAR in Your Community
 Conducting a one – day SOAR Fundamentals training
 Supporting Quality SOAR Applications in your community
 Working with Special Populations – Veterans, Children, Justice Involved Persons and Appeals
Expectations of Attendants of a Leadership Academy
 Receive recommendation from your State Team Lead
 Successfully complete the SOAR Online Course (http://soarworks.prainc.com) prior to attending
 Attend all three days of the program from 8:30 AM – 4:30 PM
Roles & Responsibilities of Local Leads Post-Leadership Academy
 Conduct periodic one-day trainings for those who have completed the online course; including a
SOAR Fundamentals refresher of SOAR core elements and training on state-specific SOAR
processes
 Follow-up with SOAR trainees in regular meetings to discuss issues and progress on completing
applications
 Collaborate with community providers and local SSA And DDS contacts to plan, implement and
support local SOAR initiatives
 Work closely with the State Team Lead and SOAR TA Center to carry out the SOAR
implementation plan in your region and to track and report outcomes
Selecting a Local Lead
 A successful SOAR local lead:
 Has experience completing SSI/SSDI applications using the SOAR model (recommended
but not required)
 Is invested in SOAR and the success of SOAR within their community
 Has the time and ability to work with multiple agencies and/or the Continuum of Care
within their community
 Has the capacity to lead a SOAR steering community and follow-up with trainees re
outcomes
 Will maintain and update their community’s SOAR action plan
 Will be able to conduct one-day SOAR Fundamentals trainings for individuals who
successfully complete the SOAR online course
SSI/SSDI Outreach, Access and Recovery (SOAR) Technical Assistance Center
December 17, 2014
Local SOAR Action Plan - Guidelines
#1. COMPLETING APPLICATIONS AND TRAINING





Identify programs that will participate in your community pilot of SOAR and engage agency
administrators to support and implement SOAR in their programs.
 Can programs enhance or re-configure staff to create/expand an SSI/SSDI effort?
 Are there outreach workers in the community that can assist with SSI/SSDI applications?
How will you identify who will be trained in SOAR and complete applications?
 Do the identified staff have the time to undertake the training and complete applications?
How will you utilize the SOAR online course to support training in your area?
When, where, and how will you provide follow-up support to trainees? How can you utilize the
SOAR Fundamentals materials?
 Are there local SOAR leaders in the state/community that can assist?
How can you assure that the applications submitted to SSA are consistent and high quality?
#2. COLLABORATIONS
a. Collaboration with SSA and DDS
 Negotiate a specific referral process with SSA and DDS. Consider including:
 MOUs between community providers assisting with applications so that expectations
and commitments are clear
 Training community providers to complete the SSI application on an outreach basis
 SSA gives community providers a maximum of 60 days to gather medical
documentation, write a Medical Summary Report, and submit the full application packet
 Identify SSA and DDS liaisons for SOAR in local offices
 SSA "flags" SOAR applications and forwards them to designated DDS SOAR liaison
 How can SSA and DDS participate in the SOAR steering committee and provide feedback
about the SOAR process and quality of submitted applications?
b. Collaboration with Medical Providers
 Get buy-in from health care providers that treat homeless persons in the community.
 Set up a process to obtain medical records from essential providers.
 Can you arrange to obtain medical records without charge?
 Identify area hospitals, primary care clinics and mental health centers that do or could
provide needed assessments or evaluations to support SSI/SSDI applications including
Healthcare for the Homeless providers.
 Arrange for psychiatric evaluations; consider using medical or graduate school students.
 Explore possibility of using retroactive Medicaid to reimburse for medical evaluations.
c. Other Collaborations
 Who else needs to be included as part of SOAR (e.g., Continuum of Care, shelters or
outreach programs, Mayor’s Office, local homeless coalitions, local prisons or jails)?
 How will you address the need for representative payee services?
SSI/SSDI Outreach, Access and Recovery (SOAR) Technical Assistance Center
December 17, 2014
#3. TRACKING OUTCOMES, FUNDING AND SUSTAINABILITY






How will you track key outcomes of SSI/SSDI applications and use them to expand or sustain
your efforts?
 Days to decision (number of days between submission and initial decision); outcome of
initial decision; housing status at time of initial contact; and length of time homeless; use of
Appointment of Representative (SSA-1696); completion of Medical Summary Report; need
for consultative exam; Medicaid/public assistance reimbursements
 Will you use the Online Application Tracking (OAT) system, HMIS, or other local database?
Who takes responsibility for coordinating and reporting on outcomes?
Can you reallocate existing resources (staff, funding, etc.) towards SOAR efforts?
What federal, state, local, or private funding streams are available to support SOAR?
Can you collaborate with local hospitals, jails, universities, etc. for additional resources?
Is there an opportunity for your state or county to benefit from retroactive recovery of
uncompensated care and/or general assistance benefits?
#4. LOCAL LEADERSHIP TEAM








Who will comprise the steering committee for implementation of your local SOAR Action Plan?
How will the steering committee communicate with other key stakeholders?
Who will lead coordination and implementation of next steps?
How will communication and collaboration between the local and state teams be carried out?
When will the team meet next? How often will you meet thereafter?
Are there any additional planning team members that should be identified and involved?
How will this planning be integrated into current homelessness planning at the state and local
levels (e.g. Continuum of Care plan; state or community plan to address or end homelessness)?
Routinely review your progress and seek technical assistance if needed.
WHEN CREATING GOALS, OBJECTIVES, AND ACTION STEPS, REMEMBER TO MAKE THEM ‘SMART’:





Specific – clearly define what you are going to do
Measurable – define criteria for measuring progress towards attaining the goal
Achievable – is the plan realistic and attainable?
Relevant – does the action step/objective/goal contribute to the overall mission?
Time-bound – ground goals within a timeframe/target date to keep the work on track
SSI/SSDI Outreach, Access and Recovery (SOAR) Technical Assistance Center
December 17, 2014
Action Plan Template
Goal 1: Completing Applications and Training
1.
EXAMPLE: Increase the number and quality of applications submitted using SOAR, and increase the number of
providers trained in the SOAR model
Measurable Objective (EXAMPLE)
Increase the number of applications per year
Increase the quality of applications
Increase the number of SOAR providers
2015
2016
2017
50/yr.
65%
5
125/yr.
75%
10
200/yr.
85%
15
Action Steps
a.
Lead Person
Conduct a baseline survey to identify:
 Who is SOAR trained/who is filing applications currently
 How many applications are filed each year currently
 Current approval rate of SSI/SSDI applications
 Interest in SOAR from organizations that haven’t received training
COC members drive & support
efforts (Sharon, Peg, & Carol)
Timeframe
By June 15th
– create
survey
June 16-July
5 – conduct
survey
July 15 –
report back
to SOAR
committee
Goal 2: Collaborations
2. What is your goal for collaborations with SSA, DDS, medical and mental health providers, and other key stakeholders?
Measurable Objective
2015
Action Steps
Lead Person
SSA and DDS
a.
b.
Medical Providers
c.
Other
d.
2016
2017
Timeframe
Action Plan Template
Goal 3: Tracking Outcomes, and Sustainability
3. What is your goal for tracking outcomes and increasing funding and sustainability efforts?
Measurable Objective
2015
Action Steps
2016
2017
Lead Person
Timeframe
a.
b.
Goal 4: Local Leadership Team
4. What is your goal for the local leadership team and how it will operate?
Measurable Objective
2015
Action Steps
2016
Lead Person
2017
Timeframe
a.
b.
Action Plan Evaluation
Quarterly review of action plan
Action plan reviewed and updated by the leadership team
Updated action plan distributed to SOAR community and stakeholders
Other action plan review steps?
October
2014
January
2015
April
2015
July 2015
Best Practices for Assisting SSI/SSDI Applicants
Experiencing Homelessness
Critical
Component
Requirements
Strategies

Provide sufficient staff time to do
outreach and engagement and to assist
applicants with SSI/SSDI applications
Arrange for training using either the inperson 2-day Stepping Stones to
Recovery training; or the online SOAR
training course
Provide ongoing training and support,
locally based, for case managers
assisting applicants
Ability and flexibility to hold meetings
on an outreach basis
Attention to detail, follow-through and
ongoing effort to maintain contact
Clarity on SSI/SSDI process to maintain
communication with SSA and DDS
Use SSA-1696 Appointment of
Representative form

Use SSA and agency release for each
treatment source
Use cover letter specifying that
information will be re-released to SSA
Staff write medical summary report
that is co-signed by treating physician
or psychologist

If needed, provide or arrange for
physicians or psychologist to conduct
assessments, including diagnosis and
functioning
Provide assessment on an outreach
basis, as needed
Have physician or psychologist co-sign
medical summary report


Dedicated Staff


Maintain
Contact



Authorized
Representative*

Medical Records
and Medical
Summary
Report*



Assessments*












Staff should have experience
interviewing for and documenting
functional information for writing a
medical summary report
Staff should be skilled in engagement
and rapport building
Help facilitate access to housing and
other essential services when available
Provide immediate response to access
services so applicants feel heard and
understood and contact is maintained
Provide assistance to applicants who
appoint case manager as their
representative; offer others information
on how to apply for SSI on their own
Work proactively with medical records
directors
Ensure medical providers are aware of
what needs to be sent
Inform them of information needs
Offer to copy records
Ensure agency release is HIPAA
compliant
Arrange for training of physician or
psychologist regarding information
needed by DDS
Explain the importance and purpose of
the medical summary report to
physicians and psychologists
NOTE: If an assessment is needed, but
not available before an application is
submitted, SSA is likely to order a
Consultative Exam (CE)
SSI/SSDI Outreach, Access and Recovery (SOAR) Technical Assistance Center
December 4, 2014
Critical
Component
Quality Review*
Electronic
Submission
SSA/DDS
Collaboration
Avoid
Consultative
Examinations
(CEs)
Organizational
Representative
Payee
Requirements
Strategies

Expert uses protocol to review
application for accuracy, completeness
and clarity
 Complete all available SSA forms online
 Submit medical records electronically
through the ERE or DDS fax cover sheet
process
Request that SSA and DDS:
 Flag cases from assisting agencies
 Expedite the review
 Assign claims representatives and
disability examiners who specialize in
applications from individuals
experiencing homelessness
 Communicate directly with assisting
agencies about information needs for
particular applications
 Contact assisting agency if CE needed
 Review and implement the SOAR
Process adapted for use in the State
 Provide or arrange for physicians and
psychologists (outdoors, if needed) to
conduct needed evaluations prior to
submitting documentation to DDS so
that CEs are not needed (see # 5 above)
 Ensure collection of all medical and
functional information relevant to the
claim
If CE is required:
 Request that applicant’s treating
physician be allowed to conduct exam
 Make sure applicant gets to the exam;
accompany applicant, if possible

Expert receives special training regarding
review techniques

Provide training on the use of SSA’s
electronic process
Sign up for Electronic Records Express
with DDS
Keep in ongoing contact with appropriate
staff at SSA and DDS
Respond quickly to requests for
additional information


Ensure access to appropriate
representative payee services are
available








Provide and train the physician or
psychologist who will conduct the
thorough evaluation SSA needs to
determine disability
Prepare for needed diagnostic
evaluations by having other clinical staff
and case managers assist in collection of
historical information
Make least use of most expensive
clinicians
NOTE: Requiring a CE means that SSA
does not have enough medical
documentation to make a decision. CEs
increase the length of time needed for
SSA to make a decision.
Develop representative payee services in
existing or future SSI/SSDI initiative
programs
Assist beneficiary to become their own
payee as appropriate
SSI/SSDI Outreach, Access and Recovery (SOAR) Technical Assistance Center
December 4, 2014
Critical
Component
Requirements
Strategies


Incorporate strategies for encouraging
consideration of and participation in
employment at earliest possible time
Ensure case managers are aware of
work incentives under SSI and SSDI
using SOAR online training curriculum
Invite Department of Labor and
vocational service providers to be part of
the SOAR initiative

 Resources available in every state can be
Employment
accessed at:
http://www.chooseworkttw.net/resourc
e/jsp/searchByState.jsp
 Connect with SSA Work Incentive
Coordinators
Track key data elements:
 Use the SAMHSA’s free Online
 Date initial application submitted
Application Tracking (OAT) program for
 Date initial decision rendered
SOAR
 Outcome of initial decision
 Use locally established process for
Outcome
 Housing status at time of application
tracking applications (HMIS, Excel,
Tracking
 Use of SOAR Critical Components
Access)
 Track additional data elements including
Medicaid reimbursement and other cost
savings/cost recovery
 Establish funding for ongoing program
 Use outcome data to make the case for
implementation
sustaining or expanding SSI/SSDI
application assistance
 Work with hospitals, State Medicaid and
General Assistance offices to recoup
money spent on uncompensated care
and general assistance benefits; be clear
Funding and
that as they benefit, their assistance in
Sustainability
continuing or expanding SSI outreach is
needed
 Provide eligibility assistance to people at
risk for homelessness in jails and prisons;
link to re-entry
 Explore collaborations with employment,
housing, and veterans programs
*Analysis of OAT conducted in 2013 found using these components significantly improved the likelihood of
an application being approved (p<.001). Using them in combination with one another further increased
the likelihood of application approval.
SSI/SSDI Outreach, Access and Recovery (SOAR) Technical Assistance Center
December 4, 2014
TO:
Program Directors Considering SOAR Training for Staff
FROM:
National SOAR Technical Assistance Team
DATE:
RE:
SOAR Training
We are delighted that you are interested in having staff trained to assist people with Social Security
Disability applications using the SSI/SSDI Outreach, Access and Recovery (SOAR) approach. As you may
know, the main goal of SOAR is to obtain expedited approvals for SSI/SSDI applicants who are
homeless or at risk of homelessness and who have mental illness and/or co-occurring disorders. We
want to be sure that you understand the level of effort that SOAR requires so you feel comfortable
committing to this initiative prior to having your staff trained.
The training can be conducted as a 2-day in-person training or it can be completed online at one’s own
pace. How the training is conducted in your area will depend on how your state or locality has decided
to conduct SOAR training. Either way, the training takes about 2 full days. For the online curriculum, a
sample SSI/SSDI application packet must be submitted and approved by the SOAR Technical Assistance
Center before a Certificate of Completion is awarded.
This training is not about the completion of forms. Rather, it is about engagement with individuals who
are homeless or at risk for homelessness, understanding the requirements of the Social Security
Administration (SSA) for benefits and obtaining needed documentation, serving as appointed
representative, obtaining medical records, and writing a detailed medical summary report that
captures the individual’s personal, treatment, and functional history so benefits can be expedited.
SOAR considers access to SSI/SSDI as a major tool in recovery, both from mental illness and
homelessness. Without these benefits, it is extraordinarily difficult for individuals who are homeless to
engage in treatment, to keep appointments, to maintain housing, and to meet other basic needs.
The SOAR model requires that community staff directly assist applicants. To do this, staff must:
 Serve as appointed representative for the purpose of applying for SSI/SSDI. This is not the same
as being the representative payee. The appointed representative can “stand in” for the
applicant, respond to questions, receive copies of all mail sent to the applicant, and
communicate back and forth with SSA and DDS, the agency that makes disability
determinations. The representative is not responsible for the decision so liability is not an issue.
 Complete the applications both for SSI and SSDI. These applications consist of several
documents: (1) a 23-page application form for SSI; (2) an on-line application form for SSDI; (3)
a 12-page on-line disability report along with several releases of information, both agency
releases and SSA releases.
SSI/SSDI Outreach, Access and Recovery (SOAR) Technical Assistance Center
December 17, 2014





Collect medical records from providers who have treated the applicant.
Complete a psychosocial assessment, a functional impairment assessment, and a substance use
worksheet. The information from these is then incorporated into a comprehensive medical
summary report.
Write a medical summary report that includes psychosocial, treatment, and functional
information that is co-signed, if at all possible, by a physician or psychologist who has seen the
individual. This does not have to be an ongoing treatment provider but it does need to be a
physician or psychologist who has met with the individual. The reason for this co-signature is it
makes the report “medical evidence,” which is given greater weight in the disability
determination process.
Conduct ongoing outreach and engagement with the individual who is homeless to stay
connected throughout this process and to work with the individual to obtain other needed
services and treatment such as housing, physical and mental health care, other support
services, food, and clothing.
Track applications and outcomes, including number of applications completed,
approvals/denials, and time to decision from application submission to receipt of SSA’s
decision.
We estimate that this intensive work takes roughly 20-40 hours per applicant from first meeting to
getting a decision on the claim. This time is usually spent over the course of 2-3 months though,
certainly, it is expected to be more intensive in the first month.
The benefit to your agency is that people you serve will have income and health insurance to meet
basic needs which makes them more likely to stay in treatment, keep appointments, and pay their bills.
Thus, if your agency is Medicaid (or Medicare) reimbursable, your bills will be paid. Without such work,
individuals typically take anywhere from 1-3 years to obtain approval, during which time people are
lost to the process and require a great deal of community support simply to survive. With the SOAR
approach, we are seeing approvals on average in 98 days. Clearly, the rewards are great for all
involved.
We ask that you sign and return this memo simply to indicate that you understand what SOAR requires
and are willing to support your staff to engage in this effort. We believe that you will find this to be a
win-win for the individuals you serve as well as for your agency. Thank you for your consideration and
support.
_____________________________________
Agency Name
____________________________________
Signature of Agency Director
_____________________________________
Date
SSI/SSDI Outreach, Access and Recovery (SOAR) Technical Assistance Center
December 17, 2014
SOAR Online Course
Overview and Objectives
Overview
The SOAR (SSI/SSDI Outreach, Access and Recovery) Online Course trains case managers to assist
individuals who are experiencing homelessness to apply for the Social Security Administration (SSA)
disability programs: Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI).
The techniques taught in this online course can improve the quality and completeness of any
application for SSI/SSDI, however, the label “SOAR” should only be used on SSI/SSDI applications for
persons who are homeless or at risk for homelessness.
The SOAR Online Course consists of seven classes, each of which has a series of articles, short quizzes,
and a practice case. 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. Video interviews, medical records, and progress notes provide the information needed to
complete SSA forms and write a Medical Summary Report (MSR) for the applicant. The complete
application packet is submitted to the SOAR Technical Assistance (TA) Center for review. Upon
approval, the participant will receive a certificate of completion and 16 Continuing Education Units
(CEUs) from the National Association of Social Workers (NASW). There is no charge for this course.
We estimate that it will take about 16 hours to complete the course and participants can work at their
own pace, starting and stopping as they wish. However, we encourage students to complete the
course within 30 days to retain the information learned and get connected sooner to local SOAR
initiatives.
Learning Objectives
Class 1: The Need for SOAR
The Need for SOAR provides an introduction to SOAR, its values, and the roles and responsibilities of
key stakeholders, especially case managers.
 Why SOAR is an important tool for case managers to use when assisting people who are
experiencing or at-risk of homelessness and who have a mental illness, co-occurring substance
use disorder or other disability apply for SSA disability benefits
 What values inform the SOAR process
 Important community organizations and stakeholders necessary for a successful SOAR effort
and the roles they play
 An overview of SSA’s disability benefit programs, SSI and SSDI
 Key steps in the disability application process
Class 2: Initiating the Application
Initiating the Application describes strategies to engage an applicant in the application process. It also
stresses two key components in the SOAR program – becoming the applicant’s representative and
collecting medical evidence.
 Effective strategies for case managers to use in engaging the applicant they are assisting
 Importance of becoming the applicant’s representative
 SOAR strategies for collecting medical evidence
 Ways of establishing the protective filing date and starting the application process
SSI/SSDI Outreach, Access and Recovery (SOAR) Technical Assistance Center
December 17, 2014
Class 3: Exploring Basic Eligibility
The Social Security Administration has two types of eligibility requirements – medical and non-medical.
Exploring Basic Eligibility examines the non-medical requirements, which include resources and living
arrangements.
 What constitutes “non-medical” eligibility
 Income and resources limits for SSI eligibility
 How to complete the SSI and SSDI application forms
 Different types of living arrangements and their impact on potential benefits
Class 4: Medical Information
Medical Information focuses on the medical eligibility requirements. It describes what information is
necessary and the steps in the disability determination process.
 What medical documentation is necessary
 How to work with SSA’s Listings of Impairments
 Steps in the disability determination process
 Strategies for gathering information about substance use
 What Consultative Exams are and when they are required
 How to complete the Adult Disability Report
Class 5: The Link to Functioning
Medical records alone are frequently not adequate for the disability determination process. It is
important to make the link between the diagnosis and the applicant’s ability to function in a work
setting. SOAR documents this link in the Medical Summary Report.
 Importance of linking the illness or condition to the applicant’s ability to function in four main
areas
 How to effectively write about functioning
 Elements of the Medical Summary Report
Class 6: Completing the Application Packet
There are several documents that need to be included in a complete SOAR application packet that is
submitted to SSA. There is also necessary follow-up post approval. Completing the Application Packet
covers these topics, and also includes a discussion of appeals in the event of a denial.
 Elements of a complete SOAR application packet
 Next steps following an approval
 SSA’s appeals process
Class 7: Supporting Recovery
Getting disability benefits is an initial step on the road to recovery. Supporting Recovery reviews other
programs that can assist an applicant after s/he receives disability benefits.
 Strategies for accessing housing once benefits have been received
 Medicare Savings Programs to help with health care costs
 Work incentives for applicants wishing to return to work
SSI/SSDI Outreach, Access and Recovery (SOAR) Technical Assistance Center
December 17, 2014
Online Application
Tracking System
The SAMHSA SOAR
(SSI/SSDI Outreach, Access and Recovery)
Technical Assistance Center
is operated by
Policy Research Associates
345 Delaware Avenue
Delmar, New York 12054
p. 518-439-7415 ext. 5242
f. 518-439-7612
[email protected]
http://soarworks.prainc.com
Available from
the SAMHSA
SOAR TA Center
The SAMHSA SOAR Technical Assistance
Center is sponsored by the Substance Abuse
and Mental Health Services Administration.
at
How Can OAT Help Your Agency, Community, or State?
Online Application Tracking...
ƒƒ Keeps track of SOAR-assisted
SSI/SSDI applications
ƒƒ Records decisions on applications,
including appeals
ƒƒ Summarizes outcomes in reports that
can be used for sustainability efforts
ƒƒ Is located on a secure server with no
personally identifiable information
ƒƒ Takes 5 minutes or less to enter data
on each application
ƒƒ Incurs no cost to you or your agency
Why Track Outcomes?
ƒƒ Expand your SOAR initiative
ƒƒ Persuade potential partners to join
your SOAR effort by showing your
achievements
ƒƒ Monitor case workers’ approval rates
and use of SOAR core components to
better target technical assistance and
refresher training
Advantages
For case workers...
ƒƒ Track your SOAR applications online
anytime
ƒƒ Have all your application outcomes in
one place
For agency leads, supervisors...
ƒƒ Track performance by individual or all
case managers
ƒƒ Have easy access to reports for quality
review purposes
What people are saying
about OAT...
This format is easy to use.
—Case worker from NJ
This is really exciting to see all
my data in the system.
—Case worker from FL
I am glad that it will be so easy!
Looking forward to getting more
and more providers on board!
—State lead
For state and local leads...
ƒƒ Access reports on application
outcomes anytime
ƒƒ Prepare agency reports by date
ƒƒ Generate separate reports for initial
applications and appeals
Enroll in OAT
ƒƒ Register at the OAT home page
https://soartrack.prainc.com
ƒƒ View brief tutorials and user
guides
ƒƒ Send questions to
[email protected]
at – it helps
ƒƒ Sustain local, state, and Federal SOAR
efforts — outcomes are essential!
http://soarworks.prainc.com