Transcript SOAR SSI/SSDI Outreach, Access, and Recovery Expediting
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Strengthening Applications:
Quality Review of SOAR Applications
Presented by:
SAMHSA SOAR Technical Assistance Center Policy Research Associates, Inc.
Under contract to:
Substance Abuse and Mental Health Services Administration U.S. Department of Health and Human Services
Welcome!
Webinar Instructions
Question instructions Muting Recording availability Downloading documents Evaluation
Agenda
Quality Review Strategies and Options
Kristin Lupfer, SOAR Technical Assistance Center
Internal Case Reviews and Checklists
Kas Causeya, BEST Program, Central City Concern, Portland, OR
Community Mentoring and Review
Michele Levy, Homeless Advocacy Project, Philadelphia, PA
Quality Review from a State SOAR Program
Monica Bellamy, Department of Community Health, Detroit, MI
Questions and Answers
Facilitators: SAMHSA SOAR Technical Assistance Team
Quality Review Strategies and Options
Kristin Lupfer
SAMHSA SOAR Technical Assistance Center Policy Research Associates, Inc.
Critical Components for Success
1.
Staff trained & available to assist with applications 2.
3.
Maintain contact with applicant Become applicant’s representative 4.
Obtain medical records, past and present 5.
Collaborate with physicians 6.
Electronic submission of information 7.
Collaborate with DDS and SSA
8.
Ensure quality of applications
9.
Arrange for representative payees 10.
Track and report outcomes
Why do Quality Review?
To ensure the greatest chance of an approval on initial application To reinforce with SSA and DDS what to expect from SOAR applications
What is Quality?
Complete information Online form submission Medical records indicating impairment Detailed functional summary Doctor’s co-signature (when possible) Timely communication with SSA/DDS
Levels of Quality Review
Individual care coordinator Peers/mentors Supervisors Local/Regional SOAR Planning Group SOAR Trainers SSA/DDS State SOAR Program SAMHSA SOAR TA Center
Strategies for Quality Review
Use the Quality Review Checklist Have a trained mentor review applications for completeness prior to submission Review medical summary reports Review outcomes Targeted refresher trainings
You CAN do this!
We support you!
Internal Case Reviews and Checklists
Kas Causeya
BEST Program, Central City Concern, Portland, OR
A Complete Packet Includes:
1696- Appointment of rep. All medical records ROI’s for SSA Functional summary Medical summary signed by MD Our CE (aka IE) reports not DDS’s Pictures if deemed appropriate As much lay evidence as possible 3369- Work history report Miscellaneous questionnaires (pain, seizure, employer, DA+A, current medications and side effects)
BEST Flag
BEST Appeal Flag
Community Mentoring and Review
Michele Levy
Homeless Advocacy Project Philadelphia, PA
HAP and SOAR
HAP’s SOAR Project in Philadelphia began in July, 2007 HAP Partners SSA: Specifically, the SSA Downtown Philadelphia field office Disability Determination Services: Specifically, the Wilkes-Barre Office Philadelphia Office of Supportive Housing
HAP’s SOAR Projects
Initial project with OSH for homeless adults Partnership with DHS for youth aging out of the delinquency or dependency systems HPRP project for “newly homeless” persons TANF SOAR Project with DPW
Philadelphia SOAR Outcomes
First application filed in December 2007 To date, 717 claims in HAP’s SOAR Projects have been approved and 3 claims have been denied.
Average processing time from date application filed is 32 days.
Securing Positive Outcomes
Selecting Advocates
: who should be trained to participate in application filings via SOAR?
Which population do they serve?
The nature of the advocate’s job Past relationship with the relevant agency
Securing Positive Outcomes
Determining SOAR Clients
: which potential clients should be included in the SOAR project?
Most recent psychiatric or other medical evaluation Current or past medication – type and dosage Current functioning
Securing Positive Outcomes
Providing Ongoing Supervision and Support
Review first letter of support (a/k/a medical summary report) submitted by each advocate Remain available to answer questions and to review any documents Provide reminders of upcoming deadlines and the steps in the claims process
Securing Positive Outcomes
Knowing Your Adjudicator and Claims Representative
What medical evidence will your adjudicator require for various impairments?
How much information does your adjudicator need in the letter of support?
What should be provided to secure re openings of prior filings?
What will your claims representative require to process the claim?
Securing Positive Outcomes
Maintaining Communication Among SOAR Partners
Is the process running smoothly between the SSA claims representative and the disability adjudicator?
Is the advocate maintaining effective communication with the adjudicator and claims representative?
Remaining available to trouble-shoot as issues arise.
Contact Information
Michele Levy Managing Attorney 215.523.9585
Homeless Advocacy Project 42 S. 15 th Street, 4 th Floor Philadelphia, PA 19102 Telephone: 215.523.9595
Fax: 215.981.3866
www.homelessadvocacyproject.org
Quality Review from a State SOAR Program
Monica Bellamy
Department of Community Health Detroit, MI
SOAR Across Michigan
Is Sponsored by: Michigan Department of Community Health In partnership with: Michigan State Housing Development Authority Corporation for Supportive Housing Department of Human Services With contractual assistance and support from: Policy Research Associates, Inc.
SOAR Across Michigan
A total of 65 trainings have taken place statewide 1600+ persons have been trained in every region of the state
What is going on in Michigan?
2020+
applications submitted
72%
success rate of getting applications approved on first application and for applications on appeal combined.
Applications approved in an average of
79 days
statewide.
48%
of clients are chronically homeless
Who is Participating?
There are a minimum of 4 trainings offered per year to cover all 8 regions of the state.
Who’s getting trained:
Community Mental Health Agencies Domestic Violence agencies Emergency Shelter Staff Grass Roots Community Agencies Volunteers
What Have We Learned?
More support and input is needed from Regions More support and TA is need for trainee’s to assist them in getting started More support and TA is needed directly after training.
Follow-up to Improve Outcomes
Getting started document (www.prainc.com/soar) One on One follow up with trainee’s MOU agreement follow-up w/ directors Meet periodically to plan and address issues that arise
Follow-up to Improve Outcomes
Monthly Newsletter Contract w/ Advanced Trainers TA calls
What is the State Doing?
Providing on-going TA to all Regions Establishing Collaborations with SSA offices, both on regional and local levels — designated staff.
Establishing Collaborations with DDS —designated staff Conduct state-level planning to support SOAR Across Michigan Monitor progress and report on individual and system outcomes
Refresher Training
60 to 90 days after 2 day Stepping Stones to Recovery training.
Review the most critical aspects of the SOAR Process to get successful outcomes.
Review updated and new information Review and discuss revised forms and processes Give tips and best practices for successful outcomes Provide an opportunity for questions and answers along with TA
SOAR Across Michigan
Improving Outcomes is Possible Collaboration works!
More intense TA provided for trainee’s More community support
Makes a difference with outcomes
For More Information:
Monica Bellamy
SOAR Across Michigan State Team Lead Michigan Department of Community Health Phone: 313-456-4360 E-mail: [email protected]
Questions and Answers
Facilitators: SAMHSA SOAR Technical Assistance Center Team Policy Research Associates, Inc.
For More Information on SOAR
Visit the SOAR website at www.prainc.com/soar Or contact: SAMHSA SOAR TA Center Policy Research Associates, Inc.
Delmar, NY 518-439-7415 [email protected]