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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.Maintain contact with applicant 3.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: 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 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.

Michele Levy Managing Attorney Homeless Advocacy Project 42 S. 15 th Street, 4 th Floor Philadelphia, PA Telephone: Fax: Contact Information

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 persons have been trained in every region of the state

What is going on in Michigan? 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 ( 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:

Questions and Answers Facilitators: SAMHSA SOAR Technical Assistance Center Team Policy Research Associates, Inc.

For More Information on SOAR Visit the SOAR website at Or contact: SAMHSA SOAR TA Center Policy Research Associates, Inc. Delmar, NY