1. Bring Badly Needed Federal Dollars Into Rural Communities
Creating a Rural Federal Disability Benefits Specialist Program
SSD/SSI advocacy fills a very large missing piece in social service work

2. Rural Oregon Benefits Pilot
Project Background and Funding
Made possible through Community Service Block Grant funds (CSBG), and
American Recovery and Reinvestment Act of 2009 (ARRA)

3. Community Services Block Grants
CSBG is a federal, anti-poverty block grant which funds the operations of a state-administered network of local agencies
  This CSBG network consists of:
Over 1,100 agencies deliver programs and services to low-income Americans
96 percent of the nation's counties

4. Community Service Block Grants
Oregon Housing and Community Services office administers these federal funds (OHCS)
OHCS provides:
Core funding to local agencies to reduce poverty
Revitalize low-income communities, and
Empower low-income families to become self- sufficient.

5. Community Service Block Grants
CSBG funds are used to provide services for
Employment
Education
Better use of available income
Housing
Nutrition
Emergency services
Health

6. The CSBG Network Most agencies are Community Action Agencies
Oregon has 17 CAA’s; 1 Farm Workers Organization
Community representation and accountability are hallmarks of the CSBG network
Agencies governed by tri-partite boards
Boards consists of:
elected public officials
low-income community representatives, and
appointed leaders from the private sector

7. ARRA Funds Allocations
In addition to regular CSBG funding, Oregon received an additional 7.9 million in CSBG/ARRA monies 99% of ARRA funds went to eligible entities 1% of CSBG/ARRA was earmarked for: “benefits enrollment coordination activities relating to the identification and enrollment of eligible individuals in Federal, State and local benefits programs”

8. The Benefits Project Timeline
April 26, 2010: Disability Benefits Training & Consulting LLC (DBTC) was invited to OHCS to present an overview of benefits work for the disabled homeless and indigent OHCS staff felt this was a perfect fit for the ARRA funding The project came together very rapidly

9. Timeline Cont.d
OHCS invites CAA’s to participate in pilot project One stipulation: Benefits Specialist position must be a full-time, dedicated to the pilot program May 17, 2010: OHCS issues RFP May 28, 2010: RFP awarded to DBTC June 1, 2010: Four CAA’s are chosen for the pilot June 4, 2010: Contract signed with DBTC

10. June 7, 2010 – September 20, 2010 Six day on-site trainings “SSI Boot Camp” Visited seven separate towns Training included six months of follow-up technical assistance to each agency Pilot completed March 31, 2011 OHCS extended DBTC’s contract for 12 months to Develop a statewide peer group Continue to collect data

11. Future Plans
Involve the HUD Continuum of Care coalitions for housing for the homeless
Continue to add benefits to rural 10 year plans to end homelessness
Collect statistical data with the use of HMIS
Develop working relationships with the SSA

12. Pilot Project Results
Total # of Referrals from 5 sites: 93 Cases accepted for representation 48 Not accepted for representation 31 Decisions still pending for rep’g 14 Enrolled statuses: Preparing cases for application 11 New applications filed 20 Cases that had applications already 17 Number of Allowances so far 6

13. Coos/Curry Counties, Coos Bay, Oregon

14. Lane County; Eugene & Springfield , Oregon

15. Klamath/Lake Counties; Klamath Falls, Oregon

16. DBTC’s “SSI BOOT CAMP”

17. Douglas/Josephine Counties, Canyonville, Oregon

18. UCAN’s “SSI BOOT CAMP”

19. Let’s take a break

20. Benefits Program Development
Why a Benefits Specialist?
Critical components for success
Relationships with Social Security Administration
General Assistance/Presumptive Medicaid Programs
Possible funding streams
Training and program set up costs
Successful programs

21. 100% of these federal dollars go directly back into your community
Far too few know how to effectively help the severely disabled through this system
Who benefits from SSI/SSD work?
Not just the recipient......
100% of these federal dollars go directly back into your community

22. The Community Connection & Stakeholders
Disabled citizen becomes a consumer
Families
of the
disabled
All SSA/DDS Offices
Dept. of Corrections
& Jails
All Medical Providers
Child
Support
SSI/SSD Benefits
Assistance
Mental Health
Providers
TANF
A & D Treatment Centers
Legal Aids
State
Medicaid Programs
Housing Programs

23. Why a Benefits Specialist?
Two thirds of disability applicants are denied
25% of the claims awarded for severe mental illness
This model creates:
Focused program separate from normal case management
Badly needed outreach to rural areas
Dramatically improves opportunities for comprehensive healthcare and housing
Very concrete and positive “ripple effect” on the local community as a whole

24. Critical Components for Success
Very organized, proactive benefits specialist with good writing skills
Trained benefits specialist in SSA’s disability eligibility criteria
Focused and manageable caseload sizes ( “pre- application” cases at one time)
Ample funds for psychological evaluations and subcontracted psychologists who can provide diagnostic evaluations
Comprehensive functional documentation and “lay” evidence
Good relationship with local Social Security Administration offices
Good relationship with local treatment providers
A partnership with a local FQHC is a very big plus!
Understanding of General Assistance Programs or Presumptive Medicaid applications.

25. Benefits Specialist Job Description Much more like paralegal work
Sign on as the official representative
Investigate all evidence sources
Collect and review all evidence
Interview the claimant for their history and functional information
Write a comprehensive narrative report for each client
File the application with SSA
File all appeals timely
Track all referral and case progress data

26. Why train a benefits specialists?
Engagement with severely disabled people experiencing homelessness, or in psychiatric wards, or those who are incarcerated takes longer
This section of administrative law allows for “lay” representatives, or non-attorney representatives
They know their clients better than other one-time service professionals such as attorneys
Need to have outreach capabilities
Most don't charge fees for their assistance
Time spent may be billable as case management

27. Building rapport with local SSA offices and DDS
Introduce the program in person
Ask if the office would be willing to “flag” program cases in their computer
Ask for a liaison to rapidly process program applications to DDS
Ask DDS if they would be willing to provide a homeless liaison as well

28. General Assistance & Presumptive Medicaid Applications
Some states can grant Medicaid before an SSI award
Complete documentation and forms to the local Seniors & People with Disabilities offices at the time of application
Time limit for this decision is 90 days
If Presumptive Medicaid is granted first the claimant will have insurance during the SSI application (If SSA denies first denial may be “binding” on Presumptive Medicaid
In Oregon SPD is very responsive to this model. They want to help! And our help helps them!

29. Basic Funding for one FTE
One Benefits $30,000 - $36,000/yr Paralegal wage range
Plus administrative and fringe expenses
One FTE should be able to “win” 30 to 35 severely disabled clients per year once fully trained
Training expenses (trainer’s time and per diem)
A “rolling” or ongoing case load may climb to 15 to 20 in active, pre-application development and 15 to 20 cases waiting for decisions at any given time

30. Important additional funds to consider
Recommend ample funds for psychological evaluations; should range from $ to $ each
Recommend negotiating with local psychologists for half of their retail price (above)
Experience shows 75% of the mentally ill applicants will need a current psychological evaluation to bolster their chances of an “award” of the benefits

31. Program Funding Ideas
For mental health clients this type of benefits case management is billable to Medicaid
Grants from local hospital foundations
Local Housing Authorities
Veterans assistance programs
PATH programs
Cities' or Counties' (investment in 10 year homelessness plans)
Multiple agencies participating/sharing the cost of one FTE
Grants from pharmaceutical companies (creates paying customers that no longer need prescription assistance programs)
Medicaid revenue will begin to increase as a result of this work for many sites

32. What comprehensive training should provide
Thorough, on-site training
Office, files and forms set-up
On-line application training
Research tools
Referral and case data tracking system
Medical records request tracking
On-going, case specific technical assistance
Contact list of pertinent local agencies

33. Portland, Ore. program stats from 3/1/08 to 3/31/10
Approximate preparation time for a complete application to be submitted to SSA is 2 months
968 referrals reviewed face to face & records review
377 cases enrolled into program in 25 months
61 claim applications in development stage
248 claims filed on-line with SSA
205 claims awarded benefits, 25 were in appeal
90% allowance rate
Average time for decision after submission to SSA = 46, (shortest = 1 day)

34. What made the Portland, Ore. project work so well?
Portland added benefits to their 10 year plan to end homelessness
Two grants from hospitals
Seed money from the City of Portland
Congressional communication with SSA
Cooperation from local SSA field offices and DDS
Money for psych evaluations
Manager legally trained in SSI/SSD process
Many referral sources throughout the city

35. Expected Results: In creating a model similar to Portland's the goals should be:
Cooperative relationships with SSA, DDS and DHS
66% or greater success rate at the initials levels
30 to 35 allowances per year per benefits specialist once fully trained

36. Some other successful models
B.A.R.T., Denver, Colorado
S.M.A.R.T., Sacramento, California
Miami/Monroe, Florida
Atlanta, Georgia
Albuquerque, New Mexico
Boston, Massachusetts
Philadelphia, Pennsylvania
Nashville, Tennessee

37. The Klamath Falls, Oregon Project

38. Our Service Area Klamath County, OR Lake County, OR
Area of 6,136 sq mi – 600 sq miles larger than Connecticut
County population 63,775 – fewer than Kennewick, WA
15% unemployment rate
20% poverty rate
Lake County, OR
Area of 8,358 sq mi – the size of Connecticut AND Delaware
County population 7,442 – about the same population as Chehalis, WA
14% unemployment rate
18% poverty rate

39. Starting The Program
June 2010 – KLCAS picked for Benefits Specialist Pilot
August hired as Benefits Specialist
“SSI Boot Camp” included me, a new Program Manager, and one other “back up” person
Intensive immersion into SSD/SSI rules, procedures, jargon and methodology
Significant portion of “SSI Boot Camp” spent introducing program to community through outreach
Introduced ourselves to local SSA employee
Introductory luncheon held for potential referral sources. Over 30 community partners, including local hospital social workers

40. Outreach to the Community
Our message to the community is this ~
“There is Federal money (SSI/SSDI) available to take care of severely disabled homeless and low income individuals. That is where the burden for their care should fall, not on limited local resources. By simply taking the time to help them obtain what they are entitled to, they can become contributing members of their community! Helping us help them is an investment in the community!”
Every person awarded SSI/SSDI qualifies for Medicaid/Medicare, easing the burden on local providers
Disabled homeless qualify for HUD have money to pay rent
Back awards and monthly awards are spent in the community
Benefits Specialist Programs help stabilize/reduce homelessness
Individuals now have means to treat drug/alcohol addictions

41. Our community really “Got It”
Medical community very receptive with prompt, free medical records
DHS’s Seniors and People with Disabilities is a huge resource
Numerous referral sources:
Homeless mission is our biggest referrer
Mental Health has come to see us as a resource they can use to reduce their work load
Developmental Disability Services
Local doctors starting to refer clients who they have diagnosed with disabling diseases
Our programs at KLCAS (energy assistance and homeless prevention) screen clients for the program
Vocational Rehab, our local VA, City Council persons, DHS, and others have all contributed

42. Social Security Medford District Office They have become our biggest fan!
The Medford district office handles the largest territory in Oregon, covering four very large counties
Small Klamath Falls field office only takes incoming forms and makes appointments for the Medford office
After several requests obtained a face-to-face meeting with Medford district office
Very rapidly embraced our program and appointed a point person for us
Point person was the on-line application specialist
Agreed to file all applications and appeals on-line

43. KLCAS’s Commitment – The Difference Between Failure and Success
Our Director, Donna Bowman, and Program Manager, Rob Petchell are proactive and community oriented and look for underserved niche’s in social services
The KLCAS vision is to offer a wide variety of programs to the homeless and lower income in a service center type environment
The Benefits Specialist program was sought because it complimented existing programs and because there is a high need – not because it was an easy revenue stream to obtain

44. KLCAS’s Commitment – The Difference Between Failure and Success
Funding is currently an ongoing problem but KLCAS is committed to the program and has sought innovative ways to ensure the program continues
Organizational Representative Payee Program – Social Security allows Rep Payees to collect a nominal fee for money management services. In Klamath Falls there was no Organizational Payee service; able to fill another need while supplementing funding for the Benefits Specialist Program.
Supportive Services for Veteran Families – All of the services we offer at KLCAS, including the Benefits Specialist Program, are sought after by the VA for their Veteran Families. We are currently seeking a $600,000+ grant from the VA that will allow part of the Benefits Specialist’s time to be charged to that grant.
We hope to establish a success rate that will convince our community partners to invest real dollars in our program.

45. Presenters Contact Information:
Lynn Adams, CSBG Program Analyst State of Oregon, Housing & Community Services 725 Summer St. NE Suite B, Salem OR (503) Mellani Calvin, Program Director Disability Benefits Training & Consulting, LLC 1336 E. Burnside St., Ste. 130 Portland OR Phn: , Fax: Walter Davis, Homeless Benefits Specialist Klamath-Lake Community Action Services 1803 Main St. Klamath Falls, OR (541)