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Bring Badly Needed Federal Dollars Into Rural Communities

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Presentation on theme: "Bring Badly Needed Federal Dollars Into Rural Communities"— Presentation transcript:

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


17 Douglas/Josephine Counties, Canyonville, Oregon


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)

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