1. SOCIAL SECURITY ADMINISTRATION (SSA) STATE PARTNERSHIP INITIATIVE (SPI) CALIFORNIA’S INDIVIDUAL SELF-SUFFICIENCY PLANNING (ISSP) PROJECT

2. CALIFORNIA ISSP PROJECT California awarded $3.5 million, five year research and demonstration project to assist individuals with severe psychiatric disabilities go to work and lessen or eliminate SSA benefits One of eighteen State Partnership Initiative Grants nationwide

3. CALIFORNIA ISSP PROJECT Statewide multi-constituency group provided oversight, developed program design Kern County On Track Employment Services, San Mateo County Vocational Rehabilitation Services project sites Allen, Shea and Associates Program Evaluator Department of Rehabilitation managed grant, provided vocational rehabilitation services through Mental Health Cooperative Programs

4. “Scariest thing about going to work is the fear of losing my healthcare.” ISSP Participant

5. HYPOTHESIS The employment supports of benefits planning and service coordination before, during and after existing vocational rehabilitation and mental health treatment programs will:  Increase employment earnings  Increase employment success rate  Decrease public mental health costs  Decrease SSA benefits

6. CORE SERVICES  Grant Funded  Benefits counseling, planning and management  Ongoing service coordination and employment support  Existing Services Available  Vocational counseling, training and education  Employment preparation, job development and placement  Mental health treatment

7. THE BENEFITS PLANNER/SERVICE COORDINATOR TEAM Provide benefits and budget education, planning and management assistance Counsel impact of work on household income Assist with service and benefits acquisition Assist with employment and career counseling Collaborate with community service providers, to include SSA field office Mitigate overpayment and eligibility problems Provide consultation/training to colleagues

8. “Being able to come back time after time to hear the same information about work incentives helped me a lot to take some of the fear out of working.” ISSP Participant

9. SSA WAIVERS SSA approved California in May 2001 to pilot 4 SSI waivers for project participants. These included:  $4 earnings to $1 cash benefit reduction, instead of 2 to 1  Ability to save up to $8k in an Individual Development Account per year, instead of $2k  Count unearned income as earned income for the 4 to 1 reduction  Suspension of Continuing Disability Reviews during waiver participation

10. THE INDIVIDUAL SELF-SUFFICIENCY PLAN Participants:  Commit to obtaining and maintaining employment  Choose services and benefits needed  Develop employment support system

11. PARTICIPANT PROFILE  All have a severe psychiatric disability  40% Psychosis  56% Mood Disorder  4% Other  All receive Social Security benefits  40% SSI  32% SSDI  28% Both

12. PARTICIPANTS SERVED Maintained active caseload of 150 participants 50 per two person team Served from 1999 through 2004 286 served during project

13. INCREASED EMPLOYMENT EARNINGS Average Covered UI Earnings Per Person Per Quarter $895 $1,046 $496 $585 $634 $339 At Intake 1 yr. Post Intake 2 yrs. Post Intake

14. Rate of DOR Successfully Employed Case Closures INCREASED EMPLOYMENT SUCCESS RATE 72% 39%

15. DECREASED PUBLIC MENTAL HEALTH COSTS ISSP Participants (N=209) (1 yr Before vs 3.7 yrs after) Comparison Group (N=591) (1yr. Before vs 1 yr after DOR Closure) % Decrease of Medi-Cal Costs Per Person Per Year 21% 12% 13% 16% 2%

16. DECREASED SSA BENEFITS As of June 2004:  92 participants working (43 at start of project)  17 off cash benefits; 9 more if no waiver  64 reduced cash benefits  11 increased SSDI amount by more than 20%  58 participants not working  Benefit amount increased 12% due to COLAs during project period

17. “Having the support and assistance of the ISSP team has been very important in getting and keeping a job.” ISSP Participant

18. LESSONS LEARNED -1 On going benefits counseling/service coordination is a powerful service  Providing employment services and supports to individuals with severe psychiatric disabilities significantly increase earnings and savings in public benefits  Long term employment support facilitates permanent results

19. LESSONS LEARNED – 2 The complexity of SSA rules significantly impact SSA costs Resolving benefit payment crises and proactive planning builds trust that SSA supports work Close, positive relationship with SSA field offices result in overpayment reduction and saves substantial SSA administrative cost

20. RECOMMENDATION - 1 Fund Benefits Planning/Service Coordination as an employment support before, during and after transitional employment services.

21. RECOMMENDATION - 2 Department of Rehabilitation and County Mental Health work together to provide employment services and mental health supports.

22. “The ISSP program gave all of us that were involved one of the biggest reasons to get better. The biggest reason was believing in myself again. It gave me a dream for the future. The program was the best thing Social Security ever had to offer people on SSI.” ISSP Participant

23. CALIFORNIA ISSP PROJECT Points of Contact: 1. Grant Manager: Warren Hayes (916) 263-8986 whayes@dor.ca.gov 2. Project Site Managers: Kern CountyDennis Farrell (661) 868-8367 dfarrell@co.kern.ca.us San Mateo CountyRobert Manchia (650) 802-6491 rmanchia@co.sanmateo.ca.us 3. Project Evaluator: John Shea (707) 258-1326 allenshea@sbcglobal.net