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2. 2017 SOAR Outcomes 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

3. Disclaimer
This training is supported by the Substance Abuse and Mental Health Services Administration (SAMHSA) and the U.S. Department of Health and Human Services (DHHS)
The contents of this presentation do not necessarily reflect the views or policies of SAMHSA or DHHS.

4. Webinar Instructions Muting Recording availability
Downloading documents
Evaluation

5. Agenda
Welcome
Robert Grace, Public Health Advisor, Substance Abuse and Mental Health Services Administration (SAMHSA)
2017 SOAR Outcomes Overview
Kristin Lupfer, MSW, Project Director, SAMHSA SOAR TA Center, Policy Research Associates, Inc.
Making Improvements- New York
Linda Camoin, SOAR State Team Lead, Assistant Director, Bureau of Housing and Support Services, Office of Temporary and Disability Assistance, Albany, New York
Consistent Progress- Arkansas
Abigail Kirkman, SAMHSA SOAR TA Center on behalf of Christy Mathis-Conway, Arkansas
Tales from the Top Ten- Washington, D.C.
Ashley Moore, SOAR Social Worker, Bread for the City, Washington, D.C.
Questions & Answers

6. Welcome Robert Grace, Public Health Advisor Homeless Programs Branch
Center for Mental Health Services
Substance ABUSE and Mental Health Services Administration

7. The SOAR Model
Making an Impact
SAMHSA SOAR TA Center

8. SSI/SSDI Outreach, Access, and Recovery
A model for assisting eligible individuals to apply for Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI)
For individuals who are experiencing or at-risk of homelessness and have a serious mental illness, co-occurring substance use disorder, or other physical disabilities
Sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA) in collaboration with the Social Security Administration (SSA) since 2005
All 50 states and Washington, D.C. currently participate

9. A Foundation for Recovery
SSI/SSDI provides more than income:
Access to health care and housing
Increased employment opportunities
Decrease in incarcerations and hospitalizations

10. You Made This Possible
50 states and the District of Columbia reporting
Sharing and celebrating successes together
Supporting sustainability and expansion efforts

11. SOAR Works!
Compares to percent for unassisted applications from people who are homeless and 28.5 percent for all applicants

12. And Works!

13. SOAR Super Stars!
*Our “Top Ten” criteria require that states had at least 200 cumulative decisions and had approval rates at or above the national average in The average approval rate for these rock star states is 84 percent! In order of average cumulative approval rate, the Top Ten states are: Pennsylvania, Tennessee, Maryland, Arkansas, North Carolina, Rhode Island, Washington, Oklahoma, Wyoming, and the District of Columbia.

14. How Do You Compare?

15. Average Days to Decision

16. Meeting the Need

17. Increasing Efficiency

18. Quality and Success

19. Show Me The Money
SSI brought over $356 million into the economies of participating states and localities
Eight states report $503,932in Medicaid reimbursement, or an average of $5,929 per person
General assistance reimbursement was on average, $3,562 per person approved for SSI
Based on reports from 1,677 approvals, retroactive benefits averaged $5,520 per person

20. Justice-Involved Persons
Our mantra is "decision before discharge”
Collaborations were reported by 30 states and include:
Jail in-reach for pre-release applications
Jail diversion programs
State prison reentry initiatives
Training for state departments of correction (and state forensic mental health facilities)
Collaboration with parole and probation to coordinate services
The Jail Diversion Program in the Eleventh Judicial Criminal Mental Health Project in Miami, Florida assisted with a total of 45 decisions in an average of 52 days with an allowance rate of 82 percent.

21. Transition Age Youth
States that reported working with 332 TAY applicants
63 percent approval rate in an average of 96 days
These states did reconsiderations with 53 TAY applicants
62 percent approval rate in 103 days
These outcomes dispel the myth that it is more difficult to get approvals with this age group.

22. Working Together
People seeking or receiving SSA benefits are encouraged to work independently or with the help of professional supports
Twenty nine states reported that 128 applicants were working during the application process.
They reported earnings of $82,132 for those applicants!

23. CABHI: SOAR and IPS Pilot
Goal: Income maximization and housing stability
Strategy: Integrate services to increase choice
Method: Learning community and pilot (March 2016 to May 2017) for 12 state teams who received the CABHI-States Enhancement grant
AZ, CO, CT, IL, MA, MI, MS, NV, OH, TN, UT, WI
Result: When programs offered assessments for both SOAR and Individual Placement and Support (IPS) models, almost 75 percent of participants chose to enroll in both services
Cooperative Agreements to Benefit Homeless Individuals (CABHI) and SOAR are two important programs administered by the Substance Abuse and Mental Health Services Administration (SAMHSA) that work together to end homelessness, by increasing income and housing stability for adults who have serious mental illnesses and/or co-occurring substance use disorders. The SOAR TA Center facilitated a learning community and yearlong pilot with twelve states that aimed to successfully integrate Individual Placement and Support (IPS) and SOAR services within the CABHI States-Enhancement grant program for income maximization and housing stability. The integration pilot demonstrated success in increasing dual enrollments in SOAR and IPS services and strengthening collaborations between programs, resulting in increased income stability for program participants.

24. Sustaining our Efforts
New Funding:
24 states reported that they were successful in securing NEW funding for their SOAR programs
Continued Sustainability:
411 Full-time SOAR positions
178 Part-time SOAR positions

25. PATH and SOAR: Partners Since 2006
All fifty states report collaboration with the PATH program including:
Dedicated benefits specialists on PATH teams (147 FT, 75 PT)
SOAR training for PATH outreach and case management staff 
PATH outreach staff serve as local SOAR coordinators and leaders
One third of the SOAR State Team Leads are also the State PATH Contacts

26. Linda Camoin
Assistant Director Bureau of Housing and Support Services New York State Office of Temporary and Disability Assistance (OTDA)

27. New York State Overview
Overview of NYS and the state’s PIT count data vs. SOAR Online Course completions.
Explain that while it has many cities NYS is also a very rural state, so SOAR implementation will look different across the state.
The map divides the state by CoCs and that is how SOAR has been rolled out throughout the state
Explain the map – PIT count data and then the heat map represents where individuals are becoming SOAR trained

28. Average Days to Decision
Growth By Numbers
Average Approval Rate
34% (2016) % (2017)
103% increase!
Average Days to Decision
192 days (2016) days (2017)
64% decrease!
New York City and Buffalo saw the most approvals and greatest decrease in days to decision.

29. SOARing in New York
Focus on SOAR growth through HUD’s Continuum of Care (CoC) system throughout the state.
Engage with the CoC leads through regional meetings and Office of Temporary and Disability Assistance (OTDA) visits
New York State SOAR Leadership Academy (Sept. 2017)
Competitive SOAR Technical Assistance awards
SOAR Online Course Cohorts and consistent engagement from the state and SOAR TA Center
In the past active areas included majority cities: NYC, Syracuse, Rochester, Buffalo.
In the past couple of years SOAR has expanded beyond the cities and have focused on both urban and rural areas; expansion areas include: Hudson Valley, Capital Region (Albany/Schenectady/Troy), Long Island, Westchester, St. Lawrence, Southern Tier
Areas that have been awarded TA because they applied for and awarded SOAR TA award

30. Abigail Kirkman Consistently SOARing!
Senior Project Associate SAMHSA SOAR TA Center Arkansas State Liaison

31. Arkansas By The Numbers
SOAR Top 10 State , 2015, 2016, 2017
Consistently Strong Average Approval Rate from Mid South : 94% : 87% : 87% : 82% : 80% : 90%
Average days to decision: days

32. Mid South Health Systems Jonesboro, Arkansas
Mid South serves 13 counties, there is a clinic in each county but Jonesboro is the main clinic.
Counties Served: Clay, Craighead, Green, Lawrence, Mississippi, Randolph, Monroe, St. Francis, Phillips, Lee, Crittenden, Cross, Poinsett
at least two people at each clinic, when referrals came in they would go to only those two trained CMs.

33. SOAR Timeline 2008 2008-2013 2013-Present
Mid South attended a SOAR Train-the-Trainer
SOAR became a part of Mid South’s Special Projects
Engaged with SSA and DDS and identified dedicated examiners
Local Lead attended the SOAR Leadership Academy
Small trainings were held at each of the 13 county clinics (each site had at least two SOAR-trained case managers)
2013-Present
Consistently processing SOAR applications
SOAR Orientation to all new employees
Shadun Duncan, one of the first people ever trained, came back to Jonesboro and Mid South and implemented SOAR; it can work with Mid South because it is the community mental health center for NE AR. TTT in 2008
Started from the bottom; series of meetings with the local SSA office (who he met with is still there today), they set up a protocol for how they would handle SOAR cases. Designed examiners – anything that is flagged SOAR cases would go to examiners who are familiar with SOAR; also designed one examiner to be the liaison to the agency (established go to’s at SSA). “This made out clients become more than just a number.”
Also went to state level DDS, met with some of the MDs at DDS to gain buy in; established go to adjudicators at DDS, established relationships very early and they have persisted.
Christy Mathis Conway joined SOAR team in 2013, part of Special Projects, after the TTT started to do small trainings for each of the clinics – Mid South serves 13 counties, there is a clinic in each county but Jonesboro is the main clinic. Began doing trainings with each county – at least two people at each clinic, when referrals came in they would go to only those two trained CMs. Eventually thought the company needed a boarder view of SOAR, incorporated into the new employee orientation; overview of SOAR, what happens nationally, how it comes down to our state and how we implement SOAR in Jonesboro. Explains how SOAR works! Many new employees get very excited (know people who could benefit), the more aware our employees are the better referrals the SOAR team gets.

34. What Works at Mid South Good referrals and a strong referral process
In-house medical staff, strong collaborations with outside providers and wraparound services
Consistently positive relationships with SSA and DDS
A streamlined SOAR process within the Mid South Health system
All medical providers are seen in house; come in, are a good SOAR applicant, automatically they will see an in house therapist first (psych social history, mental health, substance use, physical health), after initial interview with therapist – second round of evaluations for SOAR (priority scale for SOAR), assessing for wrap around services. Once what they need is determined will refer to additional supportive services (example – Rehab Day), so while they are working on the applications, also receiving feedback from the supportive services. If they have had treatment in the past will get those records.
95 – 120 day turnaround with DDS; give them everything up front. Having the MSR is huge! Works so much better when you have it and have it signed. Do internal quality review. When an application is started they send Christy a OAT data form; letting them know that they are starting an application and have reached out to SSA – so Christy is able to track the application and check in with the SOAR CM. Normally always signed by AMS but if not, DDS (Dr. Brad) will be in communication.

35. Challenges and Resolutions
Limited availability of housing
Work very closely with PATH, two-way referrals
Housing within Mid South
Relationship building with landlords
Transient SOAR population
Collaborations with local jails and attorneys
Working within rural counties
Clinics with SOAR case managers in rural counties
Housing – huge issue in all of the clinics is a big issue, not as accessible as cities, work very closely with PATH and their outreach – two way referral with PATH providers. Mid South does have some housing but it is limited; people do not normally leave. Many have legal or criminal justice background, always working to look for private landlords. Working with SOAR will help with the landlords.
Transient SOAR population, may begin an application but cannot find the applicant – but can check jail rosters and they are there, or get a call from the prosecuting attorney; communicate well with jail/attorney.
Loses SSA – 1696; make copies of everything – and they send a copy to CMC

36. Ashley Moore, LICSW SOARing since 2011 79% initial approvals
160 applications
SOAR Program Manager at Bread for the City
D.C. State Team Lead

37. D.C. Outcomes by the Numbers
73% approval rating on initial applications
67% approval rating on appeals (reconsiderations)
79% increase in total applications from last year

38. How We Got Here SOAR leadership team
Strong partnership with SSA and DDS
Dedicated SOAR funding
Quality Review and support

39. D.C. SOAR Leadership Team
Leadership moved from DC government to non-profits with successful SOAR programs
Reps from each agency with strong SOAR programs
Legal representation (Street Lawyer)
Advocacy representation
The Catholic University of America, Professor Linda Plitt Donaldson
Strategic planning session, training space, student cohort
Regular meetings with active participation

40. We have amazing SOAR providers!
Many of the active SOAR providers are also SOAR Leaders
Meetings every other month

41. Partnership with SSA and DDS
(Recently) former District Manager was extremely supportive of community partners, helped us put a SOAR process in place
Dedicated SOAR contact at each of our offices
History of good relationships with staff at DDS
(New) Dedicated SOAR examiners at DDS and SOAR contact
Importance of putting systems in place that will live past current staffing

42. Dedicated SOAR Funding
Cooperative Agreement to Benefit Homeless Individuals (CABHI)
Coordinated Entry
Temporary Assistance for Needy Families- Program on Work Employment and Responsibility (TANF- POWER)

43. Quality Review and Support for our Providers
SOAR certification/graduation, cohorts
SOAR leadership team (includes MSR review component)
Shared Google Drive
SOAR providers and leaders listserv
Use of OAT
SOAR site visits to help accommodate for each agency’s needs

44. Challenges
Addressing the claim: “SOAR is not working”- lack of understanding about what it is or knowledge of the SOAR leadership team
Attend more meetings, share our successes, get our faces out there
DC Government working in silos
Working with advocates to come up with a SOAR strategic plan to present to various government agencies
SOAR report for ICH, request to be a working group under their umbrella to increase our access to the leaders
Our IDA struggles
Continued funding issues
Working with advocates to continue funding and suggest changes

45. You are transforming lives one application at a time.
Keep Up The Great Work!
You are transforming lives one application at a time.

46. Super SOAR Says:

47. Questions and Answers Facilitated By:
SAMHSA SOAR Technical Assistance Center Policy Research Associates, Inc.
Please type your questions into the Q&A panel located underneath the participant tab

48. https://soarworks.prainc.com SAMHSA SOAR TA Center
Connect With Us!
SAMHSA SOAR TA Center
Policy Research Associates, Inc Delaware Avenue Delmar, New York (518) x2
SAMHSA SOAR TA Center