1. Strengthening Applications: Diving In: A SOAR Application Walk Through Presented by: National 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

2. Welcome Pam Fischer SAMHSA

3. Webinar Instructions Question instructions Muting Recording availability Downloading documents Evaluation

4. Agenda Organizing the Application and Getting Started Kristin Lupfer, SOAR Technical Assistance Center Identifying Applicants and Writing Successful Reports Katie League, Baltimore, MD Being Proactive and Functional Summary Reports Sara Stoffers and Lorelei Church, Salt Lake City, UT Incorporating SOAR into a Diversion Treatment Court Susan Berberian, Decatur, GA Questions and Answers Facilitators: National SOAR Technical Assistance Tea m

5. Organizing the Application and Getting Started Kristin Lupfer National SOAR Technical Assistance Center Policy Research Associates, Inc.

6. SOAR Critical Components Serving as the appointed representative Collecting and submitting medical records Electronically submitting applications and medical evidence whenever possible Collaborating with physicians for assessments and medical information Collaborating with SSA and DDS Submitting a Medical Summary Report

7. Getting Started: Completing an Initial SOAR SSI/SSDI Application

8. Getting Started: Day 1 SOAR Consent for Release of Information

9. Getting Started: Day 1 Complete the top-half of the Applicant Tracking Worksheet and use as a cover-page in your client file

10. Getting Started: Day 2-3 Complete and have applicant sign the SSA-1696 Appointment of Representative form

11. Getting Started: Day 2-3 Request LetterSSA-827Agency Release

12. Getting Started: Day 2-3 Medical Records Department Spreadsheet

13. Getting Started: Day 2-3 Applicant Assessment Worksheet

14. Getting Started: Week 1-2 http://www.ssa.gov/disabilityreport

15. Getting Started: Week 3-4 SSA-8000: Application for SSI

16. Getting Started: Week 3-4 http://www.ssa.gov/applyfordisability/

17. Getting Started: Week 5-8 Medical Summary Report (First and last pages)

18. SOAR Application Checklist

19. Reminder! A Complete SOAR Packet Includes: 1.SOAR Checklist as a cover sheet for the completed application package 2.SSA-1696 Appointment of Representative form 3.SSA-827 Authorization to Disclose Information to SSA 4.SSA-8000 signed and dated by applicant 5.MSR signed by the SOAR provider as well as the applicant’s physician or psychologist 6.Copies of all medical records in chronological order 7.SSA-3368 and SSA-16 submitted on-line 24-48 hours before turning in completed application package (Items 1-6)

20. Identifying Applicants and Writing Successful Reports Katie League, LCSW-C Health Care for the Homeless Baltimore, MD

21. Identifying Applicants Knowledge of individual Where they present Symptom awareness Don’t choose your most challenging client Consider availability of co-signer Current partners and engagement

22. SOAR Applicant Checklist

23. Reviewing Medical Records Questions to Ask Documenting Observations Writing Your First Report: Strategies

24. Flag important information in medical records: Diagnoses Quotes Descriptions of symptom Use quotes to create paragraphs When you find something useful put it in a document right away Reviewing Medical Records

25. Questions to Ask the Client What does the client’s diagnosis mean to them? Find out how THEY experience the symptoms Don’t assume!

26. Documenting Observations Observations: - How they say things - Speech: Pace, flow, words used - Appearance, movement - Eye contact, eye movement

27. Being Proactive and Functional Summary Reports Sara Stoffers and Lorelei Church State of Utah General Assistance Salt Lake City, UT

28. Being Proactive: Starting an Application Secure protective filing date ASAP Customers may get more money the sooner you file Get Releases of Information signed ASAP Include necessary medical providers and collateral contacts Ask claimants to prepare for your next contact Create a list of all medical providers and facilities

29. Being Proactive: DDS Coordination Contact DDS for needed information: How can I help? Confirm alleged conditions Medical records requested, missing and received If denied, what symptoms are not present in the records to meet the listing? Request the records used to make the decision Know and use your local DDS terms when appropriate Send records as soon as you can Don’t wait to submit all records together If inheriting a claim, read others’ notes and verify the work noted was completed with DDS

30. Being Proactive: Collaboration Create and maintain creditability and reliability If you state the application is SOAR, then follow the SOAR model If you mark a time for an appointment, be available at that time Build relationships (community partners, collateral contacts, DDS, etc) Learn their names, roles and acknowledge their expertise Set specific deadlines. Communicate these to others (including DDS) When will you provide information? When do you need information? What will happen if the deadline is not met? Coordinate with other SOAR providers and co-workers Ask others to give you feedback Explain your roll to the claimant Use Google to research unknown information

31. Being Proactive: Organization Make copies of all information submitted to DDS Document your progress in your own records and with DDS whenever possible (Date, time, what was discussed) Use fax coversheets, ERE notes, etc… to document DDS info and requests needed Spreadsheets/tracking of previous information are great Track examiner and claim # in case notes Medical records requested, missing and received Local medical providers with medical records request procedures and contact information

32. Functional Summary Report: Educating the Client Begin laying out groundwork of summary report at first appointment Explain to the claimant the purpose of the summary report How it will be used: “Paint a picture” How long will it take? Tell them how many appointments it will take to complete summary questions Make sure they are comfortable with sharing personal history and if they are not that is okay

33. Functional Summary Outline

34. Information to Include in Summary Review health records on hand for any info Use the SSA Blue Book http://www.ssa.gov/disability/professionals/bluebook/ What is the listing? Show link between function and diagnosis Always keep in mind or substantiate why claimant cannot work Use footnotes Provide contact information of any individual or organization referenced in your Functional Summary: Full name & title, address, phone, fax, email If summarizing information in other records, cite it and attach it. (reports, photos, collateral letters etc…) Label attachments Ex: See Attachment 1: Dr. Smith’s mental health report, January 25, 2011 Utilize functional questionnaire completed by claimant

35. Wrapping Up Know what records say and don’t contradict yourself Ensure what you note in Functional Summary is consistent with medical records and Function/Work History Reports Doctor’s co-signature = Medical evidence Be careful when asking a physician to sign off on information they may not have discussed with the claimant Ask the claimant if they have shared the information with the physician Don’t tell DDS the claimant is disabled, but let them draw that conclusion because you provided the evidence and information

36. Functional Provider Signature Request

37. Incorporating SOAR into a Diversion Treatment Court Susan Berberian, LCSW, CPRP Diversion Treatment Court, Magistrate Court of DeKalb County Decatur, GA

38. Mental Health Court Voluntary pre-plea program Mental illness and co-occurring disorders Felony or misdemeanor Comprehensive Services Judicial supervision, treatment connections, community training, counseling, housing support, SSI assistance Diversion Treatment Court

39. Court observation for informed decision Description of program and expectations Two-page brief screen form Needs assessment for SSI/SSDI Medical records requested, appointment made for Biopsychosocial assessment SSI Applications in Process Tracking Form Brief Screen

40. Thorough assessment, include quotes Symptom checklist Team case review SSI may be added as a bond condition Biopsychosocial Assessment

41. Complete prepared packets of forms SSA-8000 (SSI App) SSA-16 (SSDI App) SSA-3368 (Disability Report) SSA-827, Agency Release SSA-1696 Explain the process, give handouts, etc. Online applications completed within a couple days of the appointment Signed forms are delivered to document drop box at SSA field office SSI Paperwork Appointment

42. With permission, contact family Schedule one-on-one appointment Use Medical Summary Report-Family Collateral form History, symptoms, functioning Last 12 months (incidents or episodes) Mobile crisis to house, police to house, hospital, jail, citation Family Collateral Contact

43. Medical records reviewed as received Medical Summary Report (MSR) completed DTC and family signatures obtained Mental Impairment Questionnaire (MIQ) completed MD given MSR, MIQ, letter of explanation Follow through while in DTC, referral as necessary SOAR Case Follow-Up

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

45. For More Information on SOAR Visit the SOAR website at www.prainc.com/soarwww.prainc.com/soar Or contact: SOAR TA Center Policy Research Associates, Inc. Delmar, NY 518-439-7415 soar@prainc.com soar@prainc.com