1. WeCARE - Rev. 10/20/2005 WeCARE Wellness Comprehensive Assessment Rehabilitation & Employment WeCARE is funded by the NYC Human Resources Administration and administered by F· E· G· S Health & Human Services System A Guide to the SSI Process & Tracking

2. Training Agenda: Page 2 of 22 A Guide to the SSI/SSDI Process & Tracking By the end of this training, you will be able to:  Understand the SSI/SSDI Process  Know how to look up cases you need to work on and what to do to follow-up on a case correctly and on time  Understand how to track clients throughout the SSI/SSDI process  Understand the steps and timing of the SSI/SSDI process  Use routing to help you follow-up on a case correctly and on time  Know when and how to conduct and document outreach  Know when and how to case note

3. WeCARE Program Overview Page 3 of 22  The Human Resource Administration (HRA) provides a range of social services to New York City residents in need with SafetyNet (SN) and Temporary Aid to Needy Families (TANF). Clients (both applicants-AP, and active cases-AC) who indicate to HRA that they have a medical or mental health condition which prevents them from working are referred to WeCARE.  The goal of WeCARE is to identify issues/barriers that prevent client from achieving their highest level of independence and providing accommodations and/or specialized supports to assist clients in returning to the workforce.  WeCARE was developed to help such clients achieve their highest level of independence by focusing on the following components: Wellness, Comprehensive Assessment, Rehabilitation, and Employment.  WeCARE is a paperless program, so the continuum of services from the initial evaluation through employment are documented in two databases: WeCARE, the F∙E∙G∙S internal system & NYCWAY, the portal to all HRA services.  WeCARE is a Performance-Based Contract that is time-sensitive as well: F∙E∙G∙S only gets paid for “performing,” or achieving certain milestones which are indicated in NYCWAY with the right codes in the right sequence within the prescribed timeframe for each service. HRA sets out its service and milestone expectations in the HRA Vendor Guidelines. Staff without a copy should get one.

4. What is SSI/SSDI? Page 4 of 22  The Supplemental Security Income Program (SSI) makes cash assistance payments to aged, blind and disabled people (including children under age 18) who have limited income and resources. Funding for this program comes from general tax revenues.  Social Security Disability Insurance (SSDI) provides benefits to disabled or blind individuals who are “insured” by workers’ contributions from the Federal Insurance Contributions Act (FICA) to the Social Security trust fund.

5. Goals of the SSI/SSDI Track Page 5 of 22  The goal of the WeCARE SSI/SSDI track is to assist clients with attaining Disability Benefits through the Social Security Administration (SSA).  Throughout this process, clients are provided with case management services including those intended at: Helping achieve better health status Assisting with maintaining treatment compliance Facilitating the appeals process if an application for disability benefits is denied.

6. Assignment to the SSI/SSDI Track Page 6 of 22  All clients referred to the SSI/SSDI Program have an Employment Disposition of: “Substantial Functional Limitations to Employment Due to Medical Conditions That Will Last For At Least 12 Months and Make The Individual Unable To Work.”  A client will be assigned to the SSI/SSDI track of the WeCARE program when ONE of the following occurs: The BPS Tracking Form is routed to: BPS/Initial CSP Process Completed-Refer to Federal SSI/SSDI Program (These clients will be introduced to Case Management for assistance with applying for Disability Benefits, so they will need a CSP first. These steps will be reviewed in slide # 6. For materials on Writing a CSP & the CSP Process refer to materials located in WeCARE under Staff Supports) The Wellness Tracking Form is routed to: Wellness Process Completed-Refer to Federal SSI/SSDI Program (These clients have been receiving Case Management for a medical/mental health condition (s) and ongoing case management will provide assistance with applying for SSI/SSDI) Note: Once the BPS Process or Wellness Process is completed, the workflow closes and the SSI Tracking Form is created.

7. Initial Appt on the SSI/SSDI Track Page 7 of 22 As you remember during the BPS/CSP Process the following occurs: The status of the client’s case is checked in NYCWAY The Biopsychosocial Summary (BPS) & Comprehensive Service Plan (CSP) is reviewed & completed with the client Once the CSP is signed or otherwise completed, the BPS Tracking Form closes & the SSI/SSDI Tracking Form is created Codes are entered in NYCWAY including CSP completion (169C) and the Referral to Disability Benefits (968H/168H) The client is provided with a return appointment letter generated from NYCWAY where the Disability Benefits Application Process will be initiated. It is helpful to start researching the client’s SSI/SSDI application status & beginning the next steps after the completion of the initial CSP appointment. Note: Upcoming slides will cover the SSI/SSDI process for clients upon their referral into the SSI/SSDI track.

8. Working on New SSI/SSDI Clients Page 8 of 22  When SSI/SSDI cases appear in your In-Box, you will determine whether the client has an existing SSI/SSDI application on file with the Social Security Administration (SSA)  Once this is determined, you will route the SSI/SSDI Tracking Form to ONE of the following: Hold in Case Manager In-Box-SSI/SSDI Application Previously Filed OR Hold in Case Manager In-Box-SSI/SSDI Application Preparation in Progress (This routing indicates that there is NOT an application on file and that you will prepare the document) Note: If there is an application on file with SSA, the vendor updates it within five (5) business days of entering the functional capacity outcome (968S/168S- “Unable to Work.”) Page 24 of Vendor Guidelines If there is not an existing application with SSA, the vendor submits a pre- application within five (5) business days of entering the functional capacity outcome (968S/168S- “Unable to Work”) and the application for SSI/SSDI within twenty (20) business days. Page 24 of Vendor Guidelines

9. SSI/SSDI Tracking Form in the Internal WeCARE System Page 9 of 22 This space has been covered to protect client confidentiality. These are the routing options available during the SSI/SSDI Process. The system will only show available choices based on the last action taken.

10. The Client Reports for the SSI/SSDI Disability Benefits Appointment Page 10 of 22  On the day of the Disability Benefits Application appointment, complete the following actions: Check the client’s status in NYCWAY again. If the status has now become Closed, notify the client that s/he is ineligible to receive WeCARE Services before sending the client home. After the client leaves, case note your findings in WeCARE and close the workflow appropriately. If the case is Active, complete and review the SSI/SSDI application/pre-application with the client, if applicable. Complete an online medical report, #I3368 PRO, Internet Adult Disability and Work History Report. (See upcoming slides for more information) Enter all appropriate codes in NYCWAY to initiate Federal Disability Benefit Application Process Schedule next appointment to follow-up with client Case note all your actions in WeCARE and NYCWAY, where applicable.  The SSI Tracking Form is then routed to ONE of the following: Hold in Case Manager In-Box-SSI/SSDI Pre-Application Filed OR Hold in Case Manager In-Box-SSI/SSDI Application Filed

11. Adult Disability & Work History Report (i3368) Page 11 of 22  The online medical report, #I3368 PRO, Internet Adult disability and Work History Report collects information about a client’s disabling condition & how it affects his/her ability to work.  The report also provides a filing date that must be added to the client’s case record.  Supporting documentation from WeCARE as well as a client’s treatment provider (s) are submitted along with the report to the Social Security Administration (SSA)  The Disability and Work History Report can be obtained through the SSA’s website: http://s044a90.ssa.gov/appa6Z/i3368PRO/main.html See next slide

12. Adult Disability and Work History Report (i3368) -Cont’d Page 12 of 22 Here is where you will access & complete the report.

13. The Client Does Not Report for the SSI/SSDI Disability Benefits Appointment Page 13 of 22  On the day of the Disability Benefits Application appointment, complete the following actions: Check the client’s status in NYC WAY again. If the status has now become Closed, case note your findings in WeCARE and close the workflow appropriately. If the case is Active, indicate that the client has failed to report for the appointment and that outreach has been initiated. Initiate outreach by: Entering the appropriate code in NYCWAY, paying close attention to the Future Action Date or FAD (i.e. A client must report to WeCARE within 6 business days if Applicant for Public Assistance OR 11 business days if a Recipient)- page 32 of Vendor Guidelines Telephone all clients for whom telephone numbers are available to reschedule the appointment or, if necessary, mail clients reminder/new appointment letter (s) as many times as possible prior to FAD expiring. Case note all your actions in WeCARE & NYCWAY where applicable, including details about all successful and failed outreach attempts and how such attempts were made – i.e. phone call, letter, home visit  The SSI/SSDI Tracking Form is then routed to: Hold in Case Manager In-Box-SSI/SSDI Process-FTR-Outreach Started

14. All Outreach Attempts are Unsuccessful Page 14 of 22  If your client fails to report to WeCARE after several outreach attempts you will: Check NYCWAY to determine the status of the client, during the outreach period (i.e. From the date you posted the outreach code.) When the case is closed, you will see a message pop-up: ‘258’Case No Longer Referred to WeCARE When this occurs, indicate in the SSI/SSDI tracking form that all outreach attempts have failed and the case is now closed by writing: “Case is no longer referred to WeCARE per NYCWAY- 9/29/05.” and route the SSI/SSDI tracking form: Return to HRA-FTR-Outreach Ended-Non-Cooperation-Close Workflow Case Note all your actions in WeCARE, including the fact that the case was closed on a given date (i.e. “Case is no longer referred to WeCARE per NYCWAY- 9/29/05.”) Note: This will close the SSI/SSDI process for this client and indicates that the client is no longer eligible for any WeCARE Services.

15. During the SSI/SSDI Process Page 15 of 22  Throughout the SSI/SSDI Process, you will follow-up with the Social Security Administration (SSA) regularly to inquire about the status of a client’s application and facilitate the appeals process with HRA if necessary.  Follow-up with a client on a regular basis to provide services as necessary to address all barriers to health and monitor his/her compliance with the WeCARE program and SSA’s guidelines  Make appropriate case note entries documenting all actions that take place in the Internal WeCARE System as well as in NYCWAY. (You must document all actions in NYCWAY to communicate with HRA what services you have provided the client)  Update the status of a client’s case on the SSI/SSDI Tracking Form when the following occurs by using the corresponding routing options: Additional Submission (of supporting documentation) is requested Additional Submission (of supporting documentation) is filed The SSI/SSDI application has been denied An appeal is being prepared An application for appeal is filed Outreach is started

16. The End of the SSI/SSDI Process Page 16 of 22  The SSI/SSDI Process will end when ONE of the following occurs: The SSI/SSDI application is approved and the client’s WeCARE case is returned to HRA The SSI/SSDI application is denied after a final appeal and the client’s WeCARE case is returned to HRA The HRA case is closed or Public Assistance application has been rejected and the case is returned to HRA Outreach has ended after FTR (173D) or FTC (173E) and the client’s WeCARE case is returned to HRA The case is returned to HRA for another reason Note: The SSI/SSDI Tracking Form automatically closes when the above takes place and indicates that the client is no longer eligible for any WeCARE Services.

17. Case Noting Page 19 of 22 Case Notes:  Tell a story  Are clear, concise, specific, and detailed  Flow from one entry to the next, so there needs to be consistency & continuity between entries (i.e. if one talks about calling a doctor to get new medicals, the next entry should follow-up on those medicals.)  Should address all issues  Should be OBJECTIVE and NON-JUDGEMENTAL  Are part of a legal document and a reflection of the quality of services we provide You Should NOT:  Include your opinions, beliefs, values, or assumptions  Refer to yourself in the first person (i.e. I met with the client today) Note: Any layperson should be able to understand what is going on with a client without actually meeting the person. Choose a meaningful subject for each case note so that a reader would be able to predict the content before reading it fully.

18. Case Noting Page 20 of 22 Choose a Meaningful Subject for Each Entry. Johnson, Daniel 0001234567-01-01 Motts, Franklin Santiago, Keri Motts, Franklin Ramirez, Eva King, Richard James, Paul Motts, Franklin

19. Scanning Documents Page 17 of 22 See next slide  WeCARE is designed to be a paperless program, therefore all forms/documents relative to services provided through the WeCARE program, including SSI/SSDI application should be scanned into a client’s record in the FEGS Internal WeCARE System.  Scanners are located at each of the WeCARE sites and is performed by trained WeCARE staff.  Scanned forms/documents can then be viewed in the WeCARE system by clicking on ‘View Attachment Index’ in the client’s record.

20. Viewing Scanned Documents Page 18 of 22 Here is where you will access all scanned documents for your client. Johnson, Daniel 0001234567-01-01Motts, Franklin Santiago, Keri Motts, Franklin Ramirez, Eva King, Richard James, Paul Motts, Franklin

21. This training and many other trainings can be found in the “Staff Supports” section of the FEGS/WeCARE web site: https://portal.fegswecare.org/newmenu.cfm?vsize=405. It contains important tools in assisting you help your client. WeCARE Staff Supports Clicking Here will get you here You will find: PowerPoint trainings Procedures/Instructions HRA-approved documents Scripts Tools And many more These modules are maintained by the WeCARE Operations Unit. Please feel free to e-mail them at: wecareops@fegs.org to schedule a training or share ideas. Page 21 of 22

22. Where to Get Help For problems with computer equipment, telephones, computer and email access, immediately call or email the ALLSector Helpdesk at: 212 – 366 - 8488 The Helpdesk e-mail group is located in FEGS directory: WeCAREHelpDesk@fegs.org System problems should also be reported immediately to the ALLSector Helpdesk such as: No save/submit button on form, tracking form with no routing options, tracking form stuck in Inbox, slow or no system response time, and problems with user access NYCWAY Helpdesk For access problems in the NYCWAY system, call the NYCWAY Helpdesk at: 718 - 557- 1313 If your screen is missing functionality, codes not registering and the like, call the NYCWAY software Helpdesk at: 718 - 510 - 0237 Page 22 of 22 Helpdesk HRA Resources WeCARE has HRA Out Stationed Workers (OSWs) located at all sites. OSWs act as a liaison between HRA and WeCARE by clarifying program questions to help staff serve the needs of their clients. Also refer to the WeCARE Vendor Guidelines published by HRA to get program support.