Findings from a Study of the SSI/SSDI Outreach, Access, and Recovery (SOAR) Initiative. Appendix A: Outcomes in Other SOAR Communities

12/15/2009

The data presented in the body of this report pertain only to the six case study states. However, according to information gathered from other SOAR communities by the TA contractor, other states have achieved notable individual- and system-level outcomes. Below, we describe outcomes regarding SOAR application approval rates and processing times and cost recovery efforts in a few communities to demonstrate more comprehensively SOAR's potential. All information in this appendix was provided by the TA contractor; Mathematica has not evaluated the strengths and weaknesses of the underlying data sources or otherwise verified these data.

A. SOAR Applications

Georgia.  Georgia's Department of Human Resources Mental Health Division used PATH funds to employee 1.5 FTE SOAR coordinators; in addition to coordinating statewide SOAR efforts, these staff conduct trainings and help clients prepare SOAR applications. The department also signed MOUs with state hospitals to improve access to medical records and worked to incorporate SOAR into these hospitals' discharge planning. The TA contractor reported in May 2008 that SSA had approved 42 of 63, or 67 percent, of resolved SOAR applications in Atlanta; on average, approvals took 75 days.

Tennessee.  In May 2008, the TA contractor reported that 98 percent of Nashville's first 87 SOAR applications were approved; time from application to approval averaged 56 days. Facilitating access to benefits, including SSI/SSDI, was one the guiding principles underlying Nashville's 10-year plan to end homelessness. A homeless service provider, Park Center, employed four staff focused on preparing SSI/SSDI applications.

Michigan.  Unlike many SOAR communities, Michigan immediately rolled out SOAR statewide; the state PATH program coordinated the initiative across eight regions. In May 2008, the TA contractor reported that 78 percent of the 55 resolved SOAR applications were approved; on average, approvals took 53 days.

New York.  Before New York State received federally funded TA for SOAR, a SOAR-trained case manager implemented a pre-release and re-entry application program in Sing Sing prison. In May 2008, the TA contractor reported that 88 percent of the 99 pre-release cases for which decisions had been issued were approved; on average, approvals took 59 days

B. Reimbursement of Medical Costs

Kentucky.  St. Elizabeth Medical Center in Covington spent $18,000 to fund a part-time SOAR position at a local homeless center; this staff member assists clients, including those referred to the homeless center from this hospital, with SSI/SSDI applications. The TA contractor reported that within one year, 21 of the hospital's clients were awarded benefits. The hospital recouped more than $182,000 from Medicaid and Medicare toward the $482,638 it incurred in uncompensated care to these clients. Based on the program's initial success, the hospital increased its funding, turning the part-time position into a full-time one.

Rhode Island.  In Providence, Butler Hospital invested $30,000 in ACCESS-RI, a statewide program designed to serve individuals who are chronically homeless and have been diagnosed with mental disabilities or substance abuse. The program utilizes the SOAR model. The hospital reports that it was able to recoup its initial investment plus additional expenses for providing 146 days of hospital care to four clients who were homeless after those clients were approved for SSI and Medicaid. Butler received a total of $197,000 in reimbursement for their care.

Oregon.  In Multnomah County (Portland) a team of specialists assists individuals who are homeless and who have disabilities to expedite acquisition of federal benefits and entitlements (SSI/DI and Medicaid/Medicare). The Benefits and Entitlement Specialist Team (BEST) consists of benefits specialists, a records/data coordinator, and a physician who conducts the CEs required by DDS. The team reported to the TA contractor that 16 medical providers have received significant retroactive Medicaid reimbursements after three clients were awarded benefits. These reimbursements totaled roughly $110,000.

 

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