Findings from a Study of the SSI/SSDI Outreach, Access, and Recovery (SOAR) Initiative. Introduction

12/15/2009

The Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) programs provide critical income support for those who meet eligibility requirements. For individuals or families who are homeless, receiving SSI or SSDI is often an important first step in improving their life circumstances. SSI/SSDI cash assistance provides financial resources for housing and facilitates eligibility for Medicaid, which enables beneficiaries to access critical medical and mental health services. SSI/SSDI recipients typically have access to employment assistance programs offered through agencies such as vocational rehabilitation or alternative providers and the Ticket to Work program. However, the combination of disabilities that often include mental health and/or substance abuse problems, and the precariousness of the living situations of individuals who are homeless make it difficult for them to successfully complete the SSI/SSDI application process.

The SSI/SSDI Outreach, Access, and Recovery (SOAR) initiative aims to improve access to SSI/SSDI benefits for individuals who are homeless through a multi-pronged strategy designed to mitigate the challenges this population faces when navigating the SSI/SSDI application process. One main aspect of the SOAR initiative is the provision of technical and strategic planning assistance to help states develop policies and procedures that will aid individuals who are homeless obtain SSI/SSDI. Such assistance aims to bring social service providers, advocates for the homeless, and other state and local agencies together to determine how to create an effective system for obtaining SSI/SSDI. A second important aspect of SOAR is training case managers, social workers, and other staff in Stepping Stones to Recovery (SSTR)  a curriculum designed explicitly to provide case managers and other advocates with the skills and information needed to support individuals who are homeless through the SSI/SSDI application process. SOAR employs a train-the-trainer (TTT) model in which a technical assistance (TA) contractor trains a few staff in interested states who then train others in their respective states. Finally, the initiative includes an ongoing TA function whereby the contractor helps states strengthen their efforts and gathers and disseminates information on promising practices.

SOAR has the potential to help end and prevent chronic homelessness through two avenues. First, the technical and strategic planning assistance to states may promote the development of new cross-agency collaborations and change how case managers perform their work. Second, increased SSI/SSDI receipt among those who are homeless translates into the availability of greater cash and medical resources, ultimately improving quality of life. Facilitating access to SSI/SSDI and associated Medicaid benefits among this target group can also lead to outcomes that benefit the state, such as reduced reliance on and expenditures from state-funded general assistance programs, reduced expenditures by state-only health or mental health services, and reduced incidence of uncompensated, emergency medical care.

To determine how and the extent to which SOAR is achieving its goals, the Assistant Secretary for Planning and Evaluation at the Department of Health and Human Services contracted with Mathematica Policy Research (Mathematica) in 2007 to conduct an evaluation of SOAR. The goals of the evaluation were to (1) provide a comprehensive description of SOAR processes, (2) examine the outputs and some of the short- and long-term outcomes that may be associated with these processes, (3) assess the factors that appear to be associated with successful implementation of the initiative, and (4) describe ways in which the initiative might be improved at either the state or federal level.

This report summarizes the findings from the evaluation, which are especially timely as initial federal funding for SOAR has expired and federal government agencies, as well as other funders, are considering how much and in what ways to best invest additional resources in the initiative. The findings in this report may help policymakers and program administrators determine the extent to which investments in the initiative to date have been beneficial and how consideration of additional investments could be worthwhile. The remainder of this introductory chapter of the report describes the policy context for the initiative, the key components of the SOAR model, and the study objectives and research questions. Chapter II describes the study methodology. Chapter III discusses outcomes of the initiative and Chapters IV and V describe the activities and outputs that contributed to the outcomes. Chapter VI contains concluding remarks and a discussion of considerations for the future.

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