Findings from a Study of the SSI/SSDI Outreach, Access, and Recovery (SOAR) Initiative. SOAR Individual and System Level Outcomes

12/15/2009

SOAR is intended to improve the processes associated with obtaining SSI/SSDI benefits for individuals who both have disabilities and are homeless, thereby improving their quality of life. System-level measures are required to assess the extent to which SOAR indeed improves processes, and individual-level measures are required to assess the extent to which SOAR is meaningful to this target population. SOAR is not intended to prompt temporary changes during the period of its implementation, but rather to effect lasting systems change. Thus, at the system level, a key outcome measure is the institutionalization and proliferation of SOAR practices and principles. Individual-level outcomes can be delineated into two categories: short-term and long-term outcomes (see Figure I.1 in Chapter 1). Short-term outcomes center on the immediate results of the application process. Examples include the application submission and approval rate and the time between initial application and approval. Longer-term outcomes center on the implications of application outcomes for SSI/SSDI applicants' quality of life. Examples include applicants' personal income, housing status, access to healthcare, and overall health. Short-term application outcomes can also lead to financial benefits for states and service delivery systems. For example, states may be able to recoup from SSA General Assistance benefits paid to individuals who are approved for SSI/SSDI. In addition, medical providers may be able to recoup the cost of uncompensated care provided to uninsured individuals who become enrolled in Medicaid as a result of SSI/SSDI approval.

Data on SOAR's outcomes can provide critical information to federal agencies about the relative costs and benefits of the initiative and the extent to which it is worthy of an additional investment of resources. Data can also be beneficial to states and local communities by enabling them to assess the results of their efforts with an eye toward continuous improvement, and to market the initiative to new partners and potential financial supporters. Yet, very little data on individual- and system-level outcomes exist. Most state and local communities have not systematically collected outcome data, and the data they have collected is not rigorous enough to use for evaluation purposes.

This chapter describes the challenges states face in collecting outcome data and the practices that some have put in place. It also presents information on outcomes that we obtained during in-person visits to the case study states. The data are based only on reports from stakeholders in those states and on all applications for SOAR TA from Rounds One and Two states. Mathematica did not conduct primary data collection on application submissions and approvals or on related quantitative measures because states lacked appropriate data infrastructures to do so. While the study was primarily focused on processes, we present data on outcomes as described by states because of their importance to current policy decisions.

Outcome data in this chapter are presented solely for the six case study states. However, according to information gathered by the TA contractor from stakeholders elsewhere, other states have realized some important individual- and system-level outcomes that should not be disregarded, as they are indicative of SOAR's potential. Brief descriptions of some of these outcomes are included in Appendix A.

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