Embed Size (px)
Citation preview
Please stay on the line.
Audio: 1-888-469-3145Passcode: 2045270
The webinar will begin shortly.
Strengthening Applications: Quality Review of SOAR Applications
Presented by:
SAMHSA SOAR Technical Assistance CenterPolicy Research Associates, Inc.
Under contract to:
Substance Abuse and Mental Health Services AdministrationU.S. Department of Health and Human Services
Welcome!
Webinar Instructions
Question instructions
Muting
Recording availability
Downloading documents
Evaluation
Agenda
Quality Review Strategies and Options
Kristin Lupfer, SOAR Technical Assistance Center
Internal Case Reviews and Checklists
Kas Causeya, BEST Program, Central City Concern, Portland, OR
Community Mentoring and Review
Michele Levy, Homeless Advocacy Project, Philadelphia, PA
Quality Review from a State SOAR Program
Monica Bellamy, Department of Community Health, Detroit, MI
Questions and AnswersFacilitators: SAMHSA SOAR Technical Assistance Team
Quality Review Strategies and Options
Kristin LupferSAMHSA SOAR Technical Assistance Center
Policy Research Associates, Inc.
Critical Components for Success
1. Staff trained & available to assist with applications
2. Maintain contact with applicant
3. Become applicant’s representative
4. Obtain medical records, past and present
5. Collaborate with physicians
6. Electronic submission of information
7. Collaborate with DDS and SSA
8. Ensure quality of applications
9. Arrange for representative payees
10.Track and report outcomes
Why do Quality Review?
To ensure the greatest chance of an approval on initial application
To reinforce with SSA and DDS what to expect from SOAR applications
What is Quality?
Complete information
Online form submission
Medical records indicating impairment
Detailed functional summary
Doctor’s co-signature (when possible)
Timely communication with SSA/DDS
Levels of Quality Review
Individual care coordinator
Peers/mentors
Supervisors
Local/Regional SOAR Planning Group
SOAR Trainers
SSA/DDS
State SOAR Program
SAMHSA SOAR TA Center
Strategies for Quality Review
Use the Quality Review Checklist
Have a trained mentor review applications for completeness prior to submission
Review medical summary reports
Review outcomes
Targeted refresher trainings
You CAN do this!
We support you!
Internal Case Reviews and Checklists
Kas CauseyaBEST Program, Central City Concern,
Portland, OR
A Complete Packet Includes:
1696- Appointment of rep.
All medical records
ROI’s for SSA
Functional summary
Medical summary signed by MD
Our CE (aka IE) reports not DDS’s
Pictures if deemed appropriate
As much lay evidence as possible
3369- Work history report
Miscellaneous questionnaires (pain, seizure, employer, DA+A, current medications and side effects)
BEST Flag
BEST Appeal Flag
Community Mentoring and Review
Michele Levy Homeless Advocacy Project
Philadelphia, PA
HAP and SOAR
HAP’s SOAR Project in Philadelphia began in July, 2007
HAP PartnersSSA: Specifically, the SSA Downtown Philadelphia field office
Disability Determination Services: Specifically, the Wilkes-Barre Office
Philadelphia Office of Supportive Housing
HAP’s SOAR Projects
Initial project with OSH for homeless adults
Partnership with DHS for youth aging out of the delinquency or dependency systems
HPRP project for “newly homeless” persons
TANF SOAR Project with DPW
Philadelphia SOAR Outcomes
First application filed in December 2007
To date, 717 claims in HAP’s SOAR Projects have been approved and 3 claims have been denied.
Average processing time from date application filed is 32 days.
Securing Positive Outcomes
Selecting Advocates: who should be trained to participate in application filings via SOAR?
Which population do they serve?
The nature of the advocate’s job
Past relationship with the relevant agency
Securing Positive Outcomes
Determining SOAR Clients: which potential clients should be included in the SOAR project?
Most recent psychiatric or other medical evaluation
Current or past medication – type and dosage
Current functioning
Securing Positive Outcomes
Providing Ongoing Supervision and Support
Review first letter of support (a/k/a medical summary report) submitted by each advocate
Remain available to answer questions and to review any documents
Provide reminders of upcoming deadlines and the steps in the claims process
Securing Positive Outcomes
Knowing Your Adjudicator and Claims Representative
What medical evidence will your adjudicator require for various impairments?
How much information does your adjudicator need in the letter of support?
What should be provided to secure re-openings of prior filings?
What will your claims representative require to process the claim?
Securing Positive Outcomes
Maintaining Communication Among SOAR Partners
Is the process running smoothly between the SSA claims representative and the disability adjudicator?
Is the advocate maintaining effective communication with the adjudicator and claims representative?
Remaining available to trouble-shoot as issues arise.
Michele Levy Managing Attorney
Homeless Advocacy Project42 S. 15th Street, 4th FloorPhiladelphia, PA 19102
Telephone: 215.523.9595Fax: 215.981.3866
www.homelessadvocacyproject.org
Contact Information
Quality Review from a State SOAR Program
Monica BellamyDepartment of Community Health
Detroit, MI
SOAR Across Michigan
Is Sponsored by:
Michigan Department of Community Health
In partnership with:Michigan State Housing Development AuthorityCorporation for Supportive HousingDepartment of Human Services
With contractual assistance and support from:Policy Research Associates, Inc.
SOAR Across Michigan
A total of 65 trainings have taken place statewide
1600+ persons have been trained in every region of the state
What is going on in Michigan?
2020+ applications submitted
72% success rate of getting applications approved on first application and for applications on appeal combined.
Applications approved in an average of 79 days statewide.
48% of clients are chronically homeless
Who is Participating?
There are a minimum of 4 trainings offered per year to cover all 8 regions of the state.
Who’s getting trained:
Community Mental Health Agencies
Domestic Violence agencies
Emergency Shelter Staff
Grass Roots Community Agencies
Volunteers
What Have We Learned?
More support and input is needed from Regions
More support and TA is need for trainee’s to assist them in getting started
More support and TA is needed directly after training.
Follow-up to Improve Outcomes
Getting started document (www.prainc.com/soar)
One on One follow up with trainee’s
MOU agreement follow-up w/ directors
Meet periodically to plan and address issues that arise
Follow-up to Improve Outcomes
Monthly Newsletter
Contract w/ Advanced Trainers
TA calls
What is the State Doing?
Providing on-going TA to all Regions
Establishing Collaborations with SSA offices, both on regional and local levels— designated staff.
Establishing Collaborations with DDS—designated staff
Conduct state-level planning to support SOAR Across Michigan
Monitor progress and report on individual and system outcomes
Refresher Training60 to 90 days after 2 day Stepping Stones to Recovery training.
Review the most critical aspects of the
SOAR Process to get successful outcomes.
Review updated and new information
Review and discuss revised forms and processes
Give tips and best practices for successful outcomes
Provide an opportunity for questions and answers along with TA
SOAR Across Michigan
Improving Outcomes is Possible
Collaboration works!
More intense TA provided for trainee’s
More community support
Makes a difference with outcomes
For More Information:
Monica Bellamy
SOAR Across Michigan State Team Lead
Michigan Department of Community Health
Phone: 313-456-4360
E-mail: [email protected]
Questions and Answers
Facilitators:SAMHSA SOAR Technical Assistance Center Team
Policy Research Associates, Inc.
For More Information on SOAR
Visit the SOAR website at www.prainc.com/soar
Or contact:
SAMHSA SOAR TA CenterPolicy Research Associates, Inc.
Delmar, NY518-439-7415
