SOAR and Veterans

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SOAR and Veterans

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

Webinar Instructions Question instructions Muting Recording availability Downloading documents Evaluation

SOAR Training

2-day Stepping Stones to Recovery training

www.prainc.com/soar Find your State

Agenda

Building Collaborations to Serve Veterans– Pam Heine, SAMHSA SOAR Technical Assistance Center

Veterans Benefits Administration– Christi Greenwell, Assistant Director, Client Services and Outreach,

Benefits Assistance Service, Veterans Benefits Administration

SOAR and Veterans– Nancy Campbell, National Director, HUD-VASH Program

Serving Veterans: Employment and SOAR– Anthony Foster, Incarcerated Veterans Transitional Program

Questions and Answers

Building Collaborations to Serve Veterans

Pam Heine

SAMHSA SOAR Technical Assistance Center

Policy Research Associates, Inc.

Homelessness Among Veterans

HUD’s 2011 Point-in-Time Estimate of Homelessness indicates a 12% decrease in the number of homeless Veterans from 76,329 to 67,495 since 2009

Nearly twice that number are estimated to be homeless over the course of a year

The majority are in shelters, with many living on the streets

95% of homeless vets have honorable discharges

Like the overall homeless population, almost half of homeless veterans are in 4 states: CA, FL, TX, NY

Veterans At-Risk for Homelessness

NAEH estimates that 90,000 to 470,000 veterans are at risk for homelessness where “at risk” is defined by NAEH as one or more of the following:

Below poverty level income

Paying more than 50% of income for rent

Having a disabled member of the household

Households that are not in the labor force

New VA Office of Inspector General Report

OEF/OIF veterans experienced higher homeless incidences after military separation

Veterans who experienced homelessness after military separation were younger, enlisted with lower pay grades, and were more likely to be diagnosed with mental disorders and/or traumatic brain injury (TBI) at time of separation from active duty

Presence of mental disorder (substance-related disorder and/or mental illness) is the strongest predictor of becoming homeless after discharge from active duty

Nearly 65% of homeless veterans utilized the VA’s Health Care for Homeless Veterans(HCHV), Homeless Chronically Mentally Ill (HCNI) Program and HUD/VASH

Source: Homeless Incidence and Risk Factors for Becoming Homeless in Veterans: VA office of Inspector General Report No.11-034128-173, May 4, 2012.

Prioritizing Preventing and Ending Homelessness Among Veterans

2010 – US Interagency Council on Homelessness Federal Strategic Action Plan to Prevent and End Homelessness Second of 4 goals is to prevent and end

homelessness among veterans in five years

2010 –2015 VA Five-Year Plan to Prevent and End Homelessness Among Veterans

Why is Access to SSI and SSDI Important for Veterans?

Income Housing Health insurance and treatment Employment and supports

Increase in Disability Applications 45% of the 1.6 million veterans from the

wars in Iraq and Afghanistan applying due to service-related injuries

Double the 21% from the Gulf War (1990’s) Why the increase?

– Weak economy

– Surviving wounds

– More awareness of TBI, PTSD

Veterans and SSA Benefits Veterans who receive partial disability can also receive SSA disability

benefits

Veterans can access SSA benefits while they are waiting for VA benefits

Health insurance associated with SSA benefits can be important for vets without VA health care

Younger veterans with limited work history may be eligible for SSDI

Veterans with “active duty” status and in treatment for a severe impairment, receiving pay, may still be eligible for SSA benefits

SSA has special provisions for veterans who entered the service as legal immigrants

SSA has special provisions for expediting disability applications for Wounded Warriors, which also applies to appeals

SOAR and Veterans: Right Now!

SOAR providers serve veterans

Some VA staff have been SOAR trained (GA, KS, NC, NM, SC, VA, WA)

SOAR brings hope to veterans by integrating: outreach, access and recovery (consistent with VA’s 6 key pillars)

SOAR promotes expediting claims through well established partnerships: – SSA and DDS – HUD/PATH/Continua of Care– Medical Records Departments– Community Based Service Providers

Issue: Federal Conflict of Interest Rule

POMS DI 31001.015 -- Conflict of Interest in Claimant Representation rule** restricts federal employees from representing SSA applicants

VA Case Managers -- Restricted from representing veteran with SSA using the SSA-1696 Appointment of Representative form

VA is working with US Interagency Council on Homelessness (USICH) to see there are any potential exceptions to reduce this barrier

** http://policy.ssa.gov/poms.nsf/lnx/0431001015

Think Positive!

Allowed activities will be covered by Nancy Campbell, National Director of the HUD-VASH program

Existing SOAR/VA Collaborations: Washington

Washington State Department of Veterans’ Affairs SOAR Project in Retsil, Washington

Building 9 for Veterans – 60-bed transitional housing provides safe, stable housing for male and female veterans who are homeless and committed to employment or living independently

Funding: VA Grant and Per Diem (GPD) Program provides benefits screening and assistance from SOAR trained staff

Existing SOAR/VA Collaborations: Georgia

Atlanta VA Medical Center– OEF/OIF Transition Patient Advocate,

Ron Hackney Refers many veterans to

community-based SOAR providers

SOAR in VA Action Plans

Community Homelessness Assessment, Local Education and Networking Groups (CHALENG) for Veterans [FY2010 action plan, needs survey results; SSI/SSDI ]– Albuquerque, NM

– Charleston, SC

– Topeka, KS

– Little Rock, AR

– http://www1.va.gov/HOMELESS/chaleng.asp

Other Collaborations You Should Know About

SSA Wounded Warriors program – since 2009

– http://www.socialsecurity.gov/woundedwarriors/

Medical Records (2012)- VA released new procedures for expediting the handling of military record requests associated with homeless Veterans claims processing

Outreach: SSA and VA staff both perform outreach to VA Medical Centers, DOD, shelters, streets, community events such as, Stand Downs, Service Organizations

Veterans Benefits Administration

Christi GreenwellAssistant Director, Client Services and Outreach, Benefits Assistance Service,

Veterans Benefits Administration

VBA Offices

San Juan

Seattle

Portland

Togus

Buffalo

White River Jct.

Manchester

Boston

ProvidenceHartford

Roanoke

Winston Salem

St. Petersburg

Wilmington

New York

PhiladelphiaNewark

Baltimore

RenoSalt Lake

City

Albuquerque

Phoenix

Denver

Boise

Ft. Harrison

Cheyenne

Sioux Falls

Fargo

Lincoln

Columbia

St.

Paul

Waco

Muskogee

Wichita

MilwaukeeDetroit

Houston

New Orleans

Jackson

Little

Rock

St. Louis

Des Moines

San Diego

Nashville

AtlantaMontgomery

Indianapolis

Chicago

Louisville

Pittsburgh

Oakland

Cleveland

Los Angeles

Huntington

DC

Regional Office (RO)

RO & Education Regional Processing Center (RPO)

RO & Regional Loan Center (RLC)

RO, RPO & RLC

RO & Insurance Center

Anchorage

Honolulu

Compensation & Pension Compensation & Pension BenefitsBenefits

Disability Compensation

Dependency and Indemnity Compensation

Disability Pension (Death Pension)

DisabilityDisability CompensationCompensation Disability resulting from injury or disease

incurred in or aggravated by active service. Disability may be rated from 0% to 100%,

Payments made for 10% to 100%. Special Monthly Compensation (such as aid &

attendance, loss of limb, eyesight). Payments are tax free.

2525

Granted to those with wartime service – Age 65 or older, OR – Totally and permanently disabled, OR – Patients in a nursing home receiving skilled nursing care, OR

– Receiving Social Security Disability Insurance Needs-based Special Monthly Pension (such as aid & attendance,

loss of limb, eyesight) Payments are tax free

Disability Pension

Dependency and Indemnity Dependency and Indemnity Compensation (DIC)Compensation (DIC)

A monthly benefit paid to eligible military service survivors of a member who died while on active duty, active duty for training, inactive duty training, or

Veteran whose death resulted from a service-related injury or disease.

Payments may also be awarded for non service-related injury or disease resulting in death under certain circumstances

Payments are tax free.

SSA and Department of Veterans Affairs

Verifying SSA benefits through Federal On-Line Query (FOLQ)

Completing VA Form 21-4180, Request for Certification by Social Security Administration

Establishing Relationship and Dependency for REPS Benefits

Using Administration Determinations made by SSA Processing of SSA Form-24 Matching Programs

Veterans and SOAR

Nancy Campbell, MSW, LISW

National Director, HUD-VASH Program

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Health Care for Homeless Veterans (HCHV)

The central goal of HCHV programs are to reduce homelessness among Veterans by conducting outreach to those who are the most vulnerable and are not currently receiving services and engaging them in treatment and rehabilitative programs.

The Contract Residential Treatment Program ensures that Veterans with serious mental health diagnoses can be placed in community-based programs which provide quality housing and services.

42,275 intake assessments with 88,244 Veterans treated by HCHV staff (12% increase from FY 09)

Introduced the Low Demand/Safe Haven demonstration model

217 Stand Downs (12.5% from FY 09)

174 community-based programs – 1,583 operational beds; including

927 residential treatment beds; 636 beds for Emergency Housing, and 20 beds in the Safe Haven pilot program.

Health Care for Reentry Veterans Services and Resources (HCRV)

The HCRV program is designed to address the community re-entry needs of incarcerated Veterans.

The HCRV's goals are to prevent homelessness, reduce the impact of medical, psychiatric, and substance abuse problems upon community re-adjustment, and decrease the likelihood of re-incarceration for those leaving prison.

 

40,000 veterans come out of prison each year

44 full- time re-entry specialists seeing Veterans in 1066 state and Federal prisons across the country

From Aug. 2007-Oct. 2010 approximately 24,925 Re-Entry Veterans have been seen, with 9,326 seen in FY10 alone

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Veterans Justice Outreach The purpose of the Veteran

Justice Outreach Initiative (VJO) initiative is to avoid the unnecessary criminalization of mental illness and extended incarceration among Veterans by ensuring that eligible justice-involved Veterans have timely access to VHA mental health and substance abuse services when clinically indicated, and other VA services and benefits as appropriate.

Justice Outreach (law enforcement, jails, courts) – 6,451 Veterans seen in VJO

FY 10: 46 full-time specialists funded

FY11: Additional 79 full-time specialists funded

There are approximately 50 operational Veteran Courts (more than double the number for FY 2010) that VA VJO Staff participate with

Supportive Services Grants for Low Income Veterans and Families

(SSVF) This program was authorized by

Public Law 110-387 and will provide supportive services to very low-income Veteran families in or transitioning to permanent housing. Funds will be granted to private non-profit organizations and consumer cooperatives who will assist very low-income Veteran families by providing a range of supportive services designed to promote housing stability.

85 Grants awarded Summer 2011

Announcement of new awardees expected in July 2012

Domiciliary Care for Homeless Veterans (DCHV)

Program that provides time-limited residential treatment to homeless Veterans with health care and social-vocational deficits.

DCHV programs provide homeless Veterans access to medical, psychiatric, and substance use disorder treatment in addition to social and vocational rehabilitation programs.

2,400 beds for homeless Veterans Provided residential rehabilitation

treatment to over 6,000 homeless Veterans with almost 40 percent of those returning back to work

In FY 11 $33M to develop 5 new sites 5 Sites (Denver, Philadelphia,

Atlanta, San Diego, Miami)

Income and Benefits Many homeless people are

unable to work due to a disability, or are unable to quickly earn enough to afford rent. The sooner a minimal income is obtained, the sooner a new home is possible.

This strategy includes a multi-pronged effort aimed at improving financial opportunities for Veterans, including, at minimum, vocational training and enhanced access to benefits.

Veterans Benefits Administration (VBA) provides services for homeless Veterans at all 56 regional offices. The number of homeless Veterans claims’ received during FY 2009 (6,285) increased by 9.06% from FY 2008 (5,715). Assistance is also provided to Veteran homeowners who may be in foreclosure.

VA continues to partner with the Social Security Administration (SSA) to expedite claims for Social Security Disability and with state and local governments for other types of economic assistance to Veterans

Homeless Providers Grant and Per Diem Program (GPD)

Allows VA to award grants to community-based agencies to create transitional housing programs and offer per diem payments. The purpose is to promote the development and provision of supportive housing and/or supportive services with the goal of helping homeless Veterans achieve residential stability, increase their skill levels and/or income, and obtain greater self-determination. GPD-funded projects offer communities a way to help homeless Veterans with housing and services while assisting VA medical Centers by augmenting or supplementing care.

GPD offered both Capital and “Per Diem Only” grant awards– $41 million awarded to

community-based agencies• $26 million in Capital funds• $15 million in “Per Diem

Only” awards Approximately 12,000 beds Operationalized 971 additional

transitional housing beds in FY10 New FY 12 NOFA recently issued.

Focus on “transition in place”

HUD-VASH Program A collaborative program between

HUD and VA where eligible homeless Veterans receive VA provided case management and supportive services to support stability and recovery from physical and mental health, substance use, and functional concerns contributing to or resulting from of homelessness. The program goals include promoting maximal Veteran recovery and independence to sustain permanent housing in the community for the Veteran and the Veteran’s family.

Approximately 48,000 Housing Choice Vouchers currently in use

As of March 28, 2012, 31,197 Veterans have been housed

Over 300 participating PHAs VA has now funded over 1900

case managers/other staff across the country

This includes 101 Substance Use Disorder Specialists to enhance VA case management and supportive services

Community Partnerships There has been a great deal of emphasis placed on building partnerships. This strategy

is a cornerstone of the entire Plan to End Homelessness Among Veterans, and includes substantial new efforts to create partnerships with community and local governmental agencies to enhance opportunities and services for homeless Veterans.

VA has strengthened their partnerships with community service providers:

– Nationwide, there are now nearly 4,000 interagency collaboration agreements in place.

– These agreements have aided the VA in extending outreach services to sites such as shelters, soup kitchens, safe havens, welfare offices or other locations where homeless persons may be located and have spurred the development of additional housing resources.

– This has led to improved coordination of services and the development of innovative strategies to address the needs of homeless Veterans.

– GPD partners with over 500 agencies to provide transitional housing services. – VA continues to foster interagency collaboration with: United States Interagency

Council on Homelessness (USICH), HUD, SAMSHA, DoL, Education, Health & Human Services (HHS), Department of Justice (DoJ), and others.

Role of HUD-VASH Case Manager Once accepted, a Housing Recovery Plan is developed by the case

manager and the Veteran. It is an integrated part of the overall treatment plan, and reflects the recovery goals of the Veteran which may include:

o Establishing Housing stability (paying rent, following rules, etc)o Meeting employment and income needso Resolving legal and financial issues (credit history)o Supporting physical, mental, social healtho Fostering community integration and independence

Process to monitor the progress of the plan is jointly agreed upon

Main Goal: Sustaining Veteran in permanent housing

Prohibitions Re: SOAR Federal employees are not allowed to represent veterans in their

claims for Social Security benefits. It’s a criminal conflict on interest violation (18 U.S.C. 203, 205)

This “representational duty” of being a claims representative is outside the scope and course of the routine work of VA employees. Could find themselves outside the umbrella of coverage of the Federal Tort Claims Act and staff could be personally held liable

Cannot sign SSA Form 1696 –Appointment of a Representative Cannot discuss the status of a veteran’s claim with SSA whether

the discussion takes place at a hearing or not; can be construed as advocacy

Allowable Activities Re: SOAR Staff can attend trainings to become familiar with

the process Can disclose VA records to SSA (Form 827) if

veteran signs the appropriate release Can complete the Disability Report-Adult (Form

3368) and be listed as a contact who knows the veteran

Can assist in completing the application forms and referring the veteran to an appropriate advocate/ representative

Can provide support and encouragement while Veteran is going through the process

OK to work “behind the scenes”

Other Options/Possibilities SSVF grantees State veteran employees Veterans Service Organizations Other state, city or non-profit

employees Pro bono private sector attorneys Legal services referral resources

– VA Staff must follow VHA Directive 2011-034 Homeless Veterans Legal Referral Process

Serving Veterans: Employment and SOAR

Anthony Foster, Service CoordinatorIncarcerated Veterans Transitional Program (IVTP)

Goodwill Industries of the Inland NorthwestSpokane, Washington

For veterans who have any discharge other than dishonorable

Veteran must have been incarcerated within the past 6 months

Veteran must be homeless, unemployed, and have a STRONG desire to obtain employment

Incarcerated Veterans Transition Program (IVTP)

Job readiness assistance from employment specialist

Housing assistance from housing specialist (i.e.,

housing plan, landlord referral)

Employment Readiness and Responsible Renter’s

classes

Participation in weekly job club

Transportation assistance

Clothing assistance

Referral to VA for other relevant services

IVTP Benefits

Some veterans may not be ready for work Some are experiencing chronic

homelessness

– May lose contact for months at a time

Veteran may have limited work history and/or training

Challenges We’ve Faced

Conviction record may make finding a job difficult (i.e., type of offense vs job availability)

If in substance abuse treatment, work search is postponed until treatment cycle is completed (intensive outpatient)

More Challenges…

Schedule meeting with veteran and request all relevant records (i.e., military, department of corrections, other medical facilities)

Meet with vet and complete application and disability report

Fax over all records to local Social Security Administration Office

Follow-up with veteran upon notice of decision

– Help file appeal if necessary

– Refer to community legal resources for assistance once all appeal process have been exhausted

SOAR as an Option for Veterans

Anthony FosterService Coordinatoranthonyf@giin.org(509) 232-1125

For More Information

Questions and Answers

Facilitators:SAMHSA SOAR Technical Assistance Center

Policy Research Associates, Inc.

Resources for Veterans

Experiencing Homelessness National Call Center of Homeless Veterans- free, confidential, 24/7

access to trained counselors, for families too 1-877-4AID-VET (1-877-424-3838)

Dept of Veterans Affairs/ Homeless Programs- This website provides info on VA’s programs and service for homeless veterans http://www.va.gov/HOMELESS/index.asp

National Coalition for Homeless Veterans- NCHV is recognized as the nations’ leading authority on homeless veteran's issues. Links to resources and guides. http://www.nchv.org/index.cfm

Vet Centers- Can assist veterans experiencing homelessness. http://www.2.va.gov/directory/guide/vetcenter_flsh.asp

National Center for PTSD- info, resources and practical advice for Veterans dealing with stress and trauma. http://www.ptsd.va.gov/public/pages/fslist-ptsd-overview.asp

Resources continued…

VA Medical Centers– Homeless Veterans Program Coordinators – http://www.va.gov/HOMELESS/Hmls_Vet_Prog_Coord.asp

– Healthcare for Homeless Veterans (HCHV)– http://www.va.gov/homeless/hchv.asp

“Those who have served this nation as Veterans should never

find themselves on the street living without care and without hope.”

VA Secretary Eric K. Shinseki, testimony before Senate Committee on Veteran’s

Affairs, 11/09

For More Information on SOAR

Visit the SOAR website at www.prainc.com/soar

Or contact:

SAMHSA SOAR TA Center

Policy Research Associates, Inc.Delmar, NY

518-439-7415soar@prainc.com