Reports and Briefs
Does CoC Participation in SOAR Training Improve SSI/SSDI Enrollment?
Homeless persons experience disproportionally high rates of disability; 36.8% of sheltered adults have a disability, compared to 24.6% of persons living in poverty and 15.3% of adults nationwide.[i] The 2010 federal strategic plan to prevent and end homelessness, Opening Doors, calls for the systematic connection to mainstream benefits, such as Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI), for homeless families.[ii] SSI and SSDI are disability benefit programs managed by the Social Security Administration (SSA) that provide monthly cash assistance to eligible low-income adults and children.[iii] Increasing SSI and SSDI enrollment reduces expenditures from state-funded general assistance programs and state-only medical or mental health services and lowers the rate of uncompensated, emergency care.[iv] Launched in 2005, the federally funded SSI/SSDI Outreach, Access and Recovery (SOAR) initiative helps states and localities increase eligible homeless persons’ enrollment in SSA disability benefits. Although chronically homeless singles are the primary recipient group for benefits among all homeless persons, SSI and SSDI are also crucial supports for homeless and at-risk families, providing better access to income and health insurance.[v]
One-fifth (20.3%) of all adults exiting shelter received SSA disability benefits in 2009, with 13.8% enrolled in SSI and 6.5% obtaining SSDI (map 1). Delaware had the greatest proportion of homeless persons enrolled in disability benefit programs (53.5%). Northeastern states, along with Arkansas (30.8%) and South Dakota (29.8%), also had high participation rates. States in the South Atlantic and Mountain regions had the lowest percentage of recipients, with Utah (10.7%) having the lowest rate.[vi]
Note: Persons exiting shelter refers to adults leaving the Supportive Housing Program, the Section 8 Moderate Rehabilitation for Single Room Occupancy Dwellings Program, or Shelter Plus Care.
Source: U.S. Department of Housing and Urban Development, 2009 Exhibit 1 Continuum of Care (CoC) Application. Alaska is represented at half the scale of the other states.
Nationally, about 37% of SSI or SSDI applications are initially approved. However, for homeless persons without guidance during the application process, the acceptance rate is roughly 10–15%.[vii] Homeless persons also face a number of barriers to accessing benefits, including disability evaluators unfamiliar with homelessness and a lack of medical record history documentation and transportation to application offices. While homeless families and individuals frequently meet SSA disability criteria, they are often unaware of their eligibility.[viii]
Social service providers receive SOAR training based on the Substance Abuse and Mental Health Services Administration’s Stepping Stones to Recovery curriculum, which provides an in-depth, step-by-step model for identifying eligible homeless persons and offering guidance on SSI and SSDI applications.[ix] When homeless clients receive assistance during the submission process, the approval rate on initial requests averaged 73.0% in 37 SOAR states between 2006 and 2010 (up from 10 –15% without guidance).[x] Currently, SOAR is implemented in 48 states and the District of Columbia (North Dakota and Vermont do not participate).[xi]
[i] U.S. Department of Housing and Urban Development, The 2010 Annual Homeless Assessment Report to Congress, 2011.
[ii] U.S. Interagency Council on Homelessness, Opening Doors: Federal Strategic Plan to Prevent and End Homelessness, 2010.
[iii] Established in 1974 and financed by U.S. Treasury general funds, SSI offers cash assistance to individuals who are 65 years of age or older, blind, or disabled and have minimal income and limited assets. Minors or students under age 22 who are blind or disabled are also eligible. Founded in 1956, the SSDI program covers benefits for disabled workers (and their family members) who were employed, paid Social Security taxes, and can no longer work due to a long-term or fatal medical condition or disability. Persons with co-occurring substance abuse and mental health disorders can receive SSI or SSDI, but persons affected solely by alcoholism or drug addition are not eligible. While states often allocate additional SSI monies, the 2011 federal amounts per month are $674 for an individual and $1,011 for a couple. Recipients’ monthly SSDI benefits vary by their prior payroll contributions and are funded by the federal Disability Insurance Trust Fund. SSI benefit recipients in most states are categorically eligible for Medicaid and SSDI recipients automatically get Medicare coverage after a two-year enrollment period. Thirty-two states and the District of Columbia have a dual SSI and Medicaid application, with benefit eligibility determined simultaneously. Other select states have the same eligibility criteria for Medicaid that SSA uses for SSI, but two separate applications; U.S. Social Security Administration, “Benefits for People with Disabilities,” http://www.ssa.gov/disability; U.S. Social Security Administration, “SSI Federal Payment Amounts for 2011,” http://www.ssa.gov/oact/cola/SSI.html; U.S. Interagency Council on Homelessness, “Supplemental Security Income,” http://www.usich.gov; U.S. Interagency Council on Homelessness, “Social Security Disability Insurance,” http://www.usich.gov; U.S. Department of Health and Human Services, Stepping Stones to Recovery: A Case Manager’s Manual for Assisting Adults Who are Homeless, with Social Security Disability and Supplemental Security Income Applications, 2005; U.S. Social Security Administration, “Medicaid Information,” http://www.ssa.gov/disabilityresearch/wi/medicaid.htm; National Health Care for the Homeless Council, Poverty, Employment & Homelessness, 2011 Policy Statement.
[iv] National Health Care for the Homeless Council, Poverty, Employment & Homelessness, 2011.
[v] Mathematica Policy Research, Findings From a Study of the SSI/SSDI Outreach, Access and Recovery (SOAR) Initiative, September 2009; U.S. Department of Housing and Urban Development, The 2010 Annual Homeless Assessment Report to Congress, 2011.
[vi] Persons exiting shelter refers to adults leaving the Supportive Housing Program, the Section 8 Moderate Rehabilitation for Single Room Occupancy Dwellings Program, or Shelter Plus Care; U.S. Department of Housing and Urban Development, 2009 Exhibit 1 Continuum of Care (CoC) Application.
[vii] SAMHSA SOAR Technical Assistance Center, SSI/SSDI Outreach, Access and Recovery: An Overview, October 2011.
[viii] National Health Care for the Homeless Council, Disability, Employment & Homelessness, 2011.
[ix] U.S. Department of Health and Human Services, Stepping Stones to Recovery, 2005.
[x] Policy Research Associates, 2010 National SOAR Outcomes.
[xi] Policy Research Associates, “Where is SOAR?,” http://www.prainc.com/SOAR/about/where_is_soar.asp.