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Using SOAR with Transition Age YouthPRESENTED 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!KRISTIN LUPFER, LMSW, PROJECT DIRECTORSAMHSA’S SOAR TECHNICAL ASSISTANCE CENTER

Webinar InstructionsMutingRecording availabilityDownloading documentsEvaluationQuestion instructions

Agenda Transition Age Youth: An Overview

Abigail Lemon, MA, Project Associate, Policy Research Associates

SOAR Provider Presentations Kris Kuntz, MA, Program and Research Analyst & SOAR Local Lead, St. Vincent DePaul Village, San

Diego, CA

Raven Smith, Homeless Youth Program Director & SOAR Local Lead, Posada, Pueblo, CO

Laura Kolb, J.D., Staff Attorney, Homeless Advocacy Project (HAP), Philadelphia, PA

Questions & Answers, SOAR Technical Assistance Center

Poll Question #1 Does your agency currently have a protocol or any distinguishable procedure for providing SOAR services to individuals who are categorized as Transition Age Youth (16-24 years old)? A. Yes B. No C. No, but would like to start D. Unsure

Ending Youth Homelessness:Using SOAR to Increase Access to Disability Benefits for Transition Age YouthABIGAIL LEMON, MA, PROJECT ASSOCIATE

SAMHSA SOAR TECHNICAL ASSISTANCE CENTER

POLICY RESEARCH ASSOCIATES, INC.

Transition Age YouthDefined as age 16 – 25Homeless or at risk of homelessness, transitioning out of foster careUnique service challengesCommon factors that contribute to youth homelessness:

Mental Illness Substance use Trauma Lack of education Unemployment Unstable home life Transitions out of foster care or juvenile detention without family or community

supports

Statistics January 2014 Point – In – Time count estimated, 45,205 unaccompanied children and youth experiencing homelessness nationwide; 86%, between 18 and 24 14% under age 18 55% male, 40% female, 5% identified as transgender 33 – 40% identify as LGBTQ Over 25%, history of foster care, group home or juvenile detention

residency

One of the most difficult populations to depict accurately in terms of homelessness statistics and often times underestimated

SOAR & Transition Age Youth

Engagement The ‘look’ of youth experiencing homelessness Trauma Informed Care Cultural Competency Documenting youth disability RecordsFunctional ability

SSA Programs Social Security Disability Benefits for Youth SSI for disabled children SSI for children who transition to adults Benefits for Disabled Adult Children

Age 18 Redetermination ‘Aging Out’ Youth Employment Incentives for Youth

Contact Information Abigail Lemon

SOAR Technical Assistance Center Policy Research Associates, Inc.

345 Delaware Ave Delmar, NY 12054

Phone: (518) 439-7415, EXT: 5226

Email: alemon@prainc.com

Documentation Strategies for Commonly Found ImpairmentsKRIS KUNTZ, MA, ST. VINCENT DEPAUL VILLAGE, SAN DIEGO, CA

SOAR Transition Age Youth Webinar

Documentation for young adults• SSA Blue Book• Medical sources• Working with doctors• Non medical sources• School programs• Work History

Issue Brief

Medical Sources• Must have a medically determinable illness: this can

be from when they were a child or an adult• Must be documented by an MD or PhD• Will accept evidence from other medical sources

such as nurses, physician’s assistants, licensed social workers, OT and PT, etc…

• Clinics, hospitals, schools, jail/juvenile justice, etc…

Medical Sources• Must have a medically determinable illness: this can

be from when they were a child or an adult• Must be documented by an MD or PhD• Will accept evidence from other medical sources

such as nurses, physician’s assistants, licensed social workers, OT and PT, etc…

• Clinics, hospitals, schools, jail/juvenile justice, etc…

Working with doctors• Example from a note from our doctor in our clinic for a 24

year old individual in one of our frequent user programs:

“however, given pt's [patient] severe depression and history of prior abuse, it is EXTREMELY difficult to get pt into see physicians. Pt is very reluctant to come in to be seen in our clinic, and it usually requires his case manager going to his apartment several times prior to the appointment in order to get patient into clinic for a routine medical appointment, so getting him into a specialty appointment will likely take considerable effort and time.

Non Medical Sources

Family

Friends Neighbors

TeachersAfter school programs such as sports, Boys and Girls Clubs, etc…

Church

School Programs• Special education• Individualized Education Program (IEP’s) including

the IEP transition plan• College or post secondary programs

Common Medical Conditions and Related Listings

Listing 12.03 Schizophrenic, paranoid and other psychotic disorders- How to Meet?• A and B are satisfied, or when the requirements in C are

satisfied.• A criteria: Medical documented persistence, either

continuous or intermittent, of one or more of the following:• 1. Delusions or hallucinations; or• 2. Catatonic or other grossly disorganized behavior; or • 3. Incoherence, loosening of associations, illogical thinking, or

poverty of content of speech if associated with one of the following: a. Blunt affect or, B. Flat affect, or C. Inappropriate affect.

OR• 4. Emotional withdrawal and or isolation

12.03 Schizophrenic, paranoid and other psychotic disorders• AND• B. Criteria. Resulting in at least two of the following:

• 1. Marked restriction of activities of daily living; or• 2. Marked difficulties in maintaining social functioning; or• 3. Marked difficulties in maintaining concentration,

persistence, or pace; or• 4. Repeated episodes of decompensation, each of extended

duration;OR

12.03 Schizophrenic, paranoid and other psychotic disorders

• C Criteria. Medically documented history of a chronic schizophrenic, paranoid, or other psychotic disorder of at least 2 years duration that has caused more than a minimal limitation of ability to do basic work activities, with symptoms or signs currently attenuated by medication or psychosocial support, and one of the following:

• 1. Repeated episodes of decompensation, each of extended duration;

• 2. A residual disease process that has resulted in such marginal adjustment that even minimal increase in mental demands or change or change in the environment would be predicted to cause the individual to decompensate; or

• 3. Current history of one or more years inability to function outside a highly supportive living arrangement, with an indication for a continued need for such arrangement

Work HistoryHow much support did they need? Did they need extra instruction? Were they in a very structured and supportive environment?

Be very specific: What were their duties? Did they supervise others? How did they interact with co-workers or their supervisor? What happened?

Contact Information Kris Kuntz

St. Vincent de Paul Village 1501 Imperial Avenue San Diego, CA 92101

Phone: 619.233.8500 ext. 1033Email: kris.kuntz@neighbor.org

Engagement Strategies Raven Smith, Homeless Youth Program Director & SOAR Local Lead, Posada

Pueblo, CO

POSADA“bringing Pueblo Home”

Obstacles to Successful Navigation

• Hunger/Dehydration• Lack of transportation• Embarrassment around hygiene• Lack of focus and ability to keep track of time

and appointments• Anxiety around filling out forms• Anxiety around examiners• Anxiety around being labeled and then losing

their freedom• Fear of previous treatment facilities• Worry about being stigmatized by peers

Engagement StrategiesEngagement StrategiesCreate TRUST through: Low barrier resource access

◦ Food! Hygiene! Bus passes!

Safe environment with restricted age limit◦ No competition (restrict predatory opportunities) with

older homeless population

Agency resource mapping – personal referrals◦ ID help, SSA, SNAP, Shelters, Food pantries, Legal services

Mentoring – Physically walking them through processes◦ Forms for acquiring ID’s (even trips to DMV)◦ SSA and/or Prescriber appointments

Trauma Sensitivity: Patience and Forbearance!Trauma Sensitivity: Patience and Forbearance!

Agency Resource SheetAgency Resource SheetTYPE AGENCY ADDRESS PHONE # SERVICE PROVIDED YOU WILL NEED HOURSCHILDREN Bright Beginnings/Chatholic Charities 429 West 10th Street, Suite 101544-4233 Formula, dialers,etc… ID, Social Security card Call firstCHILDREN Caring Pregnacy Center 500 Colorado Avenue 544-9312 Clothing, diapers, formula ID, Social Security card M-F 9 to 5DISABILITY Hope for Children 801 West 4th Street 545-6821 Family Assistance ID, Social Security card Call firstDISABILITY Center for Disabilities 1304 Berkley 546-1271 Assist Disabled Individuals ID, Social Security card Call firstDISABILITY Colorado Blue Sky 115 West 2nd Street 546-0572 Developmentally Disabled ID, Social Security card M-Th 8-5DISABILITY Colorado Blue Sky Housing 2003 Northmoore Terrance 542-6701 Disabled Housing Agency ReferralDIASTER American Red Cross 4104 Outlook Blvd 561-2614 Disaster Assistance 24/7 Phone AccessDIASTER Salvation Army 520 West 13th Street 543-3656 Emergency Furniture M-W 10 to 3DIASTER ARC OF PUEBLO 1115 South Praire Avenue 564-9419 After Disaster clothing Call firstEMPLOYMENT Pueblo Work Force 212 West 3rd Street 562-3745 Employment M-FEMPLOYMENT Vocational Rehabilitation 720 North Main, Ste 320 544-1406 Retraining, Education, etc… ID, Social Security card M-FFOOD Soup Kitchen 7th Street and Greenwood Street545-6540 Breakfast 9:00 Lunch 11:15 M-SatFOOD Salvation Army 520 West 13h 543-3656 Dinner and food boxes ID, Proof of income, Address DailyGENERAL Cooperative Care Center 326 West 8th Street 543-7484 Food and clothing ID, Social Security card M-F 9 to 12GENERAL Luv in Action 1044 East Abriendo 542-0549 clothing and furniture ID, Social Security card Call firstGENERAL Salvation Army 520 West 13th Street 543-3656 Clothing ID, Social Security card M-W 10 to 3GOVT Department of Social Services 805 Desert Flower Blvd 253-7800 TANF, Food stamps, Adult, Etc ID, Birth Certificates, SS Card M-F 8-5GOVT Department of Revenue 827 West 4th Street 543-5164 Drivers License/Colorado ID Birth Certificate, SS card M-F 8to 5GOVT Pueblo City/County Health Department 101 West 9th Street 583-4300 WIC, PIPS,Medical, etc… ID, Social Security card M-F 8 to 5GOVT Social Security Administration 3769 Parker Blvd 1-888-737-1761HIV/AIDS Southern Colorado AIDS Project PO Box 11451 (01) 924-8925 HIV/AIDS Outreach & Education Call firstHOMELESS POSADA 225 Colorado Ave 545-8776 Homeless Services M-F 8 to 4HOUSING Pueblo Housing Authority 1414 North Santa Fe 544-6230 Housing ID, SS Card, Birth Certificates T-W 8 to 11:30LEGAL Colorado Legal Services 1000 West 6th Street 545-6708 Free Legal Services Call for InformationMEDICAL Pueblo Community Health Center Grand 1008 North Grand Avenue 584-3964 Medical Care Must be homeless M-T & Th-F 8:30 -11:30MEDICAL Pueblo Community Health Center 300 colorado Avenue 543-8711 Primary Health Care Sign up in advance Call firstMENTAL Spanish Peaks Mental Health Center 1304 Chinook Lane 545-2746 Mental Health Care Colorado ID Call for Appointment

Contact Information Raven Smith

Posada 225 Colorado Ave. Pueblo, CO 81004

PHONE: (719) 545-8776 ext. 15Email: raven.smith@posadapueblo.org

Poll Question #2 Which actions by the SOAR provider promote trust when working with transition age youth?

A.Offer tangible items, such as; food, bus passes, hygiene products, cell phones.

B.Provide a safe environment which separates youth from older individuals.

C.Make personal referrals and accompany youth the appointments.

D.Know your community resources!

E.All of the above.

Referral Model for Transition Age YouthLAURA KOLB, J.D., STAFF ATTORNEYHOMELESS ADVOCACY PROJECT (HAP), PHILADELPHIA, PA

Homeless Advoc..What, what?

Legal Aid AgencyCivil MattersVolunteer-BasedOutreach Model

And then there was SOAR…

HAP SOAR Projects

DHS SOAR Project Targeted the following transition age youth situations:

Philly youth adjudicated delinquent Returning from out-of-home placements3-6 months prior to discharge

DHS SOAR Project

Medical determination can be made prior to youth discharge from care.

Collaboration

PhiladelphiaDepartment of Human Services(DHS)

TRAININGS

Flyers

Meetings

Getting the Word Out

DHS has older youth with disabilities

HAP has SOAR!

Post

Cards anything else

we could think of

emails

Phone

Calls

A Simple Plan

Identification/Referral of SOAR-Appropriate Youth

Referral-Based Model

SOAR INTAKE

GATHER EVIDENCE

FILE SSI APPLICATIONLOS

WIN!

What really happened...

First Contract Term (12/2009 – 6/2010): 4 DHS SOAR referrals made 4 SSI applications filed 30 days average processing time

O

n the ro

ad again

SOAR Project Expansion

Included Dependent YouthIncreased CapacityPublicized ProgramGroundwork PayoffIncreased Referral Sources

RESULTS!!

Referral Sources

Disability benefits don’t have to mean a dead end street, but rather a means to survival for youth with disabilities experiencing homelessness.

Closing Thoughts

There is no wrong door!

Contact Information

Laura KolbStaff Attorney

Homeless Advocacy Project (HAP)1429 Walnut St., 15th Floor

Philadelphia, PA 19102Phone: (215)-523-9597

Email: lkolb@haplegal.org

Questions and Answers

Facilitated By: SAMHSA SOAR Technical Assistance Center

Policy Research Associates, Inc.

Please type your question into the Q&A panel located underneath the participant tab.

For More Information on SOAR

Visit our website: http://soarworks.prainc.com SAMHSA SOAR TA Center

345 Delaware AvenueDelmar, New York 12054

(518) 439 – 7415

soar@prainc.com

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@SOARWorks