We have mentioned the SOAR program in prior columns, but it’s worth explaining more why it is critical to our local homelessness response in Nashville and providing a quick overview of the Park Center’s SOAR program, which is getting a $900,000 infusion through a recent additional contract with Metro.
Park Center is a local nonprofit serving people with mental illness and substance use disorders, and SOAR stands for SSI/SSDI Outreach, Access and Recovery and is a program promoted by the federal Substance Abuse and Mental Health Services Administration (SAMHSA).
The Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) provide income benefits to people who suffer from disabling conditions that impact their ability to work. However, these federal programs are not easily accessible to people experiencing homelessness. That’s why SAMHSA created the SOAR program, which offers an active engagement effort to link eligible people with SSI/SSDI and couple those with Medicaid benefits if possible. SOAR offers a critical service and income connection that often is the first step toward the path of recovery for many people experiencing chronic homelessness.
SAMHSA initiated the SOAR program in 2005, and according to its issue brief released in October 2022, so far more than 100,000 people nationwide who were experiencing or at risk of homelessness have been assisted. SOAR programs focus on prioritizing people with mental health and/or substance use issues, but over the years, some programs have expanded to focus on people experiencing chronic homelessness who do not have a mental health diagnosis.
I remember when the SOAR program started in Nashville in 2006. A young chap called Will Connelly, who worked as a street outreach specialist for Park Center, was serving on a committee of the former Metropolitan Homelessness Commission. He got together with some of his committee members, especially Tom Turner, CEO of the Downtown Nashville Partnership, and presented a program called SOAR that he said should be funded by Metro. Long story short, Metro created a contract with Park Center worth $173,000 to implement a SOAR program.
Eventually the SOAR program expanded into the Sheriff’s Office to serve people in jail to help break the cycle of homelessness. Other nonprofits ran and some are still running smaller SOAR programs. I mention Will Connelly (who had his hands full as my former boss at Metro a few years ago) because he’s been a local and eventually a national champion for SOAR for years. Connelly, who, after some professional detours, now serves as the CEO of Park Center, has for years ensured the Metro and Nashville focus on programs to serve people experiencing chronic homelessness. He shared with me some information about the Park Center SOAR program with permission for publication.
As of July 1, 2023, the Park Center SOAR team will include eight SOAR staff plus a Director of Homeless Outreach. Currently, the Park Center SOAR budget breaks down as follows:
- $173,000 per year through a Metro contract that started in 2006;
- $300,000 in federal American Rescue Plan (ARP) funding that Metro allocated in 2021 for a total of three years;
- Approximately $173,000 from the Tennessee Department of Mental Health and Substance Abuse Services;
- $27,500 dedicated to SOAR as part of a SAMHSA grant; and
- $900,000 in a round two ARP allocation from Metro that was awarded in June 2023.
Plans for the newest round of ARP funds include connecting with people experiencing homelessness who are uninsured and likely eligible for SSI/SSDI. People will be identified through several ways starting with the community’s Coordinated Entry process, which means that most of them, at present, would likely be served from encampments that Metro is planning to shut down. Considering how openly I have criticized Metro for its half-baked encampment closure plan (see prior columns), by finally allocating the ARP support services dollars six months after promising they would be in place, Metro has now a chance to catch up with the Housing First evidence based practices. The SOAR program will definitely play a crucial role in helping move people off the streets permanently.
Park Center will also partner with The Contributor. For those who are not aware, The Contributor Inc. has built a supportive housing program to serve the many vendors who start out experiencing chronic homelessness. As part of its comprehensive supportive housing program, The Contributor has also hired one SOAR program staff to help fill the gap for people experiencing chronic homelessness. Park Center will collaborate to ensure more vendors eligible for SOAR can be served.
Furthermore, Park Center will connect with people experiencing homelessness in inpatient psychiatric settings and in emergency rooms. Connelly said that Park Center will also try to use a housing-focused street outreach-based approach to identify and engage potential program participants in a proactive way.
What do SOAR workers actually do? According to SOAR Works, a website with state-specific information (see soarworks.samhsa.gov/states/Tennessee), once people are screened for eligibility, SOAR workers:
- Serve as appointed representatives to apply for SSI/SSDI on behalf of their clients. As such, they communicate back and forth with respond to questions, receive copies of all mail sent to the applicant and communicate directly with the Social Security Administration (SSA) or Disability Determination Services (DDS);
- Complete the applications for SSI and SSDI;
- Collect medical records from providers who have treated the applicant over the last two years;
- Write a comprehensive SOAR Medical Summary Report that includes psychosocial, treatment and functional information that is co-signed, if at all possible, by a physician or psychologist who has seen the individual;
- Conduct ongoing outreach and engagement with the individual to stay connected throughout the process and to work with the individual to obtain other needed services and treatment such as housing, physical and mental health care, other support services, food and clothing.
- Track applications and outcomes, including number of applications completed, approvals/denials, and time to decision from application submission to receipt of SSA’s decision; and
- Report outcomes on at least an annual basis within the stated time frames as requested.
On average, a SOAR case worker will be able to assist 15-20 people per year. It does not seem much, but it makes a difference, especially considering that SOAR serves as a stepping stone to housing and healthcare, and as such often ends up being a life-saving measure for people with severe and persistent mental illness.
The success of the SOAR program depends on the relationship a nonprofit has established with the local SSA offices. In addition, the SOAR program differs from working with an attorney in a few critical ways. For one, the Park Center SOAR program, especially, has shown a higher approval rate at first attempt, avoiding most appeal processes. Secondly, at a current average of 59 days to a decision it is significantly faster than the average time of two years it takes for attorneys to get approval.
SAMHSA in their 2022 issue brief presented another comparison. “In 2022 alone, there were 2,920 approvals on initial applications. Decisions on SOAR initial applications were received in an average of 153 days with an allowance rate of 68 percent. This compares to an initial allowance rate of 30 percent for all persons aged 18-64 who applied for SSI or SSDI in 2019.” By the way, Park Center’s SOAR approval rate is 95% with an average approval time of 59 days.
Finally, Park Center is in the early planning and implementation stages of SOAR efforts in local ERs. This is a big step for Nashville, since we know that many people experiencing chronic homelessness cycle in and out of hospitals and emergency departments. Breaking their cycle of homelessness could not only be a life saver but also a super cost saver, so to speak.
I mentioned the monetary aspect on purpose because we know that Park Center’s SOAR Program alone has been generating millions of dollars in cash benefits, Medicaid, and Medicare dollars over the years. Connelly shared the following hypothetical with me to illustrate this. “If one hundred people are approved for SSI with the help of SOAR assistance, and those one hundred folks stay eligible for just one year and receive the current SSI amount of $914 per month, then that effort yields $1,096,800 in federal cash benefits to these new SSI beneficiaries over the course of a single year.” This scenario does not even include the value of Medicaid or Medicare that comes with SSI/SSDI approval – and this in Tennessee, a state that has yet to expand Medicaid.
What do we conclude? SOAR programs are necessary tool for communities to consider when trying to break the cycle of homelessness, especially for people experiencing chronic homelessness with severe and persistent mental illness and/or co-occurring disorders (which means they also struggle with substance use).