Best practices for increasing access to SSI and SSDI on exit from criminal justice settings.

Transitioning from jail or prison to community living frequently results in homelessness and recidivism. Access to benefits such as Supplemental Security Income (SSI) and Medicaid can increase access to housing and treatment and reduce recidivism. The authors review best practices for prerelease access to these benefits by using examples from five jails and four state prison systems. In these settings, approval rates for SSI applications averaged 70% or higher, with evidence of improved access to housing and reductions in recidivism. Success depends on the commitment of resources and leadership, ongoing communication, and monitoring of results.

Helping adults who are homeless gain disability benefits: the SSI/SSDI Outreach, Access, and Recovery (SOAR) program.

OBJECTIVE: Approval rates for first-time applications for Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) among adults who are homeless can be as low as 10%. This study examined approval rates among applicants who were assisted by SSI/SSDI Outreach, Access, and Recovery (SOAR), a federal initiative to increase access to disability benefits among people who are homeless or at risk of homelessness and who have mental illness or other co-occurring disorders. METHODS: Data were collected in 37 states that had participated in SOAR for at least one year. RESULTS: Of 8,978 applications assisted by SOAR, 6,558 (73%) were approved. The average number of days between application and decision was 91. SOAR was associated with increased access to housing and cost savings through increased Medicaid reimbursement. CONCLUSIONS: SOAR substantially increased access to SSI and SSDI entitlements for people with disabilities who experience or are at risk for homelessness.

Successful program maintenance when federal demonstration dollars stop: the ACCESS program for homeless mentally ill persons.

A major issue that has long dogged federal human services demonstration programs is the perception that when federal dollars end, the programs end-regardless of any proven successes. Access to Community Care and Effective Services and Supports (ACCESS) was a 5-year federal demonstration project to foster partnerships between service providers for homeless people with serious mental illness and co-occurring substance abuse disorders; and to identify effective, replicable systems integration strategies. After federal funding ended, research teams visited the ACCESS sites to determine which project elements remained and which strategies were used by the sites to continue ACCESS. This article describes ACCESS services and systems integration activities retained by the sites, new funding streams, and strategies used to obtain continued funding.

Integration of service systems for homeless persons with serious mental illness through the ACCESS program. Access to Community Care and Effective Services and Supports.

OBJECTIVE: The aim of this study was to evaluate the first of the two core questions around which the ACCESS (Access to Community Care and Effective Services and Supports) evaluation was designed: Does implementation of system-change strategies lead to better integration of service systems? METHODS: The study was part of the five-year federal ACCESS service demonstration program, which sought to enhance integration of service delivery systems for homeless persons with serious mental illness. Data were gathered from nine randomly selected experimental sites and nine comparison sites in 15 of the nation's largest cities on the degree to which each site implemented a set of systems integration strategies and the degree of systems integration that ensued among community agencies across five service sectors: mental health, substance abuse, primary care, housing, and social welfare and entitlement services. Integration was measured across all interorganizational relationships in the local service networks (overall systems integration) and across relationships involving only the primary ACCESS grantee organization (project-centered integration). RESULTS: Contrary to expectations, the nine experimental sites did not demonstrate significantly greater overall systems integration than the nine comparison sites. However, the experimental sites demonstrated better project-centered integration than the comparison sites. Moreover, more extensive implementation of strategies for system change was associated with higher levels of overall systems integration as well as project-centered integration at both the experimental sites and the comparison sites. CONCLUSIONS: The ACCESS demonstration was successful in terms of project-centered integration but not overall system integration.