- [Pam] Hello everyone and welcome to the first
webinar in our fiscal year of 2019 webinar series,
titled SOAR: A reentry tool for individuals involved
in the criminal justice system.
The SOAR TA center is pleased to bring you today's webinar
in partnership with the SAMHSA GAINS Center.
My name is Pam Heine, senior project associate
with the SOAR TA Center and I will be your moderator today.
Before we begin, just a few housekeeping items to review.
A disclaimer.
This training is supported by the Substance Abuse
and Mental Health Services Administration
and the US Department of Human Services.
The contents of this presentation do not necessarily
reflect the views or policies of SAMHSA or DHHS.
The training should not be considered substitute
for individualized care in treatment decisions.
Just a few webinar instructions.
As a reminder, your lines will be muted
throughout the entire webinar.
This webinar is being recorded and will be available
for download on the SOAR website in about a week or so.
You may download the presentation slides or other materials
now by going to the top left of your screen
and clicking file, save, document, or visit the SOAR
website at SOARworks.prainc.com, click webinars,
on the left side bar and choose today's topic.
At the conclusion of the webinar, you will immediately be
redirected to a brief evaluation, which we kindly
ask you to complete and finally, we will save all questions
and comments until the end of the presentation,
at which time we will review instructions for posing
questions to panelists via the Q and A function.
A few learning objectives.
It is our intention that by the end of this webinar,
you will learn about key strategies and the best practices
for introducing SOAR and engaging
your criminal justice community.
Today's agenda, so to reach those objectives, we will begin
this afternoon with presentations from Dazara Ware,
who is a senior project associate with the SOAR TA Center
and Dan Abreu who is a senior project associate
with the GAINS Center, both here
at Policy Research Associates.
They have collaborated extensively over the years
with establishing SOAR initiatives within the criminal
justice systems around the country.
You'll then hear from Paul Mulloy, who is the Director
of Programs with the Nashville Sheriff's Office
in Nashville, Tennessee and Lolita Johnson, a LEAD SOAR
Counselor with the Davidson Country Sheriff's Office
in Nashville, Tennessee.
They will share how they have implemented
SOAR within their jail system.
Next up, providing a SOAR Prison Implementation perspective
for the state of Oklahoma are Donna Bond, who is the
Coordinator of Mental Health Reentry with the Oklahoma
Department of Corrections in Oklahoma City,
and Marcus Ayers, the Manager of Prison Based Reentry
Services, also in Oklahoma City, with the Oklahoma
Department of Mental Health Services.
And finally, we'll have plenty of time for Q and A,
which are facilitated by the SAMHSA SOAR TA Center staff.
So providing today's welcome, we have Robert Grace
who was our project officer at SAMHSA.
Bobby, please provide your welcome.
- [Robert] Yes, hi, thanks.
I'd like to start by, again, thanking all of you
for joining us today.
I'm Bobby Grace and on behalf of the Substance Abuse
and Mental Health Services Administration, SAMHSA,
and the Homeless Programs Branch of the Center for Mental
Health Services, I would like to welcome you to this
joint webinar with SAMHSA SOAR TA Center
and SAMHSA GAINS Center for behavior health
and justice transformation.
This webinar is titled SOAR: A reentry tool for individuals
involved in the criminal justice system.
SOAR, which stands for SSI/SSDI Outreach Access and Recovery
helps states and communities increase access to social
security disability benefits for eligible adults
who are experiencing or at risk of homelessness
and have a serious mental illness, medical impairment,
and or a co-occurring substance use disorder.
Today's webinar will feature speakers who will share
their best practices for implementing SOAR in a county jail,
state correctional system, and explore
how SOAR implementation in criminal justice settings
can be a strong reentry tool to increasing
housing stability and promote post-release success.
And now, I would like to turn things back over to Pam Heine
who will be moderating today's webinar, Pam.
- [Pam] Thank you, Bobby.
So now I will turn it over to Dazara Ware,
who will kick things off.
Dazara, please begin your presentation.
- [Dazara] Awesome, thank you Pam for that introduction
and thanks to the guests attending today and taking the time
to participate in this webinar.
We are super excited to have you here.
As mentioned, this webinar is entitled SOAR: a tool
for reentry for individuals involved
in the criminal justice system.
It's intended to explore the intersection of criminal
justice and behavioral health and how the SOAR model
can be used in effort to address the challenges
associated with reentry and recovery for individuals
involved in the criminal justice system with serious
mental illness, physical disabilities, and or co-occurring
substance abuse disorders.
Our presenters will share their work and their experience
with SOAR implementation in both jail and prison settings,
but first, let's cover some basics.
So what is SOAR?
So for those guests that have experience with assisting
others with disability applications, please bear with me
as I quickly review some of the key points
for others that may not be as familiar.
To start, SOAR stands for, as Bobby, Robert Grace mentioned,
SOAR stands for SSI/SSDI Outreach, Access, and Recovery
and it's a model that's sponsored by SAMHSA
in collaboration with the Social Security Administration.
It's developed to assist eligible individuals
applying for the two disability programs that are
administered by the Social Security Administration.
SSI, which is supplemental security income,
and SSDI, which is social security disability insurance.
This model is specifically designed to help states
increase this access to these benefit programs
for eligible adults who are experiencing or at risk
of homelessness and have a serious mental illness
or other disabling condition.
Yes, it's in all 50 states and Washington D.C.
However, it's important to note that although SOAR's
presence is marked nationwide, there are many communities
within each state that may not have SOAR providers,
well just yet.
The SOAR TA Center is working really hard to expand
SOAR to the point where every community everywhere
will gain access to SOAR providers in the future.
So I mentioned the two disability programs, SSI and SSDI,
so let's take a closer look.
So each program has the same criteria for determining
disability based on medical evidence
and functional abilities.
Both programs utilize the same application process
and although they have different application forms,
they share one disability determination.
Each program has an associated health insurance program.
The one on the left is the supplemental
security income, or SSI.
This is a needs based program for individuals who are
blind, disabled, or elderly with low income or resources.
The federal benefit rate for this program is $750,
which is a way of saying that's the maximum amount awarded
with federal dollars that's approved.
And this program is accompanied by Medicaid in most states
and again, this is a needs based program so resources
are really heavily investigated and looked at.
In short, if the applicant has resources and there is no
need, they won't be eligible for that program.
But on the other hand, or should I say on the right side
of the slide, is the social security disability insurance,
or SSDI, also for blind or disabled individuals.
But these individuals are insured through their
contributions to the social security trust fund.
So based on their work, the amount of money they contributed
into that trust fund while working will yield the award
amount if that person became disabled and in most states,
Medicare is associated and generally provided
under this program.
Again, these are both disability programs that require
an applicant to meet SSA's definition of disability,
defined as the inability to engage in substantial gainful
activity or work with a monetary amount that looks like
earnings of $1180 a month, as of 2018, that have a medically
determinable physical or mental impairment that is lasted
or is expected to last a continuous period of 12 months
or more or result in death.
In addition to that definition, I think it's really
important to point out that there's a myth that's often
heard with people that work with individuals in criminal
justice settings that have been circulating around the
country for years and years and that is that if a person
is incarcerated, they're automatically eligible
for disability and that's simply not true.
Incarceration is viewed as a living situation
and not a disabling condition.
However, people that are incarcerated with serious mental
illness experience functional limitations that kind of
prohibit them from working at that level long before
they become incarcerated and in fact, for many individuals,
interaction with police can be linked to the symptoms
associated with their diagnosis that is tied to the behavior
that ultimately led to arrest and further involvement
in criminal justice system in the first place.
So that's why we're doing this work.
But what happens to benefits when people,
or someone, becomes incarcerated,
well, that depends on a couple of things, time,
how long they've been incarcerated and also it depends
on what benefit program they were awarded.
So if someone was receiving supplemental security income
for individuals that received this benefit,
there's no affect on their benefit if they were incarcerated
for less than a calendar month.
However, benefits are suspended if the person is
incarcerated for one to 12 calender months and terminated
when they're incarcerated for 12 months or more.
Be mindful that these are calender months,
which is different than 30 days.
For example, if someone became incarcerated today,
October 24th, and released on November 27th,
that person has been incarcerated for more than 30 days,
but not the full calender month of October or November
and there should be no effect on their benefit check.
When benefits are terminated however,
they must reapply with a new application.
When receiving social security disability insurance,
those recipients are eligible to continue receiving
their benefits until they are convicted and confined
for more than 30 continuous days.
Once released, the individual can have benefits reinstated
at the Social Security Office.
They must, you know, arrive at the office with discharge
papers to show legitimate release.
So as we continue to speak about the SOAR model,
it's really important to have those basic rules in mind
and will help you plan the course of action for discharge
planners and reentry specialists and others that prepare
for an individual to be released.
So now that we've covered some of the basics,
it's with a very, very, very broad stroke,
we will review what make SOAR so unique.
We have our Super SOAR there and says that SOAR trained
caseworkers are the heroes.
And that is definitely the case and each of these components
is expanded upon during our online course
and through training.
But in general, the SOAR model
encourages a collaborative process and facilitates
communication among the applicants, the case managers,
social security, disability determination services,
community providers.
It provides case managers with the tools they need
to assume a really central role in gathering complete,
targeted, and relevant information
for Social Security and DDS.
SOAR operates on the use of some critical components,
which is depicted in this slide, one of which include
acting as authorized representative which is really key
to allowing for two-way communication between the Social
Security office, disability determinations,
and the SOAR case manager.
Collecting medical records,
writing a medical summary report, encouraging collaboration
with treatment sources to have that MSR signed,
completing a quality review to ensure that the information
submitted is complete and concise and stands up
to the fidelity of the SOAR model.
All of these things help the disability determination
process move more smoothly and quickly by providing
the assistance to Social Security and DDS that's needed.
Another unique feature is that SOAR seeks approval
on the initial applications, avoiding the need for appeals.
And we tend to go above and beyond by working to increase
access to supportive services and employment opportunities.
There's tons of support available for SOAR providers.
State and local leads kind of spearhead and coordinate
the implementation of the SOAR initiative and these local
leaders identify and engage stakeholders to participate
in starting committees that kind of meet regularly
to collaborate, report on progress, troubleshoot
any challenges, and basically provide that continued support
to SOAR case managers with supplemental trainings
and online core support.
SOAR case managers are the kind of,
they're the crown jewel of the structure
and work hard to provide quality applications in order
to yield the best results for not only the individual
but to demonstrate their work in their efforts.
All these are key players and very valuable partners
in the SOAR initiative, all united to end homelessness
and increase post-release success for individuals
with disabling conditions.
And there's more support.
The SAMHSA SOAR TA Center will be with you
every step of the way.
Our website holds our contact information for each
of our liaisons that are assigned to each state.
We encourage strongly contact and communication with us.
Through our website you will gain access to all the tools
and resources that you need to support you,
including those supplemental training tools
and the online course access.
Through continued support and collaboration with state
and local leads, SOAR providers across the country
continue to, well, they continue to soar.
These are our national outcomes for 2018.
Cumulatively, 50 states and Washington DC have reported
using the SOAR model to assist over 71,705 people
who are experiencing or at risk of homelessness
with disability applications.
Again, this is the annual report for last fiscal year,
covering the date range of July 1st, 2017,
to June 30th, of 2018.
There is a 65% approval rate on initial applications
at 100 days to decision with approximately 4,300 approvals.
That's a lot of lives that are changed.
These outcomes can be compared to the national average
of 29% for all people applying without assistance.
Specific to our criminal justice outcomes,
this report was generated as of August 1st, 2018.
It demonstrates or depicts SOAR assisted applications
that have been completed for people that are living
in correctional facilities.
So as you can see, it's a 76% approval rate
and average range of 79 days.
And although these outcomes are strong, our goal is to see
more people that are currently involved in criminal justice
systems have access to SOAR services.
Because we are confident that the access to these benefits
will really help promote post-release success.
The possibilities kind of speak loudly and clearly.
So SSI and SSDI, I've said it about four times already,
promotes post-release success.
The income attached to this benefit program really reduces
state cost in a way that we might not consider.
The insurance that is available creates healthier
individuals that are more likely to participate
in treatment and thereby creating healthier communities.
But I want to emphasize the income portion, because of it's
connection with housing, making it a strong factor
in post-release success and promoting
the participation and treatment.
It's really hard to think about treatment when you're
basic needs are not met due to having no income
and no idea where you're gonna lay your head at night.
The use of SOAR to secure funding to, that can promote
funding, housing opportunities and housing stability,
that's so desperately needed upon post release,
increases the treatment participation and decreases
the utilization of hospitals and emergency rooms for care.
Collaboration is the cornerstone for SOAR success.
Partnering with medical records providers, community
mental health providers, sheltering agencies,
housing partners, hospitals, court systems,
probation, parole, on and on.
Why?
Because partnerships and collaborations are critical
to any reentry program success.
We share the same clientele and often provide the same
services to the exact same person.
Avoiding the missed opportunities to share our information
could save valuable time and resources and promote
a true recovery model for a person,
for the people that we serve.
Working together to strategize ways to share information
and organize our effort to assist this individual
with the tools they need upon release in order
to reduce their likelihood of returning
into the criminal justice system.
Here are some facilities well on their way to SOAR success.
So since 2017, 12 agencies have responded to the call
and are working to implement SOAR within their programs
and their criminal justice programs.
They have applied for and received a technical assistance
award which will be discussed a little later in this webinar
to strategize a plan for SOAR implementation
in their facilities.
They understood the urgency to connect with the people
they serve with the resources that they needed to promote
successful community integration.
They worked really hard through the delays in implementation
due to staff changes, leadership changes, limited resources,
workload demand, and are using the outcomes as leverage
to fund in conversations because the data
can no longer be overlooked.
The challenges faced by reentry planners, case managers,
court systems, and all those other partners that are
responsible for assisting individuals comply with the
conditions of release while still looking for resources
to meet basic needs such as housing and treatment
is exceptionally challenging when
the individual has no income
and no support and is unlikely to maintain employment
due to disabling conditions.
So where do we start?
First, start off by believing that recovery is possible
and approaching SOAR implementation
from the solutions based perspective.
Benefits acquisitions may not solve every single issue,
but it's a start to alleviate some of them.
Then consider a pilot, stick with the plan,
and give yourself time to see the results.
Identify the need, create a proposal by discussing
prevalent, the prevalence of mental health needs
within one facility or unit or pod.
Mainly focusing on those units that may house people
with the most serious conditions.
Do some research, calculate how much it costs to house
those folks with serious mental illness in your agency
and compare it to the reduction of the cost if that person
was in the community at the earliest possible time.
Then provide that information to the decision makers
and authority within your agency to emphasize SOAR success
and highlight that success that has been
demonstrated around the country.
Work with your SOAR TA center, your liaison
and we can help with the communication with Social Security
and DDS and encourage those post-release, those pre-release
agreements and, you know, facilitate communication
and collaboration so that there could be a true initiative.
Give yourself some time, time to train, time to do,
this is not like a fill the form out and forget it
kind of approach, it's very hands-on.
Give yourself time to see results, one year to see
some results, two years to see a fully functioning program,
and track your outcomes.
Test the plan
by creating a pilot site.
Pilot sites provide a great opportunity to test your plan
in a focused kind of area.
Address those challenges, make those revisions,
use those outcomes and results as leverage
to continue talking to folks.
Breathe, celebrate your success,
learn from your mistakes, and repeat.
This is a totally replicable program that we hope to expand.
So in conclusion of my portion of this presentation,
I know that we say that SOAR is SSI/SSDI outreach, access,
and recovery, but for the purposes of this webinar today,
I encourage you to think of SOAR as SSI/SSDI opportunity
to access resources to recovery.
Thank you.
- [Pam] And now I'll pass this presentation
on to my colleague, Dan Abreu.
Dan is a seasoned criminal justice professional
and a current senior project associate
with the SAMHSA GAINS Center in Delmar, New York.
Dan.
- [Dan] Thank you Daz.
So as Daz provided an overview that SOAR really is uniquely
suited to address a lot of the issues that are presented
to the justice involved population.
I'm gonna pick up from there and talk specifically
about to give you an overview of some of the characteristics
of justice involved people with mental illness
in the justice system.
As a group, justice involved persons
excuse me, while I,
there we go.
As a group, justice involved persons are disadvantaged
in many ways that result in a higher prevalence
of mental illness in the justice system.
But also and not surprisingly that result in inability
to access healthcare and recovery support
exiting the justice system.
And SOAR can be a critical component
to balance those inequities.
If you look at the graphic on the left side of your screen,
there are almost two million individuals incarcerated
in the nation's jails and prisons.
For those of you who might not know, the US has the highest
incarceration rate in the world.
There are an additional four million people
under probation or parole supervision.
Looking at the graphic on the right side of the screen,
jails incarcerate pre-trial individuals and individuals
sentenced to one year or less.
And prisons incarcerate individuals in over one year.
On any given day, there are twice the number of individuals
incarcerated in prisons than jails.
However, and this is a staggering number, there are almost
12 million people
admitted yearly into jails and often for lengths of stay
of less than 30 days, which for a person with mental illness
is just long enough to disrupt access to healthcare benefits
housing, employment, and other social supports.
And this study from BJA demonstrates the health care needs
of justice involved individuals, which is significant.
What they found is that there is increased prevalence
of high blood pressure and diabetes.
Three times the prevalence of heart related illness.
Four and a half times the prevalence of infectious disease,
including hepatitis, HIV, and TB.
10 times the prevalence of hepatitis.
Over six times the prevalence of tuberculosis
and three and a half times the prevalence of HIV.
And looking at mental health prevalence, the prevalence
rate in the general population of serious mental illness
hovers around 4%.
But in the justice system, the rates of serious mental
illness in jails is four times higher
than the general population and 75% of people in jails
with serious mental illness have a co-occurring disorder.
Further challenge in providing care to this population
is the prevalence of trauma.
This data's derived from individuals with mental illness
who participate in one of 17 SAMHSA funded
jail diversion programs.
The trauma rates are, and as you see here,
on the left, women identified 96% lifetime prevalence rate
and men 89% lifetime prevalence rate of trauma.
The prevalence rates for incarcerated justice involved
individuals is the same for both genders.
What surprised us a little when we looked more closely
at the data is the amount of current prevalence
that was identified by people going through those
jail diversion programs.
And current trauma being identified as having had
a traumatic episode the year prior to the arrest
that brought them into the program.
74% of the women, 86% of the men reported a traumatic
incident the year prior to their arrest.
What that means in terms of people being released from jails
and prisons is that very often the first thing you're
dealing with is not so much their treatment needs
as it is safety needs.
People are in unsafe relationships
and living in unsafe environments.
Parenthetically, you should know that the rates for veterans
the trauma rates for veterans in another jail diversion
program that focused on veterans were
about the same as we see here.
There's a myth I think that trauma,
for veterans, is solely related to combat.
Not when you're talking about justice involved veterans.
Veterans that went through these jail diversion programs,
less than 50% ever
participated in any combat.
But the data did show that 73% of the veterans participating
in the diversion programs had 73% had pre-military trauma.
So again, addressing, for the purposes of SOAR
and for treatment planning, documenting trauma
is critical for these individuals.
So other studies show that people with serious mental
illness are more likely to be homeless, more likely
to have co-occurring disorders, use a greater variety
of services at a higher cost, and they're more likely,
when they're in prison, to have disciplinary problems,
they're more likely to be unemployed
and have extensive psychological impairment.
And their length of stay tends to be longer.
Generally that's due to inability to make bail,
which is further compromised by homelessness.
Because people with mental illness,
this slide I'll demonstrate that people with mental illness
are more likely to be homeless and homelessness
affects outcomes in the justice system.
You can see the legend on the right, street homeless
in dark blue, shelter homeless light blue,
non-homeless in black, that at arraignment,
street and shelter homeless are two to three times
less likely to be released at their first court appearance
and that they're one and half to three times more likely
to complete their full sentence
rather than being released early.
So homelessness compounds justice involvement.
Now in developing your programs, if you haven't worked,
oh I'm sorry.
Again, some more information about the nature of jails
in developing your programs.
Nationally, about three quarters of people being held
in jails really haven't been convicted of anything.
They're there on pre-trial status, often because they're
poor and they can't make bail.
And of course in the case of people with mental illness,
because there's a prejudice towards keeping people
in jail longer.
When we look at New York City, data from New York City,
you'll also find, and this holds true across communities,
that there is a group of high utilizers, just as we have
high utilizers in the healthcare system, in the shelter
systems, there are high utilizers in the jail systems
cycling around shelters, jails, and emergency rooms.
And this reveal of Riker's Island shows similar patterns.
So they've identified 473 people over a five year period
who had been admitted to the jail over 18 times,
mainly charged with low level charges
and a significant percentage with mental illness.
And that these 473 people accounted
for over 10,000 jail admissions.
So again, when you're thinking about implementing SOAR,
SOAR has had tremendous success working with homeless
populations and high utilizers of services and people
participating in housing first initiatives.
And these are exactly the kinds of individuals
that you'll encounter and could benefit
from a robust SOAR initiative.
If you haven't worked in jails before, there's
developing the relationships with the jail healthcare
providers and the prison healthcare providers is important.
But they're not the same across the country.
So there are some jails that employ their healthcare staff,
meaning that they're employees of the Department
of Corrections or in prisons or the sheriff's
department in the jails.
There are other communities that you'll find
where the county mental health department
and the county health department will come in to the jail
and provide those services.
There are other models where the jail will contract
with the national correctional healthcare provider.
These are providers that specialize in providing custodial
treatment across the country and may not have any particular
connection to the communities that they are working in.
And then the fourth model would be where a jail contracts
with a local provider who might be a private
or a public contractor.
Of these three models, probably the most challenging
would be the national correctional healthcare
vendors that come in.
Now, this isn't like all generalizations, some are better
than others, but generally these providers,
the contract providers, will do what they get paid to do
and if there isn't a discharge planning piece to their
contract, their main focus and their mission is going to be
on providing custodial care and it will take a little bit
more engagement and effort to enroll them
and get them to participate and spend their time
to participate in SOAR initiative.
So you should be aware of that.
And that could occur in either jails or prisons.
Again, demonstrating the importance of being able
to access healthcare and SOAR's role in this,
this study comes out of the state of Washington
where they followed 30,000 individuals released
from Washington State prisons.
And what they found over a two year period is that
443 died during that follow-up period, leading
to a mortality rate three and a half times that
of the general population.
Within the first two weeks, the mortality rate was 13 times
higher than the general population,
with the primary cause of death being drug overdose,
heart disease, homicide, and suicide.
So again, this dramatizes the need to have access
to care immediately upon release.
Further emphasizing this point, this slide depicts
the risk of arrest as a function of time spent
in the community.
The data demonstrates that the highest risk of arrest
is in the days and weeks immediately after release.
So you will note that those charged with drug crimes
have the highest risk of arrest, two to three times higher
in the immediate days after release.
Again, highlighting the need for health services
upon reentry.
So, having social security benefits can address
many of the inequities faced by the justice involved persons
with mental illness, providing access to income,
healthcare, and housing.
In the work that Daz and I and the SOAR Center
have done over the years assisting jails, prisons,
and community partners in development of SOAR programs,
we've identified five areas that need to be addressed
in program development.
Leadership, collaboration, resources, whether or not
there are competing initiatives
that will interfere with the implementation
and then training.
And I'm not gonna go into these specifically now,
rather as our next presenters from Oklahoma and Tennessee
are talking about their programs, consider these five
areas and how these programs address these various issues.
And we can address these more specifically when we get
to the question and answer part of the,
of the presentation.
So at this point, I'll turn the presentation over
to Paul Mulloy, Director of Programs for the Nashville
Sheriff's office and Lolita Johnson, Lead SOAR Counselor
from the Davidson County Sheriff's office.
- [Paul] First I want to thank SAMHSA for allowing us
to participate in this webinar on the SOAR program.
As many of you know, this is a new initiative for us
here in Nashville and we hope to highlight some
of successes that we're having and then also some
of the challenges we're still working toward.
In 2014, the mayor's office asked Sheriff Hall
if he could plan, develop, and implement a SOAR program
within the jail system and Sheriff Hall agreed
and designated two full time staff persons
to establish the SOAR program in our facilities.
Which we have four facilities here.
And after a thorough training through the SOAR process,
these two individuals are our assessors for all four
of our facilities, along with the case managers training
on referring those that would qualify for the SOAR program.
We basically initiated in 2014 but probably didn't get
started really well until about 2016.
This is a part of our reentry effort as part of the
transition from jail to community initiative
we started back in 2009.
We see SOAR as an extension of our reentry efforts.
We provide all types of programming, license, alcohol
and drug treatment, battery intervention programing,
education, and SOAR is a key component
to the mental health piece.
It was just mentioned, the collaboration of the health care
inside the jail facilities, we've been fairly lucky here,
we do have contract health care and part of that contract
provides for a mental health agency that is also located
in the community so the individuals providing the care
inside the jail facilities are also the ones
that we are referring back out to the community
as well as others that also provide SOAR access.
This is a very innovative program on our end.
This is the initial part of a program that we have not
participated in before.
We see it's going really well, along with the case managers
and the SOAR counselors were able to screen
at least 350 or more people to see who is eligible
and apply those for benefits through
the Social Security Administration.
Lolita Johnson, I'll turn this over to her,
she can go through some of the mechanics of how we
participate in SOAR, make the referral, and then also
apply the individual and then I'll come back and talk
a little bit about some of the tracking data we've been
looking at for the last few years.
Lolita, I'll turn it over to you now.
- [Lolita] Thank you Paul.
So, again, my name is Lolita Johnson.
I'm one of the Lead SOAR Counselors here at the National
Davidson County Sheriff's Office.
And I want to talk to you a little bit
about our eligibility criteria.
I know some people talk about some of the barriers
and this can kind of be a barrier for us being that it is
a jail and a lot of the offenders that we work with
do not stay in our facilities longer than maybe a year
and sometimes much shorter than that.
But in our criteria, we have individuals that are not
currently in application process or pending,
which you all probably know.
And also, they can not have, they must have at least 120
days before being released from jail.
We also only want people with a severe persistent
mental illness or have experienced homelessness.
And they have to be currently working with our psychiatrist
in the jail and taking medication there.
So a lot of times we have a lot of people that may apply
or get a referral in with the case manager that have not
seen anyone, not doing anything, so we have to kind of work
with the case managers to, you know, let them understand.
And we have been fortunate enough to be able to work
with the case managers, sit down with the staff,
and let them know what we're looking for.
And we also are able to go into the facility and talk
to the offenders and let them know kind of what we're
looking for so we've been very fortunate with that.
Another thing that's been cool with the criteria
is that we also work with mental health court
here in Davidson county and they make referrals as well
so it's not just the case managers.
We can get referrals from mental health court
as well as the public defenders office and a lot
of outside agencies that may have had someone that they
were getting ready to work with, they will also make
referrals to us and that's been very helpful because we're
able to catch people that may have been on the outside
that were trying to get the services but were not able to
and then they were incarcerated.
So we were able to help them, so that was very helpful.
Next, our technology piece.
We thought this was important because like Mr. Mulloy
stated, we have been very fortunate to have our mental
health people inside the facilities, so we have access
to ERMA, which is the electronics records
management assessment.
And what this means is, me and my co-worker, which I forgot
to mention, her name is Angela Clayborn, she's actually
not with us today, she's in training.
We have access to the medical records, to the mental
health records of everyone in our facility.
So we were able to get that access so we can kind of see
if they see the doctors, what's been going on, everything.
So it makes it very easy for us.
And we also get access to the outside records they may
have already come in that the doctors have requested.
So we have a lot of stuff already on hand
that we don't have to record sometimes from the other
agencies for the medical records.
So that's been very, very helpful.
And this is also where we keep our progress notes
to document that we see the person, we're able to upload
the records there, and it's been very helpful.
Also the jail management system, which is the sheriff's
office system, this is where all our referrals are made.
This is where we also put the information to show
we actually started working with the offender
all the way to the point of the person being approved.
And so we can keep a timeline of when we started the process
to when they were approved and we can put in our system
and keep a good track record of how long it took
as well as when the person is getting out
of the facility as well.
This is very helpful for us, it's our timeline
I guess you could say.
This part I'm gonna turn it over to Mr. Mulloy
and let him kind of talk about some
of the statistics for you.
- [Paul] What we've tried to do the last few years
is track the number of individuals who have been approved
for the SOAR program and have benefits and released
and of individuals that we were tracking that met
those criteria, there was about 42 actually.
And we looked at their total number of arrests,
which was really close to about 500 arrests, 460 or so,
and what we found is those are very low level arrests,
nuisance mainly charges, and one year prior to the SOAR
program being approved, on average, the people were
arrested three times, on average, each year.
And there's a little misnomer I think.
Sometimes in high risk population, what we see when
we track other programs, a lot of people view recidivism
as people never coming back into the system.
And unfortunately that's usually not the case.
If a person has been involved in the criminal justice system
for several years, they've built kind of a lifestyle
that there's a lot of components that need to be fixed
before they stay out of the system.
And their potential to come back to the system,
unfortunately, is pretty high.
Especially with SOAR population, this is probably one of our
most critical and highest return groups that we deal with
on a regular basis.
But this gives you a little bit of a feel for a one year
prior to arrest before the SOAR program was initiated.
And then one year post initiated.
And if you look,
you got 94 of the individuals that were approved,
they were arrested about 94 times one year prior
to the program and then after release, that same number
of individuals was released, arrested 85 times.
And a lot of times you'll look at that and say
85 is not much different than 94.
But in actuality, they've been arrested one or two less
times the year after than year prior to the SOAR program
except your one individual, he kind of blew
the chart numbers off.
But as you look at these two charts, it's obvious
that some of them are doing really well.
And they're not reentering the system.
And for the most part, these individuals have been involved
in the criminal justice system for at least
five to eight years.
So the reduction is pretty significant, especially
for the ones who have not returned in a year.
When we were looking at some of the training around
why individuals come back and how we can have a better
impact on the ones who come back into booking.
So we did a couple things that we really relative
for what we needed to do.
First, all the SOAR candidates that
we've applied have been approved by the Social Security
Administration we put in our system.
If they do come back to jail, they're flagged
as a SOAR participant.
So we can reengage those individuals and find out
what has happened and why they're back into the system.
And one of the main reasons we see
is the transportation issue.
Our jails, a large portion of our jails, are out
probably about 10 miles from downtown and the Social
Security Administration from that facility site
is about 15 miles away.
So what we've asked a lot of the individuals that we're
reengaged who have come back into the system
is that they weren't able to get to the Social Security
Administration to begin the benefits
that they have been approved for.
So for us, that was a really good training piece
and education that transportation identification for the
individuals who have already been approved for benefits
we needed to address and that's currently still an issue
for us that we're trying to address currently.
- [Lolita] I just want to add, Paul.
Can I add, Paul?
I wanted to show you one of our success stories.
We did have a gentleman and it just kind of shows
how our program works when Paul talked about transition
from jail to community.
One thing we have been fortunate with, not only do we have
the relationship with DDS and Social Security,
but we also have been fortunate enough to be able
to get Social Security cards for offenders
that, this population.
So we had a gentleman that actually went through the SOAR
program but not only that, he was able to get housing.
We were able to get bus passes for him.
We were able to get his social security card
and kind of get him into everything and he has not been back
to jail since he actually applied
and everything's been going really well.
I actually was his case manager on the outside,
because, again, the relationship with mental health
cooperatives who we work with, they kind of keep in contact
and he's doing really well.
And you know, those are the successes
that we really are proud of.
And like Paul spoke about earlier about the one guy
that's kind of off the charts, you know, you're always
going to have a few that come back, but the catch is
that we do get flagged when we see that and we're able
to try to connect with that person to get them
right back out and to see what we can do to make sure
that they don't lose their benefits and see what we can
do to help them in any way possible.
I mean, we do everything to even making sure the discharge
planner makes sure they have enough meds.
Just everything, we try to make sure we hit every avenue
to, you know, get those barriers out of the way
the best we can.
Just something I kind of wanted to add in there
because I think that's important to talk about the successes
a lot of times we don't get to hear those.
Just wanted to add that.
- [Paul] Let me just follow up and close on that
that for us, the major effort for us here in Nashville
is the transition from jail to community and the SOAR
program is a very good fit for what we do here.
When we apply someone for benefits, we also look
at all the other criminal needs that they have.
If they're undereducated, if they need housing,
if they need transportation, if they need a food box,
or they need clothing, we have a social network site
called Base Camp that we communicate internally
with all of our community partners on the outside
and those other needs are being met as well.
So it doesn't happen in a vacuum, we really try to be
as broad as we can when we're looking at all components
of reentry and we think that's what success with not just
the SOAR candidates but also the other individuals
that we deal with on the other programming piece.
At this time I want to turn it over to Donna Bond
and Marcus Ayers.
- [Donna] Okay, thank you for inviting us
to join in this webinar.
First slide.
In 2006, the initial planning started for this collaborative
program between the Oklahoma Department of Mental Health
and Substance Abuse Services
and the Oklahoma Department of Corrections.
There were a few key like-minded folks that were
in administrative roles with a common mission
and that mission and goal was first to decrease
the recidivism rate for the inmates
with the most serious mental illness.
As you know, our state is like every state, the seriously
mentally ill are very overrepresented in the prison
and their recidivism rate.
Since 2006, well, I want to say in 2006,
the planning started and February of 2007, services started
with three integrated services discharge managers
in the prisons that have the mental health unit
and that have the most, the highest number of inmates
with serious mental illness.
Next slide please.
Since 2007, we've increased the number of staff trained
in SOAR training and training with case management
and just several different evidence-based practices
and assessments that we use in our program
that we've built over the last 11 years.
I want to say that since we started in 2007,
we've now worked with over 1000 inmates in Oklahoma.
And also want to say that our recidivism rate
with this group since we started, and we measure this
in three year intervals, at last check,
we were at 22% recidivism.
We have cut it right in half on what,
with the comparison group.
So how we built and this program is that we built
and nurtured relationships with several different agencies,
like vocational rehab, all the local Social Security offices
the Department of Developmental Disabilities,
the Department of Human Services, local housing authorities,
HUD, which is the federal housing authority.
Basically anybody and everybody that we can find
that would join in with us for this program
and for our mission to decrease the recidivism rate
and to help get this population approved and on public
benefits so they would have a chance
to stay in the community.
Also, since we've started, we've applied and been awarded
four federal reentry grants that have really helped
go along with our state funded reentry.
Our initial program was possible through the funding
of the Department of Mental Health and Substance Abuse
Services, that continued to provide more than a million
dollars per year out of their general funds
for our state funded program and our community-based
contract that people transition to from prison
to the community.
The grant definitely helped because we were able to expand
and add a co-occurring population.
So we were able to add a second population and that their
needs were a little bit different but a lot of these folks
also met criteria for disability so when that was the case,
we also made sure that those applications were done as well.
Next slide.
Our goal is approval before release.
And we want the approval before release both for
SSI or SSDI, if they qualify, as well as Medicaid.
We want to know that when the people we are working with
leave, that 30 days after the day of release,
they should be eligible for that first check.
And normally that goal is met.
We start, we do our Medicaid applications at 30 days
pre-release and we have a specific contact with DHS.
We also have specific contacts with our local Social
Security offices, so when we call, we are not just talking
to anyone that answers, we actually have a contact person
for each local office.
We have a contact person at the
disability division office.
We have the general manager there has been great
to work with us if we run into any kind of issues.
He's always there to support and help us.
Next slide please.
I wanted to, can we go right back to the previous slide
really quickly, I'm sorry.
I wanted to mention that when we don't have enough time
to complete the entire process before release,
it can cause a lot of obstacles
with housing,
with just anything that has to do with them sustaining
themselves in the community, even though we have programs
with funds to help people in our program when they first
get out, if they don't have the preapproval for their
benefits to start shortly after release
or within that month or maybe two at the most,
that really puts a strain on our team and on our program.
So it's very important that we have
the right amount of time.
And with Oklahoma, they have built in new credits,
earned credits, good conduct credits,
and different things like that within DOC and within
Oklahoma to help move inmates through the system faster
which is definitely a good thing but it just makes
the need for us to plan critical.
Next slide please.
In establishing a SOAR process, once the online application
is done, we make sure that everything's accurate
and that we have a complete packet, we fax it to the local
office and the most key component to getting a quick
approval and a quick turn around is that we have a psych
summary from the attending psychologist.
When we have that to send with the rest of our medical
documentation and paperwork on that day, we can get
really quick turn around approval.
That is key and we have some wonderful psychologists
in Oklahoma and Department of Corrections that help us.
In fact, when we have our annual meetings with the
Disability Determination Division examiners
and all the local SSA office managers, and then all of our
staff, our psychologists always receive accolades
in just how well they do with their reports
and how it really helps the examiners
with being able to make a decision.
We also have information sharing agreements in place
to where if examiners don't see something in that report
or in the paperwork, they can go in to our medical records
and look for that extra information.
We want to provide it for them and so it makes the process
much more time efficient for them.
But if they do need something else,
they can go into the records.
We also have information sharing agreements in place
between the Department of Mental Health and Substance Abuse
Services and Department of Corrections.
Our collaboration truly is one of a kind in Oklahoma
and I've never heard of one exactly like it
where the agencies work so closely together
and it's just really been the key to our success.
Next slide.
We just, to follow the SOAR model, at the end,
just allowing time to complete and submit the application
within the correct time frame.
So planning, checking with case managers, checking
with your facilities records department to make sure
that the projected release date
for an inmate is not going to change,
that there aren't credits that may be extra are already
worked into that date so we know when they're going
to discharge, they don't have any surprises.
We have learned some really hard lessons with that.
We've learned to plan and call and check and double
and triple check so that we are able
to get this process done in time.
I can say that we have known of one approval
that from the day of submission into the local office
from the call back with approval as quick as seven days.
Slide.
Over the past 11 years, our approval rate has
kind of varied some, but it is at 80% right now.
I think the, for the general population and the community,
I think the approval rate is, for a first time application,
I was thinking 33, but it might even be lower than that.
I would have to double check on that.
80% is, I think, we're really proud to have that rate
and we have not gone below that.
Next slide.
We got here in our program and with the success that I've
been talking about by having all
of our reentry staff trained.
We started with three staff inside the prisons
that are hired and employed by the Department of Mental
Health and Substance Abuse Services.
We now have seven and eight with the boss,
or with the supervisor.
And mentoring is an important part of the program.
We have integrated services discharge managers
will go onsite and work with the new staff
and then they'll have the new staff come and work with them.
And I'll just give you an example of mentoring.
I was one of the first three discharge managers in 2007
and I was at the maximum security prison in McCalister
doing my very first application after my SOAR training.
I had a maximum security seriously mentally ill inmate
in a very small office along with the general manager
from the local social security office.
She came to the facility, went through the process to be,
took down to have to go through the metal detector,
all of that to come in and go through that first application
with me, which that's something I never forgot,
to have someone, you know, that type of mentoring.
So in turn, we've always provided mentoring for one another
and made sure that before a person starts doing these
applications on their own that they are ready.
And another really important
step to success is that we're consistent with our process,
that we're consistent with our timeline, we're consistent
in the way that we do our paperwork, you know, the steps.
We make sure that everybody follows the same steps.
An example is that we flag each application to say
that this is a prisoner pre-release case.
It's very important that that's flagged.
If not, it will just go into general cases and no one
will know that that's actually an inmate release case.
So you know, that's just one example that this consistency
that we are all doing things in the same way
and that the staff at the local housing
and at the disability determination division office
know what to expect from us and know that we're all going
to be doing things in a consistent way.
And just, you know, support one another and
provide anything that they need as far as new staff
that come on and if we run into anything that we can't
fix or that we don't know how to do ourselves,
we have plenty of support in the local offices
and in the state office.
So that's been very helpful.
Next slide.
I want to ask Marcus if he can think of anything
that I didn't say that he feels important to say
with our presentation.
- [Marcus] I think maybe just one thing that I would add
is just highlighting how important this process is
in the state of Oklahoma.
The population that those seven staff work with
in the Department of Corrections are individuals
with every range of mental health functional and disability
represented pretty much in the general population
and so in the state of Oklahoma, sometimes the only chance
that these individuals have for treatment is to be a part
of the Medicaid program and we're not an expansion state.
And so being able to assist these individuals with obtaining
disability is really the pathway to get them into
sometimes nursing homes, into residential care centers,
medical or sensitive health patients services as well.
So these services that we provide really make
a humongous difference in the lives of the individuals
in the full range of what they were talking about
a minute ago in terms of housing, treatment, income,
those three, all factors.
- [Donna] I think that wraps up our presentation.
- [Pam] Great, thank you so much Donna and Marcus.
Before we get to Q and A, which is going to start
in just a second, I wanted Dazara Ware to talk about
the slide that you're seeing now about SOAR and CJ
Technical Assistance opportunity that's coming up shortly.
Daz, you wanna talk about that for a sec?
- [Dazara] Absolutely.
So what you're seeing on the screen right now is our
invitation that has gone out on October 23rd
kind of soliciting respondents to an RSA that we've
presented and this is just a, not just a, but this is
a great opportunity to have the SOAR TA Center fully
engaged in your effort to implement SOAR in your facility.
The technical assistance opportunity provides planning
and technical assistance, which includes implementation
meeting that's onsite where we could gather all the key
stakeholders together to provide a guided kind of discussion
about how SOAR could work in your facility,
what areas need to be addressed, and those sorts of things.
An awardee will be provided the opportunity to participate
in the leadership academy, which would help to provide
you with the skills needed to kind of understand
how to build the infrastructure within your facility.
And then, once that case is kind of
kind of solidified, we'll go ahead and part of that plan
address those folks that you've identified to complete
the SOAR applications and assist them with online course
and how to track those outcomes.
The application's what you see right now.
It has 10 components and it's, we ask that you submit
the application in narrative form, addressing each
of the components in three and no more
than five page applications.
We'll have a kick off call for any questions that you have
about applying on November 14th, so stay tuned
for that announcement.
And overall, the applications are due on December 21st
and announcements will be made for at least six
kind of awardees in January.
So if you have any additional questions, you can ask
on this call or you are more than welcome to reach out
to any of us at the SOAR TA Center.
- [Pam] Great, thanks Daz.
- [Dazara] You're welcome.
- [Pam] So, we have some really great questions
that have come in and many are related to how do I
start a SOAR initiative, how do I get started?
What are the first steps?
And we had a couple questions that came in early
in the presentation, like I understand the statistics
but what can SOAR do and how do I start a SOAR
implementation within our criminal justice system?
How can I get my SOAR local program to reach out and
integrate SOAR with the criminal justice system community.
So I wanted to first remind that if you're new to SOAR,
or you've taken the SOAR online course or you're a SOAR
local lead, I'll just remind you to go to the SOAR website,
and again, find your state, you'll find your state lead.
You'll find your SOAR local leads, but also your SOAR TA
Center Liaison, who can give you more detailed information
about if there is any criminal justice coordination
within your locality, within your state.
That's a great place to start.
And then they can loop in Dazara Ware with the TA Center,
who you just heard from, about again, efforts that she
can help with to again establish some of the relationships
similar to the presenters today from Nashville and Oklahoma.
So again, hopefully you'll go there to get more information.
But again, you can type in some of your questions
in the Q and A box that you see on the right
hand side of your screen.
If we don't get to your question today, we will be sure
to get that to one of our panelists and answer that offline.
So don't worry, we'll make sure we get
to some of your questions.
Some are very specific to clients you're working with
and again, those we want to make sure we give you
the most accurate information so we may handle these
offline as well to draw in maybe more expertise
from SSA, for example.
So an overriding question, we had a bunch of these questions
again, and I'm gonna throw this out to all the panelists.
What messaging can you share in terms of beginning?
How does somebody start?
What are the first steps that a SOAR program may need
to take to start even thinking about integrating
in your community?
And I know Oklahoma's been doing this for a long time.
So would you want to start, Donna, with sharing?
What would be the first step to engage at the state level?
- [Donna] Well, kind of as I explained earlier,
the planning started a year or more before we actually
started services and some of the leadership
persons or individuals in leadership roles,
collaborated on this
and knew that getting public benefits in place for this
population was going to be critical.
And I also know that when we first started our reentry
program that we were part of the Mathematica study
so I think that was also,
I was not one of the key planners of the program.
I was one of the first staff to work in one of the prisons
to do the work but I was not in on the initial planning.
I was hired in 2007 to actually start doing the work.
I just know that we had multi-agency collaboration
and that I do know that Mathematica was involved
and that we were hired and were all sent for SOAR training.
- [Pam] Donna, it sounded like it started
with training for you.
Daz, would you like to chime in?
- [Dazara] Yeah, sure, thanks Pam.
So you know, I get a lot of these questions from
reentry specialists and case managers that work in jails
or prisons and really see the need but not really know
where to start the conversation.
So we spent a lot of time talking about statistics
and the prevalence and the importance of attaching
individuals with serious mental illness
that are incarcerated is quite clear.
I encourage you to do, you know, as we discussed
when we talked about how to start a SOAR initiative
in CJ settings earlier in the presentation.
I encourage you to start by gathering information.
Gathering information specific to the facility
in the community that you work with.
As we said, we talked about collaborations,
and we talked about how important it is to build
those communications and those collaborations with the same
kind of agencies that provide services to the same folks
that you provide services to.
So as you are gathering information about your facility,
how many people are currently incarcerated,
how many people are currently incarcerated that are
receiving psychotropic medication?
How many people of that population have returned back
to prison or jail?
Attach the cost, each state has a website specifically
for prisons that will tell you how much it costs
to house an individual that is incarcerated,
how much it costs them.
Put a number next, put a dollar amount next to the number
so that you can demonstrate the potential amount of money
that is spent to care for this individual.
So it starts with preparing and identifying the need
but also being able to address it more from the financial
aspects of how SOAR can work for the institution.
You have two major kind of lines of
communication or two kind of areas that you must address
when you're talking about implementing a new program.
You have to speak to the heartstrings of the people
that are providing the services because they do want
to see things that work, but you also have to speak
to the purse strings of the person that has the position
of authority so that they understand the importance
of committing to a program so that they
can see the best results.
So it starts with gathering information and I don't want
to take a whole bunch of time, there's a whole bunch
of things that I want to say, but it starts there.
And then you prepare a proposal.
You identify the need, you identify how SOAR can help,
and you talk to people.
You talk to the chief jailer, the chief social worker.
You go to all of your reentry meetings.
You talk to the chief social worker.
You talk to, you know, the public defenders office.
Because, again, all of these folks touch the life
of the same person you're providing services for.
So the more that you talk, the more that you gain the buy in
which makes your proposal even stronger.
And then you use the outcomes that have gained
from everywhere else across the country.
You contact someone from the SOAR TA Center
and say, you know, where can I find statistics on or data
about the amount of applications that you,
that have been submitted across the country
and what are the outcomes?
We'll be happy to provide that for you.
And in the meantime, in part of your conversations
not only with the community and within
your agency internally, you also want to talk
with Social Security, but if you're not comfortable
there, start just at the beginning and getting
all your information together.
It's not a process where you want it to happen,
so you wish it and then you mention it,
and then you never mention it again
'cause they didn't hear me.
It's something that you are adamant about and consistent
because you really know that access to this kind of benefit
really helps the people that you're serving.
- [Pam] Great, thanks Daz.
And I shared some of the tools that the TA Center has
and part of that are some FAQs, which will include,
I think, hopefully some answers to some of the questions
that we have here about getting started.
Another question that popped up is how do we establish
a prerelease agreement, how does that start?
Or how do we find out if our state or our locality
has a prerelease agreement?
Who would like to take that, Daz?
- [Dazara] Yeah, sure.
So that's another conversation that needs to happen
with you reaching out to the SOAR TA Center to find out
if we have any information about your state
that you just didn't know of.
And then if there is no prerelease agreement,
that starts with communication and conversation
with the Social Security field office in your area.
And the SOAR TA Center is a great resource.
We could have contact information that are already there
and we can help join you in those conversations.
If there is no prerelease agreement, we can work with you
to help to establish one.
- [Pam] Okay, great.
Another question came in about, this is a really great
question, and it comes up a lot.
It's about working with individuals.
Have you worked with individuals who do not have a serious
mental illness but have a serious drug disorder?
Or do individuals have to suffer from both an SMI
and a substance abuse disorder?
And again, this question hits on some misconceptions
about working with individuals who,
regardless of whether there's justice involved.
Who would like to take that question in terms of that?
Because we know that an individual can't be found disabled
if they only have a substance use disorder diagnosis, right.
They need to have at least, you know, another medical
condition or a mental health disorder.
Does somebody want to address that issue of folks,
I know Dan touched on this, individuals that do have
a serious mental illness, substance abuse disorder.
- [Dan] Sure, Pam.
Well, first of all, I wouldn't take the substance abuse
disorder diagnosis at face value.
Many of the individuals that are coming into jails
really haven't had access to healthcare and maybe
through the emergency system, they're diagnosed
as a substance use disorder, but when you start to look,
remember the prevalence issues around medical,
coexisting medical conditions, trauma, undiagnosed
depression, there's a lot of undiagnosed mental illness
that you'll see in the population that might look like
just substance use disorder.
So I wouldn't take this substance use
disorder at face value.
The other thing--
- [Pam] Go ahead Dan.
- [Dan] Yeah, and then the other thing is that,
to get a good history and assessment so that you're getting
the past records from the community.
And what you typically find with a lot of individuals
is that they'll have multiple diagnosis, which really is,
so it becomes important to get a good current psychiatric
assessment that looks at the longitudinal
health career of the folks.
And remember that even though there might be a lot
of substance use disorder, that with health conditions
and mental illness can reach the threshold of a disability.
- [Pam] Thanks for sharing that Dan.
I think that's a really great point to stress
and to also review the SOAR online course about this topic,
which will give you some more guidance.
So with that, we are out of time.
You'll see on the slide we have Dazara Ware's email,
should you want to reach out to her directly.
Again, I just want to thank all of the presenters
for your presentations and on behalf of the SOAR TA Center
and the GAINS Center, we'd like to, again, thank our
presenters and everyone who joined
today's important webinar.
Have a great rest of your day
and thank a lot for joining us.
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