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Friday, April 02, 2010

I think of myself as a Cultural-Ethno SSI Advocate Sans Frontier.

Tangerines, originally uploaded by dumbeast.

Somebody needed to know about my process for a grant proposal she was working on.

My process. When I get a referral from a client’s counselor at the methadone clinic, I look over the intake paperwork & evaluate it for merit—is the client in treatment? When was her last clean UA? Is her doctor supportive of a disability claim? What does her counselor think? Then I arrange to meet with the client face to face.

Every time I meet with a client at a methadone clinic, they get a nice piece fruit. A tangerine, if they’re in season. Otherwise, have an apple, a pear, a nice grape, or perhaps a nectarine? While I don’t have any scientific studies to back up this outlandish notion, it’s my feeling that opiates knock out any spare vitamins that your body might have floating around in there, and since all my clients have just dosed when I see them, and none of them can afford to eat properly, yeah, have some fruit. Generally, this simple act of giving food makes people feel like they’re dealing with a real person, who sees them as a real person. Hopefully, this will make them want to come back and see me next week, which can be a big hurdle in the methadone population.

If a client seems like a good candidate for SSI advocacy, and I have capacity, I sign them on. This involves a brief explanation of the process of applying for SSI: “It’ll take a while, it might take a few tries, it’ll depend on you developing a treatment history and seeing me every week. We’ll be dealing with a big dumb government bureaucracy that makes important decisions about peoples’ lives capriciously and randomly. We’ll give it our best shot, but I can’t promise you anything, as it’s really up to them. Are you with me? Great, let’s get started.“ Then we sign:

  1. An advocacy agreement in which they promise to meet with me every week, and to meet with their counselor every two weeks. (Everybody blithely lies to me at this juncture.)
  2. An SSA “Form 1696/Appointment of Representative” which allows me to advocate on their behalf with SSA. I always explain that I’m not going to collect a fee, and I won’t try to collect a direct payment from Social Security once they’re in pay. I sign those boxes on the form in front of them.
  3. A rash of forms that SFDPH requires us to sign, in exchange for their funding of our SSI advocacy program.
  4. A medical release which will allow me to talk to their doctors and request medical records.

From there on in, it’s a weekly ritual of checking in, filling out & submitting various forms for the application, collecting medical records, making sure that the client has access to Dr Shrink or other MH Tx. “I want you to take this Adult Disability Report form with you, fill out the parts that you can. But first, look, I’m crossing out this part at the top, where it asks for your name and your social. Because, you’re living on the street, this might get lost, and you don’t want that information to get into the wrong hands, right? Like, identity theft? But try to fill out what you can of the rest of this thing. Some of it will be easy—like this one: Are you right or left-handed? See, we already did one. Answer the easy ones. It’s also gonna ask you a bunch of stupid-ass questions that you’ve got no idea what they’re driving at. Don’t worry about it. Leave those blank, and when you come back to see me next Thursday, we’ll finish it together, okay? Just do the parts that you know. Don’t worry about not getting all the answers. Really. Whatever you can’t do, bring it back, we’ll work on it together. I’ve done a lot of these. It doesn’t have to be neat—I’m going to have to transcribe all of this into the computer eventually. Here--have a tangerine. Come see me next week, okay?”

Aside from that, I provide lots of other small services for my clients. A lot of them rarely talk to anybody from day to day. I listen to them. I try to get them to get into treatment if they’re not. I update their GA workers to keep them from getting kicked off GA-SSIP. If they have legal problems, I try to deal with them directly, or refer them to where they can get help. If they’re having problems with their methadone counselor or their SRO or their HOT worker, I try to address that.

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