Fixing the Broken Path to Disability Benefits with Lauren Fusco, Director of Partnerships at Mindset Care

[00:00:01] Welcome to Expanding Access, a podcast by Behavioral Health Tech, where we explore the cutting edge of mental health, substance use, and autism and IDD care. Each episode features insightful conversations with industry leaders who are driving real change through technology and innovation. Whether you're a provider, payer, or just passionate about expanding access to behavioral health care, you won't want to miss these stories. Let's dive in.

[00:00:30] Hello, everyone. I'm Solomay Tibabu, the host of the Expanding Access podcast. And once again, we have a very juicy topic and speaker with us today. Thank you so much, Lauren, for joining. I am so excited about the mindset story and the amazing work that your team is doing. Why don't we get started by some introductions, if you don't mind sharing who you are and how you got into this space? Absolutely. Thank you so much for having me today.

[00:00:58] My name is Lauren Fusco. I am the Director of Partnerships here at Mindset Care. My background, though, is in many, many, many years of direct services for individuals with mental health and developmental disabilities in home and community-based services in hospital settings. And so the way that I found myself here at Mindset Helping Individuals Through the Social Security Disability Benefits Process is kind of just through lived experience.

[00:01:20] No matter where I was working, what environment I was in, what population I was working alongside, the struggles through the SSI and SSDI process came up so, so frequently. And so at some organizations I worked at, they would say, you could try your best through the application process, right? Use your really sacred time to try to answer the questions to your best of your capabilities. But it was limited capacity that I was working with and individuals that I was working alongside that maybe would just be there for a week or one session.

[00:01:50] And so that was really difficult. Other organizations would say, you have to guide that person over to the Social Security office if they need assistance. And that caused different frustrations for the people and for the teams I was working with. And so I really built my career on finding resources for individuals. So when I moved over here to Mindset, I was like, what do you mean that this resource exists that helps people through this really cumbersome process? And so that's how I ended up here and supporting individuals and organizations to make sure they get the benefits they're entitled to.

[00:02:19] That's such a great example of what so many individuals need to go through throughout this process. And it's a big problem. Can we dive a little bit deeper and explain what Mindset Care does and a little bit more about the populations you serve? Absolutely. So at Mindset, our goal is to really support people end-to-end. So no matter where they are in the disability benefits process and what that entails is both programs through Social Security that are SSI and SSDI.

[00:02:48] And we can help them from start to finish. We can assist individuals ages 0 to 64 in all 50 states. So taking down age restrictions and location restrictions that are typically associated with the process or different barriers associated with those aspects. And we can also assist people with any disability or anybody whose quality of life has been impacted by their disability, whether that be a mental health diagnosis, a developmental disability. They're in a critical care situation.

[00:03:18] Maybe they're experiencing homelessness or going through cancer treatments. If they have either never been able to work because of their diagnosis or they have had to stop working because of their disability, we can hopefully support them to get those benefits that they may be entitled to. That's amazing. And I'm curious, like, how did Mindset even get started? Yeah, that's through our CEO, Darren Webb. Darren actually has lived experience supporting an individual through this process.

[00:03:45] He is the caregiver for a loved one who has schizophrenia who was receiving Social Security benefits. And then, like many people in similar situations, he had lost those benefits after a series of events. And that can happen for a number of reasons. It can happen whether it is the person didn't submit supplemental documentation that comes in the mail some months, years down the road after receiving their disability,

[00:04:11] or if an individual has been incarcerated over an X amount of time, they have to start those benefits process all over again. Or for people who have tried going back to work and give it their best shot to try to get a job and get off of benefits, if they go over certain thresholds put in place by Social Security, their benefits stop and they need to start the process again as well. So, in Darren's case, his loved one had come to him and said, Can you please help me through this? I don't know what is going on.

[00:04:38] I can't figure out the applications and the supplemental appointments and all of the mail that I'm getting associated with the process. So, Darren had wound up hiring an attorney to help him through it where he was just mailed all of the paperwork that he could have found online. Or when he went to the Social Security office and he's like, this needs to be made better for people. What can we do differently? So, using his business background and his technology background,

[00:05:03] he really wanted to blend the two to make sure that we can make the system better for people navigating this journey. Thank you for sharing that. I always love hearing Darren's story. And I just encourage folks to learn more because it is really remarkable and amazing that he's turned around with that personal family experience to be able to serve others.

[00:05:26] And now, speaking of serving others, let's go back to talking a little bit about what are some of the biggest challenges that you've seen individuals face when navigating SSI, SSDI application process. And you mentioned like the mail, I guess, like you already mentioned a few, but super curious to hear more. Yeah, the process can be incredibly overwhelming for people, especially when they have competing priorities, right? They're trying to take care of their health diagnosis or whatever disability that they're living with.

[00:05:56] They are maybe figuring out where they're living next or where their next meal's coming from, taking care of their family. So then it's also have to navigate all of this paperwork that is deeply clinical in nature. It includes a really lengthy application. Like I described, it feels like it is about 7,000 questions long, getting all up close and personal with that person, talking about their health history, their work history, their family, their finances, lots of different things.

[00:06:22] There's also really strict documentation requirements and long wait times, whether that be waiting on hold at the Social Security office or waiting for an appointment at a local office, depending on how backlogged they are. And so many individuals just don't know where to start or if they have started, they're not sure where they are in the middle of their process because this can take months to years to receive a response from Social Security or a decision made by them.

[00:06:49] And then there's also this statistic that people may have heard of nationwide that majority of initial applications get denied, which means that a person who has gone through all of the documentation that they thought they completed to the best of their abilities, they went to these supplemental appointments that Social Security requires to confirm their diagnosis with Social Security approved doctors. They collected their medical evidence from anywhere they've ever received treatment before,

[00:07:16] which is also really difficult to navigate because maybe it's been a series of different emergency rooms over different state lines or minute clinics. And so that appeals process for those who have been denied entails more documentation, completing more medical documentation as well, and potentially representing themselves in front of a judge, speaking the same language that was in that application a year plus ago.

[00:07:43] And so really complicated to work through. And so what we've seen that's missing in that process is really person-centeredness and technology to be able to streamline those systems for the individuals that we're working alongside. Thank you for sharing that. And I know that to do this work, it's really critical to partner with providers and community-based organizations. Can you share a little bit more about why that is and how does mindset go about partnering with providers?

[00:08:13] Yeah, we want to work closely and really provide a seamless collaboration for an array of different organizations, healthcare providers, insurance providers, community-based services, nonprofits, to really create a more coordinated system. How can we make sure that our mutual clients are being supported? Because oftentimes when you're working within the system of supporting individuals, we realize that they're working with several different organizations to make sure that their needs are met.

[00:08:41] So how are we making sure that that's seamless for them? So what our technology allows or what our systems really work with is making sure that that person is supported, that information is shared securely. We're tracking progress, which helps partners stay informed on our mutual individuals where they are in that process. And we want to complement the work that's going on between all the organizations we're working alongside,

[00:09:06] helping their clients access benefits that can improve other work that that organization is doing with them, whether it be matching them with healthcare systems and outcomes or overall quality of life. Similarly, we want to understand how individuals' different needs are met and partner in workflows to make sure that they are being tied alongside. So oftentimes Social Security can be the gateway to these other services,

[00:09:32] to housing, to food benefits, to Medicaid or Medicare. And so by working together, we really can make sure that that person receives all of the benefits outside of Social Security, outside of the mental health services that they're receiving, outside of the insurance providers being able to connect them to their social determinants of health. Awesome. I could see just how impactful that could be with that seamless partnership. Now, what about payers?

[00:10:01] What's the role of insurers and like some examples of how mindset collaborates with them? Yeah. Oftentimes for different insurance providers, it means different things. It can be that they have received an emergency waiver for an individual who has this disability and needs some healthcare services sooner rather than getting on Social Security first and confirming that disability. We are then able to take that next step and make sure that that person receives their disability benefits.

[00:10:29] And then ultimately, their Medicaid services beyond that, right? Working together with the MCOs to be able to get their benefits. For other providers, it could be that they may be receiving long-term disability at this moment in time. And how can we transition them off of long-term disability to get their Social Security benefits as well, which then benefits them on how is that provider paying for that person's services beforehand? And the way that we do that is really by, it depends on the organization.

[00:10:57] We can get really creative, but a lot of payers that we work with, we want to integrate with their technology that's already there, right? To really build a seamless integration, work with APIs that they already have, work with the EHRs that they're working with to make sure that we're collecting medical documentation as fast as possible. Make sure that we're working within their system so individuals' information can be shared in a secure and seamless way as well. Incredible. Thanks so much.

[00:11:25] For those that are just learning about this space, where do you wish things could evolve to? How can we make life easier for all of the stakeholders we've talked about, but especially folks seeking out SSI, SSDI? It's really knowledge, right? It's sharing that information that there are organizations out there who can help. They don't need to go through this on their own, right? And that stems from being a trusted source.

[00:11:52] So working alongside those organizations, we talked about the insurance providers in hospital systems and community-based organizations. That's where the individuals go first in hopes to get their needs met. So opposed to adding another burden, maybe it could be lightening the load of the organizations and the case managers who are working alongside of them, making sure that those professionals have the time to help that person through multiple other things while telling them about this trusted resource.

[00:12:20] For nonprofit organizations, it can be offering a new resource to their community that maybe they didn't have the capacity to share in the past. And now they get to see that data, something that we do here at Mindset 2. We want to share that data with the organizations that we're working alongside to make sure that they know that their referrals are being responded to, their individuals that they are recommending to work along with us are being helped.

[00:12:46] And they get that data for grants or to get to know how far their reach is spread and the impact that's being made. All of that really leads to making sure that that individual is best supported, that we are providing that person-centered approach really combined with thoughtful technology integration to streamline different things like obtaining documentation or tracking progress.

[00:13:12] Or we want to communicate efficiently while maintaining high-touch points and individual experiences for every individual, knowing that every person's experience is different and their ability is different. How can we make sure that this often not simplified process is simplified to the best of our abilities and their needs are heard? Really well said. And I'm guessing there might even be some caregivers in the audience just trying to figure out what the first step might be.

[00:13:41] What would you recommend to them? Yeah, please go to our website, mindset.care. What you can do. This is not only for organizations. We want to be able to support the caregivers who are coming in on their own, maybe aren't tied to other resources, the individuals who are trying their best to navigate the process. You go to that website. What you are met with is a short survey. It is truly a couple of questions. It is name, email address, phone number, and a couple of yes or nos. You hit submit.

[00:14:10] Our team will reach out to you to ask when the best time for us to contact you is. So that way we can give you a call and complete the next steps through our process. Let you know if we think that you may be eligible for these benefits, how we can support you. We also understand that not everybody loves a long phone call to go through that information. So you'll also get the ability online when you submit that information, those first couple of questions.

[00:14:36] To complete more questions, let us know what's going on in your life, why you're interested in receiving benefits. So that way we get to know you a little bit before we make that phone call, explain our services a little further with you, and decide if we're able to work alongside you and you decide if you want to work alongside us in the process. Wonderful. Thank you so much and really appreciate this opportunity to talk with you today. Thanks so much, Lauren, for being with us. Thank you for having me. It's been a great time.

[00:15:07] Thanks for tuning in to Expanding Access. We hope you're feeling inspired by today's discussion. If you've enjoyed the episode, subscribe and share it with your network. For more content and opportunities to get involved in transforming care, visit BehavioralHealthTech.com. Until next time, let's keep pushing boundaries and expanding access together.