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State of KansasVeterans Benefit Enhancement Project
Department of Social & Rehabilitation Services
Kristi Scheve, Data Exchange Manager
March 2012
Public Assistance ParticipationAverage Monthly Caseloads
(Based on First 6 Months of SFY2012)
• Child Care• 9,671 households• 18,237 children
• Medical• 379,630 individuals
(includes 46,130 CHIP children)
• TANF• 13,841 households • 35,871 persons
• SNAP• 141,356 households• 302,700 persons
Kansas’PARIS Veteran Match Numbers
MATCH EXPECTATIONS
PARIS Veterans Match Numbers
• Historically, Kansas VA match returns are 60% veteran & 40% spouse/other
• Even with first VETSNET match being within the “Expectation Range”, approximately 270 individuals with VA income are on the eligibility system not being matched thru PARIS
VBE Project - Working the Match
• You have the data, so now what?– Aid and Attendance
• Living arrangement compared to amount of A&A being received• Not receiving any, but needing long term care (NF or HCBS)
– Third Party Liability • Veteran, the Spouse, & the family
– Service-connected Disability Rating• Living arrangement is long term care• Do they have health coverage on TPL?
– Medicaid Veteran, but no VA income• Do they need help with their review?
– Claims Diagnosis/Era of Service
Kansas’ VeteransBenefit Enhancement Project (VBE)
• Project is a Multi-State Agency Effort1. Kansas Department of Social and Rehabilitation Services
• Agency that administers TANF, SNAP, Child Care, LIEAP, and whose staff determines eligibility for Medical programs
• Sends, Receives, & Filters PARIS files• Produces reports for the VBE project & eligibility staff
2. Kansas Department on Aging• Agency that is responsible for the Nursing Facility and Home &
Community Based Services (HCBS) for Frail Elderly budget• Agency with staff resources and commitment to build database to
track VBE project results• Agency “unofficially” spearheading the VBE project team
3. Kansas Dept. of Health and Environment, Division of Health Care Finance (formerly the Kansas Health
Policy Authority )• Single State Agency for Medicaid Policy• Operates the HealthWave Clearinghouse (determines eligibility for
Medical programs for children and families)• Medicaid claims system• Third Party Liability Interests
4. State Commission on Veterans Affairs• Agency responsible for outreach to veterans • Agency that selected VBE pilot counties• VBE project implementation with mobile vehicles and dedicated
staff to travel the state assisting veterans and their families
VBE Project - Coming Together
• Memorandum of Agreement– Each agency’s legal and program staff involved
• Competing Agency Priorities• Different Levels of Understanding Terms
– Agency Jargon– Only one agency, SRS, had touched the PARIS data
Kansas’ VBE Project Goals
• Outreach to veterans and their families• What family couldn’t use more household income?• What family wouldn’t want more health coverage options?
• Reduced Medicaid expenditures- Prescriptions- Durable Medical Equipment- Long Term Care (Nursing Facilities & HCBS)
• Reduced expenditures in other program areas
Kansas Veteran FactsKansas # of Veterans
Total # Veterans - 240,000Veterans Age 65 & Older - 91,000Veterans Age 85 & Older - 12,000
Source: Veteran Population Model, VetPop2007, US Department of Veterans Affairs,Office of the Assistant Secretary for Policy & Planning, Office of Policy (008A2), Document Released in January 2008.
Kansas’ Veterans BenefitEnhancement Project (VBE)
VBE Project Pilot
• VBE Project Started in Pilot Counties October 2010– 60 of the State’s 105 counties are in the pilot.
• Numbers for the Pilot– Estimated 43,518 veterans in pilot counties.– 247 on first report for VBE project outreach (August 2010
PARIS VA match – Prior to VETSNET)
• Coordinated effort to track results
Progress After Pilot Start
• No new individuals identified on subsequent PARIS VA matches (until VETSNET)
• Veterans Commission Outreach Staff were still being hired and trained after first outreach list
• Legislative Post Audit began soon after start• To date no information has been returned to VBE
team from first outreach list• Medicaid agency now using file each quarter to
identify TPL
Kansas Legislative Post Audit Scope
• Audit to address the following questions– Has the Veterans’ Claims Assistance Program helped more
veterans obtain services through staff located at the State’s three Veteran’s Affairs medical centers?
– Could Kansas achieve cost savings by helping veterans and their dependents user federal Veterans Affairs’ programs instead of state-funded programs such as Medicaid?
Kansas Legislative Post AuditInformation Gathering
• Four agencies to interview• Multiple staff members for each agency interviewed• Repeated Interviews/Conflicting Information
– Group Meeting with Auditors
• Auditor Contacting other States – Besides Washington and California, most states with VA
projects like this are in the same building phase as Kansas
Kansas Legislative Post Audit Results
• Full Audit report is available on-line– Entitled “Kansas Commission on Veterans’ Affairs: A
K-GOAL Audit Reviewing Issues Related to Veterans’ Benefits”
– Pages 15-21 are related to question #2 in the scope of the audit and related to the Kansas Veteran’s Benefit Enhancement project
http://www.kansas.gov/postaudit/audits_perform/r-11-012.pdf
Kansas Legislative Post Audit Results
• In 2009, Kansas Commission on Veterans’ Affairs own analysis estimated Kansas could save between $1.3-$1.9 million
• Audit confirms Kansas could reduce State spending on Medicaid by almost $1.3 million a year
• Audit estimates with VETSNET returning more matches the State’s savings could double to about $2.5 million a year
Kansas Legislative Post Audit Results
• In the last year, KDHE identified 243 Medicaid beneficiaries with previously undisclosed TRICARE coverage
• SRS continues to identify discrepancies in matched VA income to eligibility system budgeted income– First VETSNET match provided astounding monthly
discrepancy numbers
Kansas Legislative Post Audit Results
Kansas Legislative Post Audit Recommendations
• The State needs to reprioritize resources to achieve the estimated savings – Not Necessarily New Resources
• The State needs to establish a structure to better coordinate efforts between several state agencies– MOU Changes Suggested
• Select a lead agency• Clearly identify Roles and Responsibilities of each agency• Determine the priority of work• Create deadlines and follow-up procedures• Capture cost savings!!!
Moving Ahead“Following the Yellow Brick Road”
Questions?
Kristi Scheve, Data Exchange ManagerSRS-Economic & Employment Support
Docking State Office Building915 SW Harrison, Suite 580
Topeka, KS 66612Phone: (785) 296-6706
Fax: (785) 296-6960E-mail: [email protected]
The Washington State StoryVeteran’s Benefit Enhancement Program
A partnership between:
Washington State Health Care Authority
Washington State Department of Veterans Affairs
22
23
Washington State Success Story• In 2002, Washington State Health Care Authority (HCA)
established a partnership with Washington State Dept of Veteran’s Affairs (WDVA) to identify Vets and their dependents eligible for military related health care and the maximization of monthly cash benefits
• Facilitation results in acquiring/increase in federal benefits while reducing Medicaid expenditures.
• Established Application Referral process • HCA utilizes PARIS match data to identify Vets and spouses
which warrant a referral to WDVA. WDVA then initiates the process of increasing the entitlements.
Washington State Utilizes PARIS
• Federal File - Military related matches for TRICARE coverage of veteran and dependents
• Confirmed by COB and third party screens coded Retroactive coverage of 12 months allowed for
recoupment of Medicaid paid expenses• VA File - Maximize current VA benefit
• Aid and Attendance • $90 not in NH• $0 listed amounts – Need review• 70 - 100% service connected disability• Spouses with DIC monthly benefits/CHAMPVA
Washington State VA Healthcare System Enrollments
• All Vets are potentially eligible for VA medical care, but WA focuses on Vets who are receiving A&A or service-connected disability compensation at a 50% disability rating or higher. These Vets are not required to obtain a prescription from a VA doctor to receive drugs or medicines from the VA, but can have their own doctor provide a prescription to the VA pharmacy.
• Project Total: 3006 enrollments
Veteran Benefit Enhancement ProgramCost Avoidance Savings
Saves Medicaid Expenditures
27
SFY 2006 SFY 2007 SFY 2008 SFY 2009 SFY 2010 SFY 2011$0
$1,000,000
$2,000,000
$3,000,000
$4,000,000
$5,000,000
$6,000,000
$7,000,000
Veterans Benefit Programcost-avoidance summary
Cost-Avoidance from VA Monetary Enhancement Cost-Avoidance from TPL Identification and Update
