1. State of Kansas Veterans Benefit Enhancement Project
Department of Social & Rehabilitation Services Kristi Scheve, Data Exchange Manager
March 2012

2. Public Assistance Participation Average Monthly Caseloads (Based on First 6 Months of SFY2012)
TANF
13,841 households
35,871 persons
SNAP
141,356 households
302,700 persons
Child Care
9,671 households
18,237 children
Medical
379,630 individuals (includes 46,130 CHIP children)

3. Kansas’ PARIS Veteran Match Numbers
MATCH EXPECTATIONS
Expectations based on…
Number of Vets in the State
Number of Individuals with VA Income coded on the Eligibility System
Number of past PARIS matches (in better times) and taking into consideration caseload growth rates

4. 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

5. 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

6. Kansas’ Veterans Benefit Enhancement Project (VBE)
Project is a Multi-State Agency Effort
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

7. 4. State Commission on Veterans Affairs
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

8. 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

9. 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

10. Kansas’ Veterans Benefit Enhancement Project (VBE)
Kansas Veteran Facts
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.

11. 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

12. 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

13. 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?

14. Kansas Legislative Post Audit Information 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

15. 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 are related to question #2 in the scope of the audit and related to the Kansas Veteran’s Benefit Enhancement project

16. 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

17. Kansas Legislative Post Audit Results

18. 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

19. 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!!!

20. Moving Ahead “Following the Yellow Brick Road”

21. Questions? Kristi Scheve, Data Exchange Manager
SRS-Economic & Employment Support
Docking State Office Building
915 SW Harrison, Suite 580 Topeka, KS Phone:  (785)
Fax:  (785)  

22. The Washington State Story Veteran’s Benefit Enhancement Program
A partnership between:
Washington State Health Care Authority
Washington State Department of Veterans Affairs

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.

24. 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
% service connected disability
Spouses with DIC monthly benefits/CHAMPVA

25. 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

26. Veteran Benefit Enhancement Program Cost Avoidance Savings

27. Saves Medicaid Expenditures

28. Questions? Please contact Bill Allman William.allman@hca.wa.gov Or
Tim Dahlin