Plan to help vets use benefits builds

Vancouver man’s idea shifts costs from states to the feds

By Tom Vogt, Columbian science, military & history reporter

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A Vancouver man’s idea to save Washington millions of dollars in health-care costs continues to attract the attention of other states.

State official Bill Allman uses a national database to find Washington residents who are eligible for federal veterans’ benefits.

Now Oregon has decided to follow Washington’s lead, while California and Texas are taking steps to implement the program.

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Washington has 640,000 military veterans — about 10 percent of the state’s population.

Allman said the program has helped move about 10,000 Washington veterans and their family members to the federal Veterans Affairs health-care system. And that has saved the state more than $30 million in Medicaid expenditures, he said.

Allman, who splits his time between Department of Social and Health Services offices in Vancouver and Olympia, started the program in 2003. It uses the federal Public Assistance Reporting Information System to identify military veterans who are receiving health care through state-funded Medicaid programs that serve low-income residents.

Allman was elected president of the PARIS board of directors in March, giving him an opportunity to share his findings with officials across the country.

“It allows me to do more outreach,” said Allman, a Vietnam veteran.

He didn’t have to travel very far to participate in a recent meeting. A few days ago, Allman took part in a presentation by an Oregon colleague who was pitching a PARIS-based program to the Oregon departments of Health Services and Veterans Affairs.

“I gave my overview from a Washington state experience. The bottom line was that they were so impressed that they decided to scrap the pilot idea and proceed to implementing it statewide,” Allman said.

“As they stated, we acted as the pilot for them. I agreed to continue assisting their implementation process based upon my duties as president of the PARIS board of directors.”

There is plenty of room for expanding that sort of outreach, he said, citing a 2009 VA report.

“Only 27 percent of veterans and family members were receiving monthly monetary benefits that they were likely eligible for,” he said.

A better deal

Veterans’ benefits are particularly significant in the area of long-term care, Allman said.

When long-term care is provided by the state through Medicaid, “You have to pay it back, or the state must recoup its expenses … if you have anything to repay it with,” Allman said.

“For people who own a home, the state will go through an estate recovery process and put a lien on the home for long-term Medicaid help.”

On the other hand, “Veterans’ benefits are earned through service,” Allman said.

Texas has taken steps to move forward on a program like Washington’s, said April Ferrino, an analyst with the Texas Legislative Budget Board.

“Three big things appealed to us: assisting veterans in getting the benefits they’re entitled to; promoting interagency cooperation so the state can maximize resources within a time of stressed budgets; and creating savings for the state Medicaid program,” Ferrino said. “It seemed like a win-win for clients and the state government as well.”

The Texas legislature has passed two bills to implement the program when the state’s new fiscal year starts Sept. 1, she said.

Texas, which has 1.6 million veterans, hasn’t established dollar-saving goals. “We didn’t want to go down that road when initially looking at the program. It depends on services,” as well as levels of disability, Ferrino said.

There have been a number of PARIS success stories, she said.

“To me, that was evidence, and we could try it without guaranteeing an end result. Washington started very small, and once it started to demonstrate savings and value, that was evidence enough for the Legislature to invest more money,” Ferrino said.

California recently finished a two-year pilot program in several counties. A bill introduced in the California Assembly calls for making it a statewide program. According to the bill, additional administrative costs would be about $300,000 for a program that could save $250 million annually.

Potential savings for a bleeding budget is just one selling point, a California official said.

“It really helps the veterans,” said Manuel Urbina, with the California Department of Health Care Services. “They get great coverage from the VA system that may surpass what they got in California Medicaid benefits.”

He also noted that the VA system is much more family-friendly in providing long-term care with no strings attached.

“We would be seeking to recover from the veteran’s estate for the cost of long-term care,” Urbina said. “For many families in California, it’s an attractive reason to choose the VA.”