In light of the findings, the state looked to a 15-year-old federal data matching system—the Public Assistance Reporting Information System (PARIS)—to begin systematically identifying which veterans receiving Medicaid benefits could be transferred to the VA.

“We [launched] an interface with PARIS in July of this year,” said Toby Douglas, chief deputy director of the California Department of Health Care Services. “The aim is improve access to veterans’ benefits and to offset the costs to the Medicaid program.” Today PARIS is used in Fresno, San Bernardino and San Diego counties.Developed by the U.S. Department of Health & Human Services, PARIS was set up in 1993 initially to curtail fraud involving people who were collecting welfare benefits in more than one state. Eventually its matching database was expanded to include Veterans Affairs and Department of Defense beneficiaries.

Washington was the first state to use PARIS to transfer veterans from Medicaid to the VA, when, in 2002, it started a program focusing on long-term care beneficiaries. Since then, in addition to California, the system is now being used in Montana and Puerto Rico and is being evaluated by Iowa, New Jersey and at least a dozen other states.

“Veterans earn these benefits with their military service, but many are just not aware of what they’re eligible for or know how to go about getting them,” said Bill Allman, a project manager/analyst with the Washington State Department of Social and Health Services (DSHS).

In 2003, Allman, a Vietnam vet, started the Washington State Veterans Benefit Enhancement Project, a partnership between DSHS and the Washington Department of Veterans Affairs. In its first five years, the project has transferred more than 3,500 veterans and their families, many in long-term care, from Medicaid to VA or Department of Defense healthcare coverage. It has enabled another 1,220 veterans and dependents to receive financial assistance they weren’t getting, or to enhance an existing VA benefit.

The project has saved DSHS an estimated $13 million over four years; during the fiscal year that ended in June, DSHS saved $4.9 million.

“We expect that next year it will be even more,” said Allman, noting that the Washington state legislature, despite an $8 billion budget shortfall, recently directed an additional $1 million to the Washington VA to hire more personnel for the Veterans Project. “That kind of investment is worthwhile because we’re getting an incredible return on it.”

For veterans, especially older ones, the benefits are even more profound. One World War II veteran had been getting by on Social Security and a less than $50-a-month pension; the Washington Veterans Project determined he was entitled to a number of federal benefits, including a lump sum payment of more than $4,500 and a $940 monthly stipend.

One of the biggest benefits of the program is that the heirs of veterans who have their long-term care costs paid for by the VA rather than Medicaid are not required to pay back the expenditure. “A lot of times that requires the sale of the home,” Allman said. “So why would you want to pay for something that maybe you could get for free?”

More states follow suit
Montana began to use the system in 2006 when it wanted to transfer potential beneficiaries of the military’s Tricare health system from Medicaid. In the last year, PARIS came with 760 Tricare hits, according to Russ Hill, the state’s program compliance bureau chief. Of those, 402 people were placed on the program, producing a $1 million savings in Medicaid program costs in fiscal year 2008. This year, that figure nearly doubled to $1.9 million.Other states may also join the club.

Iowa is assessing its capacity to launch the veterans’ portion of PARIS, according to Linda Mount, executive officer of the Iowa Department of Human Services.

New Jersey is also evaluating the program, said Gary Brune, the associate director of the state’s Office of Management and Budget. “The issue was highlighted during discussions for the fiscal year 2010 budget, but the effort is in its infancy,” he said.

But not every state is game. Joan Nissley, a spokesperson for the Pennsylvania Department of Military and Veterans Affairs, said the commonwealth, where 1 million veterans reside, relies “on a decentralized system” by working with veterans’ services directors in each of its 67 counties.

But there will likely be others. Allman has been contacted by more than 15 states for information about the project. “I’ve been in state government for 25 years and I have never seen a program this beneficial,” he said. “Not only are we doing outreach to veterans and family members who are completely unaware that they’re eligible for this, but we’re saving Medicaid dollars on top of that. It’s a win-win for everybody.”

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