HELPING LOW-INCOME VETERANS ENROLLED IN MEDI-CAL CVSO WINTER PROFESSIONAL TRAINING CONFERENCE February 27, 2016 3:00 PM – 4:00 PM MANUEL URBINA Veteran Benefit Enhancement Manager California Department of Health Care Services

Medi-Cal Cost Avoidance Program The Medi-Cal program has been directly funding county veteran services for several decades. AB 1807, Statutes of 1987, Chapter 1424 authorized DHCS to make available federal Medicaid funds in order to obtain additional veterans benefits for Medi-Cal beneficiaries. DHCS’ Medi-Cal program is the ONLY public assistance program that directly funds CVSOs. It is the second largest funding source out three county subvention revenue sources, larger that the VSOF ($838,000 > $554,000). The Medi-Cal Cost Avoidance Program is administered under the provisions of the California Military & Veterans Code Section 972.5. Funding is allocated to the CVSOs based upon a pro-rata share of reported/audited “workload units” for the current fiscal year.

Medi-Cal Referrals (From CWD) MC 05s are used by county Medi-Cal eligibility workers to verify the status of veterans benefits being received. Upon receipt of the MC 05 from the CWD, the CVSO checks VA data systems to determine if the Medi-Cal applicant that reported military service is receiving VA benefits. The CVSO completes their section of the MC 05 and returns the form to the CWD. The CWD finishes the eligibility determination and gives the CVSO the “aid code” or anticipated “aid code” if eligibility is not yet determined.

Medi-Cal Referrals (From the State) Effective July 1, 2015, CVSOs started receiving additional veterans referrals directly from the state. DHCS phased out the use of the CW-5 form during FY 2015-16. On or before June 30, 2016, CWDs transitioned to the new Military Verification and Referral Form, known as the MC 05. The MC 05 is used for Medi-Cal applicants/recipients. It does not apply to other public assistance programs. CVSOs fill out the bottom portion of the MC 05 and return them to DHCS (by mail or fax). The veterans signature is not required on this form. CVSOs are to help veterans apply for both monetary benefits and VA Health.

Medi-Cal Cost Avoidance Work Load Units (WLU) CVSOs report workload activities to CalVET semiannually. NEW! CVSOs can get Medi-Cal WLU for a 10-10 EZ. CVSOs can now submit the MC 05 on to VetPro. For Medi-Cal Cost Avoidance activities, CVSOs report: one (1) unit for a verification ten (10) units for opening a claim/Benefit Enhancement The current CDVA & DHCS interagency agreement provides a total payment of $838,000 for distribution under this program. Each county’s share will be based upon a pro-rata share of "Medi-Cal workload units" allowed for the current fiscal year. CVSOs should return the MC 05 form to the CWD or DHCS (whomever sent the form originally) as soon as possible in order for DHCS to determine the applicants eligibility.

Medi-Cal Work Load Units (WLU) By Fiscal Year (FY) County WLU Total FY 2009 – 2010 28,775 FY 2010 - 2011 24,659 FY 2011-2012 23,589 FY 2012-2013 25,493 FY 2013-2014 24,679 FY 2014-2015 17,170 FY 2015-2016 21,552

CVSO WLU Activity Fiscal Year 2015 - 2016 Fiscal Year 2016 - 2017 Top Ten WLU San Bernardino Riverside Butte Humboldt Mendocino Sonoma Yuba-Sutter San Joaquin Los Angeles Lake Top Ten WLU San Bernardino Riverside Kern Butte Lake Mendocino Humboldt Yuba-Sutter Sonoma Merced

Outreach Success Publicizes veteran services in local newspaper Strong partnership with county welfare department Helped lift a veteran and her family out of poverty Assisted the veteran obtain huge back payment and enrolled family in VA Health Care System Please recognize Kelly Osborne of Tehama County!

The CVSOs are doing an outstanding job helping veterans in the community!  Of particular interest to the Medi-Cal program are the number of VA Health Care enrollments in FY 15-16. I would like to especially recognize the tremendous efforts by Kern, Orange, and Solano. These three counties had well over 300 VA Health Care enrollments last year.  Excellent job and keep up the good work!

Veterans Affairs Dental Insurance Program (VADIP) The VHA authorized a dental insurance program for veterans enrolled in VA Health Care and for individuals enrolled in CHAMPVA. It is run through the Delta Dental network. Some veterans have told CVSOs that they want to keep their Medi-Cal for dental care.

State of Oregon Measure 96 was the most popular measure on the fall ballot, winning 84 percent to 16 percent. It sets aside 1.5 percent of Oregon Lottery funds for services such as education, housing, health care and helping veterans better access their benefits. That's expected to hit more than $18 million over the next two years.

Here are some other state best practices for consideration here in California. Following a rather dismal audit, the Medicaid Director in the State of New York reminded all eligibility workers of the requirement to refer veterans to federal services.

MC 05 Transition Issues How has the transition been from the CVSO perspective? We received a recommendation that the MC 05 include additional information about the veteran, such as character of discharge, if the vet was disabled in service, if the vet is too disabled to work, If the veteran is deceased

Aid Codes Medi-Cal aid codes have been somewhat volatile over the last few years. Our aid codes are rapidly changing. CalVET and DHCS are coming up with alternatives for addressing situations where a claim takes several months and extends into the next period when the aid code may be invalid.

Contact Information Manuel Urbina Medi-Cal Eligibility Division Department of Health Care Services (916) 650-0160 Manuel.Urbina@dhcs.ca.gov