HELPING LOW-INCOME VETERANS ENROLLED IN MEDI-CAL CVSO WINTER

HELPING LOW-INCOME VETERANS ENROLLED IN MEDI-CAL CVSO WINTER PROFESSIONAL TRAINING CONFERENCE March 1, 2018 1:00 PM – 2:30 PM MANUEL URBINA & LAUREN ORTEGA Veteran Benefit Enhancement California Department of Health Care Services

The Medi-Cal Program Medi-Cal, California’s Medicaid program, covers more than 13 million Californians: children, their parents, pregnant women, seniors and people with disabilities, and low-income nonelderly adults. The program has undergone a major expansion due to the Affordable Care Act (ACA). Medi-Cal saw a total increase of 5.6 million enrollees between 2013 and 2017. 2

Medi-Cal Cost Avoidance Program DHCS’ Medi-Cal program is the ONLY public assistance program that directly funds CVSOs. It is the second largest funding source of three county subvention revenue sources, larger that the Veteran Service Office Fund (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. 3

Medi-Cal Cost Avoidance Work Load Units (WLU) CVSOs report workload activities to CalVET semiannually. CVSOs can now get Medi-Cal WLU for a 10-10 EZ. 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, DHCS, or CalVET (whomever sent the form originally) as soon as possible in order for DHCS to determine the applicants eligibility. 4

Medi-Cal Referrals (From CWD) MC 05s are used by county Medi-Cal eligibility workers to verify the status of veterans benefits being received. The CWD gives the CVSO the “aid code” or anticipated “aid code” if eligibility is not yet determined. 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. 5

Medi-Cal Referrals (From DHCS) Since July 1, 2015, CVSOs have received additional veterans referrals directly from the state. DHCS phased out the use of the CW-5 form during FY 2015-16. CWDs transitioned to the new Military Verification and Referral Form, known as the MC 05. The CW-5 is still used for Food Assistance programs. The MC 05 is used for Medi-Cal applicants/recipients. It does not apply to other public assistance programs. 6

DHCS Partnership with CalVET The California Department of Veterans (CalVET) has established a new Veterans Benefit Enhancement (VBE) team. CalVET VBE allows DHCS to considerably increase the number of referrals worked each quarter and connect veterans with the benefits they’ve earned. 7

Medi-Cal Referrals (From CalVET) Since October 1, 2017, CVSOs have received additional veterans referrals directly from the new CalVET VBE team. Each quarter, DHCS sends CalVET additional referrals after reviewing the case, CalVET may hand off the referral to the CVSO for coordination of benefits. CVSOs fill out the bottom portion of the MC 05 and return them to CalVET (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. 8

Medi-Cal Cost Avoidance Improvements California Healthcare Eligibility, Enrollment, and Retention System (CalHEERS) Creation of MC05 Form Approving VAHC Units County Welfare Department Education: Medi-Cal Eligibility Division Information Letter (MEDIL) 9

Medi-Cal Application – Military Question The Affordable Care Act allowed several million new beneficiaries to enroll in MediCal over the last three years through CalHEERS. The military question was added to CalHEERS on September 25, 2017 and allows DHCS to identify and educate recently enrolled beneficiaries on VA benefits and enhancement activities. 10

Veterans Choice Program In August 2017, the President signed the VA Choice and Quality Employment Act of 2017 which authorized 2.1 billion in additional funds for the Veterans Choice Program (VCP). The new funds represent a short-term, temporary funding solution for VCP. In 2015, distance rules were updated to consider driving distance. In 2016, launched Community Care Call Center to assist with credit & billing issues for Veterans and community providers. Impact to Veterans on Medi-Cal Experience? Improvements? 11

National News Michigan State Audit Found Michigan Veterans Affairs Agency (MVAA) outreach efforts could be improved to properly connecting Veterans in State assistance programs with potential federal benefits. Contract monitoring could be improved to maximize State grant funds. VA Partnership with CMS to improve programs and focus on eliminating fraud & reducing waste. 12

CVSO WLU Activity Fiscal Year 2015 - 2016 Top Ten WLU 1. San Bernardino 2. Riverside 3. Butte 4. Humboldt 5. Mendocino 6. Sonoma 7. Yuba-Sutter 8. San Joaquin 9. Los Angeles 10. Lake Fiscal Year 2016 - 2017 Top Ten WLU 1. San Bernardino 2. Riverside 3. Butte 4. Kern 5. Lake 6. Los Angeles 7. Shasta 8. Yuba-Sutter 9. Humboldt 10. Mendocino 13

Medi-Cal Work Load Units (WLU) By Fiscal Year Fiscal Year County WLU Total 2009-2010 28,775 2010-2011 24,659 County WLU Total 35,000 30,000 2011-2012 23,589 2012-2013 25,493 25,000 20,000 15,000 2013-2014 24,679 2014-2015 17,170 10,000 5,000 0 2015-2016 21,552 2016-2017 23,969 20092010 20102011 20112012 20122013 20132014 20142015 20152016 20162017 County WLU Total 14

Outreach Success VA Outpatient Clinic: super clinic providing medical, surgical, mental health, and diagnostic outpatient services. Strong partnership with county welfare department. Building relationships with LTC/IH service providers. Assisting veterans needing to navigate ACA coverage available to their families. Please recognize Nathan Johnson of Contra Costa County! 15

Contact Information Manuel Urbina and Lauren Ortega Medi-Cal Eligibility Division Department of Health Care Services [email protected]