Replicating The Program Nationwide

The project began in 2003 with two full-time employees and $700,000 in seed money, with the understanding from state legislators that the program would be discontinued if it did not make back at least twice that outlay. To date, the project has identified more than 10,000 veterans and their families who were not receiving the maximum amount of VA benefits. As of FY2010, it has saved Washington State approximately $30 million in Medicaid funds.

When the effort first began in 2003, Allman would tell fellow administrators in other states about his successes, but few were receptive. The economy, at the time, was still flush, and such a project seemed like something that could be put off. That attitude has changed significantly in the past few years.

“A lot of states, because of this budget crunch, want to know about this program,” Allman said.

Allman has visited 29 states to advise them on how to set up their own programs. Maryland has just initiated its own program. California will go statewide with a pilot program this year. Allman also recently worked with the Texas state government to design a program.

“California and Texas are loving this program,” he said. “They have huge veteran populations.”

“I tell every state the same thing: ‘Your savings is a given. Anytime a military-related benefit replaces Medicaid dollars, there’s your savings’,” Allman said. “I wish I could be face-to-face with every state Medicaid director in a big auditorium to ensure that all 50 states were aware of this program’s potential. In the VA’s own report in 2009, they said that only 27% of veterans who are eligible are receiving monetary benefits. How do we get to that other 73%?”

Lack of Federal Involvement

This project has achieved success despite a lack of direct involvement from VA at a federal level. When Allman needs assistance, he goes to the state VA offices, which  have been very receptive to DSHS’s needs.

The success of the project so far indicates that VA nationally has not done an adequate job of informing veterans about the benefits they are owed, Allman said. “There’s a lack of knowledge of the programs that exist in VA, even about how to simply enroll. We enroll them and encourage them to use it and, especially for Vietnam veterans, explain to them how much better VA hospitals are than they were in the past.”

According to Allman, about 7 out of 10 veterans do not know that they qualify for VA benefits. “They don’t know you only need two years of honorable service,” Allman said. “I don’t know why that’s missed a lot. When they get discharged, you’d think there would be more of a concentrated effort.”

Theoretically, VA has the budgetary flexibility to absorb what is a relatively modest increase in enrollees. However, VA has had problems with poor budget projections in the past. In 2005, due to projections that did not fully take into account veterans returning from Iraq and Afghanistan, VA found itself $1 billion short of what it needed to cover the costs of medical care that year. VA officials were forced to go to Congress and request emergency funding.  

Because of that budget shortfall and because of the perennial delay by Congress in getting budget bills approved, VA now submits its budgets two years at a time to ensure that it will always have funding for medical care at the ready.

VA officials were unavailable for comment on whether this specific initiative by state governments will negatively impact VA’s budget.

As for whether he’s worried about straining VA’s coffers by funneling more patients their way, Allman said he did not look at it from a financial standpoint. “These people are eligible for this. The fact that they didn’t know about it is not one’s fault. I feel it’s VA’s responsibility to provide this care.”

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