Transitioning Clients from ADAP to the VA

Presented by: Lisa Daniel, MPA

Identifying the Need

Conducted a Program EvaluationIdentified areas where KADAP was not payer of last resort

Found a significant number (approximately 10 percent) of clients were potentially eligible for VA health care benefits.

Determining Who is EligibleRecertification Application in Fall 2000 asked “Are you a Veteran?”35 applicants marked “Yes”Mailed letter and form with more detailed questions

Are you a Veteran?Did you serve on active duty for over 180 days with the Army, Navy, Air Force, Marines, Coast Guard, or activated National Guard or Reserves?Did you receive an Honorable, General or Other than Honorable Discharge?

Determining Who is Eligible

18 of 35 applicants were eligibleYielded a savings of $11,500 per monthTo date – transferred 30-40 clients

Clients we didn’t catch initiallyWaiting list clients

Contacting VA Hospitals

Contacted VA hospitals in KentuckyIdentified a single point of contact at each hospitalClients were instructed to contact the nearest VA hospital for an appointment

“Federal Benefits for Veterans and Dependents”

A book published each year by VAProvides information on services offered by VA (not just medical services)To qualify for medical services, a person must have

Honorable, general or other than honorable dischargeServed 180 days (this varies depending on time of service)Copies of DD-214• Sliding Fee Scale applies

Each VA Hospital is Different

Some have case managers specifically for PLWHAsSome require approval for benefits before an appointment is scheduledSome will allow the clients to retain their current HIV specialist

Notifying the Clients

Mailed each potentially eligible client a letterInformed client they were potentially eligible for Veteran’s health care benefitsReminded client KADAP is payer of last resortInstructed client to contact the nearest VA officeRequired client to submit denial letter from VAAllowed 6-8 weeks for VA application process

Client Follow-Up

If no response was received 7-10 days before deadline, mailed reminder noticeIf no response to reminder notice, client was removed from KADAPAllowed extensions for clients

T*II CANN Article

July/August 2000 edition featured article

Used questions listed in article

Opted not to ask for copies of DD-214 (discharge papers)

Client Testimonials

Follow-up with clientsClients found they were eligible for more than just health care benefits with VA

Clients refused to use VA – not being served by KADAP

QUESTIONS?