The Money Follows the Person (MFP) demonstration supports state efforts for rebalancing their long-term services and supports system so that individuals have a choice of where they live and receive services. From the start of the program in 2008 through the end of 2020, states have transitioned over 107,000 people to community living under MFP.
MFP Program Goals
- Increase the use of home and community-based services (HCBS) and reduce the use of institutionally-based services
- Eliminate barriers in state law, state Medicaid plans, and state budgets that restrict the use of Medicaid funds to enable Medicaid-eligible individuals to receive support for appropriate and necessary long-term services and supports in the settings of their choice
- Strengthen the ability of Medicaid programs to provide HCBS to people who choose to transition out of institutions
- Put procedures in place to provide quality assurance and improve HCBS
Money Follows the Person Demonstration Expansion: Notice of Funding Opportunity (NOFO)
CMS released a Notice of Funding Opportunity that will offer up to $110 million to expand access to home and community-based services (HBCS) through Medicaid’s Money Follows the Person (MFP) program. The new NOFO authorized under the Consolidated Appropriations Act of 2021 (CAA) will make individual awards of up to $5 million to states and territories that are not currently participating in MFP. These funds will support states during the initial planning and implementation of their programs.
CMS will hold two webinars to provide details about the MFP Demonstration Expansion, and to answer questions from potential applicants regarding this funding opportunity. Registration is required. The webinars will be held:
- April 13, 2022 1:00 pm to 2:00 pm (ET)
Registration: Click on https://cms.zoomgov.com/j/1601853787?pwd=Vm9UTUoyRnpVVStjSEo1QlZYWURPUT09
- April 27, 2022 1:00 pm to 2:00 pm (ET)
Registration: Click on https://cms.zoomgov.com/j/1612862544?pwd=MGd3YW5nUVJ4T050bWFraTV6V0Y1UT09
Questions: Please contact MFPdemo@cms.hhs.gov.
Notice to Current MFP Grantees: Changes to MFP Supplemental Services
On March 31, 2022, CMS notified current MFP grantees that it is increasing the reimbursement rate for MFP “supplemental services.” These services are now 100% federally funded with no state share. CMS also announced that it is expanding the definition of supplemental services to include additional services that can support an individual’s transition from an institution to the community, including short-term housing and food assistance. These changes will help to address barriers to community transition for eligible individuals in institutions, increase community transition rates, and increase the effectiveness of the MFP demonstration. Additional information on MFP supplemental services and the changes announced by CMS are available in the notice (PDF, 176.39 KB) that was provided to MFP grantees. Questions about the notice can be directed to MFPdemo@cms.hhs.gov.
MFP Grantee Information
Grant awards are available to states for the fiscal year they receive the award, and four additional fiscal years after.
Report to Congress
The authorizing legislation required that the Secretary of the Department of Health and Human Services provide for a national evaluation of the MFP demonstration and submit a final report to the president and Congress that presents the findings and conclusions of this evaluation.
- Money Follows the Person Rebalancing Report to Congress (PDF, 954.15 KB)
MFP HCBS Capacity Building Initiative
On September 23, 2020, CMS announced a supplemental funding opportunity available to the 33 MFP demonstration states that are currently operating MFP funded transition programs. Under this supplemental funding opportunity, up to $5 million in MFP grant funds is being made available to each eligible state for planning and capacity building activities to accelerate LTSS system transformation design and implementation and to expand HCBS capacity. This funding is expected to strengthen the focus and attention on LTSS rebalancing among states participating in the MFP demonstration and to support MFP grantees with making meaningful progress with LTSS rebalancing.
Eligible states can submit supplemental budget requests under this funding opportunity on a rolling basis through June 30, 2021. Consistent with all MFP grant awards, funds will be available for the federal fiscal year in which it was awarded and four additional fiscal years.
The CMS Money Follows the Person Tribal Initiative
In 2013, CMS awarded funding for the MFP Tribal Initiative (TI) to five state grantees: Minnesota, Oklahoma, North Dakota, Washington and Wisconsin. The MFP TI offers existing MFP state grantees and tribal partners the resources to build sustainable community-based long- term services and supports (CB-LTSS) specifically for Indian country. CB-LTSS are those types of assistance with daily activities that generally help older adults and people with disabilities to remain in their homes. This initiative will make available these services to people with functional limitations or cognitive impairments that need assistance with activities of daily living such as bathing, dressing, eating, or other basic activities when they have been in an institutional setting for over 90 days. These services will help them move back into the community. In addition, MFP TI may be used to advance the development of an infrastructure required to implement CB-LTSS for American Indians and Alaska Natives (AI/AN) using a single or a variety of applicable Medicaid authorities. Funding is intended to support the planning and development of:
- An in-state Medicaid CB-LTSS program (as an alternative to institutional care) tailored for AI/ANs who are presently receiving services in an institution
- A service delivery structure that includes a set of administrative functions delegated by the state Medicaid agency to tribes or tribal organizations (T/TOs), such as enabling tribe(s) to design an effective program or package of Medicaid CB LTSS and operating day to day functions pertaining to the LTSS program(s)
MFP TI may be used to cover costs necessary to plan and implement activities consistent with the objectives of this funding and within federal grant regulations. The funds are subject to all the terms and conditions of the MFP program.
The MFP TI funding announcement contains more detailed information about the MFP TI initiative. While the solicitation is now closed, it is available for review (PDF, 841 KB).
MFP Evaluation Information and Reports
- Money Follows the Person: State Transitions as of December 31, 2019 (PDF, 348.05 KB)
- CMS Guidance: Reporting Money Follows the Person (MFP) in T-MSIS
- Health Care Expenditures Two Years Post Transition (PDF, 771.53 KB)
- Does Early Use of Community-Based Long-Term Services and Supports Lead to Less Use of Institutional Care? (PDF, 401.11 KB)
- The Overview of State Grantee Progress from January through December 2016 (PDF, 3.61 MB)
- The MFP 2015 Annual Report (PDF, 3.4 MB)
- Pathways to Independence: Transitioning Adults Under Age 65 from Nursing Homes to Community Living (PDF, 1.02 MB)
- Tipping the Balance: The Balancing Incentive Program and State Progress on Rebalancing Their Long-Term Services and Supports (PDF, 729.79 KB)
- Hand in Hand: Enhancing the Synergy between Money Follows the Person and Managed Long-Term Services and Supports (PDF, 402.79 KB)
- The Right Supports at the Right Time: How Money Follows the Person Programs Are Supporting Diverse Populations in the Community (PDF, 1.07 MB)
- The Changing Medical and Long-Term Care Expenditures of People Who Transition from Institutional Care to Home- and Community-Based Services (PDF, 405.1 KB)
- Innovations in Home- and Community-Based Services: Highlights from a Review of Services Available to Money Follows the Person Participants (PDF, 266.65 KB)
- The Real Choice Systems Change Grant: Building Sustainable Partnerships for Housing (PDF, 313.08 KB)
- Proposed Methods for Developing and Testing Risk- and Reliability-Adjustment Models for HCBS Composite Measures (PDF, 515.43 KB)
- Risk Adjustment of HCBS Composite Measures, Volume 1 (PDF, 1.03 MB)
- Risk Adjustment of HCBS Composite Measures, Volume 2 (ZIP, 1.31 MB)
- Development of an HCBS Pressure Ulcer Measure, Volume 1 (PDF, 637.09 KB)
- Development of an HCBS Pressure Ulcer Measure, Volume 2 (ZIP, 652.81 KB)
- Development of HCBS Quality Measures Webinar (PDF, 587.69 KB)
- Video: Development of HCBS Quality Measures slides with accompanying audio. Closed captioning is available
- HCBS Measures Calculation Package (ZIP, 379.06 KB)
- Additional information and/or printer friendly version of any report