Money Follows the Person
The Money Follows the Person (MFP) Rebalancing Demonstration Grant helps states rebalance their Medicaid long-term care systems. Over 75,151 people with chronic conditions and disabilities have transitioned from institutions back into the community through MFP programs as of December 2016. The Affordable Care Act of 2010 strengthened and expanded the MFP program allowing more states to apply. There are currently forty-three states and the District of Columbia participating in the demonstration.
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 let people get long-term care 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 improvement of HCBS
States participating in MFP are: AL, AR, CA CO, CT, DE, GA, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NV, NY, OH, OK, PA, RI, SC, SD, TN, TX, VA, VT, WA, WI, WV and the District of Columbia.
The Affordable Care Act Extends & Expands MFP
The Affordable Care Act of 2010 strengthens and expands the MFP program to more states:
- Extends the MFP program through September 30, 2016, and appropriates an additional $2.25 billion ($450 million for each fiscal year (FY) 2012-2016). Any funds remaining at the end of each fiscal year carry over to the next FY, and can be used to make grant awards to current and new grantees through FY 2016.
- Grant awards are available to states for the fiscal year they receive the award, and four additional fiscal years after. Any unused grant funds awarded in 2016 can be used through FY 2020.
- Expands the definition of who is eligible for the MFP program to include people that live in an institution for more than 90 consecutive days. (Exception: days that a person was living in the institution for the sole purpose of receiving short-term rehabilitation services reimbursed by Medicare don't count toward this 90-day period).
- MFP Grant Amounts
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.
MFP Technical Assistance for States
National contractors with subject matter expertise are available to support the Center for Medicare & Medicaid Services (CMS), MFP grantees and others with technical assistance on program implementation, promote best practices and provide guidance on MFP quality improvement strategies to enhance system performance and individual consumer outcomes.
Find more information on MFP technical assistance.
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 helps 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, the 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 program CB-LTSS (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 community-based LTSS, and operating day to day functions pertaining to the LTSS program(s)
The 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 TI funding announcement contains more detailed information about the MFP TI initiative. While the solicitation is now closed, it is available for review.
MFP Evaluation Information and Reports
- CMS Guidance: Reporting Money Follows the Person (MFP) in T-MSIS
- Health Care Expenditures Two Years Post Transition
- Does Early Use of Community-Based Long-Term Services and Supports Lead to Less Use of Institutional Care?
- The Overview of State Grantee Progress from January through December 2016
- The MFP 2015 Annual Report
- Pathways to Independence: Transitioning Adults Under Age 65 from Nursing Homes to Community Living
- Overview of State Grantee Progress from January through December 2015
- Tipping the Balance: The Balancing Incentive Program and State Progress on Rebalancing Their Long-Term Services and Supports
- Hand in Hand: Enhancing the Synergy between Money Follows the Person and Managed Long-Term Services and Supports
- The Right Supports at the Right Time: How Money Follows the Person Programs Are Supporting Diverse Populations in the Community
- The Changing Medical and Long-Term Care Expenditures of People Who Transition from Institutional Care to Home- and Community-Based Services
- Innovations in Home- and Community-Based Services: Highlights from a Review of Services Available to Money Follows the Person Participants
- The Real Choice Systems Change Grant: Building Sustainable Partnerships for Housing.
- MFP 2014 Annual Report
- Proposed Methods for Developing and Testing Risk- and Reliability-Adjustment Models for HCBS Composite Measures
- Risk Adjustment of HCBS Composite Measures, Volume 1
- Risk Adjustment of HCBS Composite Measures, Volume 2
- Development of an HCBS Pressure Ulcer Measure, Volume 1
- Development of an HCBS Pressure Ulcer Measure, Volume 2
- Development of HCBS Quality Measures Webinar
- Video: Development of HCBS Quality Measures slides with accompanying audio. Closed captioning is available
- HCBS Measures Calculation Package
- Additional information and/or printer friendly version of any report
MDS 3.0 Section Q Information
Materials from the MDS 3.0 Section Q Training held on March 7 and March 9, 2012: