Money Follows the Person

CMS has released two important documents that outline essential elements of MLTSS programs that are in line with current best practices. The first document summarizes these essential elements and the second provides guidance for incorporating these essential elements into MLTSS programs operating under section 1115 or 1915(b) authorities. These standards will be used when CMS reviews states’ design, implementation and operation of MLTSS programs for approval and ongoing quality assurance.

Money Follows the Person (MFP) federal grants are provided to states in order to assist older adults and people with disabilities in transitioning from nursing facilities to home and community based settings. A history and current state of MFP are offered. This report provides an overview of how MFP has helped states to rebalance their LTSS programs and provides next steps and an outlook for the future of MFP or similar programs once the demonstration project’s funding has run out.

A survey of state aging, disability and Medicaid agencies was conducted in 2012, in order to better understand challenges and concerns for funding and providing quality LTSS. Five common themes were identified in this report, including staff turnover and reductions during a sluggish recovery of state budgets. Other findings include an overall expansion of home and community-based services, LTSS transformation and reduced funding and high demand for non-Medicaid aging and disability services.

Four new papers look at the Money Follows the Person demonstration program, drawing on a 2012 survey of state MFP programs. A total of 46 states have received federal grant money under the program, which was extended through 2016 by the Affordable Care Act. As of August 2012, over 25,000 individuals nationally had been transitioned back to the community since the program’s inception. The survey report describes trends in enrollment, services and per-capita spending in state MFP efforts.

As increasing numbers of state Medicaid agencies implement both MFP and MLTSS programs, it is important to understand how they can work together to achieve common goals -- shifting the balance of LTSS from institutional care to HCBS settings. This report examines how 5 states have structured the interface between the two programs, including overlap in eligible groups, design of Medicaid payment rates to managed care organizations (MCOs); and how MFP and MCO staff share or divide responsibility.

Presented at the 27th National Home and Community-Based Services (HCBS) Conference, this presentation discussed HCBS beginnings and momentum, including advocacy and costs, HCBS waivers, Aging and Disability Resource Centers (ADRCs), and Money Follows the Person (MFP), data and metrics to build community-based services, and using metrics to move forward.

MFP demonstration supports states' efforts to help Medicaid beneficiaries living in long-term care institutions transition back to community-based residences and make LTSS more accessible. Using nursing home assessment data, this report compared needs of MFP participants with a cohort of Medicaid long-stay nursing home residents who transitioned to HCBS in grantee states but were not enrolled in MFP, and a cohort of long-stay residents in MFP states who did not transition.

This technical assistance tool is a product of CHCS' Implementing the Roadmaps: Innovations in Long-Term Supports and Services program. Through this program, CHCS is helping participating states to rebalance and better manage an array of long-term services and supports for Medicaid populations. This brief highlights ways for states to participate in the Balancing Incentive Program, which offers enhanced federal financing to fund non-institutionally based LTSS within their Medicaid programs.

A competitive grant opportunity designed to assist individuals at risk of nursing home placement & spend down to Medicaid to enable them to continue to live in their community. The initiative encourages the Aging Services Network to modernize and transform funding from the OAA, or other non-Medicaid sources, into flexible consumer-directed service dollars. The grants complement CMS's Money Follows the Person to reach older adults before they enter a nursing home & supports rebalancing efforts.

This report summarizes the progress of Money Follows the Person (MFP) grant programs in 33 states and the District of Columbia. MFP grants support state efforts to help individuals living in institutions move to home and community based services (HCBS). The document examines numbers of people who transitioned, reinstitutionalization rates, achievement of spending goals on Medicaid HCBS, and major accomplishments and implementation challenges.