What are Money Follows the Person Programs?
Money Follows the Person (MFP) is a Medicaid program that provides financial assistance so that individuals who reside in nursing homes can move back into their homes. Assistance is in the form of federal grants to states which is then used to assist seniors and physically / intellectually / developmentally disabled Medicaid recipients with moving out of institutional care and back into a community setting. This may include one’s home, the home of a family member, or a group home that has no more than four unrelated residents. Furthermore, long-term services and supports are provided in order to help program participants successfully transition to community living.
Examples of available benefits via MFP include personal care assistance, home health care, home modifications for safety and accessibility, adult day care, respite care to relieve informal caregivers, and personal emergency response systems. In many states, program participants have the option to self-direct their care. With this consumer-directed model, program recipients can choose the services and supports that best serve them. They also can hire the person of their choosing to provide care. This may include a relative, such as one’s adult child.
The Centers for Medicare & Medicaid (CMS), along with the Medicaid agency in one’s state, administer the Money Follows the Person Programs. Unfortunately, this program is not available in all states. Currently, 34 states and Washington DC participate in this program.
MFP was originally authorized in 2005 by the Deficit Reduction Act (DRA), extended in 2010 by the Affordable Care Act (ACA), and was set to expire in September of 2016. There have since been several short term extensions. In 2021, the Consolidated Appropriations Act (CAA) extended funding through December 31, 2023. There continues to be a push for permanent funding.
Money Follows the Person Programs fall into a category of Medicaid program called “Home and Community Based Services (HCBS)”. They are also referred to as “Money Follows the Person Rebalancing Programs” or “Money Follows the Person Demonstration Programs”. Additionally, many states have their own names for their MFP programs.
-New York – Open Doors
-Louisiana – My Place or My Place Louisiana
-Iowa – The Partnership for Community Integration Project
-California – California Community Transitions
-Idaho – Idaho Home Choice
Which States Have Money Follows the Person Programs?
At the time of this writing, the following 34 states and the District of Columbia participate in the Money Follows the Person Program. Alternative program names are in parenthesis. Persons can inquire about the MFP program in the state in which they reside by reaching out to the MFP project director in their state. Contact information can be found here.
1. Alabama (Gateway to Community Living)
3. California (California Community Transitions)
5. Delaware (Finding a Way Home)
6. District of Columbia
9. Idaho (Idaho Home Choice)
11. Iowa (The Partnership for Community Integration Project)
12. Kentucky (Kentucky Transitions)
13. Louisiana (My Place or My Place Louisiana)
14. Maine (Homeward Bound)
17. Minnesota (Moving Home Minnesota)
21. New Jersey (I Choose Home)
22. New York (Open Doors)
23. North Carolina
24. North Dakota
25. Ohio (HOME Choice)
26. Oklahoma (Living Choice)
28. Rhode Island (The Rhode to Home)
29. South Carolina (Home Again)
30. South Dakota
33. Washington (Roads to Community Living)
34. West Virginia (Take Me Home)
Money Follows the Person Program Eligibility Requirements
While eligibility criteria for Money Follows the Person may vary slightly based on the state in which one resides, what follows are general requirements in 2022.
• One must be eligible for, and a recipient of, Medicaid for as short as one day prior to institutionalization discharge in one’s state of residence. For Medicaid long-term care for the elderly and disabled, this often means an individual cannot have a monthly income greater than $2,523 and countable assets more than $2,000. See state specific Medicaid eligibility criteria.
• The individual must be residing in a Medicaid-funded nursing home or another Medicaid-funded institution, such as institutions for mental diseases for persons 65 and over and intermediate care facilities for individuals with intellectual disabilities, for a minimum of 60 days. Institutionalization used to be required for 90 days, but effective January 26, 2021, the Consolidated Appropriations Act of 2021 decreased the required number of days to 60. Furthermore, the person must wish to return to living in the community. This is defined as one’s home, the home of a relative, an apartment, or a small group home with a maximum of 4 unrelated residents.
• One must require an institutional level of care, but could live in the community with available home and community based services through Money Follows the Person.
Are There Waitlists?
There could be a waitlist for participation in the Money Follows the Person program. This could be due to lack of funding or lack of a home and community based services waiver slot, through which home and community based services are often received. HCBS Medicaid waivers are not entitlement programs. This means there are a limited number of participant slots. On the contrary, the regular state Medicaid plan is an entitlement program and all persons who meet the eligibility requirements are able to receive services. To inquire about a wait list in the state in which one resides, contact the MFP Program Director in that state.
Program Benefits of Money Follows the Person Programs
The benefits available via Money Follows the Person are not identical in all states. Transitioning from a Medicaid-funded institutional setting to community living and providing long-term care services and supports for successful transition, however, is forefront of every MFP program.
Transitional services might include payment of a security deposit and utility deposits, purchasing furniture for an apartment, covering moving expenses, or even paying for a trial visit to a potential residence in the community. The program, however, will not cover the cost of rent or mortgage. Examples of long-term services and supports, many of which are provided via a HCBS Medicaid waiver or a state’s regular Medicaid plan, include personal care assistance, companion care, homemaker services, home health aides, nursing services, adult day care / adult day health care, home delivered meals, respite care, home modifications, and assistive technology. Essentially, these are benefits that the Medicaid recipient could potentially receive via Medicaid even without participating in the Money Follows the Person program. Not all states offer the same home and community based services via their Medicaid programs. This is why available benefits vary based on the state in which one resides.
With MFP, available benefits may go above and beyond what may be provided through a waiver program or the state Medicaid plan. For instance, a MFP program recipient might be approved for an increased number of personal care assistance hours, behavioral health services, or other services and supports that aren’t available through a waiver program or the state plan.
Depending on the Money Follows the Person Program in one’s state, some program benefits may be self-directed. This means certain relatives, such as an adult child, a grandchild, or a niece or nephew, might be able to be paid to provide care.
How Do MFP Programs Work?
States that participate in Money Follows the Person receive additional federal funding to help cover the cost of home and community based services in the community for the first 365 days following a program participant’s transition to community living. To be clear, long-term care benefits via MFP are limited to one year from the date of transition. While all states are required to pay for nursing home care, they are not required to pay for long-term home and community based services. Money Follows the Person offers an incentive to the states in the form of federal grants to pay for transition services and home and community based services to make the transition successful.
Following the 365 days of program participation, a state’s Medicaid program must continue to provide home and community based services via the state’s other available Medicaid programs (either a HCBS waiver or the state’s regular Medicaid plan), given the MFP recipient continues to meet Medicaid’s eligibility criteria.
More Information / How to Apply for Money Follows the Person
For additional information about the MFP program in a specific state, one should contact the Medicaid agency in that state. Contact information for each state can be found here. Furthermore, the local Area Agency on Aging (AAA) office in one’s state might be another helpful resource. Locate the local office in one’s state here.