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 the community, such as 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 might be personal care assistance, home health care, home modifications for safety and accessibility, adult day care, respite care for informal caregivers, and personal emergency response systems. In many states, program participants have the option to self-direct their own care. With this consumer-directed model, program recipients are able choose the services and benefits that best serve them, as well as have the capability to hire the person of their choosing to provide care, which may include the ability to hire 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 43 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, the last of which is set to expire on May 22, 2020. Currently, there is a push for a permanent extension from Congress for this program.
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 Program
-California – California Community Transitions
-Nevada – Transitioning Home
-Idaho – Idaho Home Choice
Which States Have Money Follows the Person Programs?
The following 43 states and the District of Columbia, currently participate in the Money Follows the Person Program. That said, some states may not currently have funding due to the lack of reauthorization of long-term funding for Money Follows the Person. As mentioned previously, there is support for Congress to extend this funding, though at the time of this writing, it is undetermined if this will happen. 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.
7. District of Columbia
27. New Hampshire
28. New Jersey
29. New York
30. North Carolina
31. North Dakota
35. Rhode Island
36. South Carolina
37. South Dakota
43. West Virginia
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.
• One must be eligible for, and a recipient of, Medicaid in one’s state of residence. For Medicaid long-term care for the elderly and disabled, this often means (in 2020) a single applicant cannot have a monthly income greater than $2,349 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 90 days. Furthermore, the person must wish to return to living in the community, which 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. Waitlists could have to do with lack of funding or lack of a home and community based services waiver slot. HCBS Medicaid waivers are not entitlement programs, which means there are a limited number of participation slots. On the contrary, the regular state Medicaid plan is not an entitlement program and all persons who meet the eligibility requirements are able to receiver 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
Available benefits via Money Follows the Person will not be identical in all states. However, transitioning from a Medicaid-funded institutional setting to community living and providing long-term care services and supports for successful transition is forefront of every MFP program.
Examples of benefits that may be available, 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, 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 a HCBS Medicaid waiver or their state program. This means the available benefits will vary based on the state in which one resides.
However, with MFP, available benefits 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. Also specific to MFP are services and supports that are not generally paid for by Medicaid, but make a transition to community living possible. This might include the 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. To be clear, MFP does not cover the cost of rent or mortgage.
As mentioned previously, 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.
Please note that benefits via this program are restricted to 365 days from the date a program beneficiary is discharged from a Medicaid-funded institution. However, there must be a “continuity of care” following participation in the Money Follows the Person program, which means that MFP program participants must be able to continue to receive needed long-term care services and supports. Stated another way, long-term care will no longer be funded via the Money Follows the Person program, but will need to be funded via another source, such as a HCBS Medicaid waiver or a state’s regular Medicaid plan.
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 after a program participant transitions into community living. (Remember, long-term care benefits via MFP are only available for 365 days following the date of transition). Let’s back up; all states are required to pay for nursing home care, but they are not required to pay for long-term home and community based services. Therefore, Money Follows the Person offers an incentive to the states in the form of federal grants for transition services from a Medicaid-funding nursing home or other institution back into the community, as well as to provide 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, 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.