Money Follows the Person Programs Help Seniors Move Back Home from Nursing Homes

Last updated: March 26, 2024

 

What are Money Follows the Person Programs?

Money Follows the Person (MFP) is a federal grant Medicaid program. It was established to make home and community based services (HCBS) more accessible to seniors and persons with disabilities, while simultaneously decreasing the need for Medicaid-funded nursing home care. A big component of this program is assisting 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.

Assistance in “transitioning home” may include finding affordable housing, paying security and utility deposits, and purchasing essential household items. Furthermore, long-term services and supports are available to MFP participants to assist them in successfully living in the community. This may 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. This program is not available in all states. Currently, 36 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, and with the passing of the Omnibus Appropriations Bill on December 23, 2022, funding was extended through September of 2027. There continues to be a push for permanent funding.

Many persons mistakenly think that the Money Follows the Person Program provides program participants with cash assistance. It does not. Instead, participants are provided with Medicaid-funded services and supports.

 Names, Names, Names

Money Follows the Person Programs fall into a category of Medicaid program called “Home and Community Based Services (HCBS)”. They are also called “Money Follows the Person Rebalancing Programs” or “Money Follows the Person Demonstration Programs”. Additionally, many states have their own program names.

-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?

The following 36 states and the District of Columbia participate in the Money Follows the Person Program. Alternative program names are in parenthesis.

1. Alabama (Gateway to Community Living)
2. Arkansas
3. California (California Community Transitions)
4. Connecticut
5. District of Columbia
6. Georgia
7. Hawaii
8. Idaho (Idaho Home Choice)
9. Indiana
10. Iowa (The Partnership for Community Integration Project)
11. Kansas
12. Kentucky (Kentucky Transitions)
13. Louisiana (My Place or My Place Louisiana)
14. Maine (Homeward Bound)
15. Maryland
16. Massachusetts
17. Minnesota (Moving Home Minnesota)
18. Missouri
19. Montana
20. Nevada
21. New Hampshire
22. New Jersey (I Choose Home)
23. New York (Open Doors)
24. North Carolina
25. North Dakota
26. Ohio (HOME Choice)
27. Oklahoma (Living Choice)
28. Pennsylvania
29. Rhode Island (The Rhode to Home)
30. South Carolina (Home Again)
31. South Dakota
32. Tennessee – restricted to persons with intellectual or developmental disabilities
33. Texas
34. Vermont
35. Washington (Roads to Community Living)
36. West Virginia (Take Me Home)
37. Wisconsin

While Illinois does not currently have an active Money Follows the Person Program, the state is in the process of reactivating their program, which is called Pathways to Community Living or Pathways. It is anticipated it will be active around mid-2024.

 Good News: A state that does not have a Money Follows the Person Program may still offer transitional services to assist seniors currently residing in nursing homes who wish to return home or to the community. Colorado and Delaware are two such states.

 

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 2024.

• One must be eligible for, and a recipient of, Medicaid for at least one day prior to transitioning “home” in one’s state of residence. For Medicaid long-term care for the seniors and persons who are disabled, this often means an individual cannot have a monthly income greater than $2,829 and countable assets more than $2,000. See state-specific Medicaid eligibility criteria.
• One 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 consecutive 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.
• 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.
• One must express a desire to transition back “home” and must move into a qualified community residence. This includes one’s home, the home of a relative, an apartment, or a small group home with a maximum of 4 unrelated residents. Some assisted living facilities qualify, but the individual must have lockable access and their own cooking and sleeping areas.

 

Are There Waitlists?

Depending on the state, there could be a substantial waitlist for participation in Money Follows the Person. This could be due to lack of funding or limited home and community based services Waiver slots, through which home and community based services are often received. HCBS Medicaid Waivers are not entitlement programs; there are a limited number of participant slots. When all of the slots are filled, a waitlist forms. On the contrary, some states provide MFP assistance through their state’s Regular Medicaid Plan. This is an entitlement program and all persons who meet the eligibility requirements are able to receive services. To inquire about a waitlist 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 finding affordable housing, paying one’s security deposit and utility deposits, purchasing furniture for an apartment, covering moving expenses, and even paying for a trial visit to a potential residence in the community. MFP, 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, vehicle adaptations, 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 HCBS Medicaid Waiver 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.

 Did You Know? Since the inception of Money Follows the Person, over 107,000 Medicaid recipients have transitioned from institutional care to living back in the community.

 

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 Medicaid-funded home and community based services, given the MFP recipient continues to meet Medicaid’s eligibility criteria.

 

More Information / How to Apply for Money Follows the Person

State Medicaid agencies must have a local contact agency, also called a lead contact agency, for their MFP program. This could be Area Agencies on Aging (AAA), Aging and Disability Resource Centers (ADRCs), independent living centers, or the Medicaid agency itself. To apply for MFP, a “referral” must be made to a state’s local contact agency. This can be done by anyone, including oneself, family members, or nursing home staff. Referrals are commonly made by phone or email. Additionally, some states offer an online referral process.

To learn more about a state’s MFP Program, including obtaining contact information for a state’s local contact agency, one should contact the Medicaid agency in that state. Persons can also reach out to the MFP project director in that state. The local Area Agency on Aging (AAA) office in one’s state might be another helpful resource.

 To be eligible for MFP, one must be eligible for Medicaid. Take a fast, non-binding Medicaid Eligibility Test here.

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