The Centers for Medicare and Medicaid is funding five additional states and territories to expand access to home and community-based services through Medicaid’s Money Follows the Person (MFP) demonstration program.

Awards of up to $5 million each were announced for Illinois, Kansas, and New Hampshire, as well as for American Samoa and Puerto Rico — the first time MFP grants have been made available to territories. These awards bring the total number of participating states and territories to 41. MPF was created to help people receive care in the setting of their choice and reduce unnecessary reliance on institutional care. Since the program’s launch in 2008 through 2020, states have transitioned over 107,000 people to community living.

MFP programs are designed to support Medicaid Long Term Care beneficiaries moving out of nursing homes (or other institutionalized settings) and back to their home in the community. The MFP programs give beneficiaries access to the same type of care in the community that they received in the institution and help them pay for moving expenses. States with MFP programs use federal funds to offset the costs of providing Medicaid beneficiaries the same type and level of support in the community they had in the institution. The support MFP provides varies by state, as does the application processes. 

“The Biden-Harris Administration is deeply committed to ensuring everyone is able to get the high-quality care they need — within the comfort of their own home or community,” said HHS Secretary Xavier Becerra in a statement. “Today, we are expanding access to home and community-based services, so even more states and territories are equipped to best serve the millions of seniors and people with disabilities across the country.”

MFP has a proven track record of helping seniors and people with disabilities transition safely from institutional care to their homes and communities. Letting ‘money follow the person’ is key to those successes, according to CMS Administrator Chiquita Brooks-LaSure. 

 CMS funding will support the early planning phase for MFP programs by:

• Establishing partnerships with community stakeholders, including those representing diverse and underserved populations, tribal entities and governments, key state and local agencies (such as state and local public housing authorities), and community-based organizations.
• Conducting system assessments to better understand how HCBS supports local residents.
• Developing community transition programs.
• Establishing or enhancing Medicaid HCBS quality improvement programs.
• Recruiting HCBS providers and expert providers for transition coordination and technical assistance.

A new report from CMS indicated that, thanks in part to programs like MFP, more than 85% of people who used Medicaid long-term services and supports in 2019 received HCBS rather than institutional services. First authorized in 2006, MFP has provided states with more than $4 billion to support people who choose to transition out of institutions and back into their communities.  

Medicaid funding for HCBS was temporarily increased through the American Rescue Plan and every state that elected to participate in this program has submitted a detailed plan for how they will use these funds. The administration estimates that this change will ultimately result in $25 billion in increased funding, allowing states to develop innovative ways to address existing HCBS workforce and structural issues, expand the capacity of critical services, and begin to meet the needs of people with disabilities, family caregivers, and providers, according to CMS. In June 2022, HHS notified states that they now have through March 31, 2025, to use these additional funds.

Additional resources

• Money Follows the Person program state directors
• Money Follows the Person Tribal Grants — a CMS special initiative currently available in five states. 
• Money Follows the Person Success stories
• The Clearinghouse for Home and Community-Based Services promotes the development and expansion of home- and community-based services by gathering resources and tools for research, policymaking and program development.
• Other CMS Long Term Services and Supports programs

 

Liz Seegert is an independent health journalist and AHCJ’s topic leader on aging. She covers older adults, baby boomers, health policy, and social determinants of health, as well as many other health issues. Her bylines include stories for PBS/NextAvenue.org. the American Journal of Nursing, TIME Health, Medscape, Consumer Reports, and Medical Economics, as well as dozens of other trade and mainstream media. Her articles have been syndicated in Forbes.com, the Los Angeles Times, the Hartford Courant, the Saturday Evening Post and other major outlets.