CMS expands popular home and community-based program

Liz Seegert

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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.

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Liz Seegert

Liz Seegert

Liz Seegert is AHCJ’s health beat leader for aging. She’s an award-winning, independent health journalist based in New York’s Hudson Valley, who writes about caregiving, dementia, access to care, nursing homes and policy. As AHCJ’s health beat leader for aging,