Home Long-Term Care Money Follows the Person Program Explained

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Money Follows the Person Program Explained

by Derrick
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It’s possible you’ve heard about or referred to the Medicaid Money Follows the Person (MFP) program if you’ve expressed an interest in transiting from institutional care to home care. If so, then you’ll find the following information beneficial in determining if the MFP program is for you.

What is Medicaid’s Money Follows the Person Program?

The Money Follows the Person program was established in 2008. As of the end of 2019, 101,540 individuals were transitioned to community living under this program. The general idea behind this program is to increase home and community-based services (HCBS) and reduce the need for institutional care settings.

MFP works with state laws, Medicaid plans and other state restrictions that limit the use of Medicaid benefits. It provides more leeway for individuals to receive long-term care support outside of institutional facilities.

If a person receiving Medicaid assistance has been in a nursing home but could realistically be cared for in another setting, then Money Follows the Person can help with the transition and care. The program is available for seniors as well as those that are disabled physically, intellectually or developmentally. Approved home care residences include one’s own home, a family member’s home or a group home with no more than four other unrelated residents. 

How do Individuals and States Benefit?

According to studies, participants feel that they have an improved quality of life after transitioning from a long-term care facility to a community care setting. Additionally, Medicare and Medicaid expenditures decrease for participants by about 20 percent. 

States are required to pay for nursing home care through Medicaid but not long-term or community based services. MFP gives participating states an incentive to utilize more transitional services and home-based care through federal grants. Participating states have reported a substantial reduction in their HCBS expenditures due to MFP funding. 

Who is Eligible for Money Follows the Person?

Although Money Follows the Person eligibility varies by state, there are several factors that can help you determine if you or your loved one would qualify for these benefits. Applicants must be receiving Medicaid. They must not have a monthly income more than $2,349 and countable assets more than $2,000 (as of 2020). 

Those wishing to apply must be living in a Medicaid-funded institution for at least 90 days. They also must express the desire to return to a community living situation as defined previously. The severity of disability must be such that applicants would normally require the level of care provided by an institution but could realistically live in another care setting with the support of MFP. 

How Difficult is the Application Process?

In some states there are substantial waitlists. The delays may be due to lack of funding or lack of a HCBS waiver slot. You can check for waitlists with the Money Follows the Person program director person listed for the state you live in. 

What Money Follows the Person Benefits

MFP program benefits vary by state (check your state’s resources). Regardless, the transition from an institutional setting to community residence with long-term care support services is the main focus. Therefore, MFP might cover security or utility deposits, furnishings, moving expenses, or a trial residence in an approved community. Rent or mortgage payments would not be provided. 

Community-based long- term services and supports (CB-LTSS) include daily living activities such as bathing, dressing, and eating. MFP can be used to cover the costs associated with receiving support for these and other activities. Thus personal care assistance, companion care, homemaker services, home health aides and nursing services are covered through this program. Other coveraged benefits are home modifications for accessibility and safety, and personal emergency response systems. 

Additionally, families of a MFP recipient can take advantage of adult day care services and respite care for informal caregivers. Program participants in many states can choose the services that are in their best interest and hire a person of their choosing to provide care, including relatives. 

These benefits must be utilized within 365 days from an individual’s discharge from an institution. After this period, participants will continue to receive necessary long-term care services through either Medicaid or a HCBS Medicaid waiver.

Which States Participate in MFP?

The MFP programs are administered by each state’s Medicaid agency and the Centers for Medicare & Medicaid (CMS). This program is classified under Medicaid’s Home and Community Based Services (HCBS). It has several other names including Money Follows the Person Rebalancing Program and Money Follows the Person Demonstration Program. 

Washington, DC and 43 other states are participants in the MFP program. Alaska, Arizona, Florida, New Mexico, Oregon, Utah, and Wyoming are non-participating states. If your state is a participating state but you are unable to find information on MFP programs, it might be because your state uses a different name. In New York, MFP is called Open Doors. Louisiana uses the term My Place or My Place Louisiana. The Partnership for Community Integration Program is the MFP program in Iowa. Nevada uses the term Transitioning Home. California Community Transitions and Idaho Home Choice are two other alternative names for this program. 

What is in Store in the Future for MFP?

Originally MFP was given authorization in 2005 by the Deficit Reduction Act (DRA). It was extended in  2010 by the Affordable Care Act (ACA). Since September 2016, the program has been granted several short-term extensions. The current extension will expire in December 2020

The COVID-19 pandemic has prompted more support of Money Follows the Person funding. Sadly at least 40% of deaths attributed to COVID-19 in the United States were among nursing home residents.  In September 2020, the 33 states that currently use MFP transition programs received additional funding to expand their HCBS capacity.  

However, Kansas, Louisiana, Massachusetts, Michigan, South Dakota, Washington, Tennessee, Arizona, and Delaware have already depleted their allotted MFP funds or are nearly depleted. Thirty-four other states are in jeopardy of running out of funds in 2020. One-third of participating states are expected to discontinue services by 2021 if MFP funding is not renewed. 

Conclusion

If you or a loved one wants to return home and needs long-term care, the Money Follows the Person program is definitely something you want to look into. Unfortunately, the uncertainty about future federal funding may mean this Medicaid benefit will no longer be available in the future. 

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