Description: The federal Money Follows the Person (MFP) demonstration was authorized by Congress as part of the 2005 Deficit Reduction Act (DRA) and was extended under the Affordable Care Act (ACA). MFP offers states the opportunity to receive enhanced federal matching funds for covered Home and Community Based Services (HCBS) for 12 months for each Medicaid beneficiary who transitions from an institutional setting to back to a community based setting as a MFP participant. The Center for Medicare and Medicaid Services (CMS) has defined MFP as “a system of flexible-financing for long-term services and supports that enable available funds to move with the individual to the most appropriate and preferred setting as the individual’s needs and preferences change.” This approach has two major components. One component is a financial system that allows sufficient Medicaid funds to be spent on home and community-based services. This often involves a redistribution of State funds between the long term institutional care (LTC) and community based waiver programs. The second component is a nursing facility transition program that identifies consumers in institutions who wish to transition to the community and helps them to do so. The Missouri Money Follows the Person Demonstration Project has targeted four groups for involvement in the project: the elderly, persons with physical disabilities under the age of 63, individuals with developmental disabilities, and those with a developmental disability and a mental illness. It is the intent of the project to transition qualified persons from long term care facilities such as nursing homes and state habilitation centers back to the community in appropriate living settings with accompanying support services.
Project Contacts: Robert Doljanac, 573.884.2768, firstname.lastname@example.org
Project Period: 2007-2016
Annual Funding: $277,420 (FY2014)
Funding Source: Center for Medicare and Medicaid Services; UMKC Institute for Human Development
Applied Research: The Institute is evaluating the Mo MFP Demonstration Project to provide insight to funding partners on the effectiveness and impact of the project on consumers.
Community Services and Supports: The Institute is taking the lead in monitoring the quality of life for individuals involved in the project and their placement in appropriate and desired living settings. This includes their receiving needed supports and services to be successful in their community living arrangement and their satisfaction with these arrangements. One of the intents of the project is that it will lead to the development and improvement in services for persons with disabilities living in the community.
Information Dissemination: The Mo MFP Demonstration Project is a system of flexible financing for long-term services and supports. Missouri has created an operational protocol that is specific to needs in Missouri. The state’s version of MFP will be shared with other participating states across the nation. Information on the progress of the Mo MFP Demonstration Project is shared at Project Stakeholders Meetings. Semi-annual evaluation reports on the project are listed on the projects website. Project information is also shared in Information Briefs on specific project topics.
Program Need and Historical Context
Home and Community Based Services (HCBS) waiver programs began as a separate long-term supports option with dedicated funding for specific disabilities. As these programs developed, available funding became fully obligated and no new housing slots were developed. This created a barrier to community services and a bias toward institutional living settings. Consumers continued to have access to institutional settings while preferred community options were not available. MFP developed as a strategy to reduce this bias and allow Medicaid funds to be used to support access to services and supports in settings preferred by the consumer.
Consumer and Community Involvement
Missouri agencies providing services for the elderly, persons with physical disabilities, individuals with developmental disabilities and those with a developmental disability and mental illness are involved in all aspects of this demonstration project: advisory, recruitment, implementation, supporting DSP participation, and mentoring. Agencies involved include: People First, Mo Planning Committee, Statewide Council on Housing & Redevelopment, Centers for Independent Living, Comprehensive Psychiatric Rehabilitation Coalition, Area Agencies on Aging, Mo Head Injury Advisory Council, and Mo ARC. Consumers and families are involved in a stakeholders group that meets to address project concerns and help develop and implement strategies to help achieve project goals.
Significant Project Activities and Outcomes
- Increase in the number of waiver funded community living situations
- Changes in state budgeting & financing policies
- An improvement in the quality of life experienced by persons with disabilities
- Establishment of a plan for long-term sustainability of funding for persons participating in the MFP Project after projects expiration
- Develop and implement a system for quality management of HCBS support services
- Develop a system to identify individuals who wish to transition back to the community
- Evaluation of MFP Demonstration Project outcomes
- Monitoring changes in state funding and budgeting policies
- Providing feedback and information on methods to improve services and supports to MFP participants
- Produce articles and briefs on topics relevant to MFP Demonstration Project
- Missouri MFP Demonstration Operational Protocol
- Semi-annual Missouri MFP Demonstration Project evaluation reports sent to CMS
- Information Briefs on select Missouri MFP Demonstration topics
System: A statewide increase in funding and budgeting options for Medicaid waiver participants. Increase in community support and services. Increase in community living arrangements for persons with disabilities.
Leveraging: A collaborative comprised of the UMKC Institute for Human Development, Missouri agencies, and state departments, with funding provided CMS to support this demonstration project.