Report to Congress—Best Practices in the Money Follows the Person Demonstration

Report to Congress—Best Practices in the Money Follows the Person Demonstration

As required by the Consolidated Appropriations Act, 2021 (P.L. 116-260)
Published: Mar 12, 2024
Publisher: CMS
Associated Project

Money Follows the Person Demonstration: Second National Evaluation

Time frame: 2021–2026

Prepared for:

U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services, Center for Medicaid and CHIP Services

Key Findings
  • State strategies to help MFP participants make successful transitions included embedding local staff in long-term care institutions to provide options counseling, engaging transition specialists to serve people in particular geographic locales, and implementing robust quality monitoring strategies during transition coordination and post-transition.
  • MFP programs leveraged partnerships to address housing barriers and improve housing options for older adults and people with disabilities. Specifically, engagement with state and local public housing authorities helped connect MFP participants with new housing opportunities, while partnerships with landlords helped create subsidy programs, and identify and address landlords’ concerns about leasing to individuals perceived as potentially high-risk tenants.
  • States leveraged the flexibilities under MFP to test new transition services and supports and new ways to deliver them, and more than half (18) of the 32 surveyed states made transition services available to individuals not eligible for MFP after observing their value under the MFP program. For example, many states permanently added transition coordination services to their section 1915(c) waiver program benefit packages, and several others added services for home modifications and one-time household set up costs—such as furnishing and initial pantry stocking.
  • To develop person-centered plans that captured a holistic understanding of participants’ needs, preferences, and desired outcomes, MFP transition specialists observed that some participants were unaccustomed to asserting their voices after being in a structured environment. Prioritizing relationship building upfront, including family members, caregivers, friends, and other informal supports in discussions, and actively creating space for participants’ voices, helped ensure service plans were person-centered.

The Money Follows the Person (MFP) Demonstration, first authorized by Congress in the Deficit Reduction Act of 2005 (P.L. 109-171), has provided nearly $6 billion to 43 states and the District of Columbia to improve access to home and community-based services (HCBS) for Medicaid-eligible individuals who need long-term services and supports (LTSS).

The Centers for Medicare & Medicaid Services (CMS) was directed by the Consolidated Appropriations Act, 2021 to prepare a report on MFP Demonstration best practices. This Report to Congress is organized by the eight Best Practice areas identified by the CAA, 2021, and focuses on the 34 MFP grantee states active at the time of the study, reflecting experiences through Spring 2022.  For each Best Practice, this report identifies effective state strategies for implementing the key components of the MFP Demonstration and features case studies of distinctive state approaches. The information in this report was developed in collaboration with states, providers, and MFP participants and their family members.

Appendix available upon request.

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