The Money Follows the Person Program


The Money Follows the Person (MFP) initiative was made part of federal law in 2005. It is a multi-year several-billion-dollar optional grant by the federal government to states who promise to use the grant money (as part of the Medicaid program) to increase the use of home and community-based services (HCBS) and reduce the use of institutionally-based services.

Not only do most people favor residing in the home or a home-like community location, but it has been proven to be more cost-effective for state governments. Thus, the federal government—by means of this initiative—has been encouraging the states to increase the availability HCBS for people with disabilities or needs for nursing-home-like care so they can move from an institutional setting into the home or an assisted living facility.

The grant money has allowed states to set up an infrastructure to determine which nursing home patients are most likely to benefit from a move from an institutional setting, to identify such patients, and to provide continuing assessment and care planning.

It also has been used by the states to offer expanded services beyond those normally encompassed in the HCBS program such as: personal care service trials; paying for a community ombudsman; transitional crisis support; team behavioral consultation staff; social work/counseling; consumer guides; transitional counseling; mental health needs; housing counseling; housing modifications; 24-hour care (in limited circumstances); service animals; vehicle modifications; moving assistance; caregiver training; roommate matching; internet installation; etc.

What is available varies from state to state, so be sure to check what it covers in your state. For more details, visit the MFP page on the Medicaid website.

While the cost of a person residing at home—even with some outside care—certainly is lower than that of the same person residing in a nursing home, the fact remains that the person will no longer be receiving around-the-clock supervision by nurses and other workers found in a nursing home. So it is of vital importance that the individual receive correct assessment that they are a good candidate for such a move, as well as continuing assessment of their condition to ensure they are not put at risk by remaining at home or in an assisted living facility.

While the MFP Program is implemented at the state government level, a particular person applying for Medicaid or HCBS will probably not even be aware that they are affected by such funding. They will still need to follow all the usual rules of qualifying for Medicaid, only now there will be a greater likelihood that they will be able to continue to live in their community.

States Participating in Money Follows the Person (MFP) are:

AL, AR, CA CO, CT, DE, GA, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NV, NY, OH, OK, OR, PA, RI, SC, SD, TN, TX, VA, VT, WA, WI, WV and the District of Columbia.

K. Gabriel Heiser is an attorney with over 25 years of experience in elder law and estate planning. He is the author of "How to Protect Your Family's Assets from Devastating Nursing Home Costs: Medicaid Secrets," an annually updated practical guide for the layperson.

Medicaid Secrets

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how are assets treated for this program and what are considered assests
Recently my mom moved in with us. We made majer adjust. to our life. We put in a stair climber for her. She uses a walker and goes to numerous dr. Actually i didnt realize it ws going to be so much work. I have no life. Shes not on medicaid. Can we get help?
When this article states, "the person will no longer be receiving round the clock care," in reference to leaving the nursing facility to go home, as a down side. In my opinion, no facility offers, "round the clock care." Even the best places are usually short staffed and unless the person is capable of communication, (which a lot aren't), they only get checked in on when the designated schedules have the staff do so. If there is good support for a caregiver in the home situation, then the person needing care will get the "round the clock" care, because it will be a one on one ratio, instead of a 1 to 12 ratio, usually there is one staffer per hallway, which I've seen as having at least twelve patients to the hallway. Plus, the staffer is often pulled away to help a staffer from another hallway that might need assistance dealing with a patient. The patient at home will not be rushed through meals, as is what usually happens in a facility, because there are so many who need help with eating and only so many staffers to assist them. And the patients won't be stuck in a room with horrible room mates. They won't have to be forced to use a diaper when they could very well use the toilet, if there were enough people to help get them on it, when needed. Not to mention, the CNAs are usually under paid (in this area around $11 or $12 per hour, which usually causes these angels of mercy have to work at least two jobs. Making them totally exhausted. The problem with follow the money, is the patient usually has to be in a nursing facility for at least 6 months before you can even apply for this program. So, the patient has to be placed in a facility (which is upsetting for all involved), then the State has to determine if that patient makes a good candidate for this program, (more time in the facility and which, believe me is an upsetting experience for the family/patient), then the patient is uprooted again, if they are determined a candidate can finally go home. Why can't the State just come out to the house, to start, with to determine if the patient will be alright to stay in the home? Because, the State is all about money and cares nothing about the patients or families that this could be helping. In theory it's a great idea, in reality, it's just more government red-tape.