Understanding the Basics of Medicaid’s Money Follows the Person Program

Summary
Money Follows the Person (MFP) programs are designed to support Medicaid Long Term Care beneficiaries who are moving out of nursing homes or other institutionalized settings and returning to live in their home or somewhere else in the community, like the home of a loved one. Support from MFP programs includes paying for moving expenses and making sure the program beneficiary has access to the same kind of long term care in the community that they received in the nursing home.

What Is Money Follows the Person?

Money Follows the Person (MFP) is a federally funded Medicaid program that supports states in their efforts to transition Medicaid Long Term Care beneficiaries from living in institutional settings, primarily nursing homes, to living in the community. States that have 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.

When it comes to MFP, living in the “community” can mean the Medicaid beneficiary returns to the home they were living in previously, or moving in with a family member or friend, or into a small group home setting with no more than four unrelated individuals in the residence. The “institution” the MFP beneficiary is leaving is most often a nursing home, but it can also be an assisted living facility, a memory care unit for Alzheimer’s or dementia patients, or any Medicaid-approved facility with on-site skilled nursing care and constant supervision.

MFP was created in 2005 and then extended in 2010, 2016 and 2021. It is intended to maximize freedom of choice for Medicaid beneficiaries and there is a long-term aim to establish permanent supports to help people transition out of institutions and go back home.

The programs are also referred to as “Money Follows the Person Rebalancing Programs” and “Money Follows the Person Demonstration Programs.” Plus, some states have their own names. In California, the MFP program is known as “California Community Transitions.” In New York, it’s called “Open Doors.” In Maine, it’s “Homeward Bound,” and in West Virginia it’s known as “Take Me Home.” Below is a complete list of states that have MFP programs with state-specific names.

How Does Money Follows the Person Work?

To be clear, individuals do not directly receive any money through the Money Follows the Person (MFP) program. The federal MFP program gives money to the states, which in turn provide long term care goods, services and other financial support to the individual so they can return to the community and still receive the kind of care they need.

However, MFP support is limited to one year. This means MFP program beneficiaries will receive long term care services and supports in the community for the first 365 days following their departure from the nursing home or other institution. After a year, Medicaid Long Term Care will continue to provide healthcare to Medicaid beneficiary in the community as long as the beneficiary still meets eligibility requirements. The exact type of support provided by MFP, and the program that will continue that support after a year, can all vary depending on the state.

Money Follows the Person Benefits

In some states, Money Follows the Person (MFP) programs will help with transitional needs like covering a security deposit, paying for moving expenses and purchasing furniture. Once the Medicaid recipient moves home, MFP will help pay for things like personal care aids, adult day care and home visits from doctors and nurses. In some cases, MFP benefits at home may surpass the benefits the individual was receiving in the institution. They might be approved for extra physical therapy, or more hours of personal care, for example.

MFP will also pay for home modifications and assistive technology to help ease the transition from the institution to the community. Home modifications can include bathroom grab bars, wheelchair ramps, widened doorways and other renovations meant to increase safety and accessibility. Assistive technology can include things like electronic pill dispensers, memory aids, screen readers and Personal Emergency Response Systems (PERS).

Consumer Directed Care

Some states with Money Follows the Person programs have Consumer Directed Care, which gives individuals additional decision-making power when it comes to their health care. With Consumer Directed Care, individuals can choose who provides their care, what kind of care and services they receive, and what type of medical goods, devices and medications they use.

These choices come within preset limits – everything from a list of medications to choose from to a fully independent budget – but they can include hiring a relative as a personal care aid. This allows the Medicaid beneficiary to receive care from a loved one like an adult child, and for that loved one to get paid for the services they were probably already providing. The paid caregiver does not need to be a medical professional, but they may have to pass some state requirements, like attending training courses or being CPR certified.

Eligibility Requirements & Waitlists for Money Follows the Person

There are two basic requirements to be eligible for Money Follows the Person. First, a person must be enrolled in a Medicaid Long Term Care program. Second, that person must have been living in a Medicaid-approved institution (a nursing home, assisted living facility, memory care unit, etc.) for at least 60 days to be eligible for the Money Follows the Person program in their state. The time requirement used to be 90 days, but that changed with the Consolidated Appropriations Act of 2021.

There are three types of Medicaid Long Term Care – Nursing Home Medicaid, Home and Community Based Services (HCBS) Waivers, and Aged Blind or Disabled (ABD) Medicaid. All three have both financial and functional (medical) requirements for eligibility. Our Medicaid Eligibility Requirements Finder tool can help you check out your own eligibility situation.

Some Medicaid Long Term Care beneficiaries may experience a wait before receiving support through MFP. This might happen because the MFP program in the beneficiary’s state doesn’t have sufficient funds to support another senior. Or it could happen because the MFP program uses an HCBS Waiver to provide the long term care support and that HCBS Waiver does not have any available enrollment spots. While Nursing Home Medicaid and ABD Medicaid are both entitlements (meaning qualified applicants are guaranteed by law to receive benefits without wait, that’s not the case with HCBS Waivers. Instead, HCBS Waiver programs have a limited number of enrollment spots, and once those spots are full additional applicants are placed on a waitlist. To learn more about Medicaid waitlists, click here.

Money Follows the Person will mostly be relevant for people with Nursing Home Medicaid who want to return home. However, there are some people who have HCBS Waivers or ABD Medicaid and live in some kind of assisted living facility but wish to return home, and in these cases Money Follows the Person could be used.

States With Money Follows the Person Programs

The following 36 states (and Washington, D.C.) currently have Money Follows the Person programs (state-specific program names in parentheses):

• Alabama (Gateway to Community Living)
• Arkansas
• California (California Community Transitions)
• Connecticut
• Georgia
• Hawaii
• Idaho (Idaho Home Choice)
• Indiana
• Iowa (The Partnership for Community Integration Project)
• Kansas
• Kentucky (Kentucky Transitions)
• Louisiana (My Place)
• Maine (Homeward Bound)
• Maryland
• Massachusetts
• Minnesota (Moving Home Minnesota)
• Missouri
• Montana
• Nevada
• New Hampshire
• New Jersey (I Choose Home)
• New York (Open Doors)
• North Carolina
• North Dakota
• Ohio (HOME Choice)
• Oklahoma (Living Choice)
• Pennsylvania
• Rhode Island (The Rhode to Home)
• South Carolina (Home Again)
• South Dakota
• Tennessee
• Texas
• Vermont
• Washington (Roads to Community Living)
• West Virginia (Take Me Home)
• Wisconsin
• Washington, D.C.

How to Apply to Money Follows the Person Programs

Every state uses a local contact agency for their Money Follows the Person program. This agency, also called a lead contact agency, might be an Area Agency on Aging (AAA), an Aging and Disability Resource Center (ARDC), an independent living center or it might be the Medicaid agency itself. To apply for MFP, there must be a “referral” made to the local contact agency on behalf of the applicant. This isn’t like a referral from one doctor’s office to another, because this referral can be made by the applicant themselves, their family or the nursing home/institution staff.

To locate the local contact agency for your region, or to find out more about the MFP program in your state, you can reach out to the MFP director in your state. A list of directors can be found here. Your local Area Agency on Aging might also be able to help, and you can find the office closest to you by clicking here.