Medicaid’s Money Follows the Person Program: State Progress and Uncertainty Pending Federal Funding Reauthorization

Issue Brief
  1. To qualify for MFP, individuals must reside in an institution for more than 90 consecutive days and move to a house, apartment, or group home with less than four residents.

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  2. H. Stephen Kaye, Evidence for the Impact of the Money Follows the Person Program at 1 (July 2019).

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  3. Eric D. Hargan, Acting Sec’y of the Dep’t of Health & Human Servs., Report to the President and Congress, The Money Follows the Person Rebalancing Demonstration at 16 (June 2017); KFF, Money Follows the Person:  A 2015 State Survey of Transitions, Services, and Costs (Oct. 2015).

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  4. Eric D. Hargan, Acting Sec’y of the Dep’t of Health & Human Servs., Report to the President and Congress, The Money Follows the Person Rebalancing Demonstration at 17 (June 2017); Mathematica, Final Report, Money Follows the Person Demonstration: Overview of State Grantee Progress, January to December 2016 at 5 (Sept. 25, 2017). Medicaid beneficiaries have low incomes, which limits their ability to pay market rents, and there is an inadequate supply of affordable housing in the community often with long waiting lists for housing subsidies. While Medicaid can fund services needed to support beneficiaries with disabilities living in the community, Medicaid does not cover housing costs, making a lack of housing the main barrier to transitions. KFF, Money Follows the Person:  A 2015 State Survey of Transitions, Services, and Costs (Oct. 2015).

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  5. 42 U.S.C. § 1396a (note); Mathematica, Final Report, Money Follows the Person Demonstration: Overview of State Grantee Progress, January to December 2016 at 1 (Sept. 25, 2017).

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  6. Medicaid Extenders Act of 2019, § 3, Pub. L. No. 116-3 (Jan. 24, 2019) (adding $112,000,000 for FY 2019), https://www.congress.gov/bill/116th-congress/house-bill/259; Medicaid Services Investment and Accountability Act of 2019, § 2, Pub. L. No. 116-16 (April 18, 2019) (adding another $20,000,000), https://www.congress.gov/bill/116th-congress/house-bill/1839/; Sustaining Excellence in Medicaid Act of 2019, Pub. L. 116-39 (Aug. 6, 2019) (adding another $122,500,000).

    Sustaining Excellence in Medicaid Act of 2019, Pub. L. 116-39 (Aug. 6, 2019).

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  7. KFF, Money Follows the Person:  A 2015 State Survey of Transitions, Services, and Costs (Oct. 2015).

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  8. The MFP enhanced federal matching rate is determined by subtracting the state’s regular matching rate from 100%, dividing the result in half, and then adding that number of percentage points to the state’s regular matching rate. The MFP enhanced matching rate is capped at 90%.

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  9. Medicaid.gov, Total MFP grant awards through September 2016, initial award dates and identified end dates for MFP funded transitions (last accessed Nov 8, 2019), https://www.medicaid.gov/medicaid/ltss/downloads/money-follows-the-person/mfp-grant-awards.pdf.

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  10. Mathematica, Final Report, Money Follows the Person Demonstration: Overview of State Grantee Progress, January to December 2016 at 24 (Sept. 25, 2017).

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  11. One state, Maryland, did not respond to this survey question.

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  12. Mathematica, Final Report, Money Follows the Person Demonstration: Overview of State Grantee Progress, January to December 2016 at 5 (Sept. 25, 2017); Eric D. Hargan, Acting Sec’y of the Dep’t of Health & Human Servs., Report to the President and Congress, The Money Follows the Person Rebalancing Demonstration (June 2017).

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  13.   Eric D. Hargan, Acting Sec’y of the Dep’t of Health & Human Servs., Report to the President and Congress, The Money Follows the Person Rebalancing Demonstration (June 2017).

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  14. Eric D. Hargan, Acting Sec’y of the Dep’t of Health & Human Servs., Report to the President and Congress, The Money Follows the Person Rebalancing Demonstration (June 2017).

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  15. Id.

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  16. H. Stephen Kaye, Evidence for the Impact of the Money Follows the Person Program at 7 (July 2019).

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  17. Steve Eiken et al., Medicaid Expenditures for Long-Term Services and Supports in FY 2016 (IBM Watson Health, May 2018).

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  18. The majority of MFP states consistently reported per enrollee spending for MFP enrollees receiving HCBS to be lower than those in institutions, and no state reported that institutional costs were lower than HCBS in KFF surveys of MFP states in 2008, 2010, 2011, 2012, 2013, and 2015. A couple of states using capitated managed care reported that HCBS and institutional costs were comparable due to a blended capitation rate. KFF, Money Follows the Person:  A 2015 State Survey of Transitions, Services, and Costs (Oct. 2015).

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  19. Eric D. Hargan, Acting Sec’y of the Dep’t of Health & Human Servs., Report to the President and Congress, The Money Follows the Person Rebalancing Demonstration (June 2017).

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