After living for three years in a nursing home following a stroke, Gail, 78, went through his life savings paying for the nursing home and eventually qualified for Medicaid. He had always wanted to and intended to move back home, but his condition required that he stay in the nursing home. His ex-wife, Sue, and a social worker at the nursing home informed him about a program called “Money Follows the Person” (MFP), which supports efforts to move institutionalized individuals back home.In 2009, MFP enabled Gail to move into Sue’s house because she is his main care provider. The program allotted $1,500 for home services, modifications to the home in the form of ramps and a handicap accessible bathroom, 16 hours of personal care services each month, and attendance at adult day care each day. Gail’s health has remained steady, he is able to enjoy more of a routine life, and he is able to get the care he needs at home while surrounded by friends and family.
OHIO MFP CASE STUDY
Source: Kaiser Family Foundation, www.kff.org
Overview: In January 2007 Ohio was one of 17 states to receive funding for the Money Follows the Person rebalancing demonstration. The state was awarded up to $100 million in enhanced federal matching funds in order to transition roughly 2,200 seniors and people with disabilities from institutions to home- and community-based settings and to help Ohio balance its long-term services and support system. Ohio’s MFP demonstration known as HOME Choice and these statistics come from a survey that was conducted in November 2010. It describes key features of the program and highlights early program experiences.
Program Features: Ten people currently work for the MFP program in Ohio, including specialists in each of the following areas: outreach, enrollment, housing, population-specific community living administers, data, and balancing long-term services and supports within the state. Recognizing the importance of safe, affordable housing in a successful transition, Ohio is one of six states that employ a housing specialist within its Medicaid agency to help build partnerships with state public housing officials.
Services Provided: Ohio provides the following services: independent living skills training, community support coaching, HOME Choice nursing services, social work/counseling, nutrition consultation, community transition services, transition coordination, communication aids, service animals, respite, emergency rental and utility assistance, community living specialist, and care management.
Transition Progress: Since Ohio began enrolling MFP participants in October 2008, almost 900 individuals have been transitioned back to the community and another 626 individuals are in the process of transitioning. As of January 2011, the number of seniors who were transitioned was 208, with another 149 in progress, and 29 had been reinstitutionalized.
Cost: On average, the cost of a HOME Choice transition for a senior was $2379/month, the lowest cost of all categories, which included developmentally disabled ($8554/month) and physically disabled ($4519/month).
The U.S. Congress authorized the MFP as part of the Deficit Reduction Act of 2005. MFP was designed to assist states in rebalancing their long-term care systems and help Medicaid enrollees transition out of institutions and back to their communities.
Since 2008 when the first senior moved back home through the MFP program, an increasing number of states have been making stories like Gail’s a reality for seniors and others with disabilities. As of February 2011, 43 states and the District of Columbia
participate in the “Money Follows the Person Rebalancing Demonstration Program.” The significance of this program for seniors is found in its intention for establishing a strong foundation of person-centered, consumer-directed, and community-based services. Seniors are receiving the services they need in an environment that is more comfortable for their recovery and/or daily living. Ultimately, the service model is no longer provider-driven and institution-based, but rather it is more conducive to successful living because of the personalized approach. (Centers for Medicare and Medicaid Services
More recently, with the passing of the Affordable Care Act in March of 2010, the MFP received a boost in funding and a time extension through September 30, 2016. Additionally, the MFP program expanded the eligibility requirements to include anyone who is in an institution for more than 90 consecutive days. The old restriction was anyone who had been institutionalized for six months to two years. The longer an individual has been institutionalized the more likely they are to have relinquished a community residence and it is often more challenging for them to again establish a community residence. Individuals who have been institutionalized for a shorter period of time may still have a home to which they still have access.
States have their own methods for identifying appropriate candidates for the MFP program. Once identified, the individual has access to the designated funds for their case for a period of twelve months and receives assistance in achieving the needed transition services.
After the program is complete, the continuity of care in each state will vary. Generally, MFP participants may be able to access existing waivers. Participants will continue to be served through these waivers as long as they continue to meet the eligibility criteria. Therefore, there will not be a lapse in services for MFP demonstration participants. Check with your state on the plans the Medicaid office has in place for the post-demonstration period.To read more of this article from the Society of Certified Senior Advisors, click HERE.