The expiration of the Money Follows the Person (MFP) program at the end of last year left providers and individuals seeking home- and community-based service services (HCBS) underfunded and unsure of whether Congress would extend the program. In late January, the President signed a bill approving a three-month extension. We will look at the impact of the new legislation—and what factors may influence the future of this program.
MFP was initially enacted in 2005 by President Bush as part of the Deficit Reduction Act and was later extended through 2016 within the Affordable Care Act. The program was a bipartisan effort designed to incentivize investment in HCBS and improve access in states across the country for individuals with intellectual and developmental disabilities (I/DD), as well as the elderly. The 44 states that currently use this Medicaid funding have been able to assist over 88,000 people to voluntarily move out of institutions into HCBS.
The Extension’s Impact
Since the expiration of MFP in 2016, states were in the process of utilizing remaining funds until the end of 2018, when all 44 states officially exhausted their funding. The Medicaid Extenders Act of 2019, passed on January 24, 2019, currently provides three additional months of funding, which states must spend before September 31, 2019. Spousal impoverishment protections were also extended; however, those funds expire on March 31, 2019.
Although the renewed funding is seen as a positive by many advocacy groups, some concerns remain. For example, the funding may not be enough to allow states to fully recover from the long-term damage created by the gap in legislative support. In addition, it’s possible some states may not be aware of the extension or familiar with its deadlines, which could impact how quickly funding is allocated and whether the new deadline for spending is met.
Future Considerations
The Centers for Medicare and Medicaid Services (CMS) evaluated MFP in 2017. Their research found that program recipients reported improved care after transitioning to HCBS. In addition, beneficiaries of the program were measured across seven quality-of-life domains and the results showed significant improvement across all of them.
According to the evaluation by CMS, the MFP program has proven to save states money because, on average, HCBS costs less than institutional care. MFP participants reported a 25% reduction in average monthly expenses in their first year of transitioning to HCBS from an institution. Those who participated in MFP were less likely to be readmitted to an institution than individuals who transitioned but did not participate in MFP.
Despite evidence that the program is effective, the future of MFP remains uncertain. Those advocating for MFP are now concentrating their efforts to persuade Congress to pass new legislation that makes MFP a permanent program for states. This would prevent potential gaps in funding and services each time Congress debates reauthorization of the program. However, it’s unknown whether these efforts will be successful—leaving both providers and patients unclear what will happen when funds have been exhausted.
No matter what the future holds, we will continue to provide support in whatever ways we can. If you have questions or want to talk about how best to strategize with the current funding deadlines in place, don’t hesitate to contact us.
Sources:
- https://www.disabilityscoop.com/2019/01/29/trump-signs-extension-of-program-that-helps-people-leave-institutions/25949/
- https://medicaid.publicrep.org/empower-care-act/
- https://www.autismspeaks.org/advocacy-news/money-follows-person-program-extended
- https://www.disabilityscoop.com/2019/03/04/renewed-push-extend-leave-institutions/26108/