[Headline] Money Follows the Person

By Stephanie Thomas

November 1st was the deadline for states to apply for the federal Money Follows the Person Rebalancing initiative. It's our understanding 37 states applied. Grants, totaling $890 million, were awarded to 17 states in January 2007: AR, CA, CT, IA, IN, MD, MI, MO, NE, NH, NY, OH, OK, SC, TX, WA, WI. Twenty one other states have been asked by the Centers for Medicaid and Medicare Services, CMS, to clarify how their plan to rebalance long term care with their proposals. CMS is taking the rebalancing part of this initiative very seriously.

The Congressional Budget Office (the same office that gave MiCASSA such a lousy cost estimate) estimates 100,000 people will get out. We should celebrate gaining movement toward real choice and community services.

Money Follows the Person has the opportunity to being to tear down the walls of the institutional bias. States could see they can give flexibility so people have real choice in where they get their long term care, and it doesn't have to cost more money overall.

So what now? Well, there is more we can do make use of the momentum we have going.

First of all, if your state didn't apply this is an excellent opportunity for an Olmstead suit. They've had years to get it together and now the Feds have handed them a great tool to give people choice. If they couldn't even be bothered to apply there is real argument that they are not even trying to do what the Supreme Court said.

Start identifying people who want out. Challenge your state to get them out.

If your state didn’t apply, or did not get a grant, now is the time to actively remind them that you don't have to have this grant to do MFP. There is not any reason they cannot move the money from the nursing home / institution to the community under the current rules and regulations. States can and are doing it with no federal assistance!

Targeted Case Management (TCM) is a Medicaid program that can be used to pay for identifying and coordinating services for folks transitioning out of institutions. This is a link to a good article on TCM: http://www.hcbs.org/ files/ 29/ 1440/ targeted-casemanagementSPAO41404.doc

As former CMS Administrator said about MFP: "States have NO MORE EXCUSES.”

Second, if your state GOT a grant but you aren’t crazy about the whole plan, don't worry. This is round one. MFP is definitely made for a "do it, fix it" approach. Once states are approved they have to do something called a Demonstration Operational Protocol (DOP) Basically, it's a more detailed plan of how the state will use the grant. (Hint: it's also a plan of how they can make MFP an ongoing part of long term care.) They won't get their grant money unless their plan is approved by CMS, and they have 3-12 months to do it in. It has to include all policies, operating procedures and an evaluation plan. CMS is encouraging states to have all the stakeholders (this means you too) to be involved, and section 6071(1) of the Deficit Reduction Act requires it. For more information on the DOP you can go to the CMS website or email: bob.adapt@sbcglobal.

Let's celebrate MFP as a real advance in freeing our people. Then let's put it to good use. And of course we must renew the push for MiCASSA: The Community Choice Act.

Created on

Tuesday 23 July 2013

Posted on

Thursday 10 December 2020

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