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The Money Follows the Person Program Aids Quality of Life for Georgians With Disabilities

Kristi Fuller Senior Research Associate Georgia Health Policy Center, Andrew Young School of Policy Studies at Georgia State University

Kristi Fuller, Senior Research Associate, Georgia Health Policy Center, Andrew Young School of Policy Studies at Georgia State University

By Kristi Fuller, Georgia Health Policy Center

As a single mother of two young girls, Michelle found herself in a nursing facility after suffering from a brain-stem stroke which led to loss of speech and quadriplegia.

“No one belongs in a nursing facility,” Michelle* said, “especially not at 34 years old. These are good people here but I didn’t belong there.”

Patricia, 57, was diagnosed with multiple sclerosis and found herself needing care in a nursing home following a significant attack that affected her ability to use her legs.

Both women, at different ages and with different diagnoses, needed skilled care following a major health event and hospital stay. What they did not know at the time was how long they would stay in the facility — in Patricia’s case for 2½ years.

There was no defined end to their nursing home stays until Patricia and Michelle were connected with the Money Follows the Person (MFP) program. The MFP program was established in 2008 through a Centers for Medicare and Medicaid Services demonstration grant awarded to the Georgia Department of Community Health.

The program’s goals include increasing the use of home and community-based services, removing state barriers for Medicaid-eligible individuals from accessing care where they choose, supporting transitions from institutional to community settings and establishing procedures to ensure the services provided are of high quality. Forty-three states and the District of Columbia have received grants to implement the MFP program.

The MFP program targets people with developmental disabilities, individuals with physical disabilities who are under age 65, traumatic brain injury, older adults and young people with a mental health diagnosis.

Before and after transition from an institution, MFP services enable participants to have access to services and supports for one year not typically covered by Medicaid, such as residential security and utility deposits, furnishings and basic household items, moving costs, environmental modifications to make a home or apartment accessible, connections with peer supports and other community services.

In the 10 years since the program began in Georgia, more than 3,073 individuals with disabilities have relocated to their local community. The Georgia Health Policy Center at Georgia State University conducts the evaluation of the MFP program in the state on behalf of the Georgia Department of Community Health. The evaluation includes an assessment of quality of life before and after community transition, as well as cost analysis.

Evaluation results show those who moved out of institutional settings with the support of MFP feel safer, have greater levels of choice and control, and are happier with the help they are receiving and the way they live their lives.

Patricia described MFP’s support as “instrumental” for enabling her to move into an affordable, accessible apartment where she now lives with supportive services. Analysis of Medicaid expenditures for MFP participants found that the average per person expenditures decreased after participants moved to the community and these savings were maintained two years later.

Unfortunately, after suffering another stroke, Michelle died in 2015. The time that Michelle spent with her children in her own home post-nursing home allowed her daughters to know her and remember her in ways that would not have been possible without MFP.

Edwin McWilliams from Disability Connections worked with Michelle to assist her in planning her move.

“She set a goal to be more independent and her love for her children was the driving force behind all her endeavors for independence,” McWilliams said.

The demonstration program ends this year, but because of the positive outcomes for individuals and the state, Georgia modified Medicaid-funded home and community-based programs to sustain the availability of transition support in the future.

With the continuation of the transition services, people living in Georgia facilities will have access to a supportive path to community living for years to come.

”I know I have more to give the world and the world has more to give me,” Patricia said.

For more information about the MFP program in Georgia, visit https://dch.georgia.gov/georgia-money-follows-person-ga-mfp.

*The last names of MFP clients have been withheld to protect individuals’ privacy.

Kristi Fuller is a senior research associate at the Georgia Health Policy Center. She leads the center’s work in aging and disability policy and long-term services and supports.

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