HHS Spending Billions of Dollars to Move Medicaid Recipients Out of Institutions

February 23, 2011 - 10:12 AM

health care bill

Rep. Joe Wilson, R-S.C., right, hands a copy of the Democrats’ health care bill to an aide after a news conference on Capitol Hill on Wednesday, Nov. 4, 2009. (AP Photo/Alex Brandon)

(CNSNews.com) - The Health and Human Services Department plans to spend $4.3 billion authorized by the Democrats' health care law to move Medicaid beneficiaries out of institutions and into their own homes or "community settings."

“Our country recognized in the Americans with Disabilities Act that everyone who can live at home or in a community-based setting should be allowed to do so,” Secretary Sebelius said. “The Affordable Care Act provides states critical new dollars toward achieving that goal.”

Thirteen states will receive a total of $45 million to start their own "Money Follows the Person" program, which has been extended for another five years under the health care law.

Money Follows the Person (MFP) provides individuals living in nursing homes or other institutions with the services and support they need to live in their own home or a group home. Medicaid recipients benefiting from the MFP program include the elderly, people with intellectual, developmental and/or physical disabilities or mental illness.

HHS says MFP programs so far have helped 12,000 individuals move out of institutions and back into their communities. The grants announced on Tuesday -- $45 million for starters, and a total of $621 million through 2016 -- are expected to help an additional 13,000 people.

“The Money Follows the Person program is hugely important to improving the lives of Medicaid beneficiaries,” said Donald Berwick, M.D., administrator of the Centers for Medicare & Medicaid Services, which will oversee the MFP program. “This helps bring everyone, even those who in the past may have had no choice but to live in an institution, into the community where they can become full participants in the activities most of us take for granted.”

A second program -- called the Community First Choice (CFC) option -- also gives states additional money to make community living a first choice. The Community First Choice Option, which was created by the Affordable Care Act, provides states with a 6-percentage-point increase in federal matching funds for providing services and supports to people on Medicaid.

Over the next three years (through 2014) states could see a total of $3.7 billion in taxpayer funds to provide these services.

“There is more evidence than ever that people who need long-term care prefer to live in their own homes and communities whenever possible,” Berwick said. “To restrict these individuals to institutions where even the simplest decisions of the day such as when to get up, what to eat and when to sleep are made by someone else must no longer be the norm. This new federal funding will make a difference in people’s lives.”

Services and supports provided under CFC include those that help individuals with their daily activities, such as bathing, eating and health-related tasks. The money may also cover the cost of moving people out of institutions, including security and utility deposits, first-month's rent, and purchasing basic household supplies.

To qualify for the increased federal matching funds, states must develop “person-centered plans” that allow the individual to decide what services are needed to achieve or maintain independence.

States must also establish "implementation councils" to advise how the Community First Choice option should work. Those councils must have a majority of members who are disabled and/or elderly.