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| Money Follows the Person Demonstration | |
|---|---|
| Name | Money Follows the Person Demonstration |
| Established | 2005 |
| Administered by | Centers for Medicare & Medicaid Services |
| Program type | Federal demonstration grant |
| Country | United States |
Money Follows the Person Demonstration
Money Follows the Person Demonstration was a federal demonstration initiative to transition beneficiaries from institutional settings to community-based living. It was authorized under the Deficit Reduction Act of 2005 and administered by the Centers for Medicare & Medicaid Services in partnership with state Medicaid agencies. The demonstration connected policy objectives from the Olmstead v. L.C. litigation with programmatic tools used by the Social Security Administration, Department of Health and Human Services, Kaiser Family Foundation, and state-level departments such as the New York State Department of Health and the California Department of Health Care Services.
The demonstration emerged amid policy debates involving the Deficit Reduction Act of 2005, the Olmstead v. L.C. Supreme Court decision, and advocacy from organizations like the AARP, The Arc of the United States, and the Robert Wood Johnson Foundation. It aimed to implement principles endorsed by the Administration for Community Living and to operationalize deinstitutionalization efforts seen in earlier initiatives such as the Home and Community-Based Services (HCBS) waivers and the Americans with Disabilities Act. The initiative interfaced with state actions influenced by reports from the Government Accountability Office, research by the Urban Institute, and litigation trends involving the Department of Justice and state human services departments.
Design incorporated components from Medicaid policy tools used by Congressional Budget Office analyses and program evaluation frameworks similar to those applied by the Centers for Disease Control and Prevention. States applied for enhanced Federal Medical Assistance Percentages and developed transition protocols coordinated with entities such as the National Association of State Directors of Developmental Disabilities Services and the National Governors Association. Implementation drew on models from The Commonwealth Fund projects, pilot approaches seen in Massachusetts and Ohio, and technical assistance provided by contractors associated with the Lewin Group and Mathematica Policy Research.
Eligibility criteria aligned with Medicaid institutional criteria used in reviews by the Social Security Advisory Board and assessments paralleling standards from the Veterans Health Administration and Department of Veterans Affairs programs for community reintegration. Enrollment procedures required assessments similar to those used in the National Core Indicators and coordination with entities like the Centers for Medicare & Medicaid Services Innovation Center and state Medicaid managed care plans such as Kaiser Permanente or Centene Corporation plans where applicable. Populations served included individuals with histories of care in settings referenced in litigation and reports by the Bazelon Center for Mental Health Law, the National Disability Rights Network, and state protection and advocacy agencies.
Funding used enhanced match arrangements administered by the Centers for Medicare & Medicaid Services and reflected budgetary analyses akin to those produced by the Congressional Research Service and the Office of Management and Budget. The partnership model resembled intergovernmental agreements seen in initiatives involving the Health Resources and Services Administration and federal grant programs administered by the Administration for Community Living. States implemented funding strategies referencing best practices from Minnesota, Texas, Florida, and Pennsylvania, while evaluations considered fiscal impacts discussed in reports from the Kaiser Family Foundation and analyses by the Urban Institute.
Evaluations were conducted by research organizations such as Mathematica Policy Research, the Urban Institute, and the Lewin Group, and reported outcomes comparable to findings in studies sponsored by the Robert Wood Johnson Foundation and the Kessler Foundation. Reported measures included reduced institutional occupancy similar to trends documented in Olmstead-related compliance reviews, improved community integration outcomes consistent with goals from the Administration for Community Living, and cost analyses examined by the Government Accountability Office. Peer-reviewed discussions appeared alongside comparative research involving models from Japan and Canada health systems literature.
Critiques came from stakeholders including the Bazelon Center for Mental Health Law, the National Disability Rights Network, and state advocacy groups such as Disability Rights California and ENIL (European Network for Independent Living) commentators in comparative analyses. Challenges cited administration reports from the Centers for Medicare & Medicaid Services and audit findings echoed concerns raised by the Government Accountability Office and investigators from the Office of Inspector General (HHS), including issues of sustainability, variation among states like Alabama and California, workforce shortages similar to those reported by the Bureau of Labor Statistics, and complexities in coordinating with Medicare and Medicaid rules administered by the Centers for Medicare & Medicaid Services.
The demonstration influenced subsequent policy actions involving the Administration for Community Living, HCBS rulemaking, and state Medicaid reforms promoted by the National Governors Association and the Kaiser Family Foundation. Its legacy appears in programmatic continuations within states such as New York, Massachusetts, and Washington (state), and in federal initiatives reflected in reports by the Government Accountability Office and analyses by the Urban Institute and Mathematica Policy Research. The project's integration of litigation-driven mandates from Olmstead v. L.C. with Medicaid financing has been cited in policy discussions involving the Affordable Care Act implementation and in advocacy by organizations including the AARP and the Arc of the United States.
Category:Medicaid programs