Championing ‘Money Follows the Person’

In December 2017, Sen. Rob Portman (R-OH) and Sen. Maria Cantwell (D-WA) introduced the EMPOWER Care Act (S. 2227) to reauthorize the Money Follows the Person (MFP) Demonstration Program. ANCOR has led the disability effort to reauthorize MFP and is advocating on the Hill for its swift passage.

The EMPOWER Care Act will:

1. Extend MFP through 2022;
2. Remove barriers for individuals and states;
3. Enhance accountability;
4. And contribute to sharing of best practices across states.

This will assist states with achieving cost-efficiencies in their Medicaid programs while simultaneously enhancing opportunities for individuals to live independently and age with dignity in their homes and communities. 

MFP was first authorized in the Deficit Reduction Act of 2005 with strong bipartisan support and signed into law by President Bush. The program is designed to assist states with:

• Supporting Medicaid enrollees who want to transition from nursing facilities and other institutional setting back to community-based settings; and
• Developing infrastructure to promote and enhance access to HCBS.

Since its inception, 47 states have participated in the program and over 75,000 individuals have been transitioned back to the community. According to independent evaluations by Mathematica, MFP participants report significant and lasting improvements in quality of life and community integration after returning to the community. Their findings also suggest that, after individuals return to the community, their overall Medicare and Medicaid expenditures decrease by roughly 23%. 

States have made significant progress on “balancing” their long-term services and supports system to enhance access for HCBS, due in part to MFP. In FY 2005, states only spent approximately 37% of their LTSS expenditures on HCBS. According to the most recent data, states now spend over 53% on HCBS. 

While states have made great progress transitioning individuals to the community, more work is needed. Significant variations remain across states and different populations who need HCBS. The current MFP program expired on September 30, 2016. While states can continue to use remaining grant funding through 2020, they are currently scaling back their programs and reducing dedicated staff and resources. The most recent national evaluation indicates that last year was the first year that number of new transitions through the program declined. We are beginning to lose the momentum and progress we have made.   

ANCOR commends Sen. Portman, Sen. Cantwell and their respective staff for the bipartisan process to develop this legislation.

If you would like more information, contact Sarah Meek, Director of Legislative Affairs, at [email protected].