Money Follows the Person Demonstration Program

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The Money Follows the Person (MFP) Demonstration, originally authorized under section 6071 of the Deficit Reduction Act of 2005 (DRA), supports state strategies to rebalance long-term services and supports (LTSS) systems from institutional to community-based care. MFP has played a key role in many states’ LTSS rebalancing efforts under the Medicaid program providing flexible funding opportunities to help states develop and test the necessary processes, tools, and infrastructure to advance LTSS system reform and to support successful transitions from institutional to community-based settings for individuals eligible for Medicaid LTSS. Under the Consolidated Appropriations Act of 2021 (CAA), Congress authorized an additional $1.253 billion in federal funds for the MFP Demonstration and extended the project through federal fiscal year (FY) 2023. The CAA also provided the Centers for Medicare & Medicaid Services (CMS) with authorization to expand the MFP Demonstration to additional states and territories. Currently, there are thirty-four (34) states, including the District of Columbia, participating in the MFP Demonstration. The MFP Demonstration Expansion focuses on states and territories not currently participating in the MFP Demonstration. The MFP Demonstration Expansion (MFP Expansion) citation in this notice of funding opportunity references states and territories eligible to apply. The Money Follows the Person Demonstration (MFP) refers to existing and new participating projects. This Notice of Funding Opportunity (NOFO) will make funds available for a Planning Phase with an anticipated start date of September 1, 2022. Award recipients will begin with the Planning Phase during which they will work with stakeholders to design and develop an MFP Demonstration that supports the states’ unique LTSS system reform goals. Award recipients will also have the opportunity to implement capacity building initiatives during and after the end of the Planning Phase. Funding requests are available for planning and capacity building for an amount up to $5 million per state; awards are anticipated to range between $4 million and $5 million per state. Funding will be available for the year in which it is awarded and four additional years. Following the Planning Phase and CMS approval of certain recipient requirements as described further in this NOFO, the state will be awarded funds for the Program Implementation and Home and Community-based Services (HCBS) Transitions Phase to implement the MFP Demonstration in accordance with the MFP Program Terms and Conditions (PTCs). Funding is issued to recipients via a supplemental award no later than September 30, 2023, as dictated by the Consolidated Appropriations Act, 2021 (CAA), Division CC, Title II, Section 204. Under MFP, participating states may receive cooperative agreement funding for qualified HCBS, demonstration services, and supplemental services, as well as for administrative activities, capacity building, and personnel costs: · States receive an MFP-enhanced federal medical assistance percentage (FMAP) on qualified HCBS and MFP demonstration services during an MFP participant’s 365-day enrollment period. Demonstration services are optional Medicaid reimbursable services that a state currently does not cover under its Medicaid program. CMS expects the recipient to use an equivalent amount of state funds, commensurate with the increase from section 6071(e)(5) of the DRA, for the purposes of providing new or expanded HCBS and for initiatives to strengthen HCBS system infrastructure. · MFP supplemental services are services to support an MFP participant’s transition that are otherwise not allowable under the Medicaid program, e.g., apartment application fees. Supplemental services are not expected to be continued after the 365-day enrollment period. · Capacity building, supplemental services, administrative activities, and personnel costs related to operationalizing the demonstration are fully cooperative agreement-funded. During this Program Implementation and HCBS Transitions Phase, recipients will receive cooperative agreement funding for qualified HCBS, demonstration services, and supplemental services, as well as for administrative activities and personnel costs. Award recipients will be able to continue implementing capacity building activities that were initiated during the Planning Phase.

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