Money Follows the Person: A 2015 State Survey of Transitions, Services, and Costs

Conclusion

MFP states have collectively transitioned over 52,000 individuals back to a community home over the course of the last eight years with the help of enhanced federal funding under MFP. MFP has given states a foundation upon which to improve existing transition programs, launch new strategies, and continue to rebalance LTSS in favor of community-based services. This year’s survey found: an increasing number of transitions among individuals with mental illness; reliance on case management services to ensure successful transition back to the community; an increasing number of states adding MFP participants to managed care (with a few states reporting coordination problems to date); and the leveraging of MFP dollars and transition experience to strengthen ongoing rebalancing efforts, including BIP, CFC, and other Medicaid HCBS options.

Despite steady growth in the number of transitions, states also face transition challenges related to lack of safe, affordable, and accessible housing, absence of mental health services/providers in some areas, low participation rates in self-directed service options, and sustainability of the demonstration as federal funding expires. MFP funding runs through September 2016, and although states can continue to transition individuals through 2018 (with CMS approval) and have through 2020 to use their remaining funding, states may be pressed to continue funding at current service levels and with existing staffing once MFP expires. MFP Project Directors reported working to sustain successful elements of the demonstration – strong transition coordination and continued inter-agency coordination – in order to continue to support transitions beyond MFP and to strengthen ongoing LTSS rebalancing efforts.