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Minnesota Money Follows the Person Rebalancing Demonstration Program

On Feb. 22, 2011, the U.S. Department of Health and Human Services announced awards to thirteen states to receive Money Follows the Person Demonstration Program Grants. Congress authorized the MFP program under the 2005 Deficit Reduction Act. Additional funding is available from 2011-16 under the Affordable Care Act. Minnesota is one of the thirteen states awarded grants in 2011 and joins 29 other states and the District of Columbia already operating MFP programs.

Minnesota will leverage an award of up to $187.4 million in federal funds over 5 years to improve community services and support people in their homes rather than institutions. First-year funding for Minnesota is $13.4 million. Participation in this program will help DHS:

• Continue to rebalance its long-term care system away from dependence on institutional care to achieve a sustainable balance of institutional and community-based services

• Provide more individualized care for some of Minnesota’s most vulnerable residents

What are goals of the demonstration?

Through the demonstration, DHS would be able to achieve the following goals:

1. Simplify and improve the effectiveness of transition services that help people return to their homes after hospital or nursing facility stays.
2. Advance promising practices to better serve individuals with complex needs in the community.
3. Increase stability of individuals in the community by strengthening connections among healthcare, community support, employment and housing systems.
4. Increase use of home and community-based services by setting priorities to address specific institutional needs for reform.

What is Minnesota’s approach?

DHS already serves the majority of those needing long-term care through home and community-based services. DHS intends to use the demonstration to:

• Assess and build on all current waiver, state plan, managed care and home and community-based programs and services, as authorized by state rule and statute

• Focus on Minnesotans who currently receive long-term support in institutional settings

• Simplify and individualize how people with complex needs are served

• Test strategies that better serve individuals with the most complex needs through HCBS

• Transition approximately 2,500 individuals from institutional settings to more cost-effective home and community-based alternatives over the five-year grant period

For each year Minnesota participates in the demonstration, DHS will set a specific number of transitions of eligible individuals from an inpatient facility to a qualified residence. Throughout the demonstration, DHS will continue to increase the proportion of State Medicaid expenditures for HCBS relative to those spent on institutional long-term care. The Centers for Medicare and Medicaid Services defines eligible individual and qualified residence:

Eligible individual: Person who receives MA for at least one day before enrollment in MFP and has resided in a qualified institution for at least 90 consecutive days.

Qualified institutions: Inpatient facilities as defined in section 6071(b)(3) of the Deficit Reduction Act:

• Hospitals

• Institutions for mental diseases to the extent services there are covered by Medical Assistance

• Intermediate care facilities

• Nursing facilities

Qualified residence: As defined in section 6071(b)(6) of the Deficit Reduction Act:

• Home owned or leased by the individual or the individual’s family member

• Apartment with an individual lease, with lockable access and egress, and which includes living, sleeping, bathing, and cooking areas over which the individual or the individual’s family has domain and control or

• Residence, in a community-based residential setting, in which no more than 4 unrelated individuals reside

The Minnesota demonstration will collaborate across stakeholders and work with the HCBS Partners Panel. DHS is in the process of negotiating terms and conditions of the demonstration with CMS. .

How can I get more information?

Send an e-mail to MFP.Demo@state.mn.us with questions or comments about the Money Follows the Person demonstration. Also see the Centers for Medicare & Medicaid Services Money Follows the Person website.

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