Program That Helps People with Disabilities Move Out of Institutions Temporarily Re-Authorized

Congress has temporarily extended the federal government’s largest grant program that helps states transfer people with disabilities from institutions into independent living arrangements.

Tucked into a larger federal appropriations package and signed into law by President Trump on December 20, 2019, the extension keeps the Money Follows the Person (MFP) program afloat for an additional five months, through May 22, 2020. However, this extension is the fourth such temporary extension in the past year, and a permanent funding stream remains elusive.

“While this is a disappointing turn of events, we have our marching orders for 2020 — advocate, advocate, advocate for a permanent commitment to Money Follows the Person,” Peter Berns, CEO of The Arc, told Disability Scoop.

Created in 2005, the MFP program is designed to help end Medicaid’s traditional “institutional bias,” referring to the historical tendency of the federal government to direct Medicaid funding for people with disabilities toward services in institutional settings, such as psychiatric facilities and nursing homes, as opposed to home and community based settings, such as individual homes or group homes with four or fewer unrelated residents.

Through the MFP program, the Department of Health and Human Services (HHS) awards grants to states for demonstration projects to experiment with ways to transition people from institutional to community settings. In addition, the MFP program also permits states to use grant funding for employment supports and other long-term services to ensure successful transitions.

Overall, 47 states have received funding through the program, which is credited with de-institutionalizing more than 91,000 people.  

The program’s funding, however, has always been in limbo. Five years into its existence, the Affordable Care Act authorized six years of funding for the program, until it abruptly expired in 2016. After being dormant for two years, the program was reauthorized in early 2019 and has since remained on life support.

“While we have appreciated the short-term extensions passed this Congress . . . permanent reauthorization is necessary to ensure that states continue to participate in the MFP program,” the Consortium for Citizens with Disabilities wrote in a letter to Congress in December. “Several states have already stopped transitions under MFP or even dropped out of the program entirely while awaiting the assurance of long-term funding . . . MFP has consistently led to positive outcomes for people with disabilities and older adults and shown cost-savings to states since it began in 2005.”

Click here to read a policy brief from the Kaiser Family Foundation about the MFP program.