CMS Boosts Funds for Medicaid Home- and Community-Based Services

The U.S. Centers for Medicare & Medicaid Services (CMS) has allocated an additional $165 million to states that participate in the agency’s Money Follows the Person (MFP) program, which is designed to help Medicaid recipients transition from receiving care in nursing homes to home- and community-based services. 

Currently 33 states and the District of Columbia participate in the MFP program. Though CMS did not respond to inquiries before Hospice News’ deadline, the agency’s website indicates that hospice, home health care, durable medical equipment, personal care, caregiver training, case management and other services fall under the designation home- and community-based services.

The prevalence of COVID-19 infections in nursing homes has created stronger impetus to move patients out of facilities and into the home.

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“The tragic devastation wrought by the coronavirus on nursing home residents exposes America’s over-reliance on institutional long-term care facilities,” said CMS Administrator Seema Verma. “Residential care will always be an essential part of the care continuum, but our goal must always be to give residents options that help keep our loved ones in their own homes and communities for as long as possible.”

The nursing home sector has been hit particularly hard by the pandemic, with more than 230,000 confirmed cases in that setting nationwide, along with more than 123,000 suspected cases and nearly 55,000 COVID-19 deaths.

Consequently, nursing homes have implemented strict restrictions on who can enter their buildings, as well as the circumstances and conditions in which an individual may enter. This has led to significant difficulty for many hospices that are trying to access their patients in those facilities and hampers their ability to provide respite care in nursing homes or hospitals.

Moving some of these individuals to the home may restore greater access to these patients for hospice providers.

Since the MFP program began in 2007 it has transitioned more than 101,500 Medicaid beneficiaries from institutional care to home- and community-based services. However the agency saw a 46% dip in the program’s numbers during 2019 compared to the prior year. Through this supplemental funding CMS intends to regain some of the program’s momentum.

Each participating state can receive as much as $5 million in additional funds for planning and capacity-building programs for home- and community-based services. This includes efforts such as assessing the current state and capacity of those services within their jurisdiction, building up the workforce that provides those services, caregiver education and training, housing initiatives for Medicaid beneficiaries and other initiatives.

“Home and community-based care is not only frequently more cost effective, but is preferred by seniors and adults with disabilities seeking to maintain the dignity of independent living. This new federal investment will help states get our loved ones back home,” Verma said.

Very few hospices currently participate in the MFP program, but some advocates for seniors and the seriously ill have suggested that the role of hospice in the program be expanded, as well as palliative care.

“The [MFP] demonstration is a long standing and important program that has helped states improve their home and community based services (HCBS) systems and increase options for older adults and people with disabilities,” a LeadingAge spokesperson told Hospice News. “LeadingAge supports funding for the program and hopes Congress extends MFP on a long-term basis. Furthermore, we urge states, as they consider the future of their MFP programs, to consider adding hospice to the services available and also consider offering education to these beneficiaries on palliative care.”

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