Money Follows the Person Rebalancing Grant Demonstration Patient Protection and Affordable Healthcare Act Section 2403

Description

The MFP Rebalancing Demonstration Program was authorized by Congress in section 6071 of the Deficit Reduction Act of 2005 (DRA) and was designed to provide assistance to States to balance their long-term care systems and help Medicaid enrollees transition from institutions to the community. The MFP Demonstration Program reflects a growing consensus that long-term supports must be transformed from being institutionally-based and provider-driven to ?person-centered? consumer directed and community-based. Congress initially authorized up to $1.75 billion in Federal funds through fiscal year (FY) 2011 to: 1) Increase the use of HCBS and reduce the use of institutionally-based services; 2) Eliminate barriers and mechanisms in State law, State Medicaid plans, or State budgets that prevent or restrict the flexible use of Medicaid funds to enable Medicaid-eligible individuals to receive long-term care in the settings of their choice; 3) Strengthen the ability of Medicaid programs to assure continued provision of HCBS to those individuals who choose to transition from institutions; and, 4) Ensure that procedures are in place to provide quality assurance and continuous quality improvement of HCBS. Currently, twenty-nine States and the District of Columbia have implemented MFP Demonstration Programs. After a pre-implementation period, States began actively transitioning individuals into community settings in the spring of 2008. Since the beginning of calendar year 2009, the number of participants transitioning has increased as solutions to barriers were identified and significant technical assistance is continuing to be provided to help States meet transition benchmarks they set. As of December 2009, almost 6,000 individuals have returned to the community as a result of these demonstrations. Section 2403 of the ACA provides an opportunity for those States that are presently participating in the program to continue building and strengthening their MFP Demonstration Programs and for additional States to participate. The law amends section 6071 of the DRA to make the following changes: 1) Extends the MFP Demonstration Program through September 30, 2016, and appropriates an additional $450 million for each FY 2012-2016, totaling an additional $2.25 billion. Any remaining MFP appropriation at the end of each FY carries over to subsequent FYs and is available to make grant awards to current and new grantees until FY 2016. Grant awards shall be made available to the State for the FY in which the award was received and for additional FYs. As such, any unused portion of a State grant award made in 2016 would be available to the State until 2020. Under the Affordable Care Act, individuals that reside in an institution for more than 90 consecutive days are now eligible to participate in the demonstration. However, one exception applies in the expanded definition of eligibility: days that an individual was residing in the institution for the sole purpose of receiving short-term rehabilitation services that are reimbursed under Medicare are excluded and will not be counted toward the 90-day required period. 2) Additional funding is provided through 2016 for the National MFP Evaluation. The Affordable Care Act extends the DRA provision that a maximum of $1.1 million per year shall be available for research and evaluation purposes and is part of the $2.25 billion total noted above.

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