Federal Support of Community Living Up for Debate - SILC
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Federal Support of Community Living Up for Debate

Mathew Harp, a young man, sits in his wheelchair smiling outside his home

Federal Support of Community Living Up for Debate

Share your Nursing Home Transition Success Story

“Money Follows the Person” is a straight forward name for a program designed to help people with disabilities live in their communities. The Money Follows the Person (MFP) Program promotes community-based care and services that allow people with disabilities to live in their homes instead of nursing homes, which results in increased independence and improves health outcomes. The benefits of promoting independence for people with disabilities are highly documented and programs that support independence, like MFP, tend to have bipartisan support. The big reason for this is right there in the program name, “Money,” because increasing the independence of people with disabilities saves money.

The MFP program was born of a need to re-balance the federally funded healthcare programs for states to be more effective both financially and in health outcomes. Currently, Medicaid requires states to provide care in nursing homes, but makes home and community-based services (HCBS) optional. MFP provided grants to states to cover services necessary for community living for individuals wishing to leave nursing homes or other institutions. Thanks to MFP, over 75,000 individuals with chronic conditions and disabilities and seniors have been able to transition from institutions back into the community since 2015.

This was the case for Matthew Harp, who at 22-years old, was the youngest person living in his nursing home, because his mother and sister could no longer meet his needs on their own. As he told NPR, “I had only a few friends that would come and see me. I missed everyone very much. And I wanted to leave. I wanted to live with my family so that I would not miss them so much.”

After a year in the nursing home, Matthew was able to move back into his mother’s home. The MFP program paid to renovate his mother’s rented house and to repave the sidewalk in front of the home to make it more accessible for Matthew’s wheelchair.

Unfortunately, the MFP program expired over a year ago. States can continue to use their remaining grant funding through 2020, but that is not enough to maintain the program at current levels, and certainly will not allow states to expand the number of participants. This means fewer individuals will be able to transition out of institutional settings into the care setting of their choice. However, this does not have to be the end of MFP and of success stories like Matthew’s.

The EMPOWER Care Act, sponsored by Senators Bob Portman (R-OH) and Maria Cantwell (D-WA), aims to reauthorize the MFP program through 2022. In Tennessee, the extension of this program would continue to support Tennesseans with disabilities who want to leave institutional settings and move back home. Currently, there are 2,000 Tennesseans enrolled in the program, who are receiving services in their homes at a much lower cost to the state. With continued funding, there’s a chance that many more people could transition to community living and enjoy greater independence. A win-win for the state of Tennessee and people with disabilities.

Senate Bill 2227, the EMPOWER Care Act is expected to be discussed the last week of February 2018. Do you have a story of nursing home transition or community living that you want your representatives to know about as they review the EMPOWER Care Act this week? You can contact them to talk about the positive impact of independence at the US Capitol Switchboard by calling (202) 224-3121.



AAPD. “Action Alert! The EMPOWER Care Act Gets Individuals with Disabilities & Seniors Back Home.” www.aapd.com

LeadingAge. “Money Follows the Person Bill Introduced.” www.leadingage.org

Center for Public Representation. “EMPOWER Care Act.” medicaid.publicrep.org

NPR. “Youth In Nursing Homes Seek Alternative Care.” https://www.npr.org/2010/12/09/131916238/youth-in-nursing-homes-seek-alternative-care