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

Money Follows the Person (MFP) Rebalancing Grant Demonstration FAQs

1) What is the Money Follows the Person (MFP) Rebalancing Grant Demonstration?

The Money Follows the Person (MFP) Rebalancing Grant Demonstration is a discretionary grant program from the Centers for Medicare and Medicaid Services (CMS). It is designed to help states shift long-term care away from heavy reliance on institutions (like nursing facilities) and toward home and community-based services (HCBS), so Medicaid enrollees who want to live in the community can do so.

2) What is the core purpose of the MFP program?

The core idea is to support Medicaid enrollees who want to move out of nursing facilities and other institutions and live in community settings, while also helping states redesign policies, financing approaches, and service systems so community living becomes realistic and sustainable.

3) Is MFP only about paying for individual transitions out of institutions?

No. The goals are described as broad and structural. In addition to supporting individual transitions, MFP is intended to help states make longer-term system reforms so that community-based services are accessible, reliable, and sustainable.

4) What are the stated goals of MFP?

Based on the description provided, MFP aims to:

• Increase the use of home and community-based services (HCBS) while reducing institution-based services
• Remove legal and administrative barriers in state law and Medicaid policy that limit flexible use of Medicaid funds
• Strengthen states' capacity to keep providing HCBS after someone leaves an institution
• Ensure strong quality assurance and continuous quality improvement for HCBS

5) What kinds of activities can MFP resources support?

The opportunity description emphasizes using MFP resources to build infrastructure needed for successful transitions and stronger community systems. Examples mentioned include transition coordination, housing-related supports, service planning, and system reforms that make community services more accessible and reliable.

6) Who created the MFP Demonstration originally?

The program was originally created by Congress in section 6071 of the Deficit Reduction Act of 2005 (DRA).

7) How did the Affordable Care Act (ACA) change or expand MFP?

Section 2403 of the Affordable Care Act (ACA) expanded and extended MFP by allowing existing participating states to continue strengthening their programs and enabling additional states to join. The ACA amendments also extended the demonstration through September 30, 2016 and added significant funding for fiscal years 2012 through 2016.

8) How long was the demonstration extended under the ACA?

The ACA amendments extended the MFP Demonstration through September 30, 2016.

9) How much additional funding did the ACA provide for MFP?

The ACA added $450 million per year for fiscal years 2012 through 2016, totaling $2.25 billion in additional appropriations.

10) Do unused MFP federal appropriations expire at the end of a fiscal year?

Not under the rules described. Any unused federal appropriation at the end of a fiscal year carries forward into later years and can still be used to make awards through FY 2016.

11) Once a state receives an award, how long are the funds available?

According to the description, once a state receives an award, the funds remain available beyond the initial fiscal year. An award made in 2016 could still be used by the state through 2020 if not fully spent earlier.

12) What is the institutional stay requirement for an individual to be eligible under the ACA-updated rules?

Under the updated rules described, an individual who has lived in an institution for more than 90 consecutive days can be eligible to participate.

13) Are Medicare-paid short-term rehabilitation days counted toward the 90-day institutional stay requirement?

No. The description notes an exception: days spent in the institution solely to receive short-term rehabilitation services paid by Medicare do not count toward the 90-day requirement.

14) What is the National MFP Evaluation and how is it funded?

The National MFP Evaluation is a research and evaluation component extended under the ACA. The law continues the DRA provision allowing up to $1.1 million per year for research and evaluation activities, and this evaluation funding is included within the overall $2.25 billion total referenced.

15) How many states were already operating MFP demonstration programs at the time described?

At the time described, 29 states and the District of Columbia were already operating MFP demonstration programs.

16) When did transitions begin under the early demonstrations?

After an early pre-implementation period, transitions began in spring 2008.

17) What early participation results are mentioned?

As of December 2009, nearly 6,000 people had moved back into community settings through the demonstrations.

18) What is the Funding Opportunity Number and CFDA number for this specific opportunity?

The Funding Opportunity Number is CMS-1LI-11-001 and the CFDA number is 93.791.

19) How many awards did CMS expect to make under this funding opportunity?

CMS expected to make about 20 awards.

20) What is the award amount for this competition?

The award ceiling and floor are both listed as $22,500,000, indicating a standardized award amount for this competition.

21) Is there a cost-sharing or matching requirement?

No cost-sharing or matching requirement is noted in the information provided.

22) Who is eligible to apply?

Eligibility is limited to state governments, specifically a single State Medicaid Agency in a state or territory that is not already participating in the MFP demonstration.

23) Can more than one entity in a state apply?

No. Only one application may be submitted per state.

24) How is "state" defined for eligibility in this opportunity?

The definition of "state" follows federal grant regulations and includes the District of Columbia, Puerto Rico, and U.S. territories and possessions such as Guam, the U.S. Virgin Islands, American Samoa, and the Commonwealth of the Northern Mariana Islands.

25) Is there any special note for U.S. territories related to FMAP?

Yes. Territories are advised that any increased Federal Medical Assistance Percentage (FMAP) associated with MFP would count toward their overall Medicaid allotment, which can affect how much total Medicaid funding is available to them.

26) When was this opportunity posted and when were applications due?

The opportunity was posted on July 23, 2010, and the application deadline was January 7, 2011.

27) When was this opportunity archived?

It was archived on February 6, 2011.

28) Which federal agency sponsors this grant opportunity?

The sponsoring agency is the Centers for Medicare and Medicaid Services (CMS).

29) Where were applicants directed for help accessing the full announcement?

Applicant support for accessing the full announcement was routed through the Grants.gov Contact Center.

30) What is the overall long-term care "rebalancing" approach described in this opportunity?

Rebalancing, as described, means shifting a state long-term care system away from institutional care and toward home and community-based services (HCBS), backed by infrastructure (like transition coordination and service planning) and policy/financing reforms that make community living a standard option rather than an exception.