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Money Follows the Person Programs Hindered by Lack of Direct-Care Workers, Survey Finds

January 5, 2012

A survey of directors of Money Follows the Person (MFP) Demonstration Programs conducted by the Kaiser Commission on Medicaid and the Uninsured found that the lack of available direct-care workers is an ongoing impediment to meeting program goals.

The MFP program, originally established in 2006 and extended until 2016 by the Affordable Care Act, provides increased federal Medicaid matching funds to states to help them transition beneficiaries from institutional settings to community-based settings. Forty-three states and the District of Columbia participate in the program.

In Money Follows the Person: A 2011 Survey of Transitions, Services and Costs (pdf), published in December 2011, Kaiser reports that since the MFP program began, the number of people transitioned to community-based settings increased dramatically — up to nearly 17,000 in 2011, from 8,902 in 2010. However, the number of people transitioned still falls well below the original program goals.

The survey, conducted in August 2011, identified two major challenges that MFP demonstrations face: housing and workforce capacity.

Bolstering the Direct-Care Workforce

About half of the MFP states reported an inadequate supply of direct-care workers, especially in rural areas. Two previous MFP surveys, conducted in 2008 and 2010, also identified inadequate workforce capacity as a leading problem.

MFP states are working to bolster the direct-care workforce by:

  • establishing a direct-care service registry website;
  • encouraging some beneficiaries to hire family caregivers through the consumer-directed option; and
  • offering online training programs for direct-care workers that provide education and competency-based training curricula.

The Kaiser issue paper notes that “as more Medicaid beneficiaries are identified to transition to the community, and as the population continues to age, more attention to workforce and housing options will be important to help facilitate successful community placements.”

– by Gail MacInnes, PHI National Policy Analyst

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