In 2007, the federal government began an initiative to help low-income seniors and persons with disabilities move back into the community from nursing homes. The multi-billion dollar program, called Money Follows the Person, awards grants to states to help them develop community-based resources for long-term care, and reduce reliance on institutional care.
Although more than $1 billion was awarded during the five-year demonstration period, the states have fallen short of their goals.
The initial projection was to help 35,380 recipients of Medicaid transition back into the community in five years, but as of March 31, only 22,500 had done so.
Different states have had varying levels of success. Texas and Ohio have moved thousands of people back into the community, while Missouri, Kentucky and North Carolina have helped fewer than 500 find new homes in each state. California has had particular difficulty, moving only 827 people back into the community, although the state received a $41 million grant.
The state of New York was projected to receive $27 million and help 2,800 individuals transition back into the community. According to the Henry J. Kaiser Family Foundation, the state has received $82 million in grants.
A particular challenge for states has been helping seniors make the transition. According to a report from Mathematica Policy Research, a firm hired by the government to examine the initiative, only about one-third of participants in the program are seniors, though people over age 65 account for the vast majority of those eligible for the program.
Many of the people helped by the program are adults with special needs, under age 65.
Under the Affordable Care Act, the Money Follows the Person initiative has been extended for an additional five years.