MLTC Policy 16.04

  • Policy is also available in Portable Document Format (PDF)

Office of Health Insurance Programs

Division of Long Term Care

MLTC Policy 1604: Money Follows the Person (MFP)

Date of Issuance: September 21, 2016

The purpose of this policy is to inform all Managed Long Term Care (MLTC) plans about the availability of additional supports available through the Money Follows the Person (MFP) Demonstration, and the required role of a plan in that collaboration.

The Money Follows the Person (MFP) Demonstration is part of Federal and State initiatives designed to rebalance long term care services, and promote consumer choice. As New York State continues to shift the focus of its long term care systems away from institutional care and towards integrated home and community-based care, support from the MFP program becomes valuable to all Managed Care Organizations (MCOs). MFP is designed to streamline the process of deinstitutionalization for vulnerable populations. Under the name Open Doors, the MFP program funds Transition Specialists and Peer Support to assist these individuals to transition out of institutions such as nursing homes and intermediate care facilities, and into qualifying community settings. A qualified setting may be a house, an apartment, or a group home (with a maximum of four unrelated people).

More information is available about MFP at: https://www.health.ny.gov/health_care/medicaid/redesign/nys_money_follows_person_demonstration.htm

In order to facilitate access to MFP services, MLTC Plans are required to do the following:

Include the "MFP Attestation for Enrollment Agreement" in the plan´s existing Enrollment Agreement.

_____ If I am or become a resident in a nursing facility, I agree to a referral to New York State´s contractor for Money Follows the Person/Open Doors, a program that can work with my MLTC plan to help me return to community living.

Include the following language describing MFP in your plan´s handbook.

Money Follows the Person (MFP)/Open Doors
This section will explain the services and supports that are available through Money Follows the Person (MFP)/Open Doors. MFP/Open Doors is a program that can help enrollees move from a nursing home back into their home or residence in the community. Enrollees may qualify for MFP if they:
  • Have lived in a nursing home for three months or longer
  • Have health needs that can be met through services in their community

MFP/Open Doors has people, called Transition Specialists and Peers, who can meet with enrollees in the nursing home and talk with them about moving back to the community. Transition Specialists and Peers are different from Care Managers and Discharge Planners. They can help enrollees by:
  • Giving them information about services and supports in the community
  • Finding services offered in the community to help enrollees be independent
  • Visiting or calling enrollees after they move to make sure that they have what they need at home

For more information about MFP/Open Doors, or to set up a visit from a Transition Specialist or Peer, please call the New York Association on Independent Living at 1-844-545-7108, or email mfp@health.ny.gov. You can also visit MFP/Open Doors on the web at www.health.ny.gov/mfp or www.ilny.org.

Review "NYS Money Follows the Person Guidance for Managed Care Organizations" and share with all appropriate plan staff, including Care Managers, to encourage recommended practices. "NYS Money Follows the Person Guidance for Managed Care Organizations" can be found at the above link under policy documents.

To encourage access to MFP services, the Department recommends MLTC plans review relationships with network nursing home providers and consider amending subcontracts to encourage collaboration to access MFP. The Minimum Data Set 3.0 (MDS) is administered to all nursing facility residents upon admission, quarterly, yearly, and whenever there is a significant change in condition. The Section Q question, "Do you want to talk to someone about the possibility of returning to live and receive services in the community?" is designed to promote choice and explore potential return to community settings. CMS requires that nursing facility residents who express an interest in learning more about community living options are appropriately referred to MFP/Open Doors Transition Centers within a 10 day timeframe. Potential contract language referencing the Section Q trigger for Open Doors referrals is suggested.

For more information regarding the MFP/Open Doors program, please send an email to the following address: MFP@health.ny.gov.