Texas was among the first 30 states chosen to participate in the Money Follows the Person Demonstration (MFPD) in 2007. As of June 2016, 43 states participate in this federal demonstration designed to help older adults or persons who have disabilities move from institutional settings back into their communities.

MFPD provides federal grant funding as well as funding from Medicaid matching cost savings [1], as defined at the bottom of this document.> to assist states in moving individuals from institutions to the community. In fiscal year 2016, HHSC has budgeted over $16 million in federal funding to help individuals transition out of nursing facilities, State Supported Living Centers, Intermediate Care Facilities for Individuals with Intellectual Disabilities and other institutions. Funds are also used to provide behavioral health supports that help individuals remain living in the community, enhance opportunities for integrated employment for greater self-sufficiency, and increase the availability of affordable, accessible housing.

MFPD has helped Texas rebalance its long-term services and supports system by increasing the use of community-based services rather than institutional services. Early in calendar year 2008, Texas reported 51 percent of its long term services and support expenditures were used to support institution-based services. By the end of calendar year 2014, institution-based services accounted for 41.2 percent of long-term services and supports spending. Community-based services now comprise the majority of Texas long-term services and supports system.

The charts below show another significant impact of MFPD in Texas. As the line chart indicates, the MFPD has helped over 10,000 individuals transition from institutional to community-based services. Another 34,598 transitioned under the Texas Promoting Independence initiative. The Promoting Independence initiative includes all transitions from institutions to communities, and not just those in which an enhanced Federal Medical Assistance Percentage (FMAP) is received.

Promoting Independence and MFP Demonstration Transitions 2000-2015

Promoting Independence and MPF Demonstration Transitions 2000-2015. Annual unduplicated number of Individuals who Transitioned from Institutional to Community-based Services. Yearly unduplicated totals for individuals transitioning through Promoting Independence: 2003: 2,421; 2004: 3,428; 2005: 3,245; 2006: 2,655; 2007: 3,115; 2008: 3,528; 2009: 3,779; 2010: 4,534; 2011: 2,343; 2012: 1,448: 2013: 1,032; 2014: 1,627; 2015: 1,083; total equals 34,238. Yearly unduplicated totals for individuals transitioning through Money Follows the Person Demonstration: 2003: Not Applicable; 2004: Not Applicable; 2005: Not Applicable; 2006: Not Applicable; 2007: Not Applicable; 2008: 807; 2009: 1,230; 2010: 1,834; 2011: 1,598; 2012: 1,404; 2013: 1,275; 2014: 1,272; 2015: 1,036; total equals 10,456; combined total of Promoting Independence and Money Follows the Person equals 44,694.

Promoting Independence and MFP Demonstration Transitions 2000-2015

Promoting Independence and MFP Demonstration Transitions 2000-2015. Total Number of Individuals who Transitioned from Institutional to Community-based Services. Promoting Independence Unduplicated Total started at 2,421 in 2003 and increased steadily to a cumulative total of 34,692 in 2016. Money Follows the Person Demonstration Total started at 807 in 2008 and increased steadily to a cumulative total of 10,456 in 2015. The cumulative total for both types of transitions increased from 2,421 in 2003 to approximately 45,148 in 2016.

[1] Under the MFPD, Texas receives enhanced Federal Medical Assistance Percentage (FMAP) for eligible services. FMAP is the percentage rate used to determine the amount of matching funds states contribute for Medicaid funded services. Enhanced FMAP reduces the percentage owed by the state, thus generating a cost savings for Texas.