For Patricia, home tastes like sweet and sour meatballs, mashed potatoes, and broccoli. Several years after her favorite homecoming meal, she still smiles at the memory.
At age 57, Patricia stayed in a nursing home for more than two years due to complications from multiple sclerosis.
“Being in a nursing home was not a piece of cake. Besides losing your freedom, you lose all your privacy and most of your decision making,” Patricia recalls. “I was only 57, so I felt like I had a lot more to offer life. Most people probably feel this way, when you go in, but rarely do they leave. And then all of a sudden, because my friend found the Money Follows the Person program, I was in an apartment, a nice apartment, and I had furniture. I had a life again.”
Help to Move Home
Money Follows the Person (MFP) is a national Medicaid demonstration program, sponsored by the Centers for Medicare & Medicaid Services. The program, awarded to the Georgia Department of Community Health in 2008, helps people who are living in institutions, such as psychiatric residential treatment facilities, nursing homes, or other long-term care facilities, return to their homes and communities while continuing to receive supportive services — thus, increasing access to home- and community based services and lowering long-term care costs.
MFP helps people with developmental disabilities, physical disabilities (under age 65), traumatic brain injury, and older adults or youth with a mental health condition. MFP services enable the transition to the community by paying for things not typically covered by Medicaid, like security and utility deposits, furnishings or basic household items, moving costs, modifications to make a home or apartment accessible, and connections to other community services.
Since 2010, the Georgia Health Policy Center has conducted ongoing evaluations of the MFP program implementation in the state.* As of July 2019,
Georgia has successfully transitioned more than 3,000 individuals from institutional care to home- and community-based services.
On average, MFP saves more than $11,700 in health care expenditures per participant.
Pre- and 2-year-post-transition surveys show that quality of life has improved for Georgia’s MFP participants, with greater satisfaction related to living situation, choice and control, community integration, and health status, and global life satisfaction.
In Their Own Words and Pictures
Photovoice is a participatory action research method that encourages participants to record, reflect, and share their experiences through photography. In the first evaluation of its kind nationally, Georgia MFP participants used Photovoice to assess their quality of life following their transition.
Themes from participants’ photographs and narratives identified programmatic successes, as well as opportunities for continued enhancement of long-term care services provided in home- and community-based settings.
“Photovoice gave us the opportunity to put the many voices together and amplify them,” explains Kristi Fuller, an assistant project director at GHPC, and the lead of the MFP evaluation. “We selected Photovoice as a way to engage participants — to put them in the driver’s seat to tell the full story of their transition.”
GHPC hosted the exhibition, Gaining Freedom, Coming Home, in November 2016, showcasing the photography and stories of five MFP participants, including Patricia. The participants chose “freedom” for the title, as it best reflected their quality of life as a result of MFP.
“It was nice to think about what things were most important to me, what I missed, and what I was really grateful for having again,” says Patricia. “It really gave me the freedom to express myself and get out all the feelings that I had. You don’t realize that there are people in nursing homes that aren’t on death’s door, that are still vibrant on the inside.” ●●
Landers, G., Fuller, K., & Zhou, M. (2017). Medicaid savings continue in the year after end of participation in the program, Money Follows the Person. Journal of the Georgia Public Health Association, 7(1):42-44.
“I renewed my passion for cooking and found a way to do it regardless of my disability. They served chicken every day at the nursing home for two-and-a-half years and the rest of the food was awful. … I wanted a balanced diet and variety.”
Card Games With Kids
“I’m still able to have children come to my house and experience their love, energy, and curiosity. I wouldn’t be able to have that had I not gotten out of the nursing home.”
“My Cadillac of a scooter that keeps me mobile. God bless my mother for buying me this for outdoor travel and Money Follows the Person for getting me my power wheelchair for indoor mobility.”