Money Follows the Person Rebalancing Demonstration Program - Capacity Building

DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services 7500 Security Boulevard, Mail Stop S2-14-26 Baltimore, Maryland 21244-1850 Disabled and Elderly Health Programs Group September 23, 2020 Dear MFP Grantees:
High rates of COVID-19 infection and death among persons

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residing in nursing facilities and other medical institutions have led to an increased interest in promoting the use of home and community-based services (HCBS) over institutional services in many states.

As the primary funder of long-term services and supports (LTSS) nationally, Medicaid can play an important role in supporting states’ efforts with LTSS rebalancing, which is commonly defined as achieving a more equitable balance between the share of spending and use of services delivered in home and community-based settings relative to institutional care, where the majority of LTSS had been provided historically.

The Centers for Medicare & Medicaid Services (CMS) is issuing this letter to describe a supplemental funding opportunity available to Money Follows the Person (MFP) demonstration states that are currently operating MFP funded transition programs.

Supplemental Funding Opportunity under the Money Follows the Person Demonstration For more than a decade, the MFP demonstration has played a key role in many states’ LTSS rebalancing efforts.

Established by Congress through section 6071 of the 2005 Deficit Reduction Act, MFP provides state Medicaid programs the opportunity to help Medicaid beneficiaries who live in institutions to transition into the community and gives people with disabilities and older adults more choice in deciding where to live and receive LTSS.1 MFP was designed with four goals:
• Increase the use of HCBS and reduce the use of institutionally based services; • Eliminate barriers in state law, state Medicaid plans, and state budgets that restrict the use of Medicaid funds to enable Medicaid-eligible individuals to receive support for appropriate and necessary LTSS in the settings of their choice; • Strengthen the ability of Medicaid programs to provide HCBS to people who choose to transition out of institutions; and • Put procedures in place to provide quality assurance and improve HCBS.

1 More information on the MFP program can be found here:
https://www.medicaid.gov/medicaid/long-term-services-supports/money-follows- person/index.html Under this supplemental funding opportunity, MFP grant funds are being made available to state MFP demonstrations that are currently operating MFP funded transition programs, for planning and capacity building activities to accelerate LTSS system transformation design and implementation and to expand HCBS capacity.

This funding is expected to strengthen focus and attention on LTSS rebalancing among states participating in the MFP demonstration and to support MFP grantees with making meaningful progress with LTSS rebalancing.

Examples of activities for which supplemental funding would be available include (but may not be limited to):
• Assessing HCBS system capacity and determining the extent to which additional providers and/or services might be needed; • Assessing institutional capacity and determining the extent to which the state could reduce this capacity; • Developing and implementing strategies to reduce institutional bed capacity and transition impacted individuals to more integrated settings; • Engaging stakeholders in system planning, development, and implementation activities; • Provider/direct service worker recruitment, education, training, and technical assistance (including training people with disabilities to become direct service workers); • Caregiver training and education; • Assessing and implementing changes to reimbursement rates and payment methodologies to expand HCBS provider capacity and/or improve HCBS and/or institutional service quality; • Provider quality improvement activities; • Developing and implementing improvements to HCBS eligibility and assessment process (to expedite HCBS eligibility, streamline processes, etc.); • Building Medicaid-housing partnerships; and • Pre-admission diversion strategies.

The award may be used to cover costs necessary to implement the activities described above or other activities consistent with the objectives of this funding opportunity.

Grant awards under this funding opportunity must comply with grant regulations and program requirements.

The supplemental budget request under this funding opportunity is expected to include the following:
• Description of how this proposed HCBS capacity building initiative will support the goals of the MFP demonstration; • Milestones and timeframes for implementing the activities set forth in the initiative; • Description of how this HCBS capacity building initiative aligns with current MFP sustainability planning activities; and • Outline for MFP stakeholder engagement relevant to this proposal, as identified in the state’s operational protocol.

CMS will not require any new reporting processes for grantees under this funding opportunity.

However, CMS may make minor adjustments to the current reporting processes to capture information related to the goals and objectives of this funding opportunity.

For example, grantees will need to report on the activities and milestones funded through this opportunity in the semi- annual report currently required of state MFP programs.

Supplemental budget requests under this funding opportunity will be accepted on a rolling basis through June 30, 202 1. Eligible states can request up to $5 million dollars.

Funds will be available for the federal fiscal year in which it was awarded and four additional fiscal years.

APPLICATION AND SUBMISSION INFORMATION A.

Content and Form of Application Submission Project Narrative.

CMS will not accept applications with a Project Narrative that exceeds five (5) pages.

The Project Narrative should provide a clear and concise description of your project.

CMS recommends that your project narrative include the following components:
1) Summary/Abstract 2) Goals, Objectives, and Outcomes, 3) Proposed Project 4) Project Management.

The components count as part of the page limit.

1. Summary/Abstract.

This section should include a brief description of the proposed project, including:
the goal(s) and objectives, and a description of how the applicant will use this funding to implement capacity building activities to support LTSS system transformation design and implementation and to expand HCBS capacity.

2. Goals, Objectives, and Outcomes:
Applicants should describe the proposed project’s goals and objectives, including how the project aligns with current MFP sustainability planning activities.

Include specific targets relevant to your proposed initiative.

3. Proposed Project:
This section should provide a clear and concise description of the ways in which you will meet the goals and objectives of this funding opportunity.

It should include brief descriptions of:
•How the funds will be used to build HCBS infrastructure and capacity to support MFP sustainability activities; •How the project will support LTSS system transformation design and implementation and to expand HCBS capacity; •How the project will strengthen partnerships between state agencies in support of state rebalancing initiatives; •The target populations that will be targeted and how they will benefit from the project; •The geographic area of the state where the activities will be implemented Applicants should describe how the project activities build on current work within the State and fit with other related initiatives and how the project activities will be sustained after Federal grant funding has ended.

4. Project Management:
Applicants should include a clear delineation of the roles and responsibilities of project staff with the State MFP Program and any consultants.

Applicants should include a timeline of activity milestones.

B.

Cover Letter signed by Grantee Authorized Organization Representative (AOR– 10a of NOA) C.

SF-424A Budget Information:
Non-Construction (Completed in Grantsolutions).

D.

MFP Supplemental Budget Workbook (Budget Narrative tabs only).

Completed and uploaded to Grantsolutions.

Please direct questions on this funding opportunity to:
mfpdemo@cms.hhs.gov.

Sincerely,
Related Programs

Money Follows the Person Rebalancing Demonstration

Department of Health and Human Services



Who's Eligible





Obtain Full Opportunity Text:
Money Follows the Person Rebalancing Demonstration Program - Capacity Building

Additional Information of Eligibility:
The Request for Information (RFI) is open to all organizations to provide feedback on.

Eligibility criteria for the potential activity will be defined at a later stage.

Full Opportunity Web Address:
https://www.grantsolutions.gov/gs/preaward/previewPublicAnnouncement.do?id=77906

Contact:


Agency Email Description:
Grantsolutions Customer Support

Agency Email:


Date Posted:
2021-01-21

Application Due Date:


Archive Date:
2021-07-30



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