Case Study:'Money Follows the Person' Consulting

The Client:
State of Georgia Department of Human Resources (DHR), Division of Mental Health, Developmental Disabilities and Addictive Diseases (DMHDDAD)

The Project:
“Money Follows the Person” (MFP) Consulting

The Opportunity:
To explore budget options that would allow DMHDDAD to pool its fiscal resources in the southwest region of Georgia into a more flexible MFP program for individuals with developmental disabilities.

MFP refers to “a system of flexible financing for long-term services and supports that enables available funds to move with the individual to the most appropriate and preferred setting as the individual’s needs and preferences change. It is a market-based approach that gives individuals more choice over the location and type of services they receive.”*

The PCG Approach:
Public Consulting Group’s (PCG) comprehensive review of DMHDDAD’s budget practices included a review of the best and most promising practices from comparison states and states that have been recognized for budgeting innovation and excellence.

PCG provided DMHDDAD with a detailed discussion of how its budget was organized and the problems its process presented for achieving a flexible system where money could follow the person, regardless of service setting.

The Result:
PCG made a series of recommendations, ranging from efforts that could work within the current provisions and constraints of the Georgia budgeting process to efforts for broader system change.

Suggested approaches included:

• Employing direct care staff at the regional level that could alternate between institutional and community-based duties, as dictated by consumer preferences;
• Creating a clearing account object class that would allow DMHDDAD to transfer funds between institutional and community-based settings, as needed.
• Considering enactment of an ICF-MR provider tax;
• Developing a community placement program with legislatively-supported funding flexibility that would allow DMHDDAD to project costs for individuals moving into community settings;
• Amending existing HCBS Waiver(s) and/or developing new HCBS Waiver(s) that would leverage one-time transition funding and allow for funding to follow individuals from institutional to community settings;
• Working with the Governor’s office and Georgia’s congressional delegation to advocate for federal MFP legislation to ensure that DMHDDAD’s and the State’s goals would be met at the federal level.

In addition to its recommendations, PCG provided DMHDDAD with a work plan of steps required to achieve its recommendations.

*Centers for Medicare & Medicaid Services letter to State Medicaid Directors, August 17, 2004.