If someone is interested in the MFP program, who do they contact and who will contact them with a response?

If an individual is interested in the program they may send an email via our website contact page or call the Division of Aging at 1-888-673-0002, Option 5.

How does the program determine qualified days of care when an individual enters a Nursing Facility but is then discharged to a hospital and then readmitted to a Nursing Facility?

Individuals who have qualifying days of care six months or more meet the requirement of “Have resided in a NF six months or more.” The days in the hospital count as qualified days if individual is readmitted to the Nursing Facility.

There is a 12-month limit to Transition Coordination case management. What will happen to those individuals in the community once the 12-month limit has been reached?

They will be transferred to one if the Home-Community Based Services (HCBS) waiver case managers.

What is Cost-Sharing?

The Social Security Act permits the State to require certain recipients to share some of the costs of Medicaid by imposing upon them such payments as enrollment fees, premiums, deductibles, coinsurance, co-payments, or similar cost sharing charges. The Transition Specialist will be responsible for explaining cost sharing responsibilities associated with the transition from nursing facility to the community.

Can Transition Services/funding be utilized to maintain housing during a hospitalization or a re-admittance back to a facility setting?

No. Transition Services/funding is to be used only for the set up of housing and active transition to a home-and-community-based setting.

If the participant loses Medicaid eligibility or decides to move to a residence not qualified, will they still be eligible for the program?

No. An individual must remain under Medicaid and choose a qualified residence to reside in to participate in the program. A qualified community based setting is a home owned or leased by the individual or the individual's family member or an apartment with an individual lease, with lockable access and egress, and which includes living, sleeping, bathing, and cooking areas over which the individual or the individual's family has domain and control. Qualified community based settings include apartments available in HUD subsidized housing complexes or congregate housing complexes that accommodate elders and individuals with special needs, or a residence, in a community-based residential setting, such as an adult foster care home, in which no more than four (4) unrelated individuals reside. Assisted living facilities are not considered a qualified community-based setting for purposes of the MFP demonstration program. If a participant does choose to live in an assisted living facility or loses their Medicaid eligibility, the ADVANTAGE MFP Transition Team will continue to work with them and provide all the necessary resources to live on their own. However, these individuals will not be considered a part of the MFP program.