Are Money Follows the Person Program Participants Better O�? A Pre- Post- Analysis of Quality of LifeKristi Fuller, MSW; Lillian Haley, PhD, MSW; Brittney Romanson, MPH; and Glenn M. Landers, MBA, MHA

For more information, contact the Georgia Health Policy Center at 404.413.0314 or visit us

online at www.gsu.edu/ghpc.

RESEARCH OBJECTIVETo evaluate the quality of life of Money Follows the Person (MFP) program participants before transition and one year after transition at the state level.

STUDY DESIGNThis study analyzed the results of quality of life surveys that were conducted prior to transition from a nursing home or intermediate care facility, and again approximately one year after transition to a community setting. The pre-transition surveys were primarily conducted in-person, and the post-transition surveys were primarily conducted by telephone. Surveys were completed either by the participant, a proxy, or the participant with assistance.

POPULATION STUDIEDThe study population included Money Follows the Person program participants in Georgia that completed a pre-transition survey and a post-transition follow-up survey from January 2009 through December 2011. A total of 206 participants had matched surveys during this time period, but 23 respondents had passed away, thus a total of 366 surveys from two time points were analyzed.

PRINCIPAL FINDINGSAs expected, a signi�cant decrease in the number of people living in group homes or nursing homes is observed post-transition. In fact, at the follow-up there was a 53 percent increase in those reporting that they had a choice in where they live, and a 33 percent increase in participants stating that they liked where they live. The participants also reported an increased ability to make choices and have control of scheduling meals, bed time and having privacy when they chose to.

At both time points nearly all participants reported receiving help with bathing, dressing or preparing meals, often by someone who was paid to help them. However, at the post-transition follow-up there was a 35 percent increase in the number of participants stating that they picked the people who were paid to help them. ANDREW YOUNG SCHOOL

O F P O L I C Y S T U D I E S

Additionally, fewer participants living in the community reported that they had to go without a bath, meal, or medicine when they needed it. At the post-transition survey, participants reported that they had increased access to do the things that they wanted to do outside of the facility or home, and a 26 percent decrease was seen in participants stating that they have to miss things or change their plans due to an inability to get around.

However, there were multiple indications that the participants had less community integration or inclusion post-transition. For example, at the follow-up there was a 14 percent increase in the number of participants that stated that they could not see friends and family when they wanted to and the percentage of participants indicating that they go out to do fun things in the community dropped by 23 percent. Potentially re�ective of these limitations, there was an increase in the post-transition responses measuring sadness (+8%), irritability (+9%), and aches and pains (+8%) in the past week. Despite some of the challenges denoted above, when asked if the participants were happy with the way the lived their lives, 5 percent more participants were happy after the transition.

FIGURE 1: COMPARISON OF RESPONSES TO SELECTED SURVEY QUESTIONS

CONCLUSIONSWith an intended outcome of providing individuals with the choice of community living with appropriate supports and services, the MFP program has attempted to remove many barriers in order to achieve this goal successfully. The 183 MFP program participants in Georgia included in this analysis indicated that there were many areas where they were exerting increased choice and control, realizing more access to medical care and the ability to schedule plans without having to change them. These participants also suggest that some barriers remain with regard to accessing social activities and a feeling of community integration which is re�ected in that fewer participants reported doing fun things in the community and more reported feeling sad or blue during the past week.

IMPLICATIONS FOR POLICYThe results of this study indicate that the MFP program participants have improved quality of life post-transition. To further improve outcomes post-transition, state level program policy could focus on social outlets and community integration. This may include the provision of educational opportunities, work or volunteer placement, increased emphasis on peer support, added �exibility in transportation services, and family meetings that elucidate realistic expectations of support and interactions with family and friends. In some cases, additional services could be considered as reimbursable under the program, and in others additional assessments or planning prior to transition may be useful. Further, funding for infrastructure such as a�ordable housing and transportation could improve the number of successful transitions. Finally, it should be recognized that the MFP program service period lasts 365 days, thus while the program has great opportunity for improving quality of life, the impact of overlapping long-term care programs such as Medicaid and non-Medicaid home and community based services should be considered.

RESEARCH FUNDERSThe Georgia Department of Community Health through grant funding received from the Centers for Medicare and Medicaid Services.