If you are caring for a loved one who has been in an intermediate care facility for individuals with intellectual disabilities, a nursing facility, or a chronic disease hospital for at least 90 days and wants to move back into the community with services, you may be interested in learning about the MFP Community Living (MFP – CL) Waiver in Massachusetts. This waiver is part of the Money Follows the Person (MFP) Rebalancing Demonstration, a federal initiative to rebalance the long-term care system by shifting resources from institutional to home and community-based settings. It also allows participants to design and direct their services, including hiring and managing support workers, such as family members.
Ahead, we explore the MFP Community Living (MFP – CL) Waiver in detail, including its eligibility requirements, services and supports, and caregiver compensation.
The MFP Community Living (MFP – CL) Waiver is a Medicaid program that aims to provide an alternative to nursing facilities, intermediate care facilities for individuals with intellectual disabilities, or chronic disease hospital care for people who have disabilities or are age 65 or older. The waiver supports people who want to move from institutional settings to home and community-based settings, such as their homes, apartments, or assisted living facilities. The waiver covers people eligible for MassHealth Standard, the name of the Medicaid program in Massachusetts.
The MFP Community Living (MFP – CL) Waiver offers various services and supports tailored to each participant's individual needs and preferences. The services are delivered through a person-centered planning process involving the participant, their family, and a transition coordinator. The participant can choose between two service delivery models: agency with choice or participant-directed program.
To qualify for the MFP Community Living (MFP – CL) Waiver, a person must meet the following criteria:
The MFP Community Living (MFP – CL) Waiver provides a range of services and supports that are designed to help participants transition from institutional settings to home and community-based settings and to live independently and safely in their chosen settings. Some of the services and supports include:
One of the benefits of the MFP Community Living (MFP – CL) Waiver is that it allows participants to design and direct their services in partnership with a qualified provider agency or to hire and manage their support workers. This means that participants can choose who provides their services, including family members, friends, or neighbors. The waiver pays for the wages and benefits of these support workers through either the agency with choice model or the participant-directed program model.
In the agency with choice model, the participant selects a provider agency that acts as the employer of record for their support workers. The agency handles the payroll, taxes, insurance, training, and supervision of the workers. The participant can hire, fire, schedule, and direct their workers in collaboration with the agency.
In the participant-directed program model, the participant acts as the employer of their support workers. The participant is responsible for recruiting, hiring, training, scheduling, supervising, and firing their workers. The participant must also comply with the labor laws and regulations that apply to employers. The waiver provides a fiscal intermediary service that helps the participant with the payroll, taxes, insurance, and reporting of their workers.
Both models allow participants to pay their support workers at a competitive rate determined by the waiver. The rate varies depending on the type and level of service provided. For example, as of 2021, the hourly rate for a personal care attendant was $15.75. The waiver also covers the costs of worker's compensation, unemployment insurance, and health insurance for support workers.
If you think you or your loved one may be eligible for this waiver, or if you want to learn more about other Medicaid waivers that may compensate family caregivers, please fill out this form, and we will get back to you as soon as possible. We are here to help you navigate the complex world of caregiving and find the best solutions for your situation.