Last updated: June 6, 2026
The hard part may not be wanting to come home. It may be the stairs, the bathroom, the doorway, the missing ramp, or the fear that a nursing facility discharge will fail because the home is not ready.
What this page covers
Money Follows the Person, often called MFP, is a Medicaid program used by participating states to help people move from institutions back to community living. It is not a general home repair grant. It is not a check sent to a homeowner. It is usually part of a larger transition plan for a person who is in a nursing facility, hospital, intermediate care facility, or another qualified setting and wants to move to a home, apartment, family home, or small community residence.
The federal Medicaid MFP page says MFP helps states move long-term services and supports from institutional care toward home and community-based care. CMS also says states have used MFP for one-time transition costs, home accessibility modifications, medical equipment, transition coordination, and housing partnerships.
For a person trying to leave a facility, the key question is not, “Can I get a free remodel?” The better question is, “Can a needed accessibility change be approved as part of my Medicaid transition plan?”
If the home is unsafe right now
If there is an immediate danger, do not wait for an MFP referral. Call 911 for fire, gas smell, live wires, collapse risk, or urgent medical danger. If the person is still in a facility, tell the facility social worker, discharge planner, nurse, doctor, and case manager that the home is not safe for discharge until the hazard is addressed.
If a facility is trying to discharge someone to an unsafe setting, contact the state long-term care ombudsman. ACL explains that the long-term care ombudsman works to resolve problems involving the health, safety, welfare, and rights of people in long-term care facilities.
Where to start fast
If the person is still in a facility, start with the facility social worker and ask for a transition referral. If the person already has Medicaid long-term care, call the case manager, care coordinator, managed care plan, or waiver worker. If nobody knows where to send the referral, try your state MFP contact, an Aging and Disability Resource Center, a Center for Independent Living, or 211.
Fastest realistic steps
- Ask the facility social worker for an MFP referral. Use the words “Money Follows the Person,” “transition to the community,” and “home modification.”
- Ask Medicaid who handles transitions. MFP is state-run, so the program name may be different in your state.
- Ask for an accessibility assessment. A home modification usually needs proof that the change is tied to safety, function, or discharge.
- Do not start work without approval. Many programs will not pay for work started before written approval, required bids, landlord consent, or permits.
- Build a backup plan. If MFP cannot help, ask about Medicaid waiver modifications, local disability programs, nonprofit repair help, fair housing rights, and housing counseling.
You can look for your state project director on the federal MFP contact list. That list was last updated in 2023, so also check your state Medicaid website.
For older adults and caregivers, the Eldercare Locator can help find Area Agencies on Aging and local aging services. For people with disabilities of any age, a local Center for Independent Living may help with transition planning, housing barriers, and advocacy. The CIL directory can help you find one. For local help when you do not know where to call, 211 help can connect you with housing, disability, repair, food, utility, and community resources.
How MFP can help with home modifications
MFP does not work the same way in every state. In many places, MFP pays for or coordinates short-term transition services for the first period after a person leaves an institution. Ongoing long-term services may then continue through Medicaid home and community-based services, a Medicaid waiver, managed long-term care, PACE, or another state Medicaid pathway.
Federal funding information in the HHS MFP funding listing says the demonstration is designed to help Medicaid enrollees transition from institutions to the community. It also says the Consolidated Appropriations Act, 2023 added funding and extended the program through September 30, 2027. That does not mean every person or every state service is open forever. It means the federal demonstration has current funding authority, while state participation, referrals, local contractors, waiver slots, and service caps still matter.
CMS also says states may use MFP supplemental services for supports that help a transition succeed, including home accessibility modifications. Some services may happen before discharge if the state allows it.
| Need | How MFP may help | What to ask |
|---|---|---|
| Cannot enter home safely | Ramp, threshold change, handrails, or other access work may be considered. | “Can the transition plan include an entry assessment and ramp bid?” |
| Bathroom is unsafe | Grab bars, roll-in shower work, tub cut, shower seat, toilet access, or layout changes may be reviewed. | “Can an OT or PT document the bathroom barrier?” |
| Wheelchair cannot pass | Door widening or path-of-travel changes may be possible if tied to assessed need. | “Can the contractor bid include doorway measurements?” |
| Medical equipment needs space or utilities | Some programs may cover specialized electrical or plumbing changes when needed for medical equipment. | “What medical proof and permits are required?” |
| No safe housing yet | MFP may connect housing search, deposits, moving costs, furniture, or community transition services depending on the state. | “Who is the housing or transition coordinator?” |
Who may qualify
Most MFP programs are for people who are Medicaid-eligible, need long-term services and supports, live in a qualified facility for a required period, and want to move to a qualified community residence. The exact rules vary by state. Some state pages say 60 days. Some programs describe different timing or target groups. Some count Medicare rehabilitation days differently. Some require a Medicaid-paid day before transition. Some work through specific waivers.
Do not assume a person is too old, too disabled, too rural, or too complicated. Also do not assume approval is automatic. MFP is usually voluntary, person-centered, and tied to a safe plan.
Common eligibility pieces
- Medicaid connection: The person is on Medicaid, can qualify for Medicaid, or has Medicaid coverage for at least part of the institutional stay as required by the state.
- Facility stay: The person has lived in a nursing facility, hospital, intermediate care facility, or other qualified setting long enough under state rules.
- Level of care: The person still needs a level of care that can be supported through home and community-based services.
- Qualified residence: The person plans to move to a home, apartment, family home, or small community setting allowed by MFP rules.
- Not a stand-alone repair request: A homeowner who is not transitioning from an institution usually needs a different home repair or accessibility program.
Medicaid home and community-based services also matter. Federal guidance on 1915(c) waivers says states can design waiver services for people who would otherwise need institutional care, and states set target groups, service limits, and enrollment caps.
Home modifications that may be considered
Home modification is usually not about making the home nicer. It is about making the home usable and safe for the person’s disability, medical equipment, or support needs.
For example, Colorado’s Medicaid home modification benefit describes changes needed for health, safety, independence, prevention of institutionalization, or support for deinstitutionalization. Examples include ramps, bathroom changes, door widening, kitchen changes, and specialized utilities for medical equipment. Colorado also lists state-specific limits.
| Often worth asking about | Often limited or denied | Why the difference matters |
|---|---|---|
| Ramps, handrails, doorway access, safe entry | New decks, porch upgrades, cosmetic entry work | The work must be tied to safe access, not general improvement. |
| Grab bars, tub cuts, roll-in shower access, toilet access | Full bathroom remodels beyond the assessed need | Programs may approve the least costly safe option. |
| Kitchen access needed for daily function | New cabinets or counters mainly for resale value | The change must support the person’s independence. |
| Electrical or plumbing needed for medical equipment | Whole-house upgrades not tied to equipment or safety | Medical proof and contractor detail may be required. |
| Primary home modifications | Vacation homes or unrelated property upgrades | Many programs limit work to the person’s main residence. |
Minnesota’s EAA policy gives a clear example of how detailed state rules can be. It defines environmental accessibility adaptations as physical adaptations to a person’s primary home or vehicle needed for health, safety, or greater independence. It also lists service limits, bid rules for some exceptions, primary-home rules, and covered assessment and installation costs. Your state may use different words, such as environmental modifications, accessibility adaptations, home modifications, or assistive technology.
What usually happens before approval
The approval process can feel slow because several people may need to sign off. The transition coordinator may need to confirm eligibility. The case manager may need to add the modification to a person-centered plan. An occupational therapist, physical therapist, nurse, or other evaluator may need to document the barrier. A contractor may need to measure and bid the work. A landlord may need to give written consent. A state or managed care plan may need to approve the price before work starts.
A normal path
- Referral: The person, family, facility, ombudsman, AAA, CIL, or Medicaid worker asks for MFP or transition help.
- Screening: The program checks Medicaid status, facility stay, level of care, target group, and housing plan.
- Assessment: An evaluator documents barriers, measurements, safety concerns, and functional needs.
- Bid and approval: Contractors, property owners, Medicaid plans, or state offices sign off as required.
- Work and follow-up: The contractor completes the work, and the team checks whether it supports a safe move.
If the person rents, ask about written landlord permission early. HUD’s disability housing page links to fair housing guidance on accommodations and modifications. Payment and restoration rules can depend on the type of housing, funding source, state law, and the request.
For manufactured homes, ask about the home, land, ramp placement, skirting, utilities, park rules, code, and permits before work begins.
State examples show why local rules matter
MFP is federal, but the real application path is state and local. These examples are not a promise that you qualify. They show how different the rules, names, and starting points can be.
| State or program | What the state page says | Why it matters |
|---|---|---|
| North Carolina | The NC MFP page says MFP helps NC Medicaid-eligible people in inpatient facilities move to homes and communities with supports. It lists accessibility modifications among transition items in archived benefits. | Ask the facility or NC Medicaid how transition coordination works for the person’s waiver or PACE path. |
| Idaho | Idaho Home Choice lists transition managers, up to $2,000 for certain moving or setup costs, waiver benefits including home modifications, and a phone number of 208-455-7118. | Transition costs and home modifications may be separate pieces of the same move plan. |
| South Carolina | SC Home Again helps Medicaid beneficiaries in nursing facilities or hospitals transition back to the community. It says limited home modifications may be available and referrals can be made online or by calling 888-971-1637. | The state makes clear that services vary and the program does not replace all living expenses or 24-hour care. |
| District of Columbia | The DC transition program lists MFP, Medicaid waiver help, documents, housing options, and Safe at Home examples such as chair lifts, handrails, bathtub cuts, shower seats, furniture risers, and grab bars. | Some places combine transition coordination with separate home safety programs. |
| California | The California CCT page says California Community Transitions is the state’s MFP program and that CCT transitions are authorized to continue through December 31, 2027. | State end dates can differ from the federal funding date and should be checked locally. |
| Maryland | The Maryland MFP page says Medicaid long-term care can follow the person to a home, apartment, or group home with four or fewer people, and lists Area Agencies on Aging, Centers for Independent Living, and Maryland Access Point as resources. | Qualified housing rules matter as much as repair needs. |
| Massachusetts | The Massachusetts MFP page says the demonstration helps older adults and people with disabilities move from nursing facilities, chronic disease or rehabilitation hospitals, or other qualified facilities back to the community. | Some states publish referral forms, fact sheets, brochures, and service pages that are more useful than a general federal page. |
| Tribal communities | CMS says the CMS Tribal MFP initiative is available in Minnesota, Oklahoma, North Dakota, Washington, and Wisconsin and supports tribal partners with home and community-based services. | Tribal members should ask both the state Medicaid MFP contact and tribal health or aging services about transition support. |
Documents and proof to gather
Do not wait until every document is perfect before asking for help. But start a folder now. Many delays happen because the program needs proof before it can approve a transition, a contractor, or a payment.
- Medicaid ID, Medicare ID if any, contact information, and facility admission date.
- Current care plan, therapy notes, discharge notes, and level-of-care records.
- Doctor, nurse, OT, PT, or therapist notes showing why the modification is needed.
- Photos and measurements of steps, doors, bathroom access, bedroom access, and unsafe areas.
- Lease, deed, manufactured home title, or written proof of where the person will live.
- Landlord consent, contractor bids, insurance proof, permits, and written scope if requested.
- Denial, waitlist, or appeal notices if help was refused or delayed.
Practical tip: Take photos from the person’s point of view. Show the wheelchair, walker, oxygen tubing, transfer problem, doorway width, step height, bathroom layout, and where a caregiver must stand. A photo of “old bathroom” is less useful than a photo showing why the person cannot enter, turn, transfer, bathe, or leave safely.
Delays, denials, and waitlists
Delays are common. The reason may be Medicaid eligibility, missing consent, lack of waiver slots, no available contractor, a landlord issue, a bid that is too high, a modification that is not tied closely enough to the person’s assessed need, or a discharge date that moved. Ask for the reason in writing. Ask what exact document or step is missing. Ask whether there is an appeal, grievance, fair hearing, managed care appeal, or supervisor review.
Common mistakes that can hurt approval
- Starting construction before written approval.
- Asking for a broad remodel instead of the specific access barrier.
- Not getting landlord consent before bids are requested.
- Using a contractor who is not approved by the program, waiver, or managed care plan.
- Missing the connection between the modification and the person’s discharge plan.
- Forgetting to ask whether Medicaid waiver services continue after the MFP transition period.
- Letting a denial sit too long without checking appeal deadlines.
If the home modification is denied, ask for the rule used to deny it. Ask whether a smaller change, more clinical proof, or a different bid would help. If the person is in managed care, the plan may have its own appeal steps before a state fair hearing. Keep every notice and envelope.
Backup options if MFP cannot solve it
MFP may not be available in every situation. The person may not meet the facility-stay rule, the home may not qualify, or the state may have limits. A denial does not always mean there is no help anywhere else.
- Medicaid waiver modifications: Ask whether an HCBS waiver, managed long-term care benefit, Community First Choice, or state plan service can cover the change.
- Assistive technology: Equipment, portable ramps, shower chairs, lifts, or communication devices may solve part of the problem faster than construction.
- Local aging and disability offices: AAAs, ADRCs, and CILs may know local repair funds, volunteer ramps, or home safety programs.
- City or county housing programs: Some local governments fund accessibility repairs, emergency repairs, or owner-occupied rehabilitation.
- Housing counseling: HUD lists housing counselors and the national phone number 800-569-4287.
- General repair programs: USAGov warns that the federal government does not offer free money to individuals for home repairs. See USAGov repair help.
Financing caution: Do not sign a loan, reverse mortgage, contractor financing agreement, lien, or property tax assessment loan just because discharge is urgent. A rushed repair loan can put the home at risk. If you are considering borrowing, talk with a HUD-approved housing counselor, legal aid, or a trusted benefits counselor first.
Scam warnings
Be careful with anyone who says they can get “free government money” for any home repair if you pay a fee first. Be careful with contractors who knock on the door, pressure you to sign today, demand large cash payments, refuse written bids, or say permits are not needed when they are. The FTC’s repair scam guide warns that home improvement scammers may promise work, take money, and leave the home worse off.
For MFP-related work, ask the case manager whether the contractor must be Medicaid-enrolled, waiver-approved, licensed, insured, or on a program list. Get the scope, price, warranty, payment terms, permit plan, and completion requirements in writing.
Phone scripts
Call the facility social worker
Hello, my name is [name]. I am calling about [person’s name], who wants to return to the community. The home needs accessibility changes before discharge. Can you make a Money Follows the Person referral or connect us with the transition coordinator? We need an assessment for [ramp, bathroom, doorway, other need]. Please tell me what you need from us and when the referral will be sent.
Call the state MFP contact
Hello, I am trying to find the right transition program for a Medicaid member in [facility name]. The person has been there since [date] and wants to move to [home, apartment, family home]. The barrier is [describe barrier]. Is your state accepting MFP referrals, and who should submit the referral? Also, can home modifications be reviewed before discharge?
Call a CIL, AAA, or ADRC
Hello, I need help with a nursing facility transition. The person wants to move home, but the home is not accessible. Can your office help with MFP, Medicaid waiver home modifications, landlord permission, accessible housing, or local repair programs? If not, who handles nursing home transitions in this county?
Call a landlord
Hello, I am helping [tenant name] plan a safe return from a facility. A health professional may recommend an accessibility modification, such as [specific change]. We are asking for written permission to have the program review the work. We are not asking you to approve a contractor today. Can we send the proposed scope and consent form when the program provides it?
FAQ
Does Money Follows the Person pay homeowners directly?
Usually, no. MFP is a Medicaid transition program, not a cash grant to homeowners. States often coordinate services and pay approved providers, vendors, or contractors under program rules. Ask your state how payment works before any work begins.
Can MFP pay for a ramp before the person leaves the nursing facility?
Possibly. Some states may approve transition-related services, including accessibility work, before discharge when the work is needed for a safe move. Ask the transition coordinator whether pre-discharge approval is allowed and what documents, bids, and consent are required.
Is MFP only for older adults?
No. Many programs serve older adults and people with disabilities. Some state programs have age, disability, waiver, or target-group rules. Check your state MFP page or Medicaid transition office.
Can MFP help if the person will live with family?
Often, yes, if the family home is a qualified residence under the state’s MFP rules and the person meets the other requirements. The property owner may need to give written consent for modifications.
What if the state says the repair is not covered?
Ask for the denial reason in writing. Ask whether a smaller modification, more medical proof, a different contractor bid, or a Medicaid waiver service could be approved. Also ask about appeal rights and deadlines.
About This Guide
This HomeRepairGrants.org guide uses official federal, state, local, and high-trust nonprofit and community sources mentioned in the article, including Medicaid, CMS, HHS, ACL, HUD, USAGov, FTC, state Medicaid and aging agencies, 211, and independent living resources.
HomeRepairGrants.org is not a government agency and does not guarantee eligibility, approval, funding, contractor availability, discharge timing, or repair coverage. This guide is not legal, financial, tax, medical, insurance, disability-rights, or government-agency advice. Always confirm current rules with your state Medicaid agency, MFP program, managed care plan, waiver case manager, local housing agency, or qualified professional.
Corrections: Email info@homerepairgrants.org with corrections.
Next review: August 17, 2026