MFP-Operational-Protocol

Money Follows the Person Operational Protocol

[Insert State or Territory]

Money Follows the Person Operational Protocol
OPERATIONAL PROTOCOL VERSION [INSERT VERSION #]
GRANT [INSERT GRANT #]
[Insert Date of Latest Revision]

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Money Follows the Person Operational Protocol

Contents of the MFP OP template
How to Use the Money Follows the Person Operational Protocol Template ........................................ 3
Section A.

MFP Program Overview........................................................................................................ 5

Section B.

Project Administration ......................................................................................................... 7

Section C.

Recruitment, Enrollment, Outreach, and Education ....................................................... 10

Section D.

Stakeholder Engagement ................................................................................................... 14

Section E.

Benefits and Services......................................................................................................... 15

Section F.

Transition and Housing Services ...................................................................................... 20

Section G.

Self-Direction and Informal Caregiving ............................................................................ 23

Section H.

Reporting ............................................................................................................................. 24

Section I.

Quality Measurement, Assurance, and Monitoring ......................................................... 25

Section J.

Continuity of Care Post-Demonstration ........................................................................... 28

Section K.

Equity ................................................................................................................................... 29

Section L.

Tribal Initiative ..................................................................................................................... 31

Section M.

Public Health Emergencies ................................................................................................ 32
Hyperlinks and Glossary .................................................................................................. 33
Optional Second Appendix .............................................................................................. 36

Under the Privacy Act of 1974 any personally identifying information obtained will be kept private to the extent of the
law. According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of
information unless it displays a valid OMB control number. The valid OMB control number for this information
collection is 0938-INSERT. The time required to amend or newly develop the Operational Protocol is estimated to
average 42 hours per response, including the time to review instructions, search existing data resources, gather the
data needed, and complete and review the information collection. The time required to complete an annual update of
the Operational Protocol is estimated to average 16 hours per response. If you have comments concerning the
accuracy of the time estimate(s) or suggestions for improving this form, please write to: CMS, 7500 Security
Boulevard, Attn: PRA Reports Clearance Officer, Mail Stop C4-26-05, Baltimore, Maryland 21244-1850.

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Money Follows the Person Operational Protocol

HOW TO USE THE MONEY FOLLOWS THE PERSON OPERATIONAL
PROTOCOL TEMPLATE
Purpose
The Operational Protocol (OP) is the operational guide that outlines the Demonstration and addresses
how the state or territory will meet the objectives of the Money Follows the Person (MFP) Demonstration.
The OP describes how the state or territory will operationalize processes to ensure that the state or
territory’s Demonstration is equipped with the tools, infrastructure, systems, and policies to make MFP
Demonstration goals and initiatives successful.
The state or territory must review and amend the OP every three years, or more frequently as needed, in
response to changes in (1) federal, state, or territory law, regulation, or policy impacting MFP eligibility,
enrollment, or program operations; and (2) MFP operations, inclusive of changes to any of the required
MFP OP elements. Refer to MFP Program Terms and Conditions (PTC) 36 for specific requirements
around amending the OP.
While the OP describes “how” the state or territory operates the MFP program, “what” the state or territory
plans to do to advance MFP and Medicaid home and community-based services (HCBS) is included in
the state or territory’s unique MFP Work Plan (WP). Reporting on progress is included in the state or
territory’s Semi-Annual Progress Report (SAR).

Instructions
The OP template consists of 12 sections. Section A is an overview of the state or territory’s MFP
Demonstration; sections B through M are the required operational elements of the state or territory’s MFP
Demonstration. Each section contains prompts for information that are labeled by section and prompt
number order (for example, section A.1, prompt A.1.1). The state or territory is required to respond to
prompts in each section. Each prompt provides:
•

Guidance on how to insert information

•

Displays and tools for formatting and inserting information:
−

Text response boxes. Information may be entered in multiple lines of text and, where
applicable, an external document may be uploaded into a text box.

−

Table shells. Table shells display the layout of tables without the information or data. Some
table shells contain example entries in red text. Table shell rows may be added if needed.
Table shells titled “Example Table” can be modified.

−

Checkboxes. Checkboxes are displayed as a checklist in which to place a check mark to
make a selection.

The yellow line at left indicates instructional text and is followed either by a text response box, checkbox,
or a table shell.
A few tips for entering information
•

Text insertions must be clear, concise, and consistent.

•

Directly address each prompt.

•

Use the “Other Information” text box when additional information is necessary to further support,
explain, or justify a response to a prompt.

•

Limit text responses to no more than three pages.

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Money Follows the Person Operational Protocol
•

Use bullet points, tables, flow charts, and diagrams to help break up long sections of text and to
briefly summarize information.

•

Use preferred terms and spell out first use of acronyms.

•

Do not leave prompts blank. Enter “Not Applicable” for OP prompts that are not relevant to the
state or territory’s MFP program.

Using hyperlinks and embedding documents
•

Use hyperlinks to link to external documents that are relevant to the MFP program, including MFP
marketing and educational materials, service-related documents such as assessments and
program checklists, and information contained on external websites.

•

Hyperlinks must be documented in Appendix A.1 of the OP.

•

If you are embedding external documents within the template, follow these instructions and select
“Display as icon.” This Word feature allows documents to be embedded as clickable icons and
may be a preferable alternative to pasting long documents in the appendix or hyperlinking to a
document.

•

Accessibility features can be maintained by assigning alt text to the icons representing embedded
objects.

Before submitting the OP, complete the following three steps:
1. Ensure that all hyperlinks work.
2. Update the contents of the MFP OP template above by right-clicking anywhere within the field
and selecting “Update field.” This will automatically update the page numbers in the contents list.
3. If amending or updating the OP, complete the change log.

Change log
If amending or updating the OP, complete the change log by inserting entries into Table 1. The first two
lines of the table provide examples of how to populate the change log.
Table 1. Change log
Date of OP
Prompt submission

Changes made since last revision of OP

A

A.1.1
A.2.2

1/1/2020

Added new components of the state or territory’s LTSS system.
Described a new target group of the state or territory’s MFP program.

B

B.2.1

7/1/2021

Described new performance evaluation criteria for the MFP project director
role.

Section

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Money Follows the Person Operational Protocol

SECTION A. MFP PROGRAM OVERVIEW
This section briefly describes how the state or territory’s MFP Demonstration is designed to meet unique
state or territory long-term services and supports (LTSS) system reform efforts to increase the use of
HCBS, rather than institutional LTSS. Use the prompts in this section to report on the state or territory’s
LTSS system assessment and gap analysis and to identify the state or territory’s MFP Demonstration
target population and geographic area(s) of service.

A.1. State or territory system and gap analysis
A.1.1.

Summary of state or territory LTSS system and gap analysis

The summary must address these components:
•

Identify LTSS population needs

•

Identify geographic area(s) of need

•

Identify ways the state or territory can test new approaches and flexibilities in its Medicaid
programs to strengthen HCBS through the MFP Demonstration

•

Identify ways to provide opportunities to furnish MFP Demonstration services in a more equitable
manner

•

Identify and determine measurable, attainable, and timely MFP Demonstration goals and
outcomes

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A.2. Service areas and target groups of MFP program
A.2.1.

Service areas

Specify the service area(s) in which the MFP Demonstration operates.
Choose an item.
Click or tap here to enter text.

A.2.2.

Target groups

Complete Table A.1.2 to indicate the MFP target population(s) included in the state or territory’s
Demonstration and indicate the corresponding state or territory operating agency administering Medicaid
HCBS services and supports. Please note that target groups falling into the “Other” category must be
defined here and throughout the OP.
Table A.1.2. MFP target population groups
Select all
that apply

Target group of eligible individuals

☐

Older adults

☐

Individuals with physical disabilities (PD)

☐

Individuals with intellectual and developmental
disabilities (I/DD)

☐

Individuals with mental health and substance use
disorders (MH/SUD)

☐

Other, please specify (e.g., HIV/AIDS, brain injury)

State or territory operating agency

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Money Follows the Person Operational Protocol
Describe reasons for targeting certain MFP populations. Include geographic strategies, considerations
specific to rural areas, provider network considerations, and alignment with state or territory Olmstead
plans and rebalancing strategies.
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A.3. Other information
If needed, provide other information regarding the state or territory’s service area(s), target populations,
or reporting that is not addressed elsewhere in the template.
Click or tap here to enter text.

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Money Follows the Person Operational Protocol

SECTION B. PROJECT ADMINISTRATION
B.1. Administrative structure
B.1.1.

Organizational chart

Provide an organizational chart that shows the entity responsible for the management of the MFP
cooperative agreement and the Authorized Organizational Representative;1 how the management entity
relates to all other departments, agencies, and service systems providing HCBS to MFP participants; and
the relationship of the organizational structure to the state or territory Medicaid agency and state or
territory Medicaid director (SMD).
Upload the organizational chart into either the appendix or text box or provide an external link.
Click or tap here to enter text.

B.1.2.

Administrative structure

Describe how the state or territory will structure the administration of the MFP program, including how
roles and responsibilities will be coordinated across state or territory operating agencies and managed
care plans (MCP) (if applicable). Clearly indicate how the organizational and structural administration will
function to implement, operate, and monitor the OP elements of the Demonstration.
Example Table B.1.2. Administrative structure
Administrative entity
(state/territory, other
government entity, MCP or
contractor/consultant)

OP element(s)

MFP role and key responsibilities
(how the entity will implement,
operate, or monitor the OP
element)

Formal commitments
(for example,
Memorandum of
Understanding)

Click or tap here to enter text.

B.2. Staffing
B.2.1.

Project director and data and quality analyst

Upload the job description and performance evaluation criteria for these positions into the appendix or
provide an external link.

B.2.2.

Other project staff

Complete Example Table B.2.2 for all non-contract positions. Describe the MFP role, responsibilities, and
relevant OP element(s) for each position in the last column on the table. Responses for the last column
may be provided as table text, embedded documents, external links, or text indicating where the
response has been added in the appendix. The relevant OP element(s) for each role are the MFP
The Authorized Organizational Representative is defined in the MFP Demonstration Program Terms and
Conditions (PTC 25).

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Money Follows the Person Operational Protocol
program components (as defined by the major section headers of this document; for instance, D.
Stakeholder Engagement, E. Benefits and Services, and H. Reporting) on which the staff person in that
position will work.
Example Table B.2.2. MFP Demonstration staff

Number
and
position
title

B.2.3.

Percent of
full-time
equivalent

Administrative or service
position
(if service position,
indicate whether
Demonstration or
supplemental)

Indicate if non-contract or
contract/consultant
position

MFP role,
responsibilities, and
relevant OP element(s)

In-kind support

Describe positions providing in-kind support (that is, support from non-MFP staff) to the MFP
Demonstration. Indicate the percentage of time each individual or position is dedicated to the grant and
the roles and responsibilities of each position. Indicate the OP element(s) the positions will support. If a
large number of staff provide in-kind support to the MFP Demonstration, describe the staff in general or
aggregate terms, such as contracting specialists, fiscal staff, etc.
Click or tap here to enter text.

B.2.4.

Staffing and contract execution timeline

Provide a hiring timeline (start and end date) for non-contract staff. For contract, consultant, or
subrecipient positions, provide the contract execution date and expected expiration/end date.
Click or tap here to enter text.

B.3. Billing and reimbursement
B.3.1.

Billing and reimbursement procedures

Describe how the state or territory will establish billing and reimbursement procedures to link Medicaid
claims to MFP individuals. Include the following:
•

Description of MFP identifier codes in the Medicaid Management Information System (MMIS) and
if applicable in the state or territory accounting system

•

Description of procedures for ensuring against duplication of payment for the Demonstration and
Medicaid programs

•

If the state or territory operates a managed long-term services and supports (MLTSS) program,
description of your state or territory’s managed care claiming methodology to determine the
portion of the capitation rate that is attributable to qualified HCBS listed in Attachment A of the
MFP PTC

•

Procedures for fraud control and monitoring

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B.4. Budget process
B.4.1.

Budget development process

Describe how the state or territory will prepare the MFP budget. Include the following:

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Money Follows the Person Operational Protocol
•

Process for projecting annual expenditures

•

Cross-agency roles and responsibilities for developing, reviewing, and approving the budget

•

Procedures for adjusting or reconciling the budget

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B.5. Other information
If needed, provide other information regarding the state or territory’s MFP Demonstration administration
that is not addressed elsewhere in the template.
Click or tap here to enter text.

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Money Follows the Person Operational Protocol

SECTION C. RECRUITMENT, ENROLLMENT, OUTREACH, AND
EDUCATION
C.1. MFP-qualified inpatient facility recruitment
C.1.1.

MFP-qualified inpatient facility types

In Table C.1.1, describe how the state or territory will collect and verify that MFP participants are
transitioning to the community from an MFP-qualified inpatient facility. Describe the process for each
target population and inpatient facility type. If there are multiple “other” populations to note, illustrate the
type(s) of inpatient facilities separately for each “other” population with a new row.
Table C.1.1. MFP-qualified inpatient facility type by target group

Target population(s)

MFP-qualified inpatient
facility types from which
the target population will
transition

Older adults

☐ Nursing facility

Description of data collection and verification procedures

☐ ICF/IID
☐ Hospital
☐ IMD
Individuals with PD

☐ Nursing facility
☐ ICF/IID
☐ Hospital
☐ IMD

Individuals with I/DD

☐ Nursing facility
☐ ICF/IID
☐ Hospital
☐ IMD

Individuals with
MH/SUD

☐ Nursing facility
☐ ICF/IID
☐ Hospital
☐ IMD

Other, please specify in ☐ Nursing facility
text box below (e.g.,
☐ ICF/IID
HIV/AIDS, brain injury)
☐ Hospital
☐ IMD

Note: MFP programs transitioning MFP participants from an IMD (see PTC 14) must provide a description
in section C.1.2 of the OP of how the state or territory will verify certain requirements, such as that the
individual meets MFP individual eligibility criteria.
ICF/IID = Intermediate Care Facility for Individuals with Intellectual Disabilities; IMD = Institution for
Mental Diseases.

C.1.2.

Institution for mental diseases (IMD) exclusion

For MFP programs transitioning MFP participants from an IMD (see PTC 14), provide a description of
how the state or territory will verify that the:
•

Individual meets the MFP individual eligibility criteria

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•

Individual is receiving one of these benefits:
−

Services for individuals ages 65 and older in an IMD, referred to as “IMD over 65”

−

Inpatient psychiatric services for individuals younger than 21, referred to as “psych under 21”

−

Medicaid beneficiaries ages 21 through 64 residing in an IMD who are receiving services that
are covered under a Substance Use Disorder or Serious Mental Illness section 1115
demonstration

Click or tap here to enter text.

C.1.3.

Strategies for recruiting MFP-qualified inpatient facilities

Describe strategies for recruiting MFP-qualified inpatient facilities to engage in the development and
implementation of person-centered transition programs that offer residents the choice of leaving the
facility to return to the community. Include geographic strategies, considerations specific to rural areas,
alignment with state or territory Olmstead plans and rebalancing strategies, and facility access and
engagement approaches.
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C.2. MFP participant recruitment and enrollment
C.2.1.

Eligibility criteria for participation in MFP

Describe any state or territory-specific MFP eligibility criteria. For example, describe your state or
territory’s requirements for individuals’ length of stay in an MFP-qualified inpatient facility if more than 60
consecutive days. See section IV of the MFP PTC for a description of MFP eligibility criteria.
Click or tap here to enter text.

C.2.2.

Participant recruitment and enrollment process

Describe the MFP participant recruitment and enrollment process, indicating differences as applicable for
each target group and inpatient facility type identified in C.1.1. Include the following:
•

Describe process to identify eligible individuals interested in transitioning from an inpatient facility
to a qualified residence.

•

Describe the role of No Wrong Door (NWD) systems to recruit and enroll MFP participants.

•

Describe how the state or territory will verify MFP individual eligibility criteria.

•

Describe the provider(s) rendering services to recruit and enroll individuals into MFP.

•

Describe how the state or territory will ensure a person-centered planning process during the
MFP recruitment and enrollment process. The person-centered planning process must include a
person-centered service plan that identifies the individual’s needs and individualized strategies
and interventions for meeting those needs and be led by the individual and the individual’s
authorized representative if applicable.

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C.2.3.

Data sources for recruiting MFP participants

Describe how the state or territory will process and organize data sources to identify and recruit MFP
participants. The description must include the use of the Minimum Data Set (MDS) Section Q and must
describe any variability among MFP target populations, MFP-qualified inpatient facilities, and state or
territory operating agencies.

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Click or tap here to enter text.

C.3. Outreach and marketing to participants, providers, and stakeholders
C.3.1.

Marketing plan

Describe how the state or territory will develop and implement a marketing plan to recruit and enroll MFP
participants. Include a description of the following:
•

Strategy or strategies to provide cultural, linguistic, and disability competency in the production
and dissemination of marketing materials

•

Types of marketing materials and tools

•

Types of media approaches (print, radio, television, direct mail, social media, search engine, and
so on)

Upload printed marketing materials or provide an external link to the materials in the appendix, as
appropriate.
Click or tap here to enter text.

C.3.2.

Outreach and education plan

Describe how the state or territory will develop and implement an outreach and education plan to recruit
MFP-inpatient facility providers, service providers, affordable and accessible housing providers,
community-based organizations, and other relevant stakeholders. Include a description of the following:
•

Methods and tools

•

Collaboration opportunities

•

Types of events and trainings

Upload outreach and education materials into the appendix or provide an external link.
Click or tap here to enter text.

C.3.3.

Stevens Amendment and accessibility requirements

Select the boxes below to confirm the state or territory adheres to the requirements regarding the Stevens
Amendment and complies with accessibility laws.
☐ The state or territory affirms that it has established procedures for complying with the requirement in
Section 26.G and 26.H of the CMS Standard Terms and Conditions (STC) regarding the Stevens
Amendment, which describes actions federal award recipients must take when engaging in public
reporting and acknowledgement of sponsors.
☐ The state or territory acknowledges responsibility for complying with federal laws regarding
accessibility (Attachment B of CMS STC).

C.4. Informed consent
C.4.1.

Informed consent criteria

Describe how the state or territory will implement procedures for obtaining informed consent. Include the
following:

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Money Follows the Person Operational Protocol
•

Process for ensuring that each eligible individual or the individual’s authorized representative will
be provided the opportunity to make an informed choice regarding whether to participate in the
MFP Demonstration

•

Process for ensuring that each eligible individual or the individual’s authorized representative will
have input into, and approve the selection of, the qualified residence in which the individual will
reside and the setting in which the individual will receive HCBS

•

Process for ensuring individuals are informed about all aspects of the transition process; have full
knowledge of the services and supports that will be provided both during and after the program
year; and are informed of their rights and responsibilities as a participant, including the right to file
reports or complaints regarding violation of their rights or other critical incidents

•

Method(s) for obtaining informed consent (written, verbal, digital, and so on)

Provide an external link to informed consent forms and informational material. Alternatively, paste or
embed those materials into the appendix or the text box below. If using the appendix, use the text box to
indicate where in the appendix these materials can be found.
Click or tap here to enter text.

C.5. Authorized representative
C.5.1.

Procedures for MFP engagement with an authorized representative

Describe how the MFP Demonstration will engage with an authorized representative and how the process
aligns with state or territory policy. Include the following:
•

Procedures for engaging with an authorized representative as part of an individual’s personcentered planning process during the transition period and the 365-day MFP enrollment period

•

Specific strategies and approaches when working with inpatient facility administrators who are
serving as an authorized representative, particularly around identifying and eliminating conflict of
interest concerns

•

Process for verifying that an MFP participant’s authorized representative has (1) a known
relationship with the individual; (2) ongoing interaction with the individual; and (3) recent
knowledge of the individual’s welfare

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C.5.2.

Re-enrollment

Describe the state or territory’s MFP re-enrollment policy (1) for individuals who have been reinstitutionalized or hospitalized prior to completing their 365-day MFP enrollment period, and (2) for
individuals who have been re-institutionalized after completing their 365-day MFP enrollment period.
Include actions that occur at 30- and 60-day intervals during an individual’s institutional or hospital stay.
Click or tap here to enter text.

C.6. Other information
If needed, provide other information regarding the state or territory’s approach to recruitment, enrollment,
outreach, and education that is not addressed elsewhere in the template.
Click or tap here to enter text.

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Money Follows the Person Operational Protocol

SECTION D. STAKEHOLDER ENGAGEMENT
Describe how the state or territory will engage a broad community of stakeholders, including but not
limited to, Medicaid agency leadership, participants in HCBS programs, residents in long-term care
facilities, long-term care facility staff, family members and other caregivers, HCBS providers, the aging
and disability network, MCPs, housing providers, and the direct care workforce, to inform the state or
territory’s approach to the design of the MFP Demonstration and the ways in which the state or territory
can leverage the MFP Demonstration to expand and enhance the HCBS system. Include a description of
the state or territory’s strategy(s), structure of the stakeholder process, engagement tools, communication
process, and how the stakeholder process will be strengthened throughout the MFP program period of
performance.
Click or tap here to enter text.

D.1. Stakeholders
States or territories may use Example Table D.1 to list stakeholders engaged in the design and
implementation of the MFP Demonstration; to indicate the OP element(s) the stakeholders will be
engaged with; and a brief description of the engagement structure, including the type and frequency of
engagement and role(s) in the engagement process.
Example Table D.1. Description and frequency of stakeholder engagement
Stakeholder (examples)

OP
elements

Description of engagement process

MFP participants
Residents in inpatient facilities
Family members and caregivers
Centers for Independent Living
Long-term care facilities
HCBS providers
Housing partners
Managed care plans
Aging and disability networks
Direct care workforce
Other

D.2. Other information
If needed, provide other information regarding the state or territory’s approach to stakeholder
engagement that is not addressed elsewhere in the template.
Click or tap here to enter text.

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Money Follows the Person Operational Protocol

SECTION E. BENEFITS AND SERVICES
Describe how the MFP Demonstration will provide opportunities for MFP participants to receive highquality services in their own home or community rather than institutions. The state or territory must
describe qualified HCBS (PTC 16 and Attachment A in the PTC), Demonstration services (PTC 17), and
supplemental services (PTC 24) that it will provide under the MFP Demonstration.

E.1. Qualified HCBS
The qualified HCBS program is the Medicaid service package(s) that the state or territory will make
available to an MFP participant when they move to a community-based residence. This program can be
comprised of any Medicaid home and community-based state plan services and HCBS waiver program
services. MFP-qualified HCBS are listed and described in Attachment A to the MFP PTC.
The state or territory must describe:
•

Qualified HCBS available to MFP participants

•

Target population

•

Any proposed Medicaid coverage strategy to amend and implement changes to the state plan or
HCBS waiver program(s) to carry out the Demonstration; these descriptions must indicate:
−

The specific HCBS program that will be changed or amended

−

Which authority the HCBS program operates under

−

When the change or amendment will occur

The state or territory may insert information using (1) Example Table E.1, (2) a description in the text
response box below, or (3) a combination of both a table and separate text description.
Example Table E.1. MFP-qualified HCBS
MFPqualified
HCBS

Qualified HCBS description

MFP target population(s)

HCBS
under
section
1905(a)
state plan
services
HCBS
under
sections
1915(c),
1915(i),
1915(j)
and
1915(k)
Other
HCBS
options
(describe)

Click or tap here to enter text.

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Money Follows the Person Operational Protocol

E.2. MFP Demonstration services
E.2.1.

Demonstration service description

MFP Demonstration services are qualified HCBS that could be provided, but are not currently provided,
under the state or territory’s Medicaid program. Demonstration services must be reasonable and
necessary, not available to the participant through other means, and clearly specified in the participant’s
service plan. The state or territory is expected to test and evaluate Demonstration services.
Demonstration services are not required to continue after the conclusion of the MFP Demonstration or for
the participant at the end of the 365-day enrollment period. Demonstration service descriptions must
include:
•

The qualified HCBS Medicaid authority under which the service could be covered

•

The target population(s) receiving the service

•

For a new Demonstration service not currently covered under the state or territory’s HCBS
program, a description of the scope of the service including a definition of the discrete service; a
complete list and description of any goods and services that will be provided; any conditions that
apply to the provision of the service; and eligibility or medical necessity criteria

•

For a Demonstration service currently authorized under the state or territory’s Medicaid program,
a description of how the service complements or supplements the authorized HCBS in an
amount, frequency, scope, or duration greater than allowed under the state or territory’s Medicaid
program

•

A description of how the state or territory will test and evaluate the service to determine whether
the service contributes to the successful transition and community functioning of an MFP
participant

The state or territory may insert information using (1) Example Table E.2.1, (2) a description in the text
response box, or (3) a combination of both a table and separate text description.
Example Table E.2.1. Demonstration services
Demonstration
service title

HCBS
Medicaid
authority

MFP target
population(s)

Amount, duration, and scope of
service

Service testing and
evaluation

Click or tap here to enter text.

E.3. MFP supplemental services
E.3.1.

Supplemental service descriptions

Supplemental services are one-time services to support an MFP participant’s transition that are otherwise
not allowable under the Medicaid program. Supplemental services must be reasonable and necessary,
not available to the participant through other means, and clearly specified in the participant’s service plan.
Supplemental services are not required to continue after the conclusion of the MFP Demonstration or for

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the participant at the end of the 365-day enrollment period. The state or territory is expected to test and
evaluate supplemental services. Supplemental service descriptions must include:
•

The target population(s) receiving the service

•

The category of the supplemental service (short-term housing assistance, food security, payment
for activities prior to transitioning from an MFP-qualified inpatient facility, payment for securing a
community-based-home)

•

The scope of the service, including a definition of the discrete service (for example, if providing
payment for activities prior to transitioning from an MFP-qualified inpatient facility, describe each
discrete activity under this category, such as home accessibility modifications, vehicle
adaptations, and home cleaning)

•

An assurance that services are responsive to a person’s needs and wants described in a personcentered plan

•

A complete list and description of any goods and services that will be provided

•

Any conditions that apply to the provision of the service

•

How the state or territory will test and evaluate the service to determine whether the service
contributes to the successful transition and community functioning of an MFP participant

•

Under the payment for activities prior to transitioning from an MFP-qualified inpatient facility,
please include the following information for each discrete activity:
−

Specify the time period for when payment to a provider for rendering the supplemental
service will occur (e.g., up to 15 days prior to discharge/transition to the community date)

−

Specify the time-period for when the service will be rendered (e.g., up to 15 days prior to
discharge/transition date)

The state or territory must insert information using Example Table E.3.1, and may provide additional
information in the text response box below.
Example Table E.3.1. Description of supplemental services

Supplemental service

Target population(s)

Amount,
duration, and
scope of service

Goods and
services
provided

Responsiveness to
person-centered
plan

Short-term housing
assistance
Housing Plan (separate
entry required in E.4.2)
1. Six-month rental
assistance
2. Six-month utility
payment assistance
Food security
Food Security Plan
(separate entry required
in E.4.2)
1.
2.

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Supplemental service

Target population(s)

Amount,
duration, and
scope of service

Goods and
services
provided

Responsiveness to
person-centered
plan

Payment for activities prior
to transitioning from an
MFP-qualified inpatient
facility
1. Home accessibility
2. Vehicle adaptations
3. Home cleaning
Payment for securing a
community-based home
1.
2.
3.
Other supplemental service

Click or tap here to enter text.

E.3.2.

Supplemental services housing plan and food security plan

If providing short-term housing assistance or food pantry stocking, upload the required housing plan or
food security plan that describes how these services will be administered and sustained. See the March
31, 2022 Note to MFP Recipients: Announcement of Certain Changes to Supplemental Services under
the MFP Demonstration for specific requirements for the housing and food security plans.
Click or tap here to enter text.

E.4. Managed long-term services and supports
Select the box below to indicate whether your state or territory operates an MLTSS program.
☐ Yes, the state or territory operates an MLTSS program that includes providing HCBS to these
populations: (select all that apply).
☐ Older adults
☐ Adults with PD
☐ Individuals with I/DD
☐ Individuals with MH/SUD
☐ Other, please specify (e.g., HIV/AIDS, brain injury)
For states or territories that selected “Yes”, describe how the state or territory implements the MFP
Demonstration under managed care programs. Clearly indicate the qualified HCBS, Demonstration, and
supplemental services that are delivered under managed care. Additionally, describe how the MFP
Demonstration supports or complements the state or territory’s MLTSS strategy for expanding HCBS,
promoting community integration, ensuring quality, and increasing efficiency.
Click or tap here to enter text.

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E.5. Service providers
E.5.1.

Qualified HCBS, MFP Demonstration, and supplemental service providers

For each qualified HCBS, MFP Demonstration, and supplemental service, include the following:
•

Describe how the MFP Demonstration will ensure that MFP participants are offered the choice of
a qualified Medicaid provider under a person-centered planning process.

•

Describe how the state or territory will ensure that providers have sufficient experience and
training in the provision of their applicable supplemental services.

•

Describe how the state or territory provides access to needed services or manages a waiting list
when provider shortages or other barriers prevent timely provision of HCBS, MFP Demonstration,
and supplemental services.

•

Describe how the MFP program will ensure that MFP participants are offered the choice of a
Medicaid-qualified provider under a person-centered planning process or the Medicaid authority
limiting participants’ choice of provider.

The state or territory may insert information using (1) Example Table E.5.1, (2) a description in the text
response box, or (3) a combination of both a table and separate text description.
Example Table E.5.1. Describe HCBS, MFP Demonstration, and supplemental service provider
qualifications
Service

Provider qualifications

Click or tap here to enter text.

E.6. Other information
If needed, provide other information regarding the state or territory’s benefits and services that is not
addressed elsewhere in the template.
Click or tap here to enter text.

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SECTION F. TRANSITION AND HOUSING SERVICES
F.1.

Transition services

F.1.1.

Comprehensive transition coordination services

Describe how the state or territory’s MFP Demonstration will implement comprehensive transition
coordination services during these three phases: (1) pre-transition, (2) transition, and (3) during an MFP
participant’s 365-day enrollment period. Include the following:
•

Description of transition coordination activities

•

Description of person-centered planning in the transition coordination process, including:
−

How the state or territory’s MFP Demonstration will ensure that each MFP participant’s
service plan is individualized to provide the services and supports needed to live in the
community

−

How MFP participants and their authorized representative (if applicable) will lead the
development of their service plan

•

Steps in the transition coordination process

•

Communication process between MFP transition coordination and Medicaid HCBS programs

•

How transition coordination services advance health for all people served

•

How transition coordination services promote community integration

Use discrete descriptions for each target population.
Click or tap here to enter text.

F.1.2.

Transitions under managed care plans

If MFP participants are required to enroll in a managed long-term care or comprehensive managed care
plan, clearly describe how the MFP Demonstration will coordinate the delivery of comprehensive
transition coordination services with the MCP. Include the following:
•

Describe the roles and responsibilities for the MCP during each transition phase: (1) pretransition, (2) transition phase, and (3) during an MFP participant’s 365-day enrollment period

•

Describe how the MFP program will ensure that MCPs provide all data and related
documentation necessary to monitor and evaluate MFP transition coordination services, including
identifying MFP managed care encounters through the Transformed Medicaid Statistical
Information System (T-MSIS).

Click or tap here to enter text.

F.1.3.

Housing-related services and supports

Describe how the state or territory will structure, organize, and implement housing-related supports and
services to increase affordable and accessible housing opportunities for MFP participants. Account for
any differences between target population groups and geographic service areas, specifically in rural
service areas.
Click or tap here to enter text.
Select the following housing-related services and supports available to MFP participants. See the State
Health Official letter #21-001 RE: Opportunities in Medicaid and CHIP to Address Social Determinants of
Health (SDOH) for a description of housing-related services and supports.

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☐ Home accessibility modifications (provide a dollar amount available per participant)
Click or tap here to enter text.
☐ One-time community transition costs (provide a dollar amount available per participant)
Click or tap here to enter text.
☐ Pre-tenancy supports
☐ Tenancy supports

F.2.

Partnerships with state or territory and local housing entities

Describe how the state or territory will develop and sustain partnerships with state or territory and local
housing agencies to increase access to affordable and accessible housing for MFP participants. Include
the following:
•

How the state or territory will put in place partnership arrangements with state or territory and
local housing entities

•

How the state or territory will work with those entities to assist MFP participants to obtain
affordable and accessible housing

•

Description of the proposed infrastructure expenditures to support housing partnerships;
examples of infrastructure expenditures include:
−

Housing specialist position(s)—responsible for developing/maintaining system-level
partnerships with state or territory and local housing entities

−

Technology—for example, electronic referral systems, shared data platforms, screening tool,
case management systems, databases/data warehouses, housing registry

−

Workforce development—for example, training, housing coordination certification, cultural
competency training

−

Outreach, education, and stakeholder convening—for example, design and production of
outreach and education materials, translation, investments in stakeholder convening

Click or tap here to enter text.

F.3.

MFP-qualified residence

Describe how the state or territory will verify and document the type of MFP-qualified residence (see PTC
15) an MFP participant resides in during the 365-day enrollment period. Use discrete descriptions for
each target population if applicable. Include the following:
•

Description of the process for identifying MFP-qualified residences

•

Description of the provider(s) responsible for verifying and documenting the type of MFP-qualified
residence

•

Assessments or tools for screening MFP-qualified residences, including:
−

Name and description of the assessments of tools

−

Embed any assessments or tools below or in the appendix, or provide a link to the source

Click or tap here to enter text.

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F.4.

Other information

If needed, provide other information regarding the state or territory’s transition coordination and housing
processes and services that is not addressed elsewhere in the template.
Click or tap here to enter text.

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SECTION G. SELF-DIRECTION AND INFORMAL CAREGIVING
G.1. Self-direction
Describe any opportunities for MFP participants to receive HCBS as self-directed services.
Click or tap here to enter text.

G.1.1.

Termination of self-direction

Describe how the state or territory accommodates a participant who voluntarily terminates self-direction to
receive services through an alternate service delivery method, including how the state or territory assures
continuity of services and participant health and welfare during the transition from self-direction to the
alternative service delivery method. Describe the circumstances under which the state will involuntarily
terminate the use of self-direction and thus require the participant to receive provider-managed services
instead. Specify procedures for switches from self-direction to provider-managed or other service delivery
systems.
Click or tap here to enter text.

G.2. Other information
If needed, provide other information regarding self-direction and informal caregiving that is not addressed
elsewhere in the template.
Click or tap here to enter text.

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SECTION H. REPORTING
H.1. Reporting plans and procedures
Describe how the state will develop and implement a reporting plan and procedure for data collection,
reporting, and participation in the MFP evaluation effort. The reporting plan must include data collection
plans and procedures that demonstrate the state’s capacity to collect and share data for reporting the
required program, expenditure, and financial information. States must include a description of their TMSIS data submission status and must address how identified T-MSIS data quality issues are being
addressed.
Describe the reporting procedures for ensuring timely and complete data submissions to CMS, including
quarterly, semi-annual, and annual reporting requirements; performance indicators and program outcome
metrics; and continuous quality improvement and quality measures reporting.
Describe the strategies for ensuring that all partners and participants—including all affiliated departments,
agencies, and providers—will participate in the project’s evaluation.
Click or tap here to enter text.

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SECTION I. QUALITY MEASUREMENT, ASSURANCE, AND
MONITORING
I.1.
I.1.1.

Quality assurance and improvement
Quality management strategy

Provide as an appendix a comprehensive and integrated quality management strategy. Describe how the
state assures quality and continuously improves the quality of HCBS under the state Medicaid program,
and assures the health and welfare of individuals participating in the MFP Demonstration. Include state
initiatives to improve the quality of services received by individuals receiving HCBS through the MFP
Demonstration and the systems that serve them. Include how the state monitors and evaluates the quality
of services provided to MFP participants (including supplemental services), the roles and responsibilities
of all agencies involved, and remediation and improvement processes.
Describe the program’s targeted system performance requirements to which the critical services apply,
aligning with assurances defined within the section 1915(c) HCBS waiver program, including that (1) the
state conducts level-of-care need determinations consistent with the need for institutionalization, (2) plans
of care are responsive to participants’ needs, (3) qualified providers serve participants, (4) health and
welfare of participants is protected, (5) state Medicaid agency retains administrative authority over the
program, and (6) the state provides financial accountability of the program.
If the state plans to integrate the MFP program into a new or existing section 1915(c) HCBS waiver
program, section 1915(i) state plan HCBS, section 1915(j) self-directed personal care services, section
1915(k) Community First Choice, or a section 1115 demonstration, provide a link to the approved quality
improvement system (QIS), for example as found in:
•

Appendix H of the section 1915(c) HCBS waiver application

•

QIS information provided in the section 1915(i) state plan application

•

The quality assurance and improvement plan used to monitor and evaluate the section 1915(j)
self-directed option

•

The quality assurance and improvement strategy used to monitor the section 1915(k) Community
First Choice State Plan option

•

Section IV of the section 1115 demonstration application, describing how delivery system reforms
will impact quality, access, cost of care, and health status of the covered populations

Describe how the HCBS state plan, section 1115 demonstration, or waiver program’s existing QIS is or
will be modified to ensure adequate oversight and monitoring of the MFP program.
Click or tap here to enter text.

I.1.2.

Quality assurance attestation

☐ Select this box to indicate the state or territory will cooperate in carrying out activities to develop and
implement continuous quality assurance and quality improvement systems for HCBS and LTSS.

I.1.3.

HCBS quality measures

Describe how your state or territory plans to select an experience of care survey or surveys and report on
the HCBS Quality Measure Set.
Click or tap here to enter text.

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Describe any limitations in the data sources or calculations used to report the HCBS Quality Measure Set,
as well as any other anticipated challenges for reporting.
Click or tap here to enter text.
Describe how HCBS Quality Measure Set data will be used to support MFP program monitoring and
improvement.
Click or tap here to enter text.
Please list the responsible party and any key partners for reporting on the HCBS Quality Measure Set
and driving improvement.
Click or tap here to enter text.

I.2.

Additional MFP quality assurance requirements

Describe how the state or territory will address the three additional MFP quality assurance requirements
for (1) 24-hour backup systems for crucial services, (2) risk assessment and mitigation, and (3) incident
management. For each requirement, describe how the state or territory will monitor its use and
effectiveness and explain any variations by target population, geography, or any other factor. Describe
the protocol for the reporting of incidents to the state or territory’s critical incident systems for the state or
territory’s HCBS program(s).

I.2.1.

24-hour backup systems for critical services

Using the table shell below, describe any 24-hour backup systems accessible by Demonstration
participants, as well as how participants can access the systems (for example, toll-free telephone number
or website). The state or territory should describe, at a minimum, the backup systems related to (1) critical
services, (2) transportation, (3) direct care workers, (4) repair and replacement for durable medical
equipment (DME) and other equipment (including provision of loaning equipment while repairs are being
made), and (5) access to medical care (including how participants are assisted with initial appointments,
how to make appointments, and how to deal with appointment or care issues). Add as many rows as
needed to capture all backup systems available to Demonstration participants.
Table I.2.1. 24-hour backup systems
Backup system

Description of system

Participant access

Critical services
Transportation
Direct care workers
Repair and replacement for DME
and other equipment
Access to medical care
Other (describe):

Describe the organization of 24-hour backup systems. Explain which state, territory, or local agencies are
responsible for providing 24-hour, seven day per week emergency backup in all geographical areas in
which the MFP Demonstration will operate and for each target group if it varies.
Click or tap here to enter text.
Describe the process for receiving and resolving participant complaints when the backup systems and
supports do not work.

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Click or tap here to enter text.

I.2.2.

Risk assessment and mitigation

Describe the organization of risk assessment and mitigation processes for all program participants,
including monitoring.
Click or tap here to enter text.

I.2.3.

Incident management system

Assure that MFP critical incidents are reported through the state or territory’s incident management
systems for Medicaid HCBS. Describe the organization of the incident management system used to
monitor the health and welfare of MFP participants. Identify the state or territory entity responsible for
receiving, reviewing, and responding to MFP critical incident reports and investigating consumer
complaints regarding violation of their rights. If applicable, clearly describe how the policy differs by
situation (for instance, by participant population group, qualified institutional setting, or operating division).
Click or tap here to enter text.

I.3.

Other information

If needed, provide other information regarding the state or territory’s approach to quality that is not
addressed elsewhere in the template.
Click or tap here to enter text.

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SECTION J. CONTINUITY OF CARE POST-DEMONSTRATION
In accordance with section 6071(c)(2) of the Deficit Reduction Act of 2005, the MFP Demonstration must
operate in connection with a qualified HCBS program to assure continuity of services for eligible
individuals.
Select this box.
☐ The state or territory affirms that it has established procedures and processes for ensuring that the
provision of HCBS will continue for an MFP participant at the conclusion of the 365-day enrollment
period for as long as an individual remains eligible for medical assistance.

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SECTION K. EQUITY
Describe how your state or territory’s MFP Demonstration assesses or measures equity concerns and
considerations that relate to your state or territory’s MFP Demonstration. These should relate to
consistent and systematic fair, just, and impartial treatment of all individuals, including individuals who
belong to underserved communities that historically have been denied such treatment, such as Black,
Latino, Indigenous and Native American persons, Asian Americans, Pacific Islanders, and other persons
of color; members of religious minorities; lesbian, gay, bisexual, transgender, and queer (LGBTQ+)
persons; persons with disabilities; persons who live in rural areas; and persons otherwise adversely
affected by persistent poverty or inequality.2 As a reminder, please use the MFP WP to describe any
initiatives relevant to this section, including specific and measurable objectives, MFP and state or territory
funding, and evaluation efforts.

K.1. Disparities in enrolling or participating in MFP
K.1.1.

Assessing and measuring disparities in enrolling or participating in MFP

Describe how your state or territory’s MFP Demonstration assesses or measures disparities in enrolling or
participating in MFP, or your state or territory’s plan to assess or measure these disparities. Include a
description of the areas in which disparities are or will be measured, such as race/ethnicity, religion,
geography, type of disability, gender identity, and sexual orientation.
Click or tap here to enter text.

K.1.2.

Cultural competency

Describe how your state or territory’s MFP Demonstration will assess the cultural competency of its
provider network.
Click or tap here to enter text.

K.1.3.

Data sources for measuring disparities

Describe the availability of data for measuring or assessing equity and disparities in enrolling or
participating in your MFP Demonstration. Describe barriers to obtaining data on equity and disparities and
how your MFP Demonstration plans to address or overcome these barriers.
Click or tap here to enter text.

K.2. Social determinants of health
K.2.1.

Assessing and measuring social determinants of health

Describe how the state or territory’s MFP Demonstration is or will be measuring or assessing whether it is
promoting, providing, or facilitating access to the social determinants of health (SDOH) and other needed
services. Include a description of the specific SDOH that are or will be measured, such as food insecurity,
transportation, medical devices and supplies, education, and social and community supports.
Click or tap here to enter text.

2
This definition of equity was established in the Executive Order on Advancing Racial Equity and Support for Underserved
Communities Through the Federal Government. The Executive Order is available at https://www.whitehouse.gov/briefingroom/presidential-actions/2021/01/20/executive-order-advancing-racial-equity-and-support-for-underserved-communities-throughthe-federal-government/.

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K.2.2.

Data sources for measuring SDOH

Describe the availability of data for measuring or assessing SDOH as it relates to your MFP
Demonstration. Describe barriers to obtaining data on SDOH and how your MFP Demonstration plans to
address or overcome these barriers.
Click or tap here to enter text.

K.3. Tribal Initiative
Indicate whether the state or territory has or is planning a Tribal Initiative within its MFP Demonstration. If
it has or will have a program, please complete the next section (Section L). If the state or territory does
not have a Tribal Initiative and is not planning one, please respond to the prompts below but do not
complete the next section (Section L).
☐ Yes, there is a Tribal Initiative to the MFP Demonstration or one is being planned.
☐ No, there is not a Tribal Initiative to the MFP Demonstration.
If the state or territory does not have a Tribal Initiative and is not planning one, describe why a Tribal
Initiative is not needed in the state or territory. Responses should discuss considerations that went into
the decision not to have a Tribal Initiative, including whether the state or territory has conducted any
outreach to Tribal nations and communities and, if relevant, the outcomes of those outreach efforts.
Click or tap here to enter text.

K.4. Other information
If needed, provide other information regarding the state or territory’s approach to equity that is not
addressed elsewhere in the template.
Click or tap here to enter text.

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SECTION L. TRIBAL INITIATIVE
If your state or territory has or is planning a Tribal Initiative, please describe the Tribal Initiative.

L.1.

Tribal Initiative project director

Name the project director of the Tribal Initiative, describe the percentage of time the project director
spends on this initiative, and offer a brief description of the roles and responsibilities of the position.
Click or tap here to enter text.

L.2.
L.2.1.

Capacity building and planning
Federally recognized Tribal nations

Name each of the federally recognized Tribal nations within the state or territory.
Click or tap here to enter text.

L.2.1.

Engagement with Tribal nations

Describe which tribes are MFP Tribal partners and how the state or territory engages with these partners.
Describe how the state or territory engages with tribes that are not MFP Tribal partners. Include strategies
and efforts to date and any anticipated or planned engagement efforts.
Click or tap here to enter text.

L.3.

Operations

Describe the operating details of your state or territory’s Tribal Initiative. Describe any operational
activities that differ from the state or territory’s MFP Demonstration in terms of benefits and services
available to participants through the Tribal Initiative, quality assurance, self-direction options, housing
options for participants, and how continuity of care is maintained after the end of the 365-day
Demonstration period.
Include in the MFP WP, specific Tribal Initiative objectives including transition benchmarks, outreach to
Tribes and Tribal providers, recruitment and enrollment efforts, and workforce development objectives
including the amount of services delivered Tribally.
Click or tap here to enter text.

L.4.

Other information

If needed, provide other information regarding the state or territory’s approach to Tribal Initiatives that is
not addressed elsewhere in the template.
Click or tap here to enter text.

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SECTION M. PUBLIC HEALTH EMERGENCIES
M.1. Program adaptations in response to Public Health Emergencies
M.1.1.

Program adaptations

Describe adaptations your state or territory’s MFP Demonstration made in response to a Public Health
Emergency (PHE), such as the COVID-19 PHE, declared at either the state, territory, or federal level. For
instance, these could include protocols for MFP participants living in the community who test positive for
COVID-19, plans to prevent COVID-19 spread among participants, modifying recommendations related to
infection control or immunizations (such as the COVID-19, flu, and shingles vaccines), or ways the MFP
Demonstration has expanded access to or incorporated services delivered through telehealth technology.
Identify adaptations that have ended and those that are ongoing. Describe how any MFP Demonstration
adaptations in response to PHEs align with and use policies and procedures from the state or territory’s
HCBS program(s).
Click or tap here to enter text.

M.2. Future PHEs
Describe if and how your state or territory is planning for future PHEs in its HCBS systems and MFP
Demonstration. For instance, this may include permanent adoption of measures implemented for the
COVID-19 PHE.
Click or tap here to enter text.

M.3. Other information
If needed, provide other information regarding the state or territory’s approach to PHEs that is not
addressed elsewhere in the template.
Click or tap here to enter text.

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HYPERLINKS AND GLOSSARY
States or territories may include additional information and documents that do not fit in the other template
sections in the Appendix. The template provides default appendix section and subsection headings that
states or territories may rename, delete, or otherwise modify as needed. States or territories may also
modify the appendix section titles to meet their needs. States or territories that include hyperlinks in the
OP must collect all links in the reference table below.

App A.1. Summary of Hyperlinks
Copy all hyperlinks used in the OP into the table below, by OP section. For each link, provide a brief
description (for example, “educational materials provided to participants”).
Appendix Table A.1. Summary of Hyperlinks
OP section
How to use

Link

Brief description

Embed or link to a file in Word

Instructions for embedding a file in a Word
document

Make your Word documents accessible
to people with disabilities

Accessibility instructions for Word
documents

E. Benefits and services

March 31, 2022 Note to MFP Recipients

Note to MFP Recipients: Announcement of
Certain Changes to Supplemental Services
under the MFP Demonstration

F. Transition and housing
services

https://www.medicaid.gov/federal-policyguidance/downloads/sho21001.pdf

State Health Official letter #21-001 RE:
Opportunities in Medicaid and CHIP to
Address Social Determinants of Health
(SDOH)

I. Quality measurement,
assurance, and monitoring

HCBS Quality Measure Set

Information about the HCBS Quality
Measure Set

J. Continuity of care postDemonstration

Section 6071(c)(2) of the Deficit
Reduction Act

Requirement that the MFP project must
operate in conjunction with a qualified and
operational HCBS program

K. Equity

Executive Order on Advancing Racial
Equity and Support for Underserved
Communities Through the Federal
Government

Definition of equity

A. MFP program overview
B. Project administration
C. Recruitment, enrollment,
outreach, and education
D. Stakeholder
engagement

G. Self-direction and
informal caregiving
H. Reporting

L. Tribal Initiative
M. Public health
emergencies
Appendix A
Appendix B

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App A.2. Glossary
Use the glossary section of the appendix to provide a comprehensive list of acronyms used by the state
or territory in responses throughout the OP. Commonly used acronyms are already defined in the
glossary table. As demonstrated in the example table shell below (Appendix Table A.2), the glossary can
also be used to provide additional context for certain acronyms through brief descriptions.
Appendix Table A.2. Glossary
Acronym

Meaning

CMS

Centers for Medicare & Medicaid
Services

Brief description (optional)

HCBS

Home- and community-based services

I/DD

Intellectual and developmental
disabilities

IMD

Institution for Mental Diseases

ICF/IID

Intermediate Care Facility for Individuals
with Intellectual Disabilities

LGBTQ+

Lesbian, gay, bisexual, transgender,
and queer

LTSS

Long-term services and supports

MCP

Managed care plan

MMIS

Medicaid Management Information
System

MLTSS

Medicaid managed long-term services
and supports

MH/SUD

Mental health and substance use
disorders

MDS

Minimum Data Set

MFP

Money Follows the Person

OP

MFP Operational Protocol

PD

Physical disabilities

PTC

MFP Program Terms and Conditions

PHE

Public health emergency

QIS

Quality improvement system

SAR

MFP Semi-Annual Progress Report

SDOH

Social determinants of health

SMD

State Medicaid director

SPA

State Plan Amendment

STC

Standard Terms and Conditions

T-MSIS

Transformed Medicaid Statistical
Information System

WP

MFP Work Plan

CMS’s standard grant/cooperative agreement terms
and conditions, which can be used as a reference for
definitions for key terms.

Examples of state or territory -specific acronyms
DLTC

Division of Long-Term Care

Responsible for daily operations of MFP program

DHS

Department of Human Services

Administers Medicaid in the state or territory

FFS

Fee-for-service

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Acronym

Meaning

Brief description (optional)

App A.3. Appendix Section
App A.3.1.

Appendix subsection

App A.4. Appendix Section
App A.4.1.

Appendix subsection

App A.5. Appendix Section
App A.5.1.

Appendix subsection

App A.5.1.1. Appendix sub-subsection

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OPTIONAL SECOND APPENDIX
App B.1. Appendix Section
App B.1.1.

Appendix subsection

App B.2. Appendix Section
App B.2.1.

Appendix subsection

App B.3. Appendix Section
App B.3.1.

Appendix subsection

App B.4. Appendix Section
App B.4.1.

Appendix subsection

App B.5. Appendix Section
App B.5.1.

Appendix subsection

App B.5.1.1. Appendix sub-subsection

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