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Often, decisions relating to the provision of long-term care services are dictated by what is reimbursable under federal and state Medicaid policy rather than by what an individual needs or wants. The Money Follows the Person (MFP) Demonstration is a large federal initiative to help states reduce their reliance on institutional care for people needing long-term care, and expand options for elderly people and individuals with disabilities to receive care in the community. Funded at $4 billion over nine years, it is the largest demonstration program of its kind in the history of Medicaid. States use the grant funds to develop systems and services to help long-term residents of nursing facilities, intermediate care facilities for individuals with intellectual disabilities, and psychiatric hospitals who want to move back to home or community-based settings. They also are increasing efforts to shift Medicaid long-term care spending permanently toward community-based care and services.