[The video begins with footage of the Austin, Texas skyline and almost imperceptibly soft violin which increases slowly increases in volume. We’re shown the capitol building and then various other parts of Austin. The mood is somewhat somber when the camera moves to a building with a sign that reads, “Maggie Johnson Nursing Center” on the outside. The view changes to one of a person walking down one of the building’s hallways. An empty room in the facility is shown. The scene changes to the hallway once more and the camera slowly zooms out to give the impression of someone leaving. Then, the camera rests on a single plastic lawn chair outside of the building. The journey continues through the parking lot and then shows another view of the Austin skyline.]
Narrator Since its beginning in Texas, the Money Follows the Person program has enabled more than 36,000 people to move out of nursing homes by shifting Medicaid spending from institutional care to home and community based services and yet, a growing number of people with mental illness and substance use disorders continue to enter nursing facilities because they are more likely to suffer chronic illness and disability. Nursing facilities cost nearly twice as much as community-based care and are not designed for mental illness or substance use disorder recovery. However, with the right kind of services, these individuals could return to the community.
[The tone of the music changes and becomes more hopeful and lighthearted as the scene changes to one of sunlight shining through trees and a walking. Then, the image changes once again, this time to shots of the inside of a home.]
Narrator Texas developed the Money Follows the Person behavioral health pilot to provide these services. This video shares the stories of six individuals who have moved back to the community through the program.
Ahna Phillips, Art Program Director, Imagine Art
Ahna We’re all whole people and the need to belong and the need to know that you’re accepted is key to our humanity.
[There is footage of a bright, blue sky with clouds floating across it.]
Changing Communities, Changing Minds: The human story of MFP-BH participants re-establishing life in the community
Jessica, MFP-BH Therapist
Jessica The Money Follow the Person program is a program to help clients when they’re relocating from either being in a nursing home or state institution back out into the community.
Jerry I go downtown you know and play chess with my old partners down there at Travis Park. It’s wonderful just being on your own, you know, having fun just going places and learning places, learning streets, bus routes, that type of thing.
[As Jerry speaks, footage of a park and of the view from inside of a bus are shown.]
Jerry You know, it’s wonderful to take care of your own business.
Diane You know, when you’re on your own, it’s just a whole different ballgame. You have your apartment, you have your closet. You can cook, you can go to the store, you can have friends over.
[The camera shows Diane inside reading a book and then walking outside.
Diane I started cooking a lot of food.
[Diane shows her spice collection which includes well over a dozen bottles of various spices.]
Diane I’d think up something I’d want to cook and I’d get up and go cook it.
Jim We moved out here to Medina Lake to a house because I got tired of the apartment scene. The good thing about being out here is that you get a nice view of the rain without actually getting soaking wet.
[Jim shows a photo in a frame.]
Jim This is when I first started talking to my fiancée. This is when I was back at my first apartment. They say the quickest way to a man’s heart is through his stomach. That also works for women too. The way I landed my fiancée was cooking, and she loves it.
[The camera moves to a view of the Austin skyline and then to a brightly colored piece of abstract art before resting on a an older woman sitting in her home. Behind her is a desk with a handful of mugs full of paint brushes, different pencils, and various other art supplies.]
Barbara Art is a constant. I work every day, usually in the afternoon.
[Barbara is shown seated at the table working on the brightly colored painting that was shown a moment ago.]
Barbara They have art classes. I taught one in calligraphy. Something to get you out of bed, that’s right.
[Barbara laughs as another piece of her art is shown. This one is an abstract watercolor painting.]
[The camera fades out and then back in to show a woman with long hair and glasses laughing as she colors with a marker.]
[The view changes to a man seated in an office.]
Tony Hyden, Studio Facilitator, Imagine Art>
Tony She’s just a real benefit to us. I never see Stone down. She just seems like she’s always optimistic and happy and makes the most of everything. Everybody really loves Stone around here.
[Stone appears smiling in a wheelchair moving through an art studio to a wall. She points at one of the pieces of art that’s hung there. It’s a bright outdoor scene with horses drinking from a small pond in front of a cluster of tee-pees.]
Stone Here is mine!
Tony She’s encouraging to a lot of us just because of her tenacity and her optimism and her roll with it attitude.
[The camera shows a woman sitting in an office.]
Dena Stone, MFP-BH Director
Dena It’s that individuals leave institutions for the community and they’re not just existing out there – you know, you can institutionalize someone in an apartment and isolate them – but they’re engaged, part of their community, and they’re achieving the things that are important to them.
[A blurred scene of a nursing facility or state hospital is shown.]
Before returning to the community, participants were in some form of institution.>
Dena A growing number of people under 65 are going into nursing homes. A number of those have mental health and substance use disorders.
[ The next section of the video cuts back and forth between various participants of the pilot program and their family members.]
Diane It must have been the summer of 2009. My roommate found me on the floor in my apartment and called EMS and I went to Brackenridge and I was at Brackenridge for quite a while. They literally saved my life.
[Now we see another woman sitting in her home.]>
Mary Jo, Sister of Participant Diane
Mary Jo She could not have taken care of herself. She couldn’t drive. How was she going to pay the rent? Just everything, everything was against her.
Barbara Unbeknownst to me, I was Bi-Polar Schizophrenic and a very severe diabetic. I got very frightened. I was hearing voices. I thought the secret service was following me.
[The camera focus shifts to another woman.]
Sister of Participant Barb
Beverly When she first went into the nursing home, it was probably one of the most difficult days of my life, to sign her in there. I did not want to do that but we saw that there would be no other place for her.
[Stone is shown playing with a tiny toy car.]
Tony What I understand from what she’s told me, she worked on her own cars when she was out fishing one day and she had a stroke, and nobody was there so nobody found her for, like, three days.
[Stone is shown smiling outside in her electric wheelchair next to some trees and other greenery.]
Diane I called my sister after about two months and I said, “You’ve got to get me out of here. Someplace else,” so she took me to Duval, to the nursing home.
Mary Jo When she was in the nursing home, all I could think of was that if she gets out, we’re going to be in the hospital – and these are my exact quotes, “We’re going to be in the hospital in two months.” We’ll be back in there, the same thing.
Jim Originally, before my accident, I was a 5-star chef. I just—I didn’t see the purpose. What the hell is the point? I can’t do my job anymore. How am I going to cope?
Diane I’m supposed to be Schizophrenic.
Barbara Well, I couldn’t believe I was Bi-Polar. I kept telling them, “I’m in here for my leg not my head.”
Jim It literally took my dad getting ready for me to fight with me for me to understand life goes on.
Barbara I had no confidence left. I was pretty flat as a pancake.
Diane You can go there to die or you can go there to get well. I guess maybe I went there to get well.
Jim The whole thing kick-started with me trying to get out of the nursing home with me talking to the social worker—
Barbara …except you do get institutionalized, they do everything for you.
Jim …saying, “I want out.”
Barbara I wasn’t ready for that yet.
Beverly My brother was yelling at me. He said, “How can you? How can you do this? No way she can survive on her own.”
Barbara My psychologist finally said, “Barbara, it’s time for you to get out. It’s time for you to go. You’re well.”
Beverly But regardless, I still had reservations because she was ill and how, really, could she care for herself?
Barbara Yeah, well I had nothing left. What was I going to do? Basically, you become rather institutionalized.
Beverly And as she started to explain the program to me, and as I talked to the social workers, and I talked to the people at STAR and what they were going to do and how they were going to set her up, and what the Rebekah Baines Johnson facility was and all the aspects of that program, it just sounded better and better and better.
Barbara I had to learn how to get back out on my own again.
Beverly You know, I kind of came to this, my sensibility was she’s got to take that shot.
Barbara So what am I going to do? How am I going to proceed?
Beverly Because if she has one chance and – if she fails – so be it, but it’s better than just staying in that nursing home, so why don’t we give this a chance. And it seemed like there was so much support behind it that it was a good bet. It was a good chance to take. It was a weighted risk but a good risk.
Barbara And this came along. It was a lot of help and good people. I could have never done this alone.
Dena We’re out to help people rehabilitate, to help people get better and realize their goals. Help them first to articulate their goals. What do I want to do? Do I have dreams? Do I have hopes? Are people not going to laugh when I say what they are and are they going to find ways small and large to help me get there?
Jim That was the key. As long as I had a caregiver, I can function.
Barbara Well, I had a wonderful therapist.
Diane She’d come over and check on us from time to time to make sure we were okay, and I said, “Kim, there is nobody like you. Nobody would go out of their way to do what you’ve done.”
Mary Jo I know one particular person – I don’t even know who it was – my sister likes to read – took her to Barnes and Noble and let her buy books. Gave her a giftcard to Barnes and Noble and I thought, wow, who are these people that are doing all of this for her. And then, it turned out to be very successful.
Diane I really appreciate – I mean, my mother, I don’t know that my mother would go this far. I really, really appreciate it.
Barbara I’m very grateful to this program. I mean, they give you furniture.
Mary Jo Ya’ll made sure she had food, you made sure she had sheets, you made sure she had everything that she needed.
Jim Without them, I wouldn’t have anything in my apartment.
Barbara So when I got here everything was in place. It was wonderful.
Beverly It’s night and day since she got in this program. We have a much better relationship than we have had in a long time. This program has provided her the opportunity to regain her life. I honestly can’t say enough about that. It’s night and day, it’s night and day.
Barbara is shown walking around and socializing with other people at an art showing.]
[The camera shifts to show a different woman.]
Linda Lopez, MFP-BH Administrator
Linda Since 2008, we have realized that a lot of our individuals find this independence of being back in the community when they’ve been told along you’re going to live the rest of the time in the nursing facility so learning that they can do for themselves is the rehabilitation, is the therapy for them.
Barbara Well, for somebody who ended up with nothing, this sounded like heaven!
Jim I try to help as many people as I can. That’s why I agreed to this. If it helps people understand that if you go through a traumatic experience in your life, you can bounce back.
Diane You have to have somebody out there that can help you along the way.
Mary Jo It’s amazing, just amazing how successful she’s been. They manage. She’s got her car back and yesterday was her birthday. She and her boyfriend went to the park. She’s happy. She made it! It’s amazing!
[The focus shifts to a men sitting around a long table and holding hands.]
Don, Former Participant/Group Leader
Don I’m just glad to see everybody again. You know, we all made it one more week. We all made it one more week.
[The camera shows a different man.]
Augustine, MFP-BH Therapist
Augustine The former client that I’m talking about, he’s the leader of the recovery spirituality group.
Don So I’m living in Carl Apartments right now, and I’m living in a two-bedroom even though I’m paralyzed from the chest down and I just want to thank God and right now I’m trying to give back to the community.
Don It’s a one time deal, you know, and so at that time you’ve got to buy all the food that you’re going to buy.
Don My pastor asked me to do a group once I got out.
Don You’re going better with your speech too and everything. You know that? By the grace of God.
Jessica Because of our assistance, he was wanting to help others who were in the same situation.
Don And so I’ve decided to live my life to the fullest and give back to the community.
Don If we feed negative thoughts and bad thoughts, they’re going to get stronger and take over our lives. If we feed good thoughts, positive thoughts, things that are lovely, things that are kind, what I’m going to do for my recovery, and we start thinking about positive things then the positive thing will take over.
The camera shows a sunset.]
In the summer of 2013, Barbara and Stone both independently created art for separate gallery shows in Austin.
Ahna Whether it’s with communication or whether it’s just getting out of bed in the morning and functioning because of a mental illness, then you know, here they find something in common, a love of art.
Tony We had an official opening. Stone was here.
Ahna She’s been experimenting with using her left hand now whereas she was right-handed before the stroke.
Tony The name of the piece is, “Wait a Year.”
Ahna She won us all over.
Tony She’s an amazing asset to our community.
Beverly Her artwork which sustains her through everything, her creativity, this situation allowed this to blossom. The artwork that she was doing in the nursing home was almost by rote. And you can see when she moved out and then she got in her place and we bought her the first present that we got her, a Christmas gift, was a drafting table so she could do her artwork. And you could see she started to just to do some more different things and it started real simple and then it started to get a little more abstract and now she’s doing some very complicated and complex work that is so much closer to what she used to do. I mean, it’s like getting her back.
[Barbara is shown at her art gallery showing holding a microphone and saying, “It sure is a pleasure to be here with these fine artists. We did a good job, didn’t we?” People respond by clapping and saying, “Yay!”]
Barbara I can’t think of anything else I’d rather do except make art. I love to make art.
After 30 months in a nursing home, she has lived in an apartment for 3 years.
Life-long artist and teacher
Jerry I wanted to go back to school and get my chef license and I wanted to be a chef.
After three years in the nursing home, he has lived for four years in apartments.
Chess player, reader, friend, and grandfather
Male voice You want to go from here to an apartment by the river?
Stone No, a house!
Male voice A house, okay. So that’s your future goal is to get a house by the river.
Stone Yup. Yup, yup, yup. And work!
Male voice And work. So what kind of work do you want to do?
Stone A printer.
Male voice You want to be a printer?
After seven months in the nursing home, she has lived for three years in an apartment.
Artist, student, and nature lover
Jim Probably within the next six to seven months, I’m going to try and get my license and a van to where I can get around myself.
After three years in the nursing home, he has lived for five years in an apartment or house.
Poker player, comic fan, volunteer, and fiancé
Diane Yeah, I love to read. I’m a ferocious reader.
After two years in the nursing home, she has lived for two years in an apartment.
Avid reader, cook, sister, and girlfriend
Don This could be—some people call it the end but this could be the beginning. A new beginning.
After 14 months in the nursing home, he has lived for four years in an apartment.
Student, group leader, pastor in training
[The music slows as the screen fades to black and then the acknowledgements roll.]
- HHSC – Texas Health and Human Services Commission
- DADS – Texas Department of Aging and Disability Services
- SPSU – Star+Plus Support Unit
- DSHS – Texas Department of State Health Services
- Amerigroup (San Antonio and Austin)
- Evercare/United Health (Austin)
- Molina (San Antonio)
- Superior (San Antonio)
Housing Relocation Contractors
- COIL – Center on Independent Living (San Antonio)
- ARCIL – Austin Resource Center for Independent Living (Austin)
Behavioral Health Providers
- CHCS – Center for Health Care Services (San Anotnio)
- ATCIC – Austin Travis County Integral Care (Austin)
- UTHSCSA – University of Texas Health Science Center at San Antonio (training and oversight of CAT therapists)
Quality Improvement Evaluators
- University of Texas at Austin Center for Social Work Research
- University of Texas Health Science Center at San Antonio
[The Money Follows the Person Behavioral Health pilot project is supported by a grant from the federal Centers for Medicare and Medicaid Services (CMS) which is administered through the Texas Health and Human Services system. The views expressed in this presentation are not necessarily representative of the funding or administering agencies.]
Video created by
- Stephen Henderson
- Drake Dowsett