Date of Award

Spring 5-12-2017

Degree Type


Degree Name

Master of Public Health (MPH)


Public Health

First Advisor

Dr. Emily Graybill

Second Advisor

Michelle M. Rushing


INTRODUCTION: The growing proportion of the elderly population and individuals with disabilities is increasing the demand for institutional long-term care. The majority of nursing home residents desire to exercise control over their lives and to have independence in activities of daily living, but nursing home care is often associated with loss of control and independence among its residents. Money Follows the Person (MFP) is a rebalancing strategy to contain cost for long-term care and enhance consumer choice for elderly individuals and individuals with disabilities. The MFP program helps qualified individuals living in institutions make the transition to life in the community.

AIM: This study is aimed to explore the association of community transitions and the measures of independence and control over life among MFP participants who have relocated from institutions to the community.

METHODS: Data from Georgia’s MFP participant survey from 2008 to 2015 were used to examine the association between community transition and measures of control and independence before transition and 12 months after transition. McNemar’s test was used to measure the before and after transition differences. Odds ratios and 95% confidence intervals were reported to determine the correlation of study measures with age, sex and disability type.

RESULTS: The analysis for 664 MFP participants (54.4% male and 45.6% female) surveys in the state of Georgia found a significant increase in 13 out of 15 measures of independence and control over life (e.g., being able to pick the place of residence, go to bed when want to, choose the type of food to eat, have privacy to talk on telephone, do paid/voluntary work and others) after transition, attributed to community transitions (p-value

DISCUSSION: Results suggested that relocating individuals with disabilities into the community can help increase perceived control and independence and reduce the limitation of choice, providing insight for policy makers to strengthen programs that can have a meaningful impact on cost-containment and quality of life for elderly people and for individuals with disabilities.