New York State Partnership Plan

Projected 1115 Waiver Budget Neutrality Impact Through December 2014

Extension Application Through 12/31/2019

Budget Neutrality Cap (Without Waiver) DY 1 - 8
(10/1/97 - 9/30/06)
Projected
DY 9
(10/1/06-9/30/07)
Actual
DY 10
(10/1/07-9/30/08)
Actual
DY 11
(10/1/08-9/30/09)
Actual
DY 12
(10/1/09-9/30/10)
Actual
DY 13A
(10/1/10-3/31/11)
Actual
DY 13B
(4/1/11-9/30/11)
Projected
DY 14
(10/1/11-9/30/12)
Projected
DY 15
(10/1/12-9/30/13)
Projected
DY 16A
(10/1/13-12/31/13)
Projected
DY 16B
(1/1/14-3/31/14)
Projected
DY 16C
(4/1/14 - 12/31/14)
Projected
Extension Period
(10/1/06 - 12/31/14
Projected
 DY 1 - DY 16  DY 17
(1/1/15 - 12/31/15)
Projected
DY 18
(1/1/16 - 12/31/16)
Projected
DY 19
(1/1/17 - 12/31/17)
Projected
DY 20
(1/1/18 - 12/31/18)
Projected
DY 21
(1/1/19 - 12/31/19)
Projected
Current Extension Period
(1/1/15 - 12/31/19)
Projected
 DY 1 - DY 21 
Demonstration Group 1 (Includes FSHRP)- TANF Children under age 1 through 20   $8,641,454,877 $9,086,365,132 $10,048,004,954 $11,210,460,422 $6,105,699,488 $6,124,915,586 $13,431,555,927 $14,853,389,777 $3,975,139,194 $3,975,139,194 $12,414,265,562 $99,866,390,111   $17,645,613,012 $18,810,799,030 $20,053,186,973 $21,377,810,257 $22,789,715,193 $100,677,124,465  
Demonstration Group 2 (Includes FSHRP) - TANF Adults 21-64 $3,045,582,094 $3,217,134,170 $3,856,757,531 $4,517,252,946 $2,467,348,368 $2,443,182,702 $5,362,266,874 $5,914,379,682 $1,579,889,213 $1,579,889,213 $4,990,746,528 $38,974,429,320 $7,081,635,471 $7,535,329,645 $8,018,298,047 $8,532,242,453 $9,079,281,993 $40,246,787,609
Demonstration Group 6 - FHP Adults w/Children $1,691,957,919 $1,813,935,485 $1,746,457,301 $1,874,936,618 $1,043,047,420 $1,055,415,331 $2,341,067,454 $2,632,237,613 $724,658,042     $14,923,713,183           $0
Demonstration Group 6A - FHP Adults w/Children @ 160%       $0 $0 $0 $0 $0 $0 $0   $0           $0
Demonstration Group 8 - Family Planning Expansion           $5,140,241 $10,702,271 $1,856,551       $17,699,062           $0
Demonstration Group 10 - MLTC Adult Age 18-64 Duals             $247,394,784 $1,027,336,330 $260,284,563 $260,284,563 $810,989,159 $2,606,289,399 $1,172,096,556 $1,364,802,292 $1,383,228,677 $1,400,567,568 $1,417,233,942 $6,737,929,036
Demonstration Group 11 - MLTC age 65+ Duals             $2,554,212,091 $10,820,566,375 $2,796,750,566 $2,796,750,566 $8,757,811,131 $27,726,090,729 $13,028,810,692 $15,702,703,366 $16,234,869,317 $16,769,495,565 $17,311,153,074 $79,047,032,013
Demonstration Group 3 (FSHRP)– Disabled Adults and Children 0-64 voluntarily enrolled in managed care in those counties participating in the Partnership Plan as of October 1, 2006.                     $6,740,030,752 $6,740,030,752 $5,217,606,005 $5,221,378,989 $5,231,860,540 $5,552,853,881 $5,892,047,876 $27,115,747,291
Demonstration Group 4 (FSHRP)– Disabled Adults and Children 0-64 required to enroll in managed care in those counties participating in the Partnership Plan as of October 1, 2006.                     $2,917,455,149 $2,917,455,149 $8,690,188,441 $9,629,135,131 $10,591,938,428 $11,241,791,703 $11,928,492,328 $52,081,546,031
Demonstration Group 5 (FSHRP)– Disabled Adults and Children 65+ voluntarily enrolled in managed care in those counties participating in the Partnership Plan as of October 1, 2006.                     $297,127,032 $297,127,032 $115,287,674 $96,117,801 $77,899,577 $82,079,354 $86,505,001 $457,889,407
Demonstration Group 6 (FSHRP)– Disabled Adults and Children 65+ required to enroll in managed care in those counties participating in the Partnership Plan as of October 1, 2006.                     $196,481,343 $196,481,343 $581,017,822 $639,235,895 $698,311,674 $735,780,264 $775,452,890 $3,429,798,545
Demonstration Group 7 (FSHRP)– Non Duals 18-64                     $260,463,274 $260,463,274 $373,622,309 $399,781,370 $425,974,437 $451,106,815 $477,722,059 $2,128,206,991
Demonstration Group 8(FSHRP) – Non Duals 65+                     $67,786,019 $67,786,019 $95,105,016 $99,552,526 $103,795,256 $107,531,930 $111,403,116 $517,387,843
W/O Waiver Total $144,639,878,523 $13,378,994,889 $14,117,434,787 $15,651,219,785 $17,602,649,986 $9,616,095,275 $9,628,653,860 $23,947,199,400 $35,249,766,328 $9,336,721,578 $8,612,063,536 $37,453,155,948 $194,593,955,373 $339,233,833,896 $54,000,982,998 $59,498,836,045 $62,819,362,925 $66,251,259,791 $69,869,007,470 $312,439,449,229 $651,673,283,125


Budget Neutrality Cap (With Waiver) DY 1 - 8
(10/1/97 - 9/30/06)
Projected
DY 9
(10/1/06-9/30/07)
Actual
DY 10
(10/1/07-9/30/08)
Actual
DY 11
(10/1/08-9/30/09)
Actual
DY 12
(10/1/09-9/30/10)
Actual
DY 13A
(10/1/10-3/31/11)
Actual
DY 13B
(4/1/11-9/30/11)
Projected
DY 14
(10/1/11-9/30/12)
Projected
DY 15
(10/1/12-9/30/13)
Projected
DY 16A
(10/1/13-12/31/13)
Projected
DY 16B
(1/1/14-3/31/14)
Projected
DY 16C
(4/1/14 - 12/31/14)
Projected
Extension Period
(10/1/06 - 12/31/14
Projected
 DY 1 - DY 16  DY 17
(1/1/15 - 12/31/15)
Projected
DY 18
(1/1/16 - 12/31/16)
Projected
DY 19
(1/1/17 - 12/31/17)
Projected
DY 20
(1/1/18 - 12/31/18)
Projected
DY 21
(1/1/19 - 12/31/19)
Projected
Current Extension Period
(1/1/15 - 12/31/19)
Projected
 DY 1 - DY 21 
Demonstration Group 1 (Includes FSHRP) - TANF Children under age 1 through 20   $4,006,367,977 $4,412,472,964 $4,828,196,168 $4,492,088,177 $1,827,792,863 $2,801,314,813 $6,274,647,760 $6,920,891,478 $1,841,829,404 $1,840,421,312 $5,730,328,833 $44,976,351,747   $7,739,333,331 $8,241,746,621 $8,785,674,939 $9,314,977,910 $9,314,977,910 $43,396,710,710  
Demonstration Group 2 (Includes FSHRP) - TANF Adults 21-64 $2,062,992,139 $2,222,230,858 $2,553,996,035 $2,712,728,726 $1,159,889,284 $1,546,569,069 $3,469,798,151 $3,820,998,638 $1,019,514,707 $1,019,416,724 $3,245,361,788 $24,833,496,118 $4,324,089,616 $4,612,583,472 $4,939,531,466 $5,451,310,347 $5,451,310,347 $24,778,825,248
Demonstration Group 5 - Safety Net Adults $3,017,805,826 $3,213,033,028 $3,818,572,584 $4,224,557,751 $1,864,361,807 $2,829,518,468 $6,893,620,899 $8,184,495,364 $2,210,213,971     $36,256,179,698           $0
Demonstration Group 6 - FHP Adults w/Children up to 150% $813,927,831 $884,575,928 $894,902,321 $965,325,522 $502,539,894 $553,389,253 $1,173,058,139 $1,313,450,137 $360,124,780     $7,461,293,807           $0
Demonstration Group 7 - FHP Adults without Children up to 100% $587,725,574 $566,489,543 $412,034,961 $316,237,864 $155,882,395 $173,575,211 $352,894,110 $401,041,648 $110,970,648     $3,076,851,953           $0
Demonstration Group 6A - FHP Adults w/Children @ 160% $0 $0 $0 $0 $0 $0 $0 $0 $0     $0           $0
Demonstration Group 7A - FHP Adults without Children @ 160% $0 $0 $0 $0 $0 $0 $0 $0 $0     $0           $0
Demonstration Group 8 - Family Planning Expansion $10,471,785 $10,598,020 $11,138,799 $11,835,960 $4,164,485 $6,573,308 $13,934,296 $2,462,132       $71,178,785           $0
Demonstration Group 9 - Home and Community Based Expansion (HCBS) N/A N/A N/A N/A N/A $3,699,108 $3,699,108 $3,699,108 $924,777 $924,777 $2,774,331 $15,721,209 $3,699,108 $3,699,108 $3,699,108 $3,699,108 $3,699,108 $18,495,540
Demonstration Group 10 - MLTC Adult Age 18-64 Duals             $249,276,515 $999,765,437 $249,927,129 $249,927,129 $773,248,277 $2,522,144,487 $1,162,406,668 $1,388,540,836 $1,422,903,191 $1,480,841,723 $1,480,841,723 $6,935,534,141
Demonstration Group 11 - MLTC age 65+ Duals             $2,561,508,288 $10,403,512,554 $2,629,869,736 $2,629,869,736 $8,187,002,770 $26,411,763,084 $12,429,251,623 $15,118,044,459 $15,619,482,984 $16,358,745,504 $16,358,745,504 $75,884,270,074
Demonstration Group 3 (FSHRP)– Disabled Adults and Children 0-64 voluntarily enrolled in managed care in those counties participating in the Partnership Plan as of October 1, 2006.                     $5,800,497,292 $5,800,497,292 $3,951,999,754 $3,956,791,450 $3,816,034,808 $3,816,034,808 $3,816,034,808 $19,356,895,626
Demonstration Group 4 (FSHRP)– Disabled Adults and Children 0-64 required to enroll in managed care in those counties participating in the Partnership Plan as of October 1, 2006.                     $2,054,061,282 $2,054,061,282 $6,053,693,623 $6,636,646,162 $7,224,046,405 $7,224,046,405 $7,224,046,405 $34,362,479,001
Demonstration Group 5 (FSHRP)– Disabled Adults and Children 65+ voluntarily enrolled in managed care in those counties participating in the Partnership Plan as of October 1, 2006.                     $333,662,997 $333,662,997 $190,609,691 $194,209,851 $188,661,308 $188,661,308 $188,661,308 $950,803,465
Demonstration Group 6 (FSHRP) – Disabled Adults and Children 65+ required to enroll in managed care in those counties participating in the Partnership Plan as of October 1, 2006.                     $150,888,689 $150,888,689 $444,696,514 $487,519,454 $530,669,118 $530,669,118 $530,669,118 $2,524,223,321
Demonstration Group 7 (FSHRP)– Non Duals 18-64                     $221,887,579 $221,887,579 $321,593,199 $347,683,789 $374,311,551 $374,311,551 $374,311,551 $1,792,211,640
Demonstration Group 8 (FSHRP) – Non Duals 65+                     $59,275,663 $59,275,663 $85,894,211 $92,861,786 $99,996,824 $99,996,824 $99,996,824 $478,746,469
Designated State Health Programs (Existing F-SHRP)                       $0           $0
Designated State Health Programs (New F-SHRP)                       $0           $0
Demonstration Population 1: State Indigent Care Pool Direct Expenditures (ICP-Direct)           $2,600,000 $14,650,000 $13,700,000 $3,400,000     $34,350,000           $0
Demonstration Population 2: Designated State Health Programs to Support Clinic Uncompensated Care Funding (ICP - DSHP)           $2,600,000 $10,583,333 $10,583,333 $2,645,833 $2,645,833 $45,791,667 $74,850,000           $0
Demonstration Population 3: Designated State Health Programs to Support Medical Home Demonstration (DSHP - HMH Demo)           $0 $100,000,000 $100,000,000 $25,000,000 $25,000,000 $50,000,000 $300,000,000           $0
Demonstration Population 4: Designated State Health Programs to Support Potentially Preventable Readmission Demonstration (DSHP - PPR Demo)           $0 $4,433,333 $4,433,333 $1,108,333 $1,108,333 $2,216,667 $13,300,000           $0
Demonstration Population 5: Designated State Health Programs (Various)                 $100,000,000 $100,000,000 $300,000,000 $500,000,000             $0
DSHP DD                     $500,000,000 $500,000,000 $0 $0 $0 $0 $0 $0
DSHP: Orderly Close out of Demo Group 6                   $363,417,732 $635,987,007 $999,404,739           $0
DSHP: APTC Wrap                   $7,000,800 $84,009,600 $91,010,400 $183,170,000 $0 $0 $0 $0 $183,170,000
DSHP For DSRIP                     $376,000,000 $376,000,000 $690,800,000 $953,200,000 $935,600,000 $687,000,000 $357,400,000 $3,624,000,000
DSRIP                     $24,000,000 $24,000,000 $1,556,000,000 $1,374,200,000 $2,564,000,000 $2,434,000,000 $1,756,000,000 $9,684,200,000
IAAF                     $1,000,000,000 $1,000,000,000 $0 $0 $0 $0 $0 $0
Demonstration only services provided in MMMC                       $0 $882,631 $1,878,240 $1,998,447 $2,126,348 $2,262,434 $9,148,100
65 Year Olds in the Adult Group                       $0 $918,894,625 $983,217,485 $1,052,042,805 $1,052,042,805 $1,052,042,805 $5,058,240,525
Coverage gap                       $0 $122,726,316 $65,386,264       $188,112,580
HARPS "HCBS Services"                       $0 $200,000,000 $491,800,000 $400,000,000 $200,000,000 $397,200,000 $1,689,000,000
With Waiver Total $123,931,127,812 $10,499,291,132 $11,309,400,341 $12,518,840,867 $12,722,773,999 $5,514,630,728 $7,919,839,230 $21,122,103,933 $32,179,033,163 $8,555,529,317 $6,239,732,376 $29,576,994,442 $158,158,169,528 $282,089,297,340 $40,379,740,911 $44,950,008,976 $47,958,652,954 $49,218,463,757 $48,408,199,843 $230,915,066,441 $513,004,363,782
Expenditures (Over)/Under Cap $20,708,750,711 $2,879,703,758 $2,808,034,445 $3,132,378,919 $4,879,875,987 $4,101,464,547 $1,708,814,629 $2,825,095,467 $3,070,733,165 $781,192,261 $2,372,331,160 $7,876,161,507 $36,435,785,845 $57,144,536,556 $13,621,242,087 $14,548,827,069 $14,860,709,971 $17,032,796,034 $21,460,807,627 $81,524,382,788 $138,668,919,343

Note: * All Final 21 months of 1115 expenditures have been reported in MBES through quarter ending March 2011.