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Supplemental Needs Trusts
Supplemental Needs Trusts Outline for Advocates - Including Impact on Various Benefits of Transfers of Lump Sums into SNT's UPdated 6/2023 Download
SNT Outline 2023-06.pdf
Training Outline for Advocates on Supplemental Needs Trusts (SNTs) (individual and pooled), and the effect of SNTs on various public benefit programs (updated 6/30/2023). Updated sections include Temporary/Public cash assistance, SNAP, ABLE accounts, Public Housing and Section 8, changes in procedures for submitting pooled trusts in NYC. Also heads up about 2023 increases in Medicaid income and asset limits and update about the 30-month community based lookback).
01 Jul, 2023 1.3 mb Downloads: 215210
Using an SNT to Eliminate the Medicaid spend-down - Fact Sheet (May 2023) Download
SNT Short 2023-05 FINAL.pdf
How to get Medicaid despite having "excess income" - Using a Supplemental Needs Trust to Eliminate the Spend-down for Persons who are Elderly (65+), Blind or Disabled. Written by New York Legal Assistance Group Evelyn Frank Legal Resources Program, updated May 2023 with new procedures in NYC for submitting disability forms, and with 2023 figures.
23 May, 2023 476 kb Downloads: 160166
MAP-751W Consumer/Provider Request to Change Information on File (3-25-21)(fill-able) Download
MAP-751W Request to Change Information (3-25-21) (fill-able)(with 3-4-22 memo where to submit).pdf
NYC HRA Form to notify HRA of corrections or changes, e.g. close case, combine case, add/remove individual, notify of death, change in immigration status, upgrade eligibility, request MSP evaluation, budgeting changes, pooled trust budgeting and add/remove third party health insurance. Per attached 3/2022 memo may be faxed to (917) 639-0837 or mailed. Note that a change in demographic information (such as name, address, phone number) should be reported in a different form: MAP-751K. The MAP-751W is also posted at https://www1.nyc.gov/site/hra/help/health-assistance.page in other languages.
24 Oct, 2022 376 kb Downloads: 7668
SNT Excess Income Contribution Worksheet Download
Pooled Income Trust Contribution Worksheet.xls
Use this Excel spreadsheet to calculate the proper monthly contribution of excess income to an SNT in order to become eligible and maintain eligibility for Medicaid and/or Medicare Savings Program in New York. (updated 2022)
04 Jul, 2022 42 kb Downloads: 37135
NYC Medicaid Alert 6-30-2022 - Change in Submissions to HRA for Disability Determination for Pooled Trusts & MBI-WPD (revises 5/31/22 Alert) Download
2022-6-30 MA Alert Disability Determination by New York State Medicaid.pdf
Eff. June 1, 2022, submissions to HRA to approve a Pooled Trust or MBI-WPD no longer need to include the disability forms (DOH-5141, DOH-5143, Authorization MAO-751e, AIDS report form MAP 252F. Instead, once the pooled trust is filed with HRA, HRA will route it to NYS DOH Disabilitiy Review Team, which will then request MAP 3177 Disability Determination Request from the consumer. Unclear if other documentation will be required but likely - stay tuned look for updates at http://www.wnylc.com/health/entry/44/ (This revises the Alert issued May 31, 2022
01 Jul, 2022 148 kb Downloads: 2311
CÓMO UTILIZAR UN FIDEICOMISO DE INGRESOS COMBINADOS PARA OBTENER MEDICAID SIN UN “EXCESO DE INGRESOS” O SPEND-DOWN Download
NYLAG PooledTrust 2022 Spanish.pdf
Traduccion enEspanol de "HOW TO USE A POOLED INCOME TRUST TO OBTAIN MEDICAID WITHOUT A
“EXCESS INCOME” OR SPEND-DOWN" (2022), by NYLAG Evelyn Frank Legal Resources Program, posted at http://www.wnylc.com/health/download/4/. Spanish translation courtesy of Centro de Harry y Jeanette Weinberg para la justicia de los ancianos en el Hogar Hebreo de Riverdale, en colaboración con la Asociación público-privada de servicios para la tercera edad de Westchester y el Centro de justicia para la mujer de Pace.

Mas informacion is at https://www.seniorlawday.info/derecho-para-la-tercera-edad/

English at https://www.seniorlawday.info/resources/ or http://www.seniorlawday.info/wp-content/uploads/2022/02/2021-Elder-Law-QA-222.pdf
28 Apr, 2022 695 kb Downloads: 6166
Form DOH-5143 - Medical Disability Form - replaces LDSS-486T (08-2018) Download
DOH-5143 Replaces 486T Medical Report for Determination of Disability (08-2018) - FILLABLE.pdf
Form to be signed by treating physician to certify disability as required for approval of Supplemental Needs Trusts, or for Medicaid based on disability where the Social Security Administration has not determined disability. Replaces Form 486T. See HRA MICSA Alert Dec. 20, 2021, available at http://www.wnylc.com/health/fdownload/799/
22 Dec, 2021 50 kb Downloads: 4521
HRA Medicaid Alert 12/20/21 - New Form DOH-5143 Replaces Form 486T for Medical Determination of Disability Download
2021-12-20 Medical Disability Form LDSS-486T Replaced with DOH-5143.pdf
Announces a change in the form for treating physician to certify disability as needed to approve supplemental needs trusts including pooled trusts, and Medicaid based on disability, if not certified by the SSA. Replaces Form 486T, though 486T will be accepted until Feb. 1, 2022. New form posted at http://www.wnylc.com/health/download/798/
22 Dec, 2021 718 kb Downloads: 2156
HRA MICSA Alert 8-12-2021 Disability Determination Form LDSS-1151 Replaced with DOH-5139 Download
2021-08-12 Disability Determination Form LDSS-1151 Replaced by DOH-5139.pdf
Announces TWO new forms to request a determination of disability for a pooled trust/ Supplemental Needs Trust, MBI-WPD and other reasons. The Disability Determination Form LDSS-1151is being replaced with DOH-5139 (download at https://www.health.ny.gov/forms/doh-5139.pdf). A new HIIPPA form must also be submitted https://www.health.ny.gov/forms/doh-5173.pdf - along with the OCA form used by the local districts. - https://www.nycourts.gov/forms/Hipaa_fillable.pdf
13 Aug, 2021 142 kb Downloads: 2676
Contact List of CASA Offices - Home Care Services Program (HCSP) Download
2020-09 NYC Home Care Services Program -CASA directory.pdf
Includes announcement of new e-mail address for inquiries about HCSP cases (7-2021)
04 Aug, 2021 309 kb Downloads: 34895
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