Executive Budget Released and FAIR Advocacy Day

Alyssa Lovelace • January 25, 2026

Join FAIR for Home Care Advocacy Day on Tuesday, February 3!

  • To RSVP for FAIR’s Advocacy Day, please contact Alyssa Lovelace at alyssa@hgmlobby.com.
  • To review FAIR’s budget requests in detail, members are encouraged to click here.

2026 Executive Budget Highlights

Lawmakers officially convened for the 2026 Legislative Session on Tuesday, January 7. Breaking with recent tradition, Governor Kathy Hochul delivered her State of the State Address on January 13, followed by the release of the Executive Budget on January 20.


The Governor introduced a $260 billion balanced budget that includes no new income tax increases and maintains more than $14.6 billion in reserves. Her agenda this year is anchored in the theme of affordability, with a strong focus on improving quality of life for all New Yorkers—particularly older adults and those relying on long‑term care services.


Key Budget Proposals Affecting Health Care & Aging Services


Medicaid Investments

The Executive Budget proposes $38.2 billion for New York’s Medicaid program, including $1.2 billion in new federal funding generated through an assessment on Managed Care Organizations (MCOs). These funds will be distributed to health care providers and related programs.


Support for New York’s Growing Older Adult Population

New York is now the fourth-oldest state in the country, with 4.6 million residents aged 60 and older—a number expected to climb to 5.4 million by 2030. Many older adults face mobility limitations, challenges with daily living activities, and the growing burden of chronic conditions.


Recognizing these trends, the Governor’s budget advances several initiatives aimed at strengthening care access and enhancing economic stability for older New Yorkers.


Specifically, the Governor’s budget includes:


  • Hospital at Home: General hospitals could provide acute medical services in a patient’s home without needing a home care agency license. Under the proposal Participating hospitals must submit annual operating cost data to the Department of Health. The DOH would establish Medicaid reimbursement rates for services provided under this model. This initiative would significantly expand the amount of acute care delivered in patients’ homes.


  • Personal Care Administrative Fees: The Executive Budget proposes to cap personal care fee‑for‑service administrative reimbursement at 15% of total costs.


  • Increased investments in Naturally Occurring Retirement Communities (NORCs): These community-based programs provide older adults with support and resources to help them age in place, reducing the need for institutional care.


  • Renewed funding of $35 million to reduce waitlists for non-medical in-home services such as personal care, case management, home-delivered meals, congregate meals, and transportation services. This investment will help address immediate service gaps that many seniors face.


  • An educational initiative aimed at increasing awareness among clinical providers and their staff about options for community-based palliative care, hospice care, and the importance of advance care planning. This will help ensure older adults have access to care that meets their needs in a timely manner.


  • A short-term, multi-agency council to identify all available benefits for older adults across various state and federal programs. This initiative will assist seniors in accessing benefits related to Veteran’s services, tax reductions, nutrition assistance, prescription drug support, and medical care.


  • Expansion of eligibility for the Senior Citizen Rent Increase Exemption (SCRIE) and Disability Rent Increase Exemption (DRIE) programs: The Governor proposes raising the income eligibility threshold from $50,000 to $75,000 for seniors in New York City, with similar provisions for other local jurisdictions opting into the program.


  • $250 million in new capital funding to accelerate and expand the development of affordable housing for seniors. This funding will produce thousands of affordable homes, ensuring that older New Yorkers have access to safe, affordable living environments.



  • CDPAP: While the Executive Budget does not include new CDPAP provisions, the Governor highlighted the savings realized from last year’s CDPAP reforms.


  • Expanded efforts to protect older adults from abuse, scams, and fraud, which have become increasingly prevalent as seniors spend more time online and are targeted by bad actors.


These proposals align with the Governor’s broader vision for making New York more affordable for its residents, particularly seniors, who often face financial and logistical barriers as they age.

Our policy Agenda

FAIR Access Initiative Policy Platform

We’ve published a clear, accessible policy overview outlining the key reforms needed to stabilize the workforce, streamline patient assessments, clarify regulations, and ensure fair reimbursement for providers.

These reforms strengthen access to care, reduce waste, and promote financial stability across the system.


Our platform highlights six core policy priorities:


  • Fair Wage Reimbursement
  • Universal Nursing Assessment
  • Repeal of the LHCSA RFO
  • Integrated Home Care Ecosystem
  • Live‑In Care Clarity
  • Workforce Ecosystem


What Has FAIR Been Up To?

The FAIR team has been actively engaged with Senate and Assembly lawmakers and their staff on the Health and Aging Committees, introducing the new Association and discussing its proposals for the budget season and Legislative Session.


These meetings have involved representatives and staff from the offices of Senators Jake Ashby, Samra Brouk, Kristen Gonzalez, Patrick Ryan, and Robert Ortt, as well as Assembly Members Jeff Dinowitz, Demond Meeks, and Phil Steck.

The FAIR Access Team was also present at the Home Care Show! We extend our gratitude to the offices of Senate Majority Leader Andrea Stewart-Cousins and Assembly Member Amy Paulin for sending representatives to join us for our live podcast.

Click here to view the recording.

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By Sasha Guillaume • February 8, 2026
February 8, 2026 FAIR Access Initiative, Inc. 51 Maryland Street Dix Hills, NY 11746 Chairpersons, Ranking Members, and Members of the Legislature, My name is Sasha Guillaume, and I am the Founder and President of the FAIR Access Initiative, a provider-led association representing home care agencies across New York State. It is an honor to represent our members and to submit this testimony to the Members of the Legislature on their behalf. The mission of FAIR Access Initiative is to strengthen the home care industry by working in partnership with the Legislature, the Executive, and the Department of Health as responsible stewards of the Medicaid program. Our focus is on identifying inefficiencies, reducing waste, and improving long-term sustainability, not expanding programs or increasing spending. FAIR Access was formed in the wake of the CDPAP transition, which exposed the risks created by a fragmented and disunified industry response. When cost growth, operational complexity, and oversight concerns reached a tipping point in the Consumer Directed Personal Assistance Program, the resulting policy response was sweeping and centralized. Regardless of one’s perspective on that outcome, it demonstrated that when provider-led solutions are absent, corrective action can be broad and disruptive. FAIR Access exists to prevent that pattern from repeating elsewhere in home care. Today, fragmentation continues to drive unnecessary Medicaid spending. Multiple entities often assess, document, supervise, and manage care for the same patient. These overlapping assessments and care planning functions can be streamlined to eliminate repetitive services that result in Medicaid paying multiple times for the same work. FAIR Access proposes a Universal Nursing Assessment, built on the existing UAS-NY, completed once and securely shared across authorized providers. This is not a new program. It is a structural efficiency that recognizes work already being performed and eliminates redundancy. We also support an Integrated Home Care Ecosystem that aligns plans, providers, and care managers around shared assessments, reconciled care plans, and interoperable data. Better alignment improves continuity of care while reducing administrative duplication and unnecessary cost. FAIR Access Initiative also sees significant opportunities to reduce redundancy through greater workforce regulatory alignment. While workforce stability is at its core a care issue, it is also a critical fiscal issue. We can build upon existing Department of Health eligibility and credentialing infrastructure to centrally manage in-service and continuing education requirements through a secure registry accessible to providers. This would eliminate repetitive training requirements for staff working across multiple agencies, while maintaining consistent standards and compliance. Additionally, FAIR Access seeks to work collaboratively with Albany to address the unintended consequences of misaligned mandates that have led to unnecessary litigation and destabilization of provider networks. Conflicting regulatory standards, particularly in live-in care, have reduced participation in one of the most cost-effective alternatives to institutional placement. FAIR Access Initiative is not here to ask for new funding. We are here to partner with the State to identify waste, improve transparency, and ensure that legislative mandates align with operational and fiscal realities.  Our goal is to offer provider-led solutions that protect Medicaid dollars and to work collaboratively as trusted stewards of a program that New York’s most vulnerable residents depend on. Thank you for the opportunity to submit this testimony. Regards, Sasha Guillaume, President FAIR Access Initiative, Inc.

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