By Erin Vallely, ATI Advocacy Specialist

January 26, 2024



At the end of January, Governor Hochul published her suggested budget for our state spending.  While the budget covers all areas of state finance, we wanted to share some important points that impact disabled and chronically ill people. While there are some positives, we are expecting some losses and need people to share their feelings on these issues with their legislators.


How the State Budget Process Works 

Each year, the governor of New York State puts together government agency funding requests and writes a comprehensive budget proposal.  After publishing it so residents can read it, the New York State Assembly and New York State Senate write their own budget proposals.

To develop a budget all our government representatives agree on, state leaders and the Governor meet to discuss the wording and amount of money each issue will receive in the final budget bill. The budget goes through another round of editing and then is voted on by the Assembly and Senate.  If enough representatives vote “yes” the budget is approved and followed.  If too many representatives vote “no” there will be more discussions and edits.


Proposed Budget Highlights 

Although we cannot tell you about every issue Governor Hochul’s budget proposal talks about, it is important to understand the biggest issues that might impact the disability and chronic illness community.  Her budget ideas contain both good news and bad news for our community.



Direct Support Staff Practice – A proposal would allow OPWDD certified direct support staff to do some nursing tasks without medical licenses in community-based settings. This would allow more individuals to remain in, or transition to, more independent settings and decrease the need for more restrictive settings.  

Medical Debt Collection – This proposal would make it illegal for hospitals to take legal action against patients who have unpaid medical bills.  This would protect anyone earning less than 400% of the Federal Poverty Level. The budget also expands financial assistance programs, limits interest rates, and lowers monthly payment amounts for medical costs.

Office of the Chief Disability Officer – The proposal includes money for another fulltime employee who will specifically support the Interagency Council for the Deaf, Deafblind, or Hard of Hearing within the Office of the Chief Disability Officer (CDO) and the deafblind community. This staff member will focus on outreach and advocacy for deafblind individuals across the state.

Olmstead Plan – $250,000 for New York’s Most Integrated Setting Coordinating Council (MISCC) was allocated to issue an Olmstead Plan. The Olmstead Act requires governments to provide services to disabled and ill people in the least restrictive environment and prioritizes home and community-based services.  This new plan will ensure people with disabilities receive services in the most integrated setting that meets their needs.

Open Meetings Law – This provision extends public groups' ability to allow participants to join meetings virtually from private locations.  This extension is currently written to last two years.  This is important because many people struggle to attend in-person meetings and we hope this becomes a permanent rule.  

Disability Employment – The proposed budget sets aside $6.7 million to invest in a multi-agency effort led by OPWDD to increase employment opportunities for disabled individuals.  The goal is to ensure the necessary supports are available to help people get and stay in jobs. 



Independent Living Center Funding – The proposal does not give our network more funding.  Additionally, we will not get the cost of living raises other human service agencies will.  This means we will be losing funding because of inflation.

Access to Home – Doing away with last year’s funding increase of $2 million, Access to Home may only be funded with $1 million.  The program is consistently underfunded and this decrease in funds undermines housing accessibility which should be part of the Master Plan on Aging and Disability.  Without accessible homes, people are forced to go to nursing homes.

Consumer Directed Support Staff – Once again, the Governor does not want to meaningfully increase consumer directed support staff.  In New York City, Long Island, and Westchester, she suggests decreasing wages and benefits for these workers to offer health insurance.  Wages and benefits would not change for agency-based personal care and other home care staff.  

Medicaid Spending Cap – The proposal renews a Medicaid spending limit which would limit the amount of money Medicaid can spend on services.  Although it will increase slightly each year based on cost estimates, the cap will still force people to go without needed services.

Physician Prescription Decisions – To save money, the governor recommends limiting physicians' choices when prescribing medications.  Physicians may be forced to choose generic options or less effective medications to decrease healthcare spending.  While generic medicines work well for some people, they do not work well for others.

Although there are some good ideas in Governor Hochul’s proposed budget, other ideas will end up hurting the disability and chronic illness community.  We are hopeful our supporters in the Assembly and Senate will support our needs.  It is important to keep advocating year after year because any progress is better than none.  The more people who understand our issues, the stronger our advocacy power will be.  


Get Involved!   

Advocacy can be intimidating.  It is important to understand the issues you are talking about and have confidence in yourself to advocate for yourself and the community.  Here are some resources you can use to learn more about the issues and how to contact your government representatives.

If you are interested in advocating for these issues, or have questions about these topics, please contact ATI at 607-753-7363 or by email at This email address is being protected from spambots. You need JavaScript enabled to view it..