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Bill No.: Summary Actions Committee&nbspVotes Floor&nbspVotes Memo Text LFIN Chamber&nbspVideo/Transcript S10103 Summary: BILL NO S10103 &nbsp SAME AS SAME AS A11165

&nbsp SPONSOR SERRANO &nbsp COSPNSR &nbsp MLTSPNSR &nbsp Amd §§2 - 8, Chap 98 of 2026; amd §§4 & 5, Chap 102 of 2026; amd §5, Chap 100 of 2026; amd §8, Chap 104 of 2026 &nbsp Provides for emergency appropriation through May 4, 2026 for the support of government.

Go to top S10103 Text:

STATE OF NEW YORK ________________________________________________________________________

10103

IN SENATE

April 29, 2026 ___________

Introduced by Sen. SERRANO -- (at request of the Governor) -- read twice and ordered printed, and when printed to be committed to the Committee on Rules

AN ACT making appropriations for the support of government; to amend chapter 98 of the laws of 2026, relating to making appropriations for the support of government, in relation thereto; to amend chapter 100 of the laws of 2026, relating to making appropriations for the support of government, in relation thereto; to amend chapter 102 of the laws of 2026, relating to making appropriations for the support of govern- ment, in relation thereto; to amend chapter 104 of the laws of 2026, relating to making appropriations for the support of government, in relation thereto; and providing for the repeal of such provisions upon expiration thereof

The People of the State of New York, represented in Senate and Assem- bly, do enact as follows:

1 Section 1. Legislative intent. The legislature hereby finds and 2 declares that the enactment of these appropriations provides sufficient 3 authority to the comptroller for the purpose of making payments for the 4 purposes described herein until such time as appropriation bills submit- 5 ted by the governor pursuant to article VII of the state constitution 6 for the support of government for the state fiscal year beginning April 7 1, 2026 are enacted. 8 § 2. Section 2 of chapter 98 of the laws of 2026, relating to making 9 appropriations for the support of government, as amended by chapter 106 10 of the laws of 2026, is amended to read as follows: 11 § 2. The amounts specified in this section, or so much thereof as 12 shall be sufficient to accomplish the purposes designated, is hereby 13 appropriated and authorized to be paid as hereinafter provided, to the 14 public officers and for the purpose specified, which amount shall be 15 available for the state fiscal year beginning April 1, 2026.

16 ALL STATE DEPARTMENTS AND AGENCIES

17 For the purpose of making payments for

EXPLANATION--Matter in italics (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD12034-01-6

S. 10103 2

1 personal service, including liabilities 2 incurred prior to April 1, 2026, on the 3 payrolls scheduled to be paid during the 4 period April 1 through [ April 30 ] May 4 , 5 2026 to state officers and employees of 6 the executive branch, including the gover- 7 nor, lieutenant governor, comptroller, and 8 attorney general, and to employees of the 9 legislature. This appropriation also 10 includes payments for services performed 11 by mentally ill or developmentally disa- 12 bled persons who are employed in state- 13 operated special employment, work-for-pay 14 or sheltered workshop programs ........... 15 .......................... [ 1,491,021,469 ] 1,491,046,469 16 --------------

17 § 3. Section 3 of chapter 98 of the laws of 2026, relating to making 18 appropriations for the support of government, as amended by chapter 106 19 of the laws of 2026, is amended to read as follows: 20 § 3. The amount specified in this section, or so much thereof as shall 21 be sufficient to accomplish the purpose designated, is hereby appropri- 22 ated and authorized to be paid as hereinafter provided, to the public 23 officers and for the purpose specified, which amount shall be available 24 for the state fiscal year beginning April 1, 2026.

25 ALL STATE DEPARTMENTS AND AGENCIES

26 For the payment of state operations non 27 personal service liabilities to the execu- 28 tive branch, including the comptroller, 29 and the attorney general, and legislature, 30 incurred in the ordinary course of busi- 31 ness, during the period April 1 through 32 [ April 30 ] May 4 , 2026, pursuant to exist- 33 ing state law and for purposes for which 34 the legislature authorized the expenditure 35 of moneys during the 2025-2026 state 36 fiscal year; provided, however, that noth- 37 ing contained herein shall be deemed to 38 limit or restrict the power or authority 39 of state departments or agencies to 40 conduct their activities or operations in 41 accordance with existing law, and further 42 provided that nothing contained herein 43 shall be deemed to supersede, nullify or 44 modify the provisions of section 40 of the 45 state finance law prescribing when appro- 46 priations made for the 2025-2026 state 47 fiscal year shall have ceased to have 48 force and effect ............................ 44,000,000 49 --------------

50 § 4. Section 4 of chapter 102 of the laws of 2026, relating to making 51 appropriations for the support of government, as amended by chapter 106 52 of the laws of 2026, is amended to read as follows:

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1 § 4. The amounts specified in this section, or so much thereof as 2 shall be sufficient to accomplish the purposes designated, is hereby 3 appropriated and authorized to be paid as hereinafter provided, to the 4 respective public officers and for the purposes specified, which amount 5 shall be available for the state fiscal year beginning April 1, 2026.

6 MISCELLANEOUS - - ALL STATE DEPARTMENTS AND AGENCIES

7 The sum of ten million dollars 8 ($10,000,000), or so much thereof as shall 9 be sufficient to accomplish the purpose 10 designated, is hereby appropriated for 11 contracts and grants approved for purposes 12 for which the legislature authorized the 13 expenditures of money during the 2025-2026 14 fiscal year. An amount up to ten million 15 dollars ($10,000,000) shall be available 16 for the payment of capital projects 17 liabilities incurred during the period 18 from April 1 through [ April 30 ] May 4 , 19 2026 for contracts and grants approved 20 prior to April 1, 2026, provided, however, 21 that nothing contained herein shall be 22 deemed to limit or restrict the power or 23 authority of state departments or agencies 24 to conduct their activities or operations 25 in accordance with existing law, and 26 further provided that nothing contained 27 herein shall be deemed to supersede, 28 nullify, or modify the provisions of 29 section 40 of the state finance law 30 prescribing when appropriations made for 31 the 2025-2026 fiscal year shall have 32 ceased to have force and effect ............. 10,000,000 33 --------------

34 § 5. Section 5 of chapter 102 of the laws of 2026, relating to making 35 appropriations for the support of government, as amended by chapter 106 36 of the laws of 2026, is amended to read as follows: 37 § 5. The amounts specified in this section, or so much thereof as 38 shall be sufficient to accomplish the purposes designated, is hereby 39 appropriated and authorized to be paid as hereinafter provided, to the 40 respective public officers and for the purposes specified, which amount 41 shall be available for the state fiscal year beginning April 1, 2026.

42 MISCELLANEOUS - - ALL STATE DEPARTMENTS AND AGENCIES

43 The sum of twenty million dollars 44 ($20,000,000), or so much thereof as shall 45 be sufficient to accomplish the purpose 46 designated, is hereby appropriated for 47 contracts and grants approved for purposes 48 for which the legislature authorized the 49 expenditures of money during the 2025-2026 50 fiscal year. An amount up to twenty 51 million dollars ($20,000,000) shall be

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1 available for the payment of capital 2 projects liabilities incurred during the 3 period from April 1 through [ April 30 ] May 4 4 , 2026 for contracts and grants approved 5 after April 1, 2026, provided, however, 6 that nothing contained herein shall be 7 deemed to limit or restrict the power or 8 authority of state departments or agencies 9 to conduct their activities or operations 10 in accordance with existing law, and 11 further provided that nothing contained 12 herein shall be deemed to supersede, 13 nullify, or modify the provisions of 14 section 40 of the state finance law 15 prescribing when appropriations made for 16 the 2025-2026 fiscal year shall have 17 ceased to have force and effect ............ 20,000,000 18 --------------

19 § 6. Section 4 of chapter 98 of the laws of 2026, relating to making 20 appropriations for the support of government, as amended by chapter 106 21 of the laws of 2026, is amended to read as follows: 22 § 4. The amounts specified in this section, or so much thereof as 23 shall be sufficient to accomplish the purposes designated, is hereby 24 appropriated and authorized to be paid as hereinafter provided, to the 25 public officers and for the purposes specified, which amount shall be 26 available for the state fiscal year beginning April 1, 2026.

27 MISCELLANEOUS -- ALL STATE DEPARTMENTS AND AGENCIES

28 GENERAL STATE CHARGES

29 STATE OPERATIONS

30 GENERAL STATE CHARGES ....................... [ 691,631,000 ] 713,806,000 31 --------------

32 General Fund 33 State Purposes Account - 10050

34 For employee fringe benefits according to 35 the following project schedule including 36 those benefits which are related to 37 employees paid from funds, accounts, or 38 programs where the division of the budget 39 has issued waivers (85022) .. [ 683,733,000 ] 705,908,000

40 Project Schedule 41 PROJECT AMOUNT 42 -------------------------------------------- 43 For the state's contribution 44 to the health insurance fund 45 and deposit into the retiree 46 health benefit trust fund 47 pursuant to section 99-aa of 48 the state finance law. The

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1 state's share of the health 2 insurance program dividends 3 shall be available to pay 4 for the premiums in 2026-27 .. 514,422,000 5 For the state's contribution 6 to the social security 7 contribution fund .......... 8 .............. [ 116,000,000 ] 137,500,000 9 For the state's contribution 10 to employee benefit fund 11 programs ...................... 40,500,000 12 For the state's contribution 13 to the dental insurance plan ... 7,415,000 14 For the payment of the metro- 15 politan commuter transporta- 16 tion mobility tax pursuant 17 to article 23 of the tax 18 law, as added by chapter 25 19 of the laws of 2009, on 20 behalf of the state employ- 21 ees employed in the metro- 22 politan commuter transporta- 23 tion district ... [ 4,670,000 ] 5,345,000 24 For the state's share of 25 contributions to the volun- 26 tary defined contribution 27 plan made on behalf of 28 eligible employees pursuant 29 to chapter 18 of the laws 30 of 2012 who elect to partic- 31 ipate in such plan and who 32 are not otherwise eligi- 33 ble to participate in the 34 SUNY optional retirement 35 program .......................... 709,000 36 For the state's contribution 37 to the vision care plan ........... 17,000 38 -------------- 39 Project schedule total ... 40 ........... [ 683,733,000 ] 705,908,000 41 --------------

42 For payments in accordance with section 19-a 43 of the public lands law (80567) .............. 7,720,000 44 For payment of claims for damage to personal 45 or real property or for bodily injuries or 46 wrongful death caused by officers, employ- 47 ees, or other authorized persons providing 48 service to state government while provid- 49 ing such service, and the state university 50 construction fund while acting within the 51 scope of their employment, and while oper- 52 ating motor vehicles, and for any individ- 53 uals operating motor vehicles which are 54 assigned on a permanent basis with unre- 55 stricted use to state officers and employ-

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1 ees when the person is permanently 2 assigned the motor vehicle (80559) ............. 178,000 3 --------------

4 § 7. Section 5 of chapter 100 of the laws of 2026, relating to making 5 appropriations for the support of government, as amended by chapter 106 6 of the laws of 2026, is amended to read as follows: 7 § 5. The amounts specified in this section, or so much thereof as 8 shall be sufficient to accomplish the purposes designated, is hereby 9 appropriated and authorized to be paid as hereinafter provided, to the 10 public officers and for the purposes specified, which amount shall be 11 available for the state fiscal year beginning April 1, 2026.

12 JUDICIARY

13 For the purpose of making payments for 14 personal service, including liabilities 15 incurred prior to April 1, 2026, on the 16 payrolls scheduled to be paid during the 17 period April 1 through [ April 30 ] May 4 , 18 2026 to officers and employees of the 19 judiciary ................................. 186,000,000 20 For the payment of state operations nonper- 21 sonal service liabilities, the sum of 22 [ thirteen million dollars ($13,000,000) ] 23 twenty-five million dollars ($25,000,000) , 24 or so much thereof as shall be sufficient 25 to accomplish the purpose designated, is 26 hereby appropriated to the judiciary out 27 of any moneys in the general fund or other 28 funds to the credit of the state purposes 29 account not otherwise appropriated. The 30 comptroller is hereby authorized and 31 directed to utilize this appropriation for 32 the purpose of making payments for nonper- 33 sonal service liabilities incurred by the 34 judiciary from April 1 through [ April 30 ] 35 May 4 , 2026 .................. [ 13,000,000 ] 25,000,000 36 For the payment of aid to localities liabil- 37 ities, the sum of eleven million dollars 38 ($11,000,000), or so much thereof as shall 39 be sufficient to accomplish the purpose 40 designated, is hereby appropriated to the 41 judiciary out of any moneys in the general 42 fund or other funds to the credit of the 43 state purposes account not otherwise 44 appropriated. The comptroller is hereby 45 authorized and directed to utilize this 46 appropriation for the purpose of making 47 payments for aid to localities liabilities 48 incurred by the judiciary from April 1 49 through [ April 30 ] May 4 , 2026 .............. 11,000,000 50 For the payment of employee fringe benefit 51 programs including, but not limited to, 52 the judiciary's contributions to the 53 health insurance fund, the employees'

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1 retirement system pension accumulation 2 fund, the social security contribution 3 fund, employee benefit fund programs, the 4 dental insurance plan, the vision care 5 plan, the unemployment insurance fund, and 6 for workers' compensation benefits, the 7 sum of sixty-two million two hundred fifty 8 thousand dollars ($62,250,000), or so much 9 thereof as shall be sufficient to accom- 10 plish the purpose designated, is hereby 11 appropriated to the judiciary out of any 12 moneys in the general fund or other funds 13 to the credit of the state purposes 14 account not otherwise appropriated. The 15 comptroller is hereby authorized and 16 directed to utilize this appropriation for 17 the purpose of making payments for employ- 18 ee fringe benefit liabilities incurred by 19 the judiciary from April 1 through [ April 20 30 ] May 4 , 2026 ............................. 62,250,000 21 --------------

22 § 8. Section 8 of chapter 104 of the laws of 2026, relating to making 23 appropriations for the support of government, is amended to read as 24 follows: 25 § 8. The amounts specified in this section, or so much thereof as 26 shall be sufficient to accomplish the purposes designated, is hereby 27 appropriated and authorized to be paid as hereinafter provided, to the 28 public officers and for the purposes specified, which amount shall be 29 available for the state fiscal year beginning April 1, 2026.

30 EDUCATION DEPARTMENT

31 AID TO LOCALITIES

32 OFFICE OF PREKINDERGARTEN THROUGH GRADE TWELVE EDUCATION 33 PROGRAM ................................ [ 2,283,000,000 ] 2,290,000,000 34 --------------

35 General Fund 36 Local Assistance Account - 10000

37 For remaining 2025-26 and prior school year 38 obligations, including aid for such school 39 years payable pursuant to section 3609-d 40 of the education law, provided that 41 notwithstanding any provision of law to 42 the contrary, subject to the approval of 43 the director of the budget, funds appro- 44 priated herein may be interchanged with 45 any other item of appropriation for gener- 46 al support for public schools within the 47 general fund local assistance account 48 office of prekindergarten through grade 49 twelve education program.

S. 10103 8

1 Notwithstanding any other law, rule or regu- 2 lation to the contrary, funds appropriated 3 herein shall be available for payment of 4 financial assistance net of any disallow- 5 ances, refunds, reimbursement and credits, 6 and may be suballocated to other depart- 7 ments and agencies to accomplish the 8 intent of this appropriation subject to 9 the approval of the director of the budg- 10 et. Notwithstanding any provision of law 11 to the contrary, funds appropriated herein 12 shall be available for payment of liabil- 13 ities heretofore accrued or hereafter to 14 accrue (21701) ........................... 2,283,000,000 15 For general support for public schools for 16 the 2026-27 state fiscal year payable 17 pursuant to a chapter of the laws of 2026, 18 provided that, notwithstanding any incon- 19 sistent provision of law, subject to the 20 approval of the director of the budget, 21 funds appropriated herein may be inter- 22 changed with any other item of appropri- 23 ation for general support for public 24 schools within the general fund local 25 assistance account office of prekindergar- 26 ten through grade twelve education program ... 7,000,000 27 --------------

28 § 9. Section 5 of chapter 98 of the laws of 2026, relating to making 29 appropriations for the support of government, as amended by chapter 106 30 of the laws of 2026, is amended to read as follows: 31 § 5. The amounts specified in this section, or so much thereof as 32 shall be sufficient to accomplish the purposes designated, is hereby 33 appropriated and authorized to be paid as hereinafter provided, to the 34 public officers and for the purposes specified, which amount shall be 35 available for the state fiscal year beginning April 1, 2026.

36 DEPARTMENT OF HEALTH

37 AID TO LOCALITIES

38 CENTER FOR COMMUNITY HEALTH PROGRAM .......... [ 38,030,000 ] 45,372,000 39 --------------

40 General Fund 41 Local Assistance Account - 10000

42 For services and expenses related to the 43 Indian health program pursuant to a plan 44 prepared by the commissioner of health and 45 approved by the director of the budget. 46 The moneys hereby appropriated shall be 47 for payment of financial assistance here- 48 tofore accrued or hereafter to accrue 49 (26840) ...................... [ 7,000,000 ] 10,062,000 50 --------------

S. 10103 9

1 Special Revenue Funds - Federal 2 Federal USDA-Food and Nutrition Services Fund 3 Federal Food and Nutrition Services Account - 25022

4 For various federal food and nutritional 5 services. The moneys hereby appropriated 6 shall be available for payment of finan- 7 cial assistance heretofore accrued (26986) 8 .............................. [ 31,030,000 ] 35,310,000 9 --------------

10 CHILD HEALTH INSURANCE PROGRAM ............................. 212,950,000 11 --------------

12 Special Revenue Funds - Other 13 HCRA Resources Fund 14 Children's Health Insurance Account - 20810

15 The money hereby appropriated is available 16 for payment of aid heretofore accrued or 17 hereafter accrued. 18 Notwithstanding any other provision of law, 19 the money hereby appropriated may be 20 increased or decreased by transfer or 21 suballocation to appropriations of the 22 office of temporary and disability assist- 23 ance, for the reimbursement of local 24 district administrative costs related to 25 children newly enrolled in medicaid whose 26 household income is between 100 percent 27 and 133 percent of the federal poverty 28 level. 29 Notwithstanding any provision of law to the 30 contrary, the amounts appropriated herein 31 shall be net of refunds, rebates, 32 reimbursements, credits, repayments, 33 and/or disallowances. 34 For services and expenses related to the 35 children's health insurance program 36 authorized pursuant to title 1-A of arti- 37 cle 25 of the public health law (26931) .... 212,950,000 38 --------------

39 ELDERLY PHARMACEUTICAL INSURANCE COVERAGE PROGRAM ............ 1,800,000 40 --------------

41 Special Revenue Funds - Other 42 HCRA Resources Fund 43 EPIC Premium Account - 20818

44 For services and expenses of the program for 45 elderly pharmaceutical insurance coverage, 46 including reimbursement to pharmacies 47 participating in such program. The moneys 48 hereby appropriated shall be available for

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1 payment of financial assistance heretofore 2 accrued (26803) .............................. 1,800,000 3 --------------

4 ESSENTIAL PLAN PROGRAM ................................... 1,150,000,000 5 --------------

6 Special Revenue Funds - Federal 7 Federal Health and Human Services Fund 8 Essential Plan Account - 25186

9 For services and expenses related to the 10 essential plan program, in accordance 11 State Innovation Waiver provisions author- 12 ized by Section 1332 of the federal 13 patient protection and affordable care 14 act. 15 Notwithstanding any inconsistent provision 16 of law, the moneys hereby appropriated may 17 be increased or decreased by interchange 18 or transfer with any appropriation of the 19 department of health or for transfer to 20 Health Research Incorporated (HRI). 21 Notwithstanding any provision of law to the 22 contrary, the amounts appropriated herein 23 shall be net of refunds, rebates, 24 reimbursements, credits, repayments, 25 and/or disallowances. 26 The money hereby appropriated is available 27 for payment of aid heretofore accrued or 28 hereafter accrued (59054) ................ 1,150,000,000 29 --------------

30 MEDICAL ASSISTANCE PROGRAM ............................... 8,449,731,000 31 --------------

32 General Fund 33 Local Assistance Account - 10000

34 For the medical assistance program, includ- 35 ing administrative expenses, for local 36 social services districts, and for medical 37 care rates for authorized child care agen- 38 cies. 39 Notwithstanding section 40 of the state 40 finance law or any provision of law to the 41 contrary, subject to federal approval, 42 department of health state funds medicaid 43 spending, excluding payments for medical 44 services provided at state facilities 45 operated by the office of mental health, 46 the office for people with developmental 47 disabilities and the office of addiction 48 services and supports and further exclud- 49 ing any payments which are not appropri- 50 ated within the department of health, in

S. 10103 11

1 the aggregate, for the period April 1, 2 2026 through March 31, 2027, shall not 3 exceed $36,099,200,000 except as provided 4 below provided, however, such aggregate 5 limits may be adjusted by the director of 6 the budget to account for any changes in 7 the New York state federal medical assist- 8 ance percentage amount established pursu- 9 ant to the federal social security act, 10 increases in provider revenues, reductions 11 in local social services district payments 12 for medical assistance administration, 13 minimum wage increases, and beginning 14 April 1, 2012 the operational costs of the 15 New York state medical indemnity fund, 16 pursuant to chapter 59 of the laws of 17 2011, and state costs or savings from the 18 essential plan program. Such projections 19 may be adjusted by the director of the 20 budget to account for increased or expe- 21 dited department of health state funds 22 medicaid expenditures as a result of a 23 natural or other type of disaster, includ- 24 ing a governmental declaration of emergen- 25 cy. 26 The director of the budget, in consultation 27 with the commissioner of health, shall 28 assess on a quarterly basis known and 29 projected medicaid expenditures by catego- 30 ry of service and by geographic region, as 31 defined by the commissioner, incurred both 32 prior to and subsequent to such assessment 33 for each such period, and if the director 34 of the budget determines that such expend- 35 itures are expected to cause medicaid 36 spending for such period to exceed the 37 aggregate limit specified herein for such 38 period, the state medicaid director, in 39 consultation with the director of the 40 budget and the commissioner of health, 41 shall develop a medicaid savings allo- 42 cation adjustment to limit such spending 43 to the aggregate limit specified herein 44 for such period. 45 Such medicaid savings allocation adjustment 46 shall be designed, to reduce the expendi- 47 tures authorized by the appropriations 48 herein in compliance with the following 49 guidelines: (1) reductions shall be made 50 in compliance with applicable federal law, 51 including the provisions of the Patient 52 Protection and Affordable Care Act, Public 53 Law No. 111-148, and the Health Care and 54 Education Reconciliation Act of 2010, 55 Public Law No. 111-152 (collectively 56 "Affordable Care Act") and any subsequent

S. 10103 12

1 amendments thereto or regulations promul- 2 gated thereunder; (2) reductions shall be 3 made in a manner that complies with the 4 state medicaid plan approved by the feder- 5 al centers for medicare and medicaid 6 services, provided, however, that the 7 commissioner of health is authorized to 8 submit any state plan amendment or seek 9 other federal approval, including waiver 10 authority, to implement the provisions of 11 the medicaid savings allocation adjustment 12 that meets the other criteria set forth 13 herein; (3) reductions shall be made in a 14 manner that maximizes federal financial 15 participation, to the extent practicable, 16 including any federal financial partic- 17 ipation that is available or is reasonably 18 expected to become available, in the 19 discretion of the commissioner, under the 20 Affordable Care Act; (4) reductions shall 21 be made uniformly among categories of 22 services and geographic regions of the 23 state, to the extent practicable, and 24 shall be made uniformly within a category 25 of service, to the extent practicable, 26 except where the commissioner determines 27 that there are sufficient grounds for 28 non-uniformity, including but not limited 29 to: the extent to which specific catego- 30 ries of services contributed to department 31 of health medicaid state funds spending in 32 excess of the limits specified herein; the 33 need to maintain safety net services in 34 underserved communities; or the potential 35 benefits of pursuing innovative payment 36 models contemplated by the Affordable Care 37 Act, in which case such grounds shall be 38 set forth in the medicaid savings allo- 39 cation adjustment; and (5) reductions 40 shall be made in a manner that does not 41 unnecessarily create administrative 42 burdens to medicaid applicants and recipi- 43 ents or providers. 44 The commissioner shall seek the input of the 45 legislature, as well as organizations 46 representing health care providers, 47 consumers, businesses, workers, health 48 insurers, and others with relevant exper- 49 tise, in developing such medicaid savings 50 allocation adjustment, to the extent that 51 all or part of such adjustment, in the 52 discretion of the commissioner, is likely 53 to have a material impact on the overall 54 medicaid program, particular categories of 55 service or particular geographic regions 56 of the state.

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1 (a) The commissioner shall post the medicaid 2 savings allocation adjustment on the 3 department of health's website and shall 4 provide written copies of such adjustment 5 to the chairs of the senate finance and 6 the assembly ways and means committees at 7 least 30 days before the date on which 8 implementation is expected to begin. 9 (b) The commissioner may revise the medicaid 10 savings allocation adjustment subsequent 11 to the provisions of notice and prior to 12 implementation but needs to provide a new 13 notice pursuant to subparagraph (i) of 14 this paragraph only if the commissioner 15 determines, in his or her discretion, that 16 such revisions materially alter the 17 adjustment. 18 Notwithstanding the provisions of paragraphs 19 (a) and (b) of this subdivision, the 20 commissioner need not seek the input 21 described in paragraph (a) of this subdi- 22 vision or provide notice pursuant to para- 23 graph (b) of this subdivision if, in the 24 discretion of the commissioner, expedited 25 development and implementation of a medi- 26 caid savings allocation adjustment is 27 necessary due to a public health emergen- 28 cy. 29 For purposes of this section, a public 30 health emergency is defined as: (i) a 31 disaster, natural or otherwise, that 32 significantly increases the immediate need 33 for health care personnel in an area of 34 the state; (ii) an event or condition that 35 creates a widespread risk of exposure to a 36 serious communicable disease, or the 37 potential for such widespread risk of 38 exposure; or (iii) any other event or 39 condition determined by the commissioner 40 to constitute an imminent threat to public 41 health. 42 Nothing in this paragraph shall be deemed to 43 prevent all or part of such medicaid 44 savings allocation adjustment from taking 45 effect retroactively to the extent permit- 46 ted by the federal centers for medicare 47 and medicaid services. 48 In accordance with the medicaid savings 49 allocation adjustment, the commissioner of 50 the department of health shall reduce 51 department of health state funds medicaid 52 spending by the amount of the projected 53 overspending through, actions including, 54 but not limited to modifying or suspending 55 reimbursement methods, including but not 56 limited to all fees, premium levels and

S. 10103 14

1 rates of payment, notwithstanding any 2 provision of law that sets a specific 3 amount or methodology for any such 4 payments or rates of payment; modifying or 5 discontinuing medicaid program benefits; 6 seeking all necessary federal approvals, 7 including, but not limited to waivers, 8 waiver amendments; and suspending time 9 frames for notice, approval or certif- 10 ication of rate requirements, notwith- 11 standing any provision of law, rule or 12 regulation to the contrary, including but 13 not limited to sections 2807 and 3614 of 14 the public health law, section 18 of chap- 15 ter 2 of the laws of 1988, and 18 NYCRR 16 505.14(h). 17 The department of health shall prepare a 18 quarterly report that sets forth: (a) 19 known and projected department of health 20 medicaid expenditures as described in 21 subdivision (1) of this section, and 22 factors that could result in medicaid 23 disbursements for the relevant state 24 fiscal year to exceed the projected 25 department of health state funds disburse- 26 ments in the enacted budget financial plan 27 pursuant to subdivision 3 of section 23 of 28 the state finance law, including spending 29 increases or decreases due to: enrollment 30 fluctuations, rate changes, utilization 31 changes, MRT investments, and shift of 32 beneficiaries to managed care; and vari- 33 ations in offline medicaid payments; and 34 (b) the actions taken to implement any 35 medicaid savings allocation adjustment 36 implemented pursuant to subdivision (4) of 37 this section, including information 38 concerning the impact of such actions on 39 each category of service and each 40 geographic region of the state. Each such 41 quarterly report shall be provided to the 42 chairs of the senate finance and the 43 assembly ways and means committees and 44 shall be posted on the department of 45 health's website in a timely manner. 46 The money hereby appropriated is to be 47 available for payment of aid heretofore 48 accrued or hereafter accrued to munici- 49 palities, and to providers of medical 50 services pursuant to section 367-b of the 51 social services law, and for payment of 52 state aid to municipalities and to provid- 53 ers of family care where payment systems 54 through the fiscal intermediaries are not 55 operational.

S. 10103 15

1 Notwithstanding any inconsistent provision 2 of law to the contrary, funds may be used 3 by the department for outside legal 4 assistance on issues involving the federal 5 government, the conduct of preadmission 6 screening and annual resident reviews 7 required by the state's medicaid program, 8 computer matching with insurance carriers 9 to insure that medicaid is the payer of 10 last resort and activities related to the 11 management of the pharmacy benefit avail- 12 able under the medicaid program. 13 Notwithstanding any inconsistent provision 14 of law, in lieu of payments authorized by 15 the social services law, or payments of 16 federal funds otherwise due to the local 17 social services districts for programs 18 provided under the federal social security 19 act or the federal food stamp act, funds 20 herein appropriated, in amounts certified 21 by the state commissioner of temporary and 22 disability assistance or the state commis- 23 sioner of health as due from local social 24 services districts each month as their 25 share of payments made pursuant to section 26 367-b of the social services law may be 27 set aside by the state comptroller in an 28 interest-bearing account in order to 29 ensure the orderly and prompt payment of 30 providers under section 367-b of the 31 social services law pursuant to an esti- 32 mate provided by the commissioner of 33 health of each local social services 34 district's share of payments made pursuant 35 to section 367-b of the social services 36 law. 37 Notwithstanding any inconsistent provision 38 of law, funding made available by these 39 appropriations shall support direct salary 40 costs and related fringe benefits within 41 the medical assistance program associated 42 with any minimum wage increase that takes 43 effect during the timeframe of these 44 appropriations, pursuant to section 652 of 45 the labor law. Each eligible organization 46 in receipt of funding made available by 47 these appropriations may be required to 48 submit written certification, in such form 49 and at such time the commissioner may 50 prescribe, attesting to the total amount 51 of funds used by the eligible organiza- 52 tion, how such funding will be or was used 53 for purposes eligible under these appro- 54 priations and any other reporting deemed 55 necessary by the commissioner. The amounts 56 appropriated herein may include advances

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1 to organizations authorized to receive 2 such funds to accomplish this purpose. 3 Notwithstanding any other provision of law, 4 the money hereby appropriated may be 5 increased or decreased by interchange or 6 transfer, with any appropriation of the 7 department of health and the office of 8 medicaid inspector general and may be 9 increased or decreased by transfer or 10 suballocation between these appropriated 11 amounts and appropriations of the depart- 12 ment of health state purpose account, the 13 office of mental health, office for people 14 with developmental disabilities, the 15 office of addiction services and supports, 16 the department of family assistance office 17 of temporary and disability assistance, 18 the department of corrections and communi- 19 ty supervision, the office of information 20 technology services, the state university 21 of New York, and office of children and 22 family services, the office of medicaid 23 inspector general, the state education 24 department, and the state office for the 25 aging with the approval of the director of 26 the budget, who shall file such approval 27 with the department of audit and control 28 and copies thereof with the chairman of 29 the senate finance committee and the 30 chairman of the assembly ways and means 31 committee. 32 Notwithstanding any inconsistent provision 33 of law to the contrary, the moneys hereby 34 appropriated may be used for payments to 35 the centers for medicaid and medicare 36 services for obligations incurred related 37 to the pharmaceutical costs of dually 38 eligible medicare/medicaid beneficiaries 39 participating in the medicare drug benefit 40 authorized by P.L. 108-173. 41 Notwithstanding any inconsistent provision 42 of law, the moneys hereby appropriated 43 shall not be used for any existing rates, 44 fees, fee schedule, or procedures which 45 may affect the cost of care and services 46 provided by personal care providers, case 47 managers, health maintenance organiza- 48 tions, out of state medical facilities 49 which provide care and services to resi- 50 dents of the state, providers of transpor- 51 tation services, that are altered, 52 amended, adjusted or otherwise changed by 53 a local social services district unless 54 previously approved by the department of 55 health and the director of the budget.

S. 10103 17

1 Notwithstanding any inconsistent provision 2 of law to the contrary, funds shall be 3 made available to the commissioner of the 4 office of mental health or the commission- 5 er of the office of addiction services and 6 supports, in consultation with the commis- 7 sioner of health and approved by the 8 director of the budget, and consistent 9 with appropriations made therefor, to 10 implement allocation adjustment developed 11 by each such commissioner which shall 12 describe mental health or substance use 13 disorder services that should be developed 14 to meet service needs resulting from the 15 reduction of inpatient behavioral health 16 services provided under the medicaid 17 program, by programs licensed pursuant to 18 article 31 or 32 of the mental hygiene 19 law. Such programs may include programs 20 that are licensed pursuant to both article 21 31 of the mental hygiene law and article 22 28 of the public health law, or certified 23 under both article 32 of the mental 24 hygiene law and article 28 of the public 25 health law. 26 Notwithstanding any inconsistent provision 27 of law, the moneys hereby appropriated may 28 be available for payments associated with 29 the resolution by settlement agreement or 30 judgment of rate appeals and/or litigation 31 where the department of health is a party. 32 For services and expenses of the medical 33 assistance program including hospital 34 inpatient services and general hospitals 35 that are safety-net providers that evince 36 severe financial distress, pursuant to 37 criteria determined by the commissioner, 38 shall be eligible for awards for amounts 39 appropriated herein, to enable such 40 providers to maintain operations and vital 41 services while establishing long term 42 solutions to achieve sustainable health 43 services. 44 Notwithstanding any inconsistent provisions 45 of law, no expenditures shall be used for 46 the medical assistance program for any 47 expenses not explicitly authorized in law 48 without the approval of the director of 49 the budget. 50 Notwithstanding any provision of law to the 51 contrary, the portion of this appropri- 52 ation covering fiscal year 2026-27 shall 53 supersede and replace any duplicative (i) 54 reappropriation for this item covering 55 fiscal year 2026-27, and (ii) appropri- 56 ation for this item covering fiscal year

S. 10103 18

1 2026-27 set forth in chapter 53 of the 2 laws of 2025 (26947) ....................... 121,190,000 3 For services and expenses of the medical 4 assistance program including hospital 5 outpatient and emergency room services. 6 Notwithstanding any provision of law to the 7 contrary, the portion of this appropri- 8 ation covering fiscal year 2026-27 shall 9 supersede and replace any duplicative (i) 10 reappropriation for this item covering 11 fiscal year 2026-27, and (ii) appropri- 12 ation for this item covering fiscal year 13 2026-27 set forth in chapter 53 of the 14 laws of 2025 (26948) ........................ 36,245,000 15 For services and expenses of the medical 16 assistance program including clinic 17 services. 18 Notwithstanding any provision of law to the 19 contrary, the portion of this appropri- 20 ation covering fiscal year 2026-27 shall 21 supersede and replace any duplicative (i) 22 reappropriation for this item covering 23 fiscal year 2026-27, and (ii) appropri- 24 ation for this item covering fiscal year 25 2026-27 set forth in chapter 53 of the 26 laws of 2025 (26949) ........................ 70,990,000 27 For services and expenses of the medical 28 assistance program including nursing home 29 services. 30 Notwithstanding any provision of law to the 31 contrary, the portion of this appropri- 32 ation covering fiscal year 2026-27 shall 33 supersede and replace any duplicative (i) 34 reappropriation for this item covering 35 fiscal year 2026-27, and (ii) appropri- 36 ation for this item covering fiscal year 37 2026-27 set forth in chapter 53 of the 38 laws of 2025 (26950) ....................... 178,425,000 39 For services and expenses of the medical 40 assistance program including other long 41 term care services. 42 Notwithstanding any provision of law to the 43 contrary, the portion of this appropri- 44 ation covering fiscal year 2026-27 shall 45 supersede and replace any duplicative (i) 46 reappropriation for this item covering 47 fiscal year 2026-27, and (ii) appropri- 48 ation for this item covering fiscal year 49 2026-27 set forth in chapter 53 of the 50 laws of 2025 (26951) ....................... 849,930,000 51 For services and expenses of the medical 52 assistance program including managed care 53 services including regional planning 54 activities of the finger lakes health 55 systems agency, including statewide coor- 56 dination and demonstration of best prac-

S. 10103 19

1 tices. The department shall make grants 2 within amounts appropriated therefor, to 3 assure high-quality and accessible primary 4 care, to provide technical assistance to 5 support financial and business planning 6 for integrated systems of care, and to 7 assist primary care providers in the 8 adoption, implementation, and meaningful 9 use of electronic health record technolo- 10 gy. 11 Notwithstanding any provision of law to the 12 contrary, the portion of this appropri- 13 ation covering fiscal year 2026-27 shall 14 supersede and replace any duplicative (i) 15 reappropriation for this item covering 16 fiscal year 2026-27, and (ii) appropri- 17 ation for this item covering fiscal year 18 2026-27 set forth in chapter 53 of the 19 laws of 2025 (26952) ....................... 778,550,000 20 For services and expenses for health homes 21 including grants to health homes. 22 Notwithstanding any provision of law to the 23 contrary, the portion of this appropri- 24 ation covering fiscal year 2026-27 shall 25 supersede and replace any duplicative (i) 26 reappropriation for this item covering 27 fiscal year 2026-27, and (ii) appropri- 28 ation for this item covering fiscal year 29 2026-27 set forth in chapter 53 of the 30 laws of 2025 (29548) ........................ 18,850,000 31 For services and expenses of the medical 32 assistance program including pharmacy 33 services provided, however, that no funds 34 shall be made available pursuant to this 35 appropriation for any drug not explicitly 36 authorized in any enacted law, rule, or 37 regulation without approval from the 38 director of the budget. 39 Notwithstanding any provision of law to the 40 contrary, the portion of this appropri- 41 ation covering fiscal year 2026-27 shall 42 supersede and replace any duplicative (i) 43 reappropriation for this item covering 44 fiscal year 2026-27, and (ii) appropri- 45 ation for this item covering fiscal year 46 2026-27 set forth in chapter 53 of the 47 laws of 2025 (26953) ....................... 359,630,000 48 For services and expenses of the medical 49 assistance program including transporta- 50 tion services. 51 Notwithstanding any provision of law to the 52 contrary, the portion of this appropri- 53 ation covering fiscal year 2026-27 shall 54 supersede and replace any duplicative (i) 55 reappropriation for this item covering

S. 10103 20

1 fiscal year 2026-27, and (ii) appropri- 2 ation for this item covering fiscal year 3 2026-27 set forth in chapter 53 of the 4 laws of 2025 (26954) ........................ 51,660,000 5 For services and expenses of the medical 6 assistance program including dental 7 services. 8 Notwithstanding any provision of law to the 9 contrary, the portion of this appropri- 10 ation covering fiscal year 2026-27 shall 11 supersede and replace any duplicative (i) 12 reappropriation for this item covering 13 fiscal year 2026-27, and (ii) appropri- 14 ation for this item covering fiscal year 15 2026-27 set forth in chapter 53 of the 16 laws of 2025 (26955) ........................... 395,000 17 For services and expenses of the medical 18 assistance program including non-institu- 19 tional and other spending. 20 The money hereby appropriated is available 21 for payment of liabilities heretofore 22 accrued or hereafter accrued. 23 Notwithstanding any inconsistent provision 24 of law, the money hereby appropriated may 25 be available for payments to any county or 26 public school districts associated with 27 additional claims for school supportive 28 health services. 29 Notwithstanding any provision of law to the 30 contrary, the portion of this appropri- 31 ation covering fiscal year 2026-27 shall 32 supersede and replace any duplicative (i) 33 reappropriation for this item covering 34 fiscal year 2026-27, and (ii) appropri- 35 ation for this item covering fiscal year 36 2026-27 set forth in chapter 53 of the 37 laws of 2025 (26956) ....................... 103,020,000 38 For services and expenses of the medical 39 assistance program including medical 40 services provided at state facilities 41 operated by the office of mental health, 42 the office for people with developmental 43 disabilities and the office of addiction 44 services and supports. 45 Notwithstanding any provision of law to the 46 contrary, the portion of this appropri- 47 ation covering fiscal year 2026-27 shall 48 supersede and replace any duplicative (i) 49 reappropriation for this item covering 50 fiscal year 2026-27, and (ii) appropri- 51 ation for this item covering fiscal year 52 2026-27 set forth in chapter 53 of the 53 laws of 2025 (26961) ....................... 480,770,000 54 --------------

55 Special Revenue Funds - Federal

S. 10103 21

1 Federal Health and Human Services Fund 2 Medicaid Direct Account - 25106

3 For services and expenses for the medical 4 assistance program, including administra- 5 tive expenses for local social services 6 districts, pursuant to title XIX of the 7 federal social security act or its succes- 8 sor program. 9 The moneys hereby appropriated are to be 10 available for payment of aid heretofore 11 accrued or hereafter accrued to munici- 12 palities, and to providers of medical 13 services pursuant to section 367-b of the 14 social services law, and for payment of 15 state aid to municipalities and to provid- 16 ers of family care where payment systems 17 through the fiscal intermediaries are not 18 operational. 19 Notwithstanding any inconsistent provision 20 of law, funding made available by these 21 appropriations shall support direct salary 22 costs and related fringe benefits within 23 the medical assistance program associated 24 with any minimum wage increase that takes 25 effect during the timeframe of these 26 appropriations, pursuant to section 652 of 27 the labor law. Each eligible organization 28 in receipt of funding made available by 29 these appropriations may be required to 30 submit written certification, in such form 31 and at such time the commissioner may 32 prescribe, attesting to the total amount 33 of funds used by the eligible organiza- 34 tion, how such funding will be or was used 35 for purposes eligible under these appro- 36 priations and any other reporting deemed 37 necessary by the commissioner. The amounts 38 appropriated herein may include advances 39 to organizations authorized to receive 40 such funds to accomplish this purpose. 41 Notwithstanding any other provision of law, 42 the money hereby appropriated may be 43 increased or decreased by interchange or 44 transfer, with any appropriation of the 45 department of health and the office of 46 medicaid inspector general and may be 47 increased or decreased by transfer or 48 suballocation between these appropriated 49 amounts and appropriations of the office 50 of mental health, office for people with 51 developmental disabilities, the office of 52 addiction services and supports, the 53 department of family assistance office of 54 temporary and disability assistance, 55 office of children and family services,

S. 10103 22

1 the department of financial services, 2 department of corrections and community 3 supervision, the office of information 4 technology services, the state university 5 of New York, the state education depart- 6 ment, and the state office for the aging 7 with the approval of the director of the 8 budget, who shall file such approval with 9 the department of audit and control and 10 copies thereof with the chairman of the 11 senate finance committee and the chairman 12 of the assembly ways and means committee. 13 Notwithstanding any inconsistent provision 14 of law, in lieu of payments authorized by 15 the social services law, or payments of 16 federal funds otherwise due to the local 17 social services districts for programs 18 provided under the federal social security 19 act or the federal food stamp act, funds 20 herein appropriated, in amounts certified 21 by the state commissioner of temporary and 22 disability assistance or the state commis- 23 sioner of health as due from local social 24 services districts each month as their 25 share of payments made pursuant to section 26 367-b of the social services law may be 27 set aside by the state comptroller in an 28 interest-bearing account in order to 29 ensure the orderly and prompt payment of 30 providers under section 367-b of the 31 social services law pursuant to an esti- 32 mate provided by the commissioner of 33 health of each local social services 34 district's share of payments made pursuant 35 to section 367-b of the social services 36 law. 37 Notwithstanding any inconsistent provision 38 of law to the contrary, funds shall be 39 made available to the commissioner of the 40 office of mental health or the commission- 41 er of the office of addiction services and 42 supports, in consultation with the commis- 43 sioner of health and approved by the 44 director of the budget, and consistent 45 with appropriations made therefor, to 46 implement allocation adjustment developed 47 by each such commissioner which shall 48 describe mental health or substance use 49 disorder services that should be developed 50 to meet service needs resulting from the 51 reduction of inpatient behavioral health 52 services provided under the medicaid 53 program, by programs licensed pursuant to 54 article 31 or 32 of the mental hygiene 55 law. Such programs may include programs 56 that are licensed pursuant to both article

S. 10103 23

1 31 of the mental hygiene law and article 2 28 of the public health law, or certified 3 under both article 32 of the mental 4 hygiene law and article 28 of the public 5 health law. 6 Notwithstanding any inconsistent provision 7 of law, the moneys hereby appropriated may 8 be available for payments associated with 9 the resolution by settlement agreement or 10 judgment of rate appeals and/or litigation 11 where the department of health is a party. 12 Notwithstanding any inconsistent provisions 13 of law, no expenditures shall be used for 14 the medical assistance program for any 15 expenses not explicitly authorized in law 16 without the approval of the director of 17 the budget. 18 For services and expenses of the medical 19 assistance program including hospital 20 inpatient services. 21 Notwithstanding any provision of law to the 22 contrary, the portion of this appropri- 23 ation covering fiscal year 2026-27 shall 24 supersede and replace any duplicative (i) 25 reappropriation for this item covering 26 fiscal year 2026-27, and (ii) appropri- 27 ation for this item covering fiscal year 28 2026-27 set forth in chapter 53 of the 29 laws of 2025 (26947) ....................... 303,540,000 30 For services and expenses of the medical 31 assistance program including hospital 32 outpatient and emergency room services. 33 Notwithstanding any provision of law to the 34 contrary, the portion of this appropri- 35 ation covering fiscal year 2026-27 shall 36 supersede and replace any duplicative (i) 37 reappropriation for this item covering 38 fiscal year 2026-27, and (ii) appropri- 39 ation for this item covering fiscal year 40 2026-27 set forth in chapter 53 of the 41 laws of 2025 (26948) ........................ 54,096,000 42 For services and expenses of the medical 43 assistance program including clinic 44 services. 45 Notwithstanding any provision of law to the 46 contrary, the portion of this appropri- 47 ation covering fiscal year 2026-27 shall 48 supersede and replace any duplicative (i) 49 reappropriation for this item covering 50 fiscal year 2026-27, and (ii) appropri- 51 ation for this item covering fiscal year 52 2026-27 set forth in chapter 53 of the 53 laws of 2025 (26949) ........................ 87,588,000 54 For services and expenses of the medical 55 assistance program including nursing home 56 services.

S. 10103 24

1 Notwithstanding any provision of law to the 2 contrary, the portion of this appropri- 3 ation covering fiscal year 2026-27 shall 4 supersede and replace any duplicative (i) 5 reappropriation for this item covering 6 fiscal year 2026-27, and (ii) appropri- 7 ation for this item covering fiscal year 8 2026-27 set forth in chapter 53 of the 9 laws of 2025 (26950) ....................... 450,960,000 10 For services and expenses of the medical 11 assistance program including other long 12 term care services. 13 Notwithstanding any provision of law to the 14 contrary, the portion of this appropri- 15 ation covering fiscal year 2026-27 shall 16 supersede and replace any duplicative (i) 17 reappropriation for this item covering 18 fiscal year 2026-27, and (ii) appropri- 19 ation for this item covering fiscal year 20 2026-27 set forth in chapter 53 of the 21 laws of 2025 (26951) ..................... 1,286,436,000 22 For services and expenses of the medical 23 assistance program including managed care 24 services including regional planning 25 activities of the finger lakes health 26 systems agency, including statewide coor- 27 dination and demonstration of best prac- 28 tices. The department shall make grants 29 within amounts appropriated therefor, to 30 assure high-quality and accessible primary 31 care, to provide technical assistance to 32 support financial and business planning 33 for integrated systems of care, and to 34 assist primary care providers in the 35 adoption, implementation, and meaningful 36 use of electronic health record technolo- 37 gy. 38 Notwithstanding any inconsistent provision 39 of law, rule, or regulation to the contra- 40 ry, funds appropriated herein shall not be 41 subject to article 6 of the financial 42 services law. 43 Notwithstanding any inconsistent provision 44 of law, rule, or regulation to the contra- 45 ry, funds appropriated herein shall only 46 be made available for applied behavior 47 analysis services if such services are 48 recommended by a health care or mental 49 health care practitioner authorized under 50 title eight of the education law who has 51 been designated as an applied behavior 52 analysis center of excellence provider by 53 the commissioner of health. 54 Notwithstanding any provision of law to the 55 contrary, the portion of this appropri- 56 ation covering fiscal year 2026-27 shall

S. 10103 25

1 supersede and replace any duplicative (i) 2 reappropriation for this item covering 3 fiscal year 2026-27, and (ii) appropri- 4 ation for this item covering fiscal year 5 2026-27 set forth in chapter 53 of the 6 laws of 2025 (26952) ..................... 1,569,872,000 7 For services and expenses of the medical 8 assistance program including pharmacy 9 services, provided, however, that no funds 10 shall be made available pursuant to this 11 appropriation for any drug not explicitly 12 authorized in any heretofore enacted law, 13 rule, or regulation without approval from 14 the director of the budget. 15 Notwithstanding any provision of law to the 16 contrary, the portion of this appropri- 17 ation covering fiscal year 2026-27 shall 18 supersede and replace any duplicative (i) 19 reappropriation for this item covering 20 fiscal year 2026-27, and (ii) appropri- 21 ation for this item covering fiscal year 22 2026-27 set forth in chapter 53 of the 23 laws of 2025 (26953) ....................... 472,876,000 24 For services and expenses of the medical 25 assistance program including transporta- 26 tion services. 27 Notwithstanding any provision of law to the 28 contrary, the portion of this appropri- 29 ation covering fiscal year 2026-27 shall 30 supersede and replace any duplicative (i) 31 reappropriation for this item covering 32 fiscal year 2026-27, and (ii) appropri- 33 ation for this item covering fiscal year 34 2026-27 set forth in chapter 53 of the 35 laws of 2025 (26954) ........................ 63,528,000 36 For services and expenses of the medical 37 assistance program including dental 38 services. 39 Notwithstanding any provision of law to the 40 contrary, the portion of this appropri- 41 ation covering fiscal year 2026-27 shall 42 supersede and replace any duplicative (i) 43 reappropriation for this item covering 44 fiscal year 2026-27, and (ii) appropri- 45 ation for this item covering fiscal year 46 2026-27 set forth in chapter 53 of the 47 laws of 2025 (26955) ......................... 7,344,000 48 For services and expenses of the medical 49 assistance program including noninstitu- 50 tional and other spending. 51 The money hereby appropriated is available 52 for payment of liabilities heretofore 53 accrued or hereafter accrued. 54 Notwithstanding any provision of law to the 55 contrary, the portion of this appropri- 56 ation covering fiscal year 2026-27 shall

S. 10103 26

1 supersede and replace any duplicative (i) 2 reappropriation for this item covering 3 fiscal year 2026-27, and (ii) appropri- 4 ation for this item covering fiscal year 5 2026-27 set forth in chapter 53 of the 6 laws of 2025 (26956) ....................... 719,220,000 7 Notwithstanding any inconsistent provision 8 of law, subject to the approval of the 9 director of the budget, upon submission of 10 an allocation adjustment from the commis- 11 sioner of health, the amount appropriated 12 herein, together with any available feder- 13 al matching funds, may be transferred or 14 suballocated to the office of mental 15 health, office of addiction services and 16 supports, office for people with develop- 17 mental disabilities, division of housing 18 and community renewal, New York state 19 housing trust fund corporation, and office 20 of temporary and disability assistance for 21 services and expenses related to providing 22 affordable housing. Any such spending 23 shall consider the geographical location 24 of the grants. 25 Notwithstanding any provision of law to the 26 contrary, the portion of this appropri- 27 ation covering fiscal year 2026-27 shall 28 supersede and replace any duplicative (i) 29 reappropriation for this item covering 30 fiscal year 2026-27, and (ii) appropri- 31 ation for this item covering fiscal year 32 2026-27 set forth in chapter 53 of the 33 laws of 2025 (29521) ....................... 384,616,000 34 --------------

35 § 10. Section 6 of chapter 98 of the laws of 2026, relating to making 36 appropriations for the support of government, as amended by chapter 106 37 of the laws of 2026, is amended to read as follows: 38 § 6. The amounts specified in this section, or so much thereof as 39 shall be sufficient to accomplish the purposes designated, is hereby 40 appropriated and authorized to be paid as hereinafter provided, to the 41 public officers and for the purposes specified, which amount shall be 42 available for the state fiscal year beginning April 1, 2026.

43 DEPARTMENT OF LABOR

44 AID TO LOCALITIES

45 UNEMPLOYMENT INSURANCE BENEFIT PROGRAM ..... [ 990,000,000 ] 1,020,000,000 46 --------------

47 Enterprise Funds 48 Unemployment Insurance Benefit Fund 49 Unemployment Insurance Benefit Account - 50650

S. 10103 27

1 For payment of unemployment insurance bene- 2 fits pursuant to article 18 of the labor 3 law or as authorized by the federal 4 government through the disaster unemploy- 5 ment assistance program, the emergency 6 unemployment compensation program, the 7 extended benefit program, the federal 8 additional compensation program or any 9 other federally funded unemployment bene- 10 fit program (34787) ........ [ 990,000,000 ] 1,020,000,000 11 --------------

12 § 11. Section 7 of chapter 98 of the laws of 2026, relating to making 13 appropriations for the support of government, as amended by chapter 106 14 of the laws of 2026, is amended to read as follows: 15 § 7. The amounts specified in this section, or so much thereof as 16 shall be sufficient to accomplish the purposes designated, is hereby 17 appropriated and authorized to be paid as hereinafter provided, to the 18 public officers and for the purposes specified, which amount shall be 19 available for the state fiscal year beginning April 1, 2026.

20 DEPARTMENT OF MENTAL HYGIENE

21 OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES

22 AID TO LOCALITIES

23 COMMUNITY SERVICES PROGRAM .................. [ 608,823,000 ] 615,555,000 24 --------------

25 General Fund 26 Local Assistance Account - 10000

27 For services and expenses of the community 28 services program, net of disallowances, 29 for community programs for people with 30 developmental disabilities pursuant to 31 article 41 of the mental hygiene law, 32 and/or chapter 620 of the laws of 1974, 33 chapter 660 of the laws of 1977, chapter 34 412 of the laws of 1981, chapter 27 of the 35 laws of 1987, chapter 729 of the laws of 36 1989, chapter 329 of the laws of 1993 and 37 other provisions of the mental hygiene 38 law. Notwithstanding any inconsistent 39 provision of law, the following appropri- 40 ation shall be net of prior and/or current 41 year refunds, rebates, reimbursements, and 42 credits. 43 Notwithstanding any other provision of law, 44 advances and reimbursement made pursuant 45 to subdivision (d) of section 41.15 and 46 section 41.18 of the mental hygiene law 47 shall be allocated pursuant to a plan and 48 in a manner prescribed by the agency head 49 and approved by the director of the budg-

S. 10103 28

1 et. The moneys hereby appropriated are 2 available to reimburse or advance locali- 3 ties and voluntary non-profit agencies for 4 expenditures made during local fiscal 5 periods commencing January 1, 2026, April 6 1, 2026 or July 1, 2026, and for advances 7 for the 3 month period beginning January 8 1, 2027. 9 Notwithstanding the provisions of article 41 10 of the mental hygiene law or any other 11 inconsistent provision of law, rule or 12 regulation, the commissioner, pursuant to 13 such contract and in the manner provided 14 therein, may pay all or a portion of the 15 expenses incurred by such voluntary agen- 16 cies arising out of loans which are funded 17 from the proceeds of bonds and notes 18 issued by the dormitory authority of the 19 state of New York. 20 Notwithstanding any other provision of law, 21 the money hereby appropriated may be 22 transferred to state operations and/or any 23 appropriation of the office for people 24 with developmental disabilities with the 25 approval of the director of the budget. 26 Notwithstanding any inconsistent provision 27 of law, moneys from this appropriation may 28 be used for state aid of up to 100 percent 29 of the net deficit costs of day training 30 programs and family support services. 31 Notwithstanding the provisions of section 32 16.23 of the mental hygiene law and any 33 other inconsistent provision of law, with 34 relation to the operation of certified 35 family care homes, including family care 36 homes sponsored by voluntary not-for-pro- 37 fit agencies, moneys from this appropri- 38 ation may be used for payments to purchase 39 general services including but not limited 40 to respite providers, up to a maximum of 41 14 days, at rates to be established by the 42 commissioner and approved by the director 43 of the budget in consideration of factors 44 including, but not limited to, geographic 45 area and number of clients cared for in 46 the home and for payment in an amount 47 determined by the commissioner for the 48 personal needs of each client residing in 49 the family care home. 50 Notwithstanding the provisions of subdivi- 51 sion 12 of section 8 of the state finance 52 law and any other inconsistent provision 53 of law, moneys from this appropriation may 54 be used for expenses of family care homes 55 including payments to operators of certi- 56 fied family care homes for damages caused

S. 10103 29

1 by clients to personal and real property 2 in accordance with standards established 3 by the commissioner and approved by the 4 director of the budget. 5 Notwithstanding any inconsistent provision 6 of law, moneys from this appropriation may 7 be used for appropriate day program 8 services and residential services includ- 9 ing, but not limited to, direct housing 10 subsidies to individuals, start-up 11 expenses for family care providers, envi- 12 ronmental modifications, adaptive technol- 13 ogies, appraisals, property options, 14 feasibility studies and preoperational 15 expenses. 16 Notwithstanding any inconsistent provision 17 of law except pursuant to a chapter of the 18 laws of 2025 authorizing a 2.6 percent 19 targeted inflationary increase, for the 20 period commencing on April 1, 2025 and 21 ending March 31, 2026 the commissioner 22 shall not apply any other inflationary 23 increases, cost of living type increases, 24 inflation factors, or trend factors for 25 the purpose of establishing rates of 26 payments, contracts or any other form of 27 reimbursement; provided that this shall 28 not prevent the commissioner from applying 29 prior adjustments for the purpose of 30 establishing rates resulting from a rebas- 31 ing of base year costs. 32 Notwithstanding section 6908 of the educa- 33 tion law and any other provision of law, 34 rule or regulation to the contrary, direct 35 support staff in programs certified or 36 approved by the office for people with 37 developmental disabilities, including the 38 home and community based services waiver 39 programs that the office for people with 40 developmental disabilities is authorized 41 to administer with federal approval pursu- 42 ant to subdivision (c) of section 1915 of 43 the federal social security act, are 44 authorized to provide such tasks as OPWDD 45 may specify when performed under the 46 supervision, training and periodic 47 inspection of a registered professional 48 nurse and in accordance with an authorized 49 practitioner's ordered care. 50 Notwithstanding any other provision of law 51 to the contrary, and consistent with 52 section 33.07 of the mental hygiene law, 53 the directors of facilities licensed but 54 not operated by the office for people with 55 developmental disabilities who act as 56 federally-appointed representative payees

S. 10103 30

1 and who assume management responsibility 2 over the funds of a resident may continue 3 to use such funds for the cost of the 4 resident's care and treatment, consistent 5 with federal law and regulations. 6 Funds appropriated herein shall be available 7 in accordance with the following: 8 Notwithstanding any inconsistent provision 9 of law, the director of the budget is 10 authorized to make suballocations from 11 this appropriation to the department of 12 health medical assistance program. 13 Notwithstanding any inconsistent provision 14 of law, and pursuant to criteria estab- 15 lished by the commissioner of the office 16 for people with developmental disabilities 17 and approved by the director of the budg- 18 et, expenditures may be made from this 19 appropriation for residential facilities 20 which are pending recertification as 21 intermediate care facilities for people 22 with developmental disabilities. 23 Notwithstanding the provisions of section 24 41.36 of the mental hygiene law and any 25 other inconsistent provision of law, 26 moneys from this appropriation may be used 27 for payment up to $250 per year per 28 client, at such times and in such manner 29 as determined by the commissioner on the 30 basis of financial need for the personal 31 needs of each client residing in voluntar- 32 y-operated community residences and volun- 33 tary-operated community residential alter- 34 natives, including individualized 35 residential alternatives under the home 36 and community based services waiver. The 37 commissioner shall, subject to the 38 approval of the director of the budget, 39 alter existing advance payment schedules 40 for voluntary-operated community resi- 41 dences established pursuant to section 42 41.36 of the mental hygiene law. 43 Notwithstanding any inconsistent provision 44 of law, moneys from this appropriation may 45 be used for the operation of clinics 46 licensed pursuant to article 16 of the 47 mental hygiene law including, but not 48 limited to, supportive and habilitative 49 services consistent with the home and 50 community based services waiver. 51 For the state and/or local share of medical 52 assistance services expenses incurred by 53 the department of health for the provision 54 of medical assistance services to people 55 with developmental disabilities (37835) .... 560,016,000

S. 10103 31

1 For services and expenses of the community 2 services program, net of disallowances, 3 for community programs for people with 4 developmental disabilities pursuant to 5 article 41 of the mental hygiene law, 6 and/or chapter 620 of the laws of 1974, 7 chapter 660 of the laws of 1977, chapter 8 412 of the laws of 1981, chapter 27 of the 9 laws of 1987, chapter 729 of the laws of 10 1989, chapter 329 of the laws of 1993 and 11 other provisions of the mental hygiene 12 law. Notwithstanding any inconsistent 13 provision of law, the following appropri- 14 ation shall be net of prior and/or current 15 year refunds, rebates, reimbursements, and 16 credits. 17 Notwithstanding any other provision of law, 18 advances and reimbursement made pursuant 19 to subdivision (d) of section 41.15 and 20 section 41.18 of the mental hygiene law 21 shall be allocated pursuant to a plan and 22 in a manner prescribed by the agency head 23 and approved by the director of the budg- 24 et. The moneys hereby appropriated are 25 available to reimburse or advance locali- 26 ties and voluntary non-profit agencies for 27 expenditures made during local fiscal 28 periods commencing January 1, 2026, April 29 1, 2026 or July 1, 2026, and for advances 30 for the 3 month period beginning January 31 1, 2027. 32 Notwithstanding the provisions of article 41 33 of the mental hygiene law or any other 34 inconsistent provision of law, rule or 35 regulation, the commissioner, pursuant to 36 such contract and in the manner provided 37 therein, may pay all or a portion of the 38 expenses incurred by such voluntary agen- 39 cies arising out of loans which are funded 40 from the proceeds of bonds and notes 41 issued by the dormitory authority of the 42 state of New York. 43 Notwithstanding any other provision of law, 44 the money hereby appropriated may be 45 transferred to state operations and/or any 46 appropriation of the office for people 47 with developmental disabilities with the 48 approval of the director of the budget. 49 Notwithstanding any inconsistent provision 50 of law, moneys from this appropriation may 51 be used for state aid of up to 100 percent 52 of the net deficit costs of day training 53 programs and family support services. 54 Notwithstanding the provisions of section 55 16.23 of the mental hygiene law and any 56 other inconsistent provision of law, with

S. 10103 32

1 relation to the operation of certified 2 family care homes, including family care 3 homes sponsored by voluntary not-for-pro- 4 fit agencies, moneys from this appropri- 5 ation may be used for payments to purchase 6 general services including but not limited 7 to respite providers, up to a maximum of 8 14 days, at rates to be established by the 9 commissioner and approved by the director 10 of the budget in consideration of factors 11 including, but not limited to, geographic 12 area and number of clients cared for in 13 the home and for payment in an amount 14 determined by the commissioner for the 15 personal needs of each client residing in 16 the family care home. 17 Notwithstanding the provisions of subdivi- 18 sion 12 of section 8 of the state finance 19 law and any other inconsistent provision 20 of law, moneys from this appropriation may 21 be used for expenses of family care homes 22 including payments to operators of certi- 23 fied family care homes for damages caused 24 by clients to personal and real property 25 in accordance with standards established 26 by the commissioner and approved by the 27 director of the budget. 28 Notwithstanding any inconsistent provision 29 of law, moneys from this appropriation may 30 be used for appropriate day program 31 services and residential services includ- 32 ing, but not limited to, direct housing 33 subsidies to individuals, start-up 34 expenses for family care providers, envi- 35 ronmental modifications, adaptive technol- 36 ogies, appraisals, property options, 37 feasibility studies and preoperational 38 expenses. 39 Notwithstanding any inconsistent provision 40 of law, moneys from this appropriation may 41 be used to fund continuity of care 42 services, family reimbursed respite, other 43 than personal services and direct housing 44 subsidies for people who are enrolled in 45 OPWDD's self-direction program, provided 46 any or all such costs are identified in a 47 self-direction budget approved by OPWDD. 48 Notwithstanding any inconsistent provision 49 of law except pursuant to a chapter of the 50 laws of 2025 authorizing a 2.6 percent 51 targeted inflationary increase, for the 52 period commencing on April 1, 2025 and 53 ending March 31, 2026 the commissioner 54 shall not apply any other inflationary 55 increases, cost of living type increases, 56 inflation factors, or trend factors for

S. 10103 33

1 the purpose of establishing rates of 2 payments, contracts or any other form of 3 reimbursement; provided that this shall 4 not prevent the commissioner from applying 5 prior adjustments for the purpose of 6 establishing rates resulting from a rebas- 7 ing of base year costs. 8 Notwithstanding section 6908 of the educa- 9 tion law and any other provision of law, 10 rule or regulation to the contrary, direct 11 support staff in programs certified or 12 approved by the office for people with 13 developmental disabilities, including the 14 home and community based services waiver 15 programs that the office for people with 16 developmental disabilities is authorized 17 to administer with federal approval pursu- 18 ant to subdivision (c) of section 1915 of 19 the federal social security act, are 20 authorized to provide such tasks as OPWDD 21 may specify when performed under the 22 supervision, training and periodic 23 inspection of a registered professional 24 nurse and in accordance with an authorized 25 practitioner's ordered care. 26 Notwithstanding any other provision of law 27 to the contrary, and consistent with 28 section 33.07 of the mental hygiene law, 29 the directors of facilities licensed but 30 not operated by the office for people with 31 developmental disabilities who act as 32 federally-appointed representative payees 33 and who assume management responsibility 34 over the funds of a resident may continue 35 to use such funds for the cost of the 36 resident's care and treatment, consistent 37 with federal law and regulations. 38 Funds appropriated herein shall be available 39 in accordance with the following: 40 Notwithstanding any other provision of law 41 to the contrary, funds appropriated herein 42 are available to reimburse in- and 43 out-of-state private residential schools, 44 pursuant to subdivision (c) of section 45 13.37-a and subdivision (g) of section 46 13.38 of the mental hygiene law, for costs 47 of supporting the residential and day 48 program services available to individuals 49 who are over the age of 21 years of age, 50 provided that the amount paid for residen- 51 tial services and/or maintenance costs is 52 net of any supplemental security income 53 benefit to which the individual receiving 54 services is eligible, and provided further 55 that funding for nonresidential services 56 will be in an amount not to exceed the

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1 maximum reimbursement for appropriate day 2 services delivered by the office for 3 people with developmental disabilities 4 certified or approved providers other than 5 in- and out-of-state private residential 6 schools, unless otherwise authorized by 7 the director of the budget. 8 Notwithstanding section 163 of the state 9 finance law, section 142 of the economic 10 development law, and article 41 of the 11 mental hygiene law, the commissioner of 12 the office for people with developmental 13 disabilities may make the funds appropri- 14 ated herein available as state aid, a loan 15 or a grant, pursuant to terms and condi- 16 tions established by the commissioner of 17 the office for people with developmental 18 disabilities, to cover a portion of the 19 development costs of private, public 20 and/or non-profit organizations, including 21 corporations and partnerships established 22 pursuant to the private housing finance 23 law and/or any other statutory provisions, 24 for supportive housing units that have 25 been set aside for individuals with intel- 26 lectual and developmental disabilities. 27 Further, the office for people with devel- 28 opmental disabilities shall have a lien on 29 the real property developed with such 30 state aid, loans or grants, which shall be 31 in the amount of the loan or grant, for a 32 maximum term of 30 years, or other longer 33 term consistent with the requirements of 34 another regulatory agency. 35 For services and expenses related to the 36 provision of residential services to 37 people with developmental disabilities 38 (37802) ...................... [ 28,333,000 ] 32,241,000 39 For services and expenses related to the 40 provision of day program services to 41 people with developmental disabilities 42 (37803) ....................... [ 6,960,000 ] 7,920,000 43 For services and expenses related to the 44 provision of family support services to 45 people with developmental disabilities 46 (37804) ....................... [ 7,830,000 ] 8,910,000 47 For services and expenses related to the 48 provision of workshop, day training and 49 employment services to people with devel- 50 opmental disabilities. Notwithstanding any 51 other provision of law, up to [ $66,700 ] 52 $75,900 of this appropriation may be 53 transferred to the New York State Educa- 54 tion Departments' Adult Career and Contin- 55 uing Education Services - Vocational Reha-

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1 bilitation (ACCES-VR) program to support 2 the LongTerm Sheltered Employment program 3 operated by FEDCAP Rehabilitation 4 Services, Inc. (37805) ....... [ 4,524,000 ] 5,148,000 5 For other services and expenses provided to 6 people with developmental disabilities 7 including but not limited to hepatitis B, 8 care at home waiver, epilepsy services, 9 Special Olympics New York, Inc. and volun- 10 tary fingerprinting (37806) ... [ 1,160,000 ] 1,320,000 11 --------------

12 § 12. Section 8 of chapter 98 of the laws of 2026, relating to making 13 appropriations for the support of government, as amended by chapter 106 14 of the laws of 2026, is amended to read as follows: 15 § 8. The amounts specified in this section, or so much thereof as 16 shall be sufficient to accomplish the purposes designated, is hereby 17 appropriated and authorized to be paid as hereinafter provided, to the 18 public officers and for the purposes specified, which amount shall be 19 available for the state fiscal year beginning April 1, 2026.

20 DEPARTMENT OF VETERANS' SERVICES

21 AID TO LOCALITIES

22 BLIND VETERAN ANNUITY ASSISTANCE PROGRAM ....................... 385,000 23 --------------

24 General Fund 25 Local Assistance Account - 10000

26 For payment of annuities to blind veterans 27 and eligible surviving spouses. Up to 28 $15,000 of this appropriation may be 29 transferred to state operations for admin- 30 istrative costs associated with this 31 program (54606) ................................ 385,000 32 --------------

33 VETERANS' BENEFITS ADVISING PROGRAM ............. [ 174,000 ] 198,000 34 --------------

35 Special Revenue Funds - Other 36 Homeless Veterans Assistance Fund 37 Homeless Veterans Assistance Account - 20204

38 For services and expenses related to home- 39 less veterans' housing (54815) .. [ 174,000 ] 198,000 40 --------------

41 § 13. No expenditure may be made from any appropriation in this act, 42 until a certificate of approval has been issued by the director of the 43 budget and a copy of such certificate shall have been filed with the 44 state comptroller, the chairman of the senate finance committee and the 45 chairman of the assembly ways and means committee provided, however,

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1 that any expenditures from any appropriation in this act made by the 2 legislature or judiciary shall not require such certificate.

3 § 14. All expenditures and disbursements made against the appropri- 4 ations in this act shall, upon final action by the legislature on appro- 5 priation bills submitted by the governor pursuant to article VII of the 6 state constitution for the support of government for the state fiscal 7 year beginning April 1, 2026, be transferred by the comptroller as 8 expenditures and disbursements to such appropriations for all state 9 departments and agencies, as applicable, in amounts equal to the amounts 10 charged against the appropriations in this act for each such department, 11 agency, and the legislature and the judiciary.

12 § 15. Severability clause. If any clause, sentence, paragraph, subdi- 13 vision, section or part of this act shall be adjudged by any court of 14 competent jurisdiction to be invalid, such judgment shall not affect, 15 impair, or invalidate the remainder thereof, but shall be confined in 16 its operation to the clause, sentence, paragraph, subdivision, section 17 or part thereof directly involved in the controversy in which such judg- 18 ment shall have been rendered. It is hereby declared to be the intent of 19 the legislature that this act would have been enacted even if such 20 invalid provisions had not been included herein.

21 § 16. This act shall take effect immediately and shall be deemed to 22 have been in full force and effect on and after April 1, 2026; provided, 23 however, that upon the transfer of expenditures and disbursements by the 24 comptroller as provided in section fourteen of this act, the appropri- 25 ations made by this act and subject to such section shall be deemed 26 repealed.

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