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Health, Department of

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Agency Web Site: https://www.health.ny.gov/Link to External Website

Mission

The mission of the Department of Health (DOH) is to ensure high quality health services are available to all New Yorkers. The Department is also the principal State agency that administers the Medicaid Program, the NY State of Health (NYSOH) Exchange, and other public health and health insurance programs.

The Department operates health care facilities including Helen Hayes Hospital, four veteran’s nursing homes, and the Wadsworth Centers for Laboratories and Research. In addition, DOH conducts oversight of health professionals and all other health care facilities to ensure that high quality, cost effective, health care alternatives are provided throughout the State.

Organization and Staffing

DOH is headed by a Commissioner, who is appointed by the Governor subject to Senate confirmation. The Agency is organized into five major business units: the Office of Public Health; the Office of Primary Care and Health Systems Management; Institutional Management; the NY State of Health; and the Office of Health Insurance Programs, which operates the Medicaid Program. Each of these business units contains multiple divisions and bureaus that work together to carry out DOH’s mission.

The workforce is spread out across the State, encompassing employees of the central office in Albany, four regional offices (located in Syracuse, New York City, Long Island, and Buffalo), the Wadsworth Center Public Health Laboratories, Helen Hayes Hospital (located in Haverstraw) as well as employees of the New York State Veterans’ Homes (located in Oxford, Queens, Batavia, and Montrose).

Major Programs

Child Health Plus (CHP)

CHP provides comprehensive health coverage for children up to age 19 with family incomes above Medicaid eligibility levels. Like Medicaid, CHP is administered by states with guidance from the Centers for Medicare and Medicaid Services (CMS) and is jointly funded by the Federal government and states. Currently, over 578,000 children in New York receive health coverage through CHP. Families with incomes below 222 percent of the Federal Poverty Level (FPL) receive free coverage for their children, while families with incomes over that threshold pay on a sliding scale of $15-$60/month per child. Enrollees in CHP receive primary, preventive, specialty, and inpatient care. The FY 2023 Enacted budget expanded benefits under CHP to align with Medicaid. These services include Children and Family Treatment and Support Services (CFTSS). Children’s Home and Community Based Services (HCBS), Assertive Community Treatment (ACT), and Residential Rehabilitation for Youth (RRSY).

Federal funding for the Children's Health Insurance Program (CHIP) has been reauthorized through FY 2027.

Elderly Pharmaceutical Insurance Coverage (EPIC)

The EPIC program provides drug coverage to income-eligible seniors aged 65 and older to supplement out-of-pocket Medicare Part D costs. This program serves approximately 293,000 seniors annually and is financed entirely with State funds, which are offset by revenues from fees paid by EPIC members and rebates from drug manufacturers for generic drugs.

The Federal Patient Protection and Affordable Care Act (ACA) provides a phase-out of the Medicare Part D coverage gap (ended January 2020). The closure of the coverage gap will result in Medicare Part D picking up a larger share of program costs that were previously covered in EPIC.

Essential Plan (EP)

The EP provides health coverage for individuals with family incomes between 138 and 250 percent of the Federal Poverty Level (FPL), and for individuals from 0-138 percent FPL who are lawfully present in the United States but do not qualify for Medicaid due to their immigration status. The program has been extraordinarily successful, enrolling over 1.4 million New Yorkers. The State receives Federal funding through the 1332 State Innovation Fund, based on the amount of Premium Tax Credits that would have been provided to individuals in the State under the ACA absent the waiver. Federal payments will be made as costs are incurred, and all Federal funds must be used for the purpose of implementing the waiver. The EP offers a comprehensive package of benefits which include primary, preventive, specialty, and inpatient care.

The FY 2026 Executive Budget makes significant investments to the Essential Plan that would reduce consumer costs and help to provide increased revenue to providers, including hospitals. These actions include:

Medicaid

Medicaid is a means-tested program that finances health care services to approximately 7 million low-income individuals and long-term care services for the elderly and disabled, primarily through payments to over 80,000 health care providers and more than 35 fully and partially capitated managed care plans. The Medicaid program is financed jointly by the State, the Federal Government, and local governments. Eligible services include inpatient hospital care, outpatient hospital services, clinics, nursing homes, managed care, prescription drugs, home care and services provided in a variety of community-based settings (including mental health, substance abuse treatment, developmental disabilities services, school-based services and foster care services).

NY State of Health (NYSOH)

Established in 2013 in accordance with the ACA, NY State of Health was built as a fully integrated marketplace across public and private programs including Medicaid, Child Health Plus, Essential Plan, and Qualified Health Plans. The Qualified Health Plans offered through NYSOH are significantly less expensive than those available prior to the creation of the marketplace, and it is the only place where consumers can qualify to get help paying for coverage through premium tax credits. NYSOH also has Federal authorization under Section 1332 of the ACA to operate the Essential Plan, which offers lower-income New Yorkers comprehensive benefits with no premium or annual deductible and very low-cost sharing.

Currently, over 6.7 million, or more than 1 in 3 New Yorkers, are enrolled in coverage through the marketplace. Commensurate with increased enrollment in NY State of Health, the number of uninsured New Yorkers has declined by over 1.3 million since 2010, and as of the end of 2023, the share of uninsured in New York remains below 5 percent.

New York has been among the top five states in keeping families and children enrolled in Medicaid during the Public Health Emergency unwind, according to a report released by the Centers for Medicare & Medicaid Services.

The Budget includes $608 million in total funding in FY 2026 for the operation of NYSOH.

Public Health

DOH promotes and protects the health of people and the communities where they live, learn, work, and play. These efforts work to prevent people from getting sick or injured and promote wellness. DOH staff are responsible for a wide range of public health issues including tracking disease outbreaks, educating the public about the health risks caused by alcohol and tobacco, and developing school nutrition programs. Major programs include:

Budget Highlights

The FY 2026 Executive Budget recommends $134.3 billion in appropriations for DOH, including $111.2 billion for Medicaid, $13.9 billion for Essential Plan, $7.7 billion for other public health programs, and $1.51 billion for capital projects. A $9.2 billion increase from the FY2025 Enacted budget. This year-to-year change primarily reflects statutory allowable growth in State Medicaid funding, increases related to funds collected and invested through the Healthcare Stability Fund, and increased federal resources programmed to the Essential Plan stemming from the 1332 Waiver expansion.

The Budget recommends a workforce of 6,217 full time equivalent employees (FTEs) for the Department. This is an increase of eight FTEs from the FY 2025 Budget. The increase of eight FTEs includes seven FTEs for DOH enforcement of the requirement that every hospital, regardless of DOH designation, provide access to trained forensic medical examiners to any survivor walking through an emergency room door, and one FTE to hire a forensic accountant to analyze data resulting from strengthened material transaction reporting requirements.

Major budget initiatives include:

Continuing the State Takeover of Local Medicaid Costs: In FY 2026, the State will assume nearly $8.3 billion in costs that would have otherwise been incurred by localities. This relief package to localities continues to grow by billions of dollars annually. Since 2015, the counties have saved $53.6 billion due to the local takeover.

Implement the Groundbreaking Medicaid 1115 Waiver Amendment: The Executive Budget continues to implement the groundbreaking amendment to New York’s Medicaid Section 1115 Demonstration, which allows the State to make investments in critical Medicaid initiatives that will improve health equity and strengthen efforts to build a health care system that benefits all New Yorkers.

The demonstration bundles a comprehensive series of actions to advance health equity, reduce health disparities, and improve access to primary and behavioral health care across the State, and will be supported through $7.5 billion in funding over the next three years.

Safety Net Hospital Transformation Program: The Budget invests an additional $1.3 billion in capital projects and operating resources to expand the existing Safety Net Transformation Program, which will promote the formation of partnerships with established hospital networks to improve the resilience of, and access to long-term safety-net institutions.

MCO Tax: In December 2024, the State secured CMS approval to implement a new Managed Care Organization (MCO) tax to leverage additional Federal resources. The Budget will utilize this funding for targeted investments and the sustainability of the Medicaid program across hospitals, nursing homes, and other critical services.

Reproductive Health: The Budget continues to build on prior actions to strengthen reproductive rights in New York, by providing a capital investment of $5 million to provide grants to eligible abortion care providers in support of capital projects that promote expanded reproductive health infrastructure, modernization of facilities and enhanced safety and security. In addition, the Budget includes $20 million provide a new flexible funding stream to allow providers to cover the full costs of medication abortion care and other abortion services.

Nutrition Program Funding: The Budget continues record-level investments for the Hunger Prevention and Nutrition Assistance Program (HPNAP) ($23.3 million) and Nourish NY Program ($5 million), maintaining their funding at the same levels as the previous fiscal year.

Expand Access to Nutrition Programs for Mothers and Children: The Budget will invest $9.5 million to support new enrollees in the State’s Women, Infants, and Children (WIC) program to meet the growing need for food and essential services.

Encourage Swimming and the Prevention of Drowning: The Budget provides $5 million to create a new program to provide free learn-to-swim lessons to children aged four and under. Working with community-based organizations, the Department of Health (DOH) will work with program participants to issue vouchers for swim lessons.

Ensuring Access to Emergency Medical Services. The Budget will invest $5.6 million directly to counties to develop their individual EMS plans with oversight under the Statewide EMS task force. The budget also includes legislation defining EMS as an essential service and requiring counties to ensure all residents have adequate access to these services.

For more information on this agency's budget recommendations located in the Executive Budget Briefing Book, click on the following link:

ALL FUNDS
APPROPRIATIONS
(dollars)
Category Available
FY 2025
Appropriations
Recommended
FY 2026
Change From
FY 2025
Reappropriations
Recommended
FY 2026
State Operations 3,750,523,000 3,755,811,000 5,288,000 4,025,789,000
Aid To Localities 120,794,356,786 129,036,046,115 8,241,689,329 190,379,559,242
Capital Projects 522,470,000 1,507,404,000 984,934,000 6,502,770,000
Total 125,067,349,786 134,299,261,115 9,231,911,329 200,908,118,242

ALL FUND TYPES
PROJECTED LEVELS OF EMPLOYMENT BY PROGRAM
FILLED ANNUAL SALARIED POSITIONS
Program FY 2025
Estimated FTEs
03/31/25
FY 2026
Estimated FTEs
03/31/26
FTE Change
Administration
General Fund 1,279 1,286 7
Special Revenue Funds - Federal 73 73 0
Special Revenue Funds - Other 118 118 0
Capital Projects Funds - Other 1 1 0
Child Health Insurance
Special Revenue Funds - Other 14 14 0
Center for Community Health
Special Revenue Funds - Federal 435 435 0
Special Revenue Funds - Other 58 58 0
Center for Environmental Health
Special Revenue Funds - Federal 79 79 0
Special Revenue Funds - Other 59 59 0
Capital Projects Funds - Federal 68 68 0
Capital Projects Funds - Other 50 50 0
Elderly Pharmaceutical Insurance Coverage
Special Revenue Funds - Other 8 8 0
Essential Plan
General Fund 6 6 0
Health Care Reform Act Program
Special Revenue Funds - Other 10 10 0
Institutional Management
Special Revenue Funds - Other 1,472 1,472 0
Capital Projects Funds - Other 51 51 0
Medical Assistance Administration
General Fund 907 907 0
Special Revenue Funds - Federal 807 807 0
Special Revenue Funds - Other 10 10 0
New York State of Health
Special Revenue Funds - Other 74 74 0
Office of Health Insurance Programs
Special Revenue Funds - Federal 4 4 0
Office of Primary Care and Health Systems Management
Special Revenue Funds - Federal 65 65 0
Special Revenue Funds - Other 345 346 1
Wadsworth Center for Laboratories and Research
Special Revenue Funds - Federal 44 44 0
Special Revenue Funds - Other 142 142 0
Capital Projects Funds - Other 30 30 0
Total 6,209 6,217 8

STATE OPERATIONS
ALL FUNDS FINANCIAL REQUIREMENTS BY FUND TYPE
APPROPRIATIONS
(dollars)
Fund Type Available
FY 2025
Recommended
FY 2026
Change
General Fund 734,731,000 748,531,000 13,800,000
Special Revenue Funds - Federal 2,590,956,000 2,599,182,000 8,226,000
Special Revenue Funds - Other 424,836,000 408,098,000 (16,738,000)
Total 3,750,523,000 3,755,811,000 5,288,000

STATE OPERATIONS
ALL FUNDS FINANCIAL REQUIREMENTS BY PROGRAM
APPROPRIATIONS
(dollars)
Program Available
FY 2025
Recommended
FY 2026
Change
AIDS Institute
Special Revenue Funds - Federal 600,000 600,000 0
Administration
General Fund 243,309,000 267,809,000 24,500,000
Special Revenue Funds - Federal 11,188,000 12,688,000 1,500,000
Special Revenue Funds - Other 30,643,000 30,643,000 0
Center for Community Health
Special Revenue Funds - Federal 226,313,000 228,456,000 2,143,000
Special Revenue Funds - Other 4,494,000 4,494,000 0
Center for Environmental Health
Special Revenue Funds - Federal 19,495,000 19,495,000 0
Special Revenue Funds - Other 8,862,000 8,862,000 0
Child Health Insurance
Special Revenue Funds - Federal 138,500,000 138,500,000 0
Special Revenue Funds - Other 18,507,000 18,507,000 0
Elderly Pharmaceutical Insurance Coverage
Special Revenue Funds - Other 13,250,000 13,250,000 0
Essential Plan
General Fund 95,343,000 95,343,000 0
Special Revenue Funds - Federal 695,343,000 695,343,000 0
Health Care Reform Act Program
Special Revenue Funds - Other 18,597,000 18,172,000 (425,000)
Institutional Management
General Fund 200,000 200,000 0
Special Revenue Funds - Other 191,111,000 191,111,000 0
Medical Assistance Administration
General Fund 395,879,000 385,179,000 (10,700,000)
Special Revenue Funds - Federal 856,060,000 860,643,000 4,583,000
Special Revenue Funds - Other 1,541,000 1,541,000 0
New York State of Health
Special Revenue Funds - Other 48,740,000 32,343,000 (16,397,000)
Office of Health Insurance Programs
Special Revenue Funds - Federal 603,491,000 603,491,000 0
Special Revenue Funds - Other 6,517,000 6,517,000 0
Office of Primary Care and Health Systems Management
Special Revenue Funds - Federal 26,353,000 26,353,000 0
Special Revenue Funds - Other 60,365,000 60,449,000 84,000
Wadsworth Center for Laboratories and Research
Special Revenue Funds - Federal 13,613,000 13,613,000 0
Special Revenue Funds - Other 22,209,000 22,209,000 0
Total 3,750,523,000 3,755,811,000 5,288,000

STATE OPERATIONS - GENERAL FUND
SUMMARY OF PERSONAL SERVICE APPROPRIATIONS AND CHANGES
FY 2026 RECOMMENDED
(dollars)
Program Total Personal Service Regular
(Annual Salaried)
Amount Change Amount Change
Administration 159,025,000 12,100,000 156,803,000 12,100,000
Essential Plan 5,452,000 0 5,415,000 0
Medical Assistance Administration 66,630,000 7,533,000 66,320,000 7,533,000
Total 231,107,000 19,633,000 228,538,000 19,633,000
STATE OPERATIONS - GENERAL FUND
SUMMARY OF PERSONAL SERVICE APPROPRIATIONS AND CHANGES
FY 2026 RECOMMENDED CONTINUED
(dollars)
Program Temporary Service
(Nonannual Salaried)
Holiday/Overtime Pay
Amount Change Amount Change
Administration 329,000 0 1,893,000 0
Essential Plan 0 0 37,000 0
Medical Assistance Administration 65,000 0 245,000 0
Total 394,000 0 2,175,000 0

STATE OPERATIONS - GENERAL FUND
SUMMARY OF NONPERSONAL SERVICE AND MAINTENANCE UNDISTRIBUTED
APPROPRIATIONS AND CHANGES
FY 2026 RECOMMENDED
(dollars)
Program Total Supplies and Materials
Amount Change Amount Change
Administration 108,784,000 12,400,000 7,808,000 0
Essential Plan 89,891,000 0 10,000 0
Institutional Management 200,000 0 0 0
Medical Assistance Administration 318,549,000 (18,233,000) 524,000 0
Total 517,424,000 (5,833,000) 8,342,000 0
STATE OPERATIONS - GENERAL FUND
SUMMARY OF NONPERSONAL SERVICE AND MAINTENANCE UNDISTRIBUTED
APPROPRIATIONS AND CHANGES
FY 2026 RECOMMENDED CONTINUED
(dollars)
Program Travel Contractual Services
Amount Change Amount Change
Administration 2,284,000 0 96,223,000 12,400,000
Essential Plan 23,000 0 89,850,000 0
Institutional Management 0 0 200,000 0
Medical Assistance Administration 300,000 0 316,625,000 (18,233,000)
Total 2,607,000 0 502,898,000 (5,833,000)
STATE OPERATIONS - GENERAL FUND
SUMMARY OF NONPERSONAL SERVICE AND MAINTENANCE UNDISTRIBUTED
APPROPRIATIONS AND CHANGES
FY 2026 RECOMMENDED CONTINUED
(dollars)
Program Equipment
Amount Change
Administration 2,469,000 0
Essential Plan 8,000 0
Medical Assistance Administration 1,100,000 0
Total 3,577,000 0

STATE OPERATIONS - OTHER THAN GENERAL FUND
SUMMARY OF APPROPRIATIONS AND CHANGES
FY 2026 RECOMMENDED
(dollars)
Program Total Personal Service
Amount Change Amount Change
AIDS Institute 600,000 0 0 0
Administration 43,331,000 1,500,000 16,131,000 0
Center for Community Health 232,950,000 2,143,000 66,639,000 700,000
Center for Environmental Health 28,357,000 0 13,282,000 0
Child Health Insurance 157,007,000 0 49,039,000 0
Elderly Pharmaceutical Insurance Coverage 13,250,000 0 2,275,000 0
Essential Plan 695,343,000 0 5,452,000 0
Health Care Reform Act Program 18,172,000 (425,000) 896,000 0
Institutional Management 191,111,000 0 120,836,000 0
Medical Assistance Administration 862,184,000 4,583,000 56,752,000 10,502,000
New York State of Health 32,343,000 (16,397,000) 4,680,000 (343,000)
Office of Health Insurance Programs 610,008,000 0 74,028,000 0
Office of Primary Care and Health Systems Management 86,802,000 84,000 40,093,000 84,000
Wadsworth Center for Laboratories and Research 35,822,000 0 16,163,000 0
Total 3,007,280,000 (8,512,000) 466,266,000 10,943,000
STATE OPERATIONS - OTHER THAN GENERAL FUND
SUMMARY OF APPROPRIATIONS AND CHANGES
FY 2026 RECOMMENDED CONTINUED
(dollars)
Program Nonpersonal Service
Amount Change
AIDS Institute 600,000 0
Administration 27,200,000 1,500,000
Center for Community Health 166,311,000 1,443,000
Center for Environmental Health 15,075,000 0
Child Health Insurance 107,968,000 0
Elderly Pharmaceutical Insurance Coverage 10,975,000 0
Essential Plan 689,891,000 0
Health Care Reform Act Program 17,276,000 (425,000)
Institutional Management 70,275,000 0
Medical Assistance Administration 805,432,000 (5,919,000)
New York State of Health 27,663,000 (16,054,000)
Office of Health Insurance Programs 535,980,000 0
Office of Primary Care and Health Systems Management 46,709,000 0
Wadsworth Center for Laboratories and Research 19,659,000 0
Total 2,541,014,000 (19,455,000)

AID TO LOCALITIES
ALL FUNDS FINANCIAL REQUIREMENTS BY FUND TYPE
APPROPRIATIONS
(dollars)
Fund Type Available
FY 2025
Recommended
FY 2026
Change
Fiduciary 150,000,000 150,000,000 0
General Fund 30,886,970,841 32,516,167,170 1,629,196,329
Special Revenue Funds - Federal 81,538,275,945 85,270,031,945 3,731,756,000
Special Revenue Funds - Other 8,219,110,000 11,099,847,000 2,880,737,000
Total 120,794,356,786 129,036,046,115 8,241,689,329

AID TO LOCALITIES
ALL FUNDS FINANCIAL REQUIREMENTS BY PROGRAM
APPROPRIATIONS
(dollars)
Program Available
FY 2025
Recommended
FY 2026
Change
AIDS Institute
General Fund 132,962,570 129,692,870 (3,269,700)
Special Revenue Funds - Federal 600,000 600,000 0
Administration
General Fund 266,000 266,000 0
Special Revenue Funds - Federal 0 1,500,000 1,500,000
Center for Community Health
General Fund 854,474,271 830,584,300 (23,889,971)
Special Revenue Funds - Federal 1,083,918,945 1,083,918,945 0
Special Revenue Funds - Other 6,165,000 6,927,000 762,000
Center for Environmental Health
General Fund 6,512,000 23,328,000 16,816,000
Special Revenue Funds - Federal 89,927,000 91,237,000 1,310,000
Special Revenue Funds - Other 14,560,000 9,560,000 (5,000,000)
Child Health Insurance
Special Revenue Funds - Federal 1,537,954,000 1,550,268,000 12,314,000
Special Revenue Funds - Other 1,106,789,000 1,312,385,000 205,596,000
Elderly Pharmaceutical Insurance Coverage
Special Revenue Funds - Other 93,217,000 93,217,000 0
Essential Plan
General Fund 1,000,000 1,000,000 0
Special Revenue Funds - Federal 11,602,403,000 13,098,000,000 1,495,597,000
Health Care Reform Act Program
Special Revenue Funds - Other 363,070,000 317,525,000 (45,545,000)
Medical Assistance
General Fund 29,085,592,000 30,465,261,000 1,379,669,000
Special Revenue Funds - Federal 66,181,823,000 68,127,858,000 1,946,035,000
Special Revenue Funds - Other 6,608,689,000 9,333,613,000 2,724,924,000
Medical Assistance Administration
General Fund 771,550,000 1,046,550,000 275,000,000
Special Revenue Funds - Federal 720,650,000 995,650,000 275,000,000
Office of Health Insurance Programs
General Fund 9,279,000 120,000 (9,159,000)
Special Revenue Funds - Federal 320,000,000 320,000,000 0
Special Revenue Funds - Other 2,930,000 2,930,000 0
Office of Primary Care and Health Systems Management
Fiduciary 150,000,000 150,000,000 0
General Fund 19,758,000 13,878,000 (5,880,000)
Special Revenue Funds - Federal 1,000,000 1,000,000 0
Special Revenue Funds - Other 12,560,000 12,560,000 0
Wadsworth Center for Laboratories and Research
General Fund 5,577,000 5,487,000 (90,000)
Special Revenue Funds - Other 11,130,000 11,130,000 0
Total 120,794,356,786 129,036,046,115 8,241,689,329

CAPITAL PROJECTS
ALL FUNDS FINANCIAL REQUIREMENTS BY PROGRAM
APPROPRIATIONS
(dollars)
Comprehensive Construction Program Available
FY 2025
Recommended
FY 2026
Change Reappropriations
FY 2026
All Payers Claims Database
Capital Projects Fund - HCRA 10,000,000 10,000,000 0 0
Capital Restructuring Program for Health Care and Related Facilities
Capital Projects Fund - Authority Bonds 0 0 0 292,429,000
Economic Development
Capital Projects Fund - Authority Bonds 0 0 0 1,660,114,000
Facilities Maintenance and Operations
Capital Projects Fund 12,266,000 9,000,000 (3,266,000) 0
Health Care Data Modernization
Capital Projects Fund - HCRA 0 0 0 30,000,000
Health Care Facility Transformation Program
Capital Projects Fund - Authority Bonds 0 1,000,000,000 1,000,000,000 3,273,571,000
IT Initiatives Program
Health Care IT Capital 10,000,000 10,000,000 0 10,000,000
Laboratories and Research
Capital Projects Fund 12,000,000 10,000,000 (2,000,000) 31,827,000
Maintenance and Improvements of Existing Institutions
Capital Projects Fund 7,600,000 12,600,000 5,000,000 36,176,000
Capital Projects Fund - HCRA 55,304,000 51,304,000 (4,000,000) 0
Reproductive Healthcare Improvement Program
Capital Projects Fund - Authority Bonds 18,300,000 15,000,000 (3,300,000) 18,300,000
Statewide Health Information Network For New York
Capital Projects Fund - HCRA 35,000,000 35,000,000 0 0
Veterans Affairs
Federal Capital Projects Fund 0 0 0 5,913,000
Water Resources
Capital Projects Fund 2,000,000 2,000,000 0 4,000,000
Capital Projects Fund - Authority Bonds 30,000,000 30,000,000 0 63,479,000
Federal Capital Projects Fund 330,000,000 322,500,000 (7,500,000) 1,076,961,000
Total 522,470,000 1,507,404,000 984,934,000 6,502,770,000

Note: Most recent estimates as of 01/21/2025