Fay began her career with the National MS Society in 1977. She has worked for the National Capital Chapter in Washington, D.C. in development; New York NMSS headquarters in management; and the Blue Ridge Chapter in Programs. Since 1985, Fay has served as the Chapter President. Over the years, Fay has worked with a number of other groups serving people with cerebral palsy, learning disabilities, spinal cord injury, autism, mental retardation, and terminal illnesses.