August 2016 20 Questions: Ben Moore III, River Hospital

Critical care redefined

River Hospital CEO Ben Moore III in talks about the future of health care in the north country in his Alexandria Bay office last month. Photo by Stephen Swofford, NNY Business.

River Hospital CEO Ben Moore III in talks about the future of health care in the north country in his Alexandria Bay office last month. Photo by Stephen Swofford, NNY Business.

Alexandria Bay’s River Hospital finds its niche in changing landscape

For River Hospital the last 10 years since Ben Moore III became CEO has been a transitional period as it experienced financial challenges, backlash from the Medicaid reimbursement changes, and then growth with the help of programs like the outpatient program for soldiers with PTSD coordinated with Fort Drum and TRICARE. Mr. Moore sat down with us this month to discuss how River Hospital overcame the challenges facing it and the future for the hospital and the north country’s health care industry as a whole. [Read more…]

May 2016 Cover Story: Economic Development

Securing a stronger future for the north country

COR Development’s Mercy Health Center Redevelopment project is set to begin its first phase of construction this summer on 30,000 square feet of commercial space and 108 apartments. Overall, the project will house 168 units and a community center on the grounds of the former Mercy Hospital in Watertown. Photo by Stephen Swofford, NNY Business.

COR Development’s Mercy Health Center Redevelopment project is set to begin its first phase of construction this summer on 30,000 square feet of commercial space and 108 apartments. Overall, the project will house 168 units and a community center on the grounds of the former Mercy Hospital in Watertown. Photo by Stephen Swofford, NNY Business.

Despite workforce challenges, regional economic development continues to power positive growth across Northern New York

By Karee Magee, NNY Business

A rural and historically challenged region where economic development was often stagnant, the Great Recession dealt a significant blow to New York’s north country as its counties saw a spike in unemployment and manufacturing jobs disappear, including about 600 from Jefferson County alone. [Read more…]

Number of uninsured New Yorkers dropped significantly in 2015

The number of New Yorkers without health insurance dropped significantly last year, according to a National Center for Health Statistics study released last week. [Read more…]

Stefanik says health care reform coming

 

LAKE PLACID — U.S. Rep. Elise M. Stefanik spoke with members of the Medical Society of the State of New York on Saturday at Lake Placid about a Republican-led effort to reform the Affordable Care Act.

The Mirror Lake Inn’s conference room was filled with about two dozen doctors and health care professionals eager to hear the congresswoman’s perspective and to offer their own input on the state of health care. Ms. Stefanik, 30, a Republican from Willsboro who has been on the job for about three weeks, addressed the room for several minutes about her health care goals, and afterward there was a more extensive question-and-answer period.

Ms. Stefanik said her goals include having both high-quality and cost-effective treatment, and increasing health care accessibility for rural communities. Because “health care is a complicated issue,” Ms. Stefanik said she would make an effort to reach out to hospitals, patients and physicians.

“These groups need to be represented,” Ms. Stefanik said.

David Welch, a doctor from Saranac Lake, told Ms. Stefanik that making “little repairs to a broken system clearly isn’t working” and said that a whole new approach to health care is needed.

“Now that we have a new Congress fully controlled by one party, what kind of new concepts are coming up?” Mr. Welch asked.

Ms. Stefanik said there is not a specific health care replacement package being presented by Republicans yet, but it will happen.

“I think the most important part of formulating a replacement package is making sure that you have input from physicians, from hospitals,” Ms. Stefanik said. “I think that over the course of 2015 you will see a replacement package.”

“I think there is going to be a willingness to work with Democrats, something that I think was a failure of the Obama administration,” she added. “Certainly, I believe the Republicans have a responsibility to put forth a replacement package.”

Ms. Stefanik told the group she was optimistic about the repeal of the Medical Device Tax, which is an excise tax on the sale of certain medical devices. She said a repeal of the tax has bipartisan support and likely would pass the House and Senate.

“It’s strategically smart for Obama to approve,” she said.

There are several medical device companies within the 21st Congressional District, which Ms. Stefanik represents. The repeal of the medical tax was a campaign issue on which she ran.

Ms. Stefanik, when asked about medical malpractice lawsuit reform, said the Republican leadership, such as Rep. Paul Ryan, R-Wis., want to make sure “tort reform is part of the package.”

Some doctors also raised concerns about “confusing” medical diagnostic codes to describe a patient’s injury and how the doctor treated it. The system existed before the ACA, but the act added thousands of new codes, which some doctors said was an added burden.

“We are given X amount of time to see a patient, and now I need to take 20 minutes to figure out the code,” said Hal Sokol, a pulmonary critical care doctor from Albany.

After the meeting, some of the doctors in the room expressed approval of Ms. Stefanik’s remarks. A few of them described the group of doctors as being conservative-leaning.

Robert Hughes, a doctor from Queensbury, said he thought Ms. Stefanik was “very astute” and “perceptive of the reality of what is going on right now.”

Dr. Sokol said he was a lot more impressed than he thought he would be.

“I think she really cares,” Dr. Sokol said.

John Kennedy, a doctor from Schenectady, told the room that Ms. Stefanik and his daughter were high school classmates at the Albany Academy for Girls.

“Two years ago my daughter said, ‘My friend Elise is the real thing; she ought to run for Congress,’” Dr. Kennedy said.

Dr. Welch said he was concerned that Republicans are still creating a plan but added that it’s also an opportunity to get health care right.

“Republicans have spent the last two years saying no, and now they have to come forward with something positive,” Dr. Welch said. “My concern is they don’t have a plan yet.”

 

By Matthew Turner, Adirondack Daily Enterprise

Tax preparers brace for busy season as short-staffed IRS to leave phone calls unanswered

Tax preparers expect to be inundated with questions from clients about the Affordable Care Act that the short-staffed IRS won’t be able to answer this tax season, which officially starts today.

The much-maligned federal agency, which has 13,000 fewer employees than it did in 2010, won’t have the ability to handle all of the phone calls and mail it’s expected to get this tax season,according to a report last week from the national taxpayer advocate Nina Olson. The report found that the agency will be able to handle only 43 percent of U.S. taxpayers’ phone calls; the IRS itself estimated it could handle 54 percent of its calls.

In some cases, that conundrum will be a boon for tax preparers because more people are expected to turn to professionals to complete their returns to ensure they’re accurate, according to John J. Gray Jr., CPA and managing partner for Hoffman, Eells & Gray CPAs, Canton. But he said staffing woes at the IRS, which has been severely underfunded because of budget cuts, makes it more challenging to serve clients in some cases.

“The IRS has a tax professional hotline, and it’s now taking two to three hours to get a person on that line,” Mr. Gray said, adding that clients often have issues with past tax returns that can be resolved only by the IRS.

He said wait times previously were about three to five minutes on that hotline until about a year and a half ago, when they began to balloon.

“I don’t know what’s going to happen with the latest budget cuts to the IRS, because it’s already bad, and I don’t know if it can be much worse,” Mr. Gray said. “If we have a priority and can’t get answers on the hotline, there’s no way they’re going to get answers on the general public line.”

Each customer service call will cost the IRS $42.33, up from $33.21 in 2013, and wait times will be as long as 19 minutes to talk with an IRS representative, according to the report from the national taxpayer advocate. And letters are expected to go unanswered, as the agency will be able to handle 1.9 million fewer letters than last year.

Faced with uncertainty over the new individual health insurance requirement under the Affordable Care Act, Mr. Gray said he expects more clients to do business this season with the firm, which also has locations in Franklin, Essex and Clinton counties. He said the Canton firm hired two full-time tax preparers for the season to prepare for extra traffic.

“People who have health insurance but don’t file the forms correctly might have to pay a penalty,’ he said. “If you don’t tell the IRS that you have coverage in place, that penalty is going to appear on your return and result in more balance due and less of a refund.”

Because of the health care rollout, the firm has “already had new clients who have asked to come on board before tax season started,” he said.

CLEARING HEALTH CARE CONFUSION

Along with their W-2 form, new enrollees in the ACA will have to file a 1095-A with their tax return this season. And that change is expected to throw some taxpayers off-guard, said JoAnn St. Croix, franchisee of H&R Block who owns offices in Watertown, Evans Mills, Carthage, Adams and Fort Drum.

“People will need to make sure they have health insurance and are able to acquire it if they don’t have it — either through the marketplace, Medicare, an employer or privately,” she said.

All tax professionals at H&R Block have received training to handle health-insurance questions.

Ms. St. Croix estimated that about 20 to 25 percent of people in the north country might not be covered with health insurance this year. She said that although the fine for being uninsured this year is expected to be “relatively small,” it will continue to increase in coming years. The fines are based on personal income and household members, she said.

“Next year, fines will double, and for each year you don’t have health insurance, they will go up,” she said.

Due to changes from the ACA, Ms. St. Croix said, the firm expects to spend a lot more time answering questions about tax returns this season.

“We’ll help anyone with questions, but the expectation that we can help everyone is not realistic,” she said, adding that she expects the firm to be busier as a result of the staffing crunch at the IRS. “But I do believe that because the IRS is being up front about (the problem), people will realize that these aren’t issues they’ve incurred on their own. It’s not a problem with their tax return as much as it is the IRS not being able to handle the volume of calls they used to.”

H&R Block expects to increase its client portfolio by about 10 percent this season in the north country, largely as a result of confusion over the ACA, Ms. St. Croix said.

Michael Crowley, CPA, principal of Crowley & Halloran CPAs in Watertown, said the firm hopes to expand its client size by 10 to 15 percent this season because of new requirements on tax returns introduced by the ACA. He said the IRS’s inability to handle questions is expected to spur more people to seek professional help.

“People that call up the IRS are going to be waiting more, and it means clients will have more questions for us,” Mr. Crowley said. “For the general populace, they’re kind of stuck if they’re not using a tax preparer. … This is the first year of the rollout with the individual mandate for health care, and there may be a large number of people who don’t know about it and want to get their taxes prepared this year.”

It’s a trend that Mr. Crowley said all tax preparers are hoping to capitalize on by expanding their number of clients.

“If we could get another 60 to 65 clients this year, we would be happy,” he said.

Nathaniel J. Carroll, tax accountant and CPA for Bowers & Co. CPAs in Watertown, said he doesn’t expect the ACA will be a major hurdle for taxpayers to handle on their tax returns.

“It boils down to two questions: Were you covered for the year and did you receive any subsidy from the act during the year? It’s just a matter of educating your clients,” he said. “That said, a large portion of the effect is more hype than anything else. It’s probably going to affect less than one out of five people.”

 

 

By Ted Booker, Times Staff Writer

Congressional candidates weigh in on health care

Healthcare has proven to be a contentious issue in the race for New York’s 21st Congressional District, with all three candidates voicing displeasure with the Affordable Care Act, even as its provisions, once advanced as theoretical solutions, solidify into reality.

But the three candidates — Republican and Conservative nominee Elise M. Stefanik, Democrat and Working Families Party nominee Aaron G. Woolf and Green Party candidate Matthew J. Funiciello — have very different takes on how to fix the nation’s healthcare system.

For Ms. Stefanik, it’s a full repeal of President Barack Obama’s signature healthcare legislation, though the candidate, a former White House aide who lives in Willsboro, also acknowledged she would be willing to look at “immediate fixes” to the law in the meantime.

“I’ve made very clear since the beginning of the campaign that I would have voted no on Obamacare,” Ms. Stefanik said, using the term favored by Republicans. “I support the repeal but I feel that it is important to put forth what a comprehensive health care package would look like and, in the meantime, talk about those immediate fixes.”

To that end, Ms. Stefanik put forward a series of proposals last week to replace the law or at least temporarily fix the parts of it she said aren’t working well.

In contrast to Ms. Stefanik’s position, Mr. Woolf’s refusal to say whether he would have voted for the law have become a mini-theme on the campaign trail lately, cropping up at events centered on entirely different topics, as during a news conference on women’s issues last week in Watertown.

But from Mr. Woolf’s perspective, it is a “hypothetical” question that doesn’t pertain to his plans to fix certain parts of the law.

“Everyone knows where I stand on this piece of legislation,” Mr. Woolf, a documentary filmmaker with a home in Elizabethtown said. “This is what we have before us. And I think one of the things that characterizes a lot of the way I approach the world politically is fixing what we have before us.”

For his part, Mr. Funiciello, a bakery and cafe owner from Glens Falls, railed against the Affordable Care Act, calling it “anti-worker.” He advocated for a single-payer healthcare system in which the government would pay for all medical services.

“I think the ACA, to put it mildly, is the most anti-worker bill that has been passed in the United States since NAFTA and GATT were railroaded through by the corporate parties,” Mr. Funiciello said, referring to the North American Free Trade Agreement and the General Agreement on Tariffs and Trade. “That one destroying our manufacturing base and this one forcing the working poor to buy for-profit health insurance. And the injustice and the brutality of that is that we are already supporting the healthcare infrastructure to the tune of 60 percent.”

Citing an article titled “Paying for National Health Insurance — And Not Getting It” published in Health Affairs by Steffie Woolhandler and David U. Himmelstein in 2002, Mr. Funiciello said that moving to a single-payer model would not be as onerous on taxpayers as previously thought.

The three candidates are running to replace Rep. William L. Owens, D-Plattsburgh, who is not seeking re-election. As one of his first acts in office, Mr. Owens voted for the Affordable Care Act — a position he spent the following two election cycles defending.

Ms. Stefanik and Mr. Woolf both agreed on repealing the medical device tax but differed on most every other point.

For instance, Ms. Stefanik said she would look to protect those with pre-existing conditions by continuing to allow states to fund the “high risk pools” that provide insurance coverage for some individuals who do not qualify for other plans. The Woolf campaign attacked this idea as one that would return the health insurance marketplace to a system where working families suffer under high deductibles.

On purchasing health care across state lines:

“It would expand choices and lower costs. Right now in this district, especially in the Clinton County, Essex County area, even Franklin County, there are limited options. But if you go across to Vermont, there are many more options in the Burlington area, so again, I think it’s rethinking how we focus on a 21st century economy,” Ms. Stefanik said.

“I also think its reflective of people of our age group who move around more frequently as opposed to our parents’s or grandparents’s generation. It allows healthcare coverage to be portable in a way it hasn’t before but ultimately that will help lower costs for everyone because you’re allowing the free market to thrive,” said Ms. Stefanik, who recently turned 30.

In a statement, the Woolf campaign said that Ms. Stefanik’s proposal would hobble states with strong patient and consumer protections in favor of states with weaker protections, ignores the varying rates of healthcare costs by geography and fails to take into account the fact that the Affordable Care Act allows for regulated cooperation over interstate purchasing.

On addressing tort reform and reducing so-called “frivolous lawsuits”:

“The cost of medical malpractice liabilities are rising so high, it’s forcing the practice of defensive medicine at the physician base but also for hospitals, and it’s ultimately driving the cost up for consumers. I think the way you can address tort reform is having a cap on what those lawsuits, basically more protection for our physicians, I think, so they’re avoiding driving up those costs and practicing defensive medicine,” Ms. Stefanik said.

“I’m all too aware how easy it is to sue a physician and the pressures our physicians are facing, seeing patients for 7 to 15 minutes, it’s all that much easier for somebody to find an error,” Mr. Woolf said. “I think it’s facile to say ‘tort reform’ as just kind of a blanket statement. We need to cut down on frivolous lawsuits but we need to make sure we have a system of justice when things go wrong.”

The employer mandate:

“Basically it incentivizes businesses to not hire above the 50 employee number… I think we should be encouraging companies to grow. I’ve heard from a number of companies who are at the cusp who are not hiring those additional three or four people because they don’t want to be above the line,” Ms. Stefanik said.

According to Yianni Varonis, Mr. Woolf’s spokesman, Mr. Woolf wants to give businesses enough time to meet the employer mandate and would be open to delaying the implementation of the rule further.

Mr. Woolf would also like to extend tax credits offered to businesses with 25 or fewer employees who offer health insurance to those who employ between 25 and 50 people, Mr. Varonis said in an email.

Mr. Woolf also proposed creating another, more affordable category for individuals who are purchasing health insurance on a state marketplace — something that would, for instance, fall below the “Bronze” plan on the New York state exchange.

On the Affordable Care Act

“I believe that everyone should have access to affordable healthcare and Obamacare is not moving us in that direction. I think that’s become pretty clear to any candidate you speak to… That’s an important vote, it’s not a hypothetical. It’s a vote that actually came up in Congress and it’s a vote that our current member of Congress voted the day after he was sworn into Congress. It’s one of the top issues in this election cycle. I think it’s an important issue to stake where you are,” Ms. Stefanik said.

“I absolutely agree that people have a right to healthcare. I feel like, when you’re sick you should be able to go to a doctor. I think what we have to do is continually tweak and improve a system that allows that to happen. I think there are particular challenges with rural healthcare delivery, I think this district has particular challenges but I think what we have is a significant number of residents who were previously uninsured that now have quality affordable healthcare and that’s an important step,” Mr. Woolf said.

By Daniel Flatley, Times Staff Writer

Seminar on Affordable Care Act set for Tuesday in Watertown

Benefit Services Group will host a free seminar on the federal Affordable Care Act for the general public from 7 to 9 p.m. Tuesday at the Italian American Civic Association, 192 Bellew Ave.

Paul J. DiFabion Jr., company president, said the objective is to explain to people what their requirements are and what options they have for health insurance coverage. Medicare and Medicaid subscribers need not attend, he said.

-Watertown Daily Times

Carthage seminar will focus on Affordable Care Act

How will the Affordable Care Act affect area businesses? The Carthage Area Chamber of Commerce will host a seminar for business owners to help answer that question.

The free seminar will be from 9 to 11 a.m. Oct. 17 at Meadowbrook Terrace Assisted Living Facility, 21957 Cole Road. The interactive seminar is designed to prepare employers for the changes that will be implemented under the health care law.

Topics to be discussed include the status of the state marketplaces, the definition of full-time employees, affordability and an overview of the new law.

Michael Grinnell of First Niagara Bank will facilitate the program.

Space is limited. To sign up, call Cheryl Schroy at 575-4999 or send an email to cheryl.schroy@fnfg.com.

-Watertown Daily Times

Health insurance marketplace open enrollment begins Tuesday

Northern New York residents who are uninsured or who do not have affordable health coverage will be able to choose an appropriate, affordable plan that fits their needs, beginning Tuesday.

On that date, a six-month open enrollment period begins through the NY State of Health, an online tool people may use to compare and shop for health insurance coverage. This is a part of the federal Affordable Care Act.

Kyle R. Kotary, director of external affairs, outreach and marketing, said people can enroll online, via telephone or in person through marketplace navigators. Navigator roles are held locally by ACR Health, the North Country Prenatal/Perinatal Council, the Health Initiative of St. Lawrence County and the Greater Watertown-North Country Chamber of Commerce.

“New Yorkers will be able to select from any of the 16 qualified health insurers and 10 dental insurers across four levels of plans — bronze, silver, gold or platinum,” Mr. Kotary said.

Residents who do not have insurance, those who pay for unaffordable insurance — when premiums total more than 9.5 percent of annual income, and those who experience specific life-changing events, such as having a baby or getting married, can shop for insurance through the marketplace. People who are insured, but pay less than 9.5 percent cap, will remain in their plans.

To help local residents decide which options are the best for them, NYS State of Health has contracted with the four local organizations to provide step-by-step guidance.

“We can’t help them choose a plan, but can show them their options,” said Steve Wood, community health coordinator of Community Health Advocates, a program offered through ACR Health. “A big part of our job is showing the plans and processing through that.”

ACR Health, he said, already receives about 20 calls daily about the setup, and now navigators are just waiting for Tuesday to get here.

Mr. Wood said a navigator’s role will be to have a brief conversation on why it’s important to have health insurance, take down the client’s personal information, plug that into the system and go through plans that come up.

Donna Hynes, insurance program coordinator at North Country Prenatal/Perinatal Council, said people can mull over information after their appointment, and either go back online and select a plan or come back to a navigator and have that person help them finish up with the process.

Mr. Wood said aside from the five-year navigator contracts, agencies expect to be even more busy continuing to enroll people in Medicaid and Child Health Plus throughout the year.

Since the entire system is new, Mrs. Hynes said, she does not know how long appointments will take, nor the extent of how busy or booked navigators will be. She said the council has more than 300 letters going out to people within Jefferson and Lewis counties who have been waiting for Tuesday to arrive.

“So many people need coverage,” she said.

That includes small businesses and their employees. Lynn M. Pietroski, chief executive officer and president of the Greater Watertown-North Country Chamber of Commerce, said the organization’s Small Business Assistance program has helped educate small businesses regarding their options since March.

“This is one of the largest initiatives in New York state, and what better way to be than to be a conduit to businesses and community members,” Mrs. Pietroski said. “If people come here and see us as a resource, then we’ve fulfilled our mission. The unknown is awful, but there’s a lot of things in place that will help with those unknowns.”

For more information, contact the NYS State of Health at 855-355-5777 or www.nystateofhealth.ny.gov; ACR Health at 475-2430 or www.aidscommunityresources.com; North Country Prenatal/Perinatal Council at 788-8533 or www.ncppc.org; the Health Initiative at 261-4760 or www.gethealthslc.org, or the chamber at 788-4400 or www.watertownny.com.

-Rebecca Madden, Watertown Daily Times

CCE to hold ACA workshops in 6 north country locations in Sept.

The Cornell Cooperative Extension Associations of Northern New York will hold free workshops at six north country sites in September to help farmers, small business owners and individuals navigate the changes created by the federal healthcare overhaul. The workshops will address questions on a wide range of topics, including exchanges for both small business owners and individuals, which are slated to open Oct. 1 in New York state.

CCE is one of 34 organizations working in partnership with New York City-based nonprofit Community Service Society to help disseminate information about the Affordable Care Act.

Pre-registration for the workshops is requested by Sept. 20. The dates of the workshops are as follows:

Plattsburgh

Tuesday, Sept. 24, 1 to 3 p.m., CCE Office, 6064 state Route 22. More information: Peter Hager, (518) 561-7450.

Westport

Tuesday, Sept. 24, 7 to 9 p.m., CCE Office, 3 Cisco St. More information: Anita Deming, (518) 962-4810.

Malone

Wednesday, Sept. 25, 1 to 3 p.m., 911 Building. More information: Harry Fefee, (518) 483-7403.

Canton

Wednesday, Sept. 25, 7 to  9 p.m., CCE office, 2043B State Highway 68. More information: Anita Figueras, 379-9192.

Watertown

Thursday, Sept. 26, 1 to 3 p.m., CCE office, 203 North Hamilton St. More information: Peggy Murray, 376-5270.

Lowville

Thursday, Sept.26, 7 to 9 p.m., CCE office, 5274 Outer Stowe St. More information: Peggy Murray, 376-5270.