Cayuga County Chamber rolls out two initiatives to help business owners

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AUBURN –– The Cayuga County Chamber of Commerce, founded 104 years ago, recently announced the launch of two new projects aimed at helping small-business owners. The Cayuga and Seneca Counties Community Profile project has created a web-based tool that brings together accessible sources of 70 different statistical indicators that would measure important community indicators, such […]

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AUBURN –– The Cayuga County Chamber of Commerce, founded 104 years ago, recently announced the launch of two new projects aimed at helping small-business owners.

The Cayuga and Seneca Counties Community Profile project has created a web-based tool that brings together accessible sources of 70 different statistical indicators that would measure important community indicators, such as employment, education, and health and safety for six counties. The Community Profile website provides data, analysis, and grants, as well as tables and charts that can be downloaded in customized formats.

Andrew Fish, executive director of the Cayuga County Chamber of Commerce, says the Community Profile project was funded or made possible by the United Way of Cayuga County, the United Way of Seneca County, the Allyn Foundation, the City of Auburn, and Cayuga Community College. It is available for anyone in the community to access and utilize.

The Community Profile project (cayugasenecaprofile.org) has the potential to increase the capacity of nonprofits, government agencies, and businesses to leverage funding and to improve their ability to plan, Tim Kelly, executive director of United Way of Cayuga County, said at the Cayuga County Chamber of Commerce’s 2012 Economic Forecast Luncheon on Jan. 26 in Auburn. The United Way contracted with the Center for Governmental Research, Inc. (CGR), a Rochester–based nonprofit provider of research to government and organizations, to develop the data and indicators on the Community Profile project’s website.

“We know that our communities in Cayuga County and Seneca County face diminishing resources that have a direct impact on quality of life. So data, good quality data, and accessible data are essential to good decision-making and to better planning,” Kelly said. “For government, community organizations, and business, data can address their need to more rapidly and more effectively obtain funding.”

Second initiative

Along with the launch of this interactive Community Profile project, the Cayuga County Chamber of Commerce also announced the launch of the Finger Lakes Grants Information Center, a regional center that provides the access to data and resources on potential grants from government agencies and service providers.

The Grants Information Center will provide training opportunities to educate and support grant-seekers about fundraising, philanthropy, and grant-writing, Ginny Kent, supervisor at the Grants Information Center and membership coordinator at the Cayuga County Chamber, said at the 2012 Economic Forecast Luncheon, which attracted a crowd of about 150 people.

“It is really important not only to understand the process of developing grant proposals, but also to understand the field of philanthropy and to understand what your potential founders are looking for when you come to them,” Kent said.

Fish contends the Community Profile project dovetails perfectly with the Grants Information Center. He says the Chamber of Commerce mobilized to secure grant funding through the Stardust Foundation to launch the Grants Information Center, recognizing that once the indicators came online, people would need some additional resources to foster improvements in the
areas the data measures, such as salary by sector, change in number of businesses by sector, and job growth.

“Not only do they have the data, now they can [also] learn how best to use that and how best to interpret it,” he says. They can see “what are some funding opportunities that are out there, whether they are through other foundations or through government agencies, or philanthropy and other things that they can go after to meet the specific needs that are here and what kind of information would they need to back that up.”

He says although the Grants Information Center is not going to be writing grants for people, it is going to be able to give them the tools and resources they need to make quality proposals, with the goal of leveraging local investment and local talent to bring dollars into communities all over the Finger Lakes area.

Fish says he sees both projects benefiting for-profit businesses in the Finger Lakes region –– including small firms. The Community Profile project has a lot of economic data, which people can review to identify potential markets. On the other hand, the Grants Information Center will help monitor grant opportunities for businesses, including research grants and development grants, then notify them when it sees one that fits their business, and assist them to create a more competitive application, he says.

“The other thing is, businesses in general, when you have employees who are having a higher quality of life, who are happier, who are healthier, they are going to work better for you,” Fish says. “So by supporting the other nonprofit agencies that are delivering the services necessary to help people along those lines, we are actually helping the businesses in the long run as well.”

Fish sees the two projects coming out at the right time since both of them are necessary for the community. He feels that as the pool of grant money from government agencies and foundations is shrinking, it’s important that the chamber and its partners provide tools for people to be more competitive.

“I’m glad that we were able to get it off the ground and going in the beginning of the year, where we’ve got a lot of big plans to get people indoctrinated in how to use it,” says Fish. “It’s going to be a good year for both programs.”

Fish says the Community Profile project has already contracted with CGR to do an update of data in 2013, and the Grants Information Center is going to measure its success by evaluating the number of grant dollars that organizations attain, utilizing the services at the center.

Hiscock & Barclay launches new practice group

Law, Accounting & Taxes, Subscriber Only

SYRACUSE — Law firm Hiscock & Barclay, LLP of Syracuse is forming a new practice area aimed at work in white-collar criminal defense and government investigations. Daniel French, a former U.S. attorney, and his partner, Lee Alcott, have both joined Hiscock as of counsel. French will co-chair the new group with Gabriel Nugent, a current

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SYRACUSE — Law firm Hiscock & Barclay, LLP of Syracuse is forming a new practice area aimed at work in white-collar criminal defense and government investigations.

Daniel French, a former U.S. attorney, and his partner, Lee Alcott, have both joined Hiscock as of counsel. French will co-chair the new group with Gabriel Nugent, a current Hiscock partner.

French and Alcott will remain principals of their existing firm, French-Alcott, PLLC of Syracuse.

French-Alcott and Hiscock have been working together on white-collar cases for about six years now, Nugent says. Consistent demand for the work prompted the firms to formalize their relationship.

The practice will focus on criminal and civil cases at the federal, state, and local level, Nugent says. It could include everything from cases involving mortgage regulations, allegations of health-care fraud, insider trading, and more.

Prosecutors have been dusting off a number of older laws in those areas recently and using them to pursue new and different targets in investigations, Nugent adds.

“Really, that’s occurring all throughout the country in a number of different areas,” he says.

Attorneys will also try to help clients avoid ending up under investigation in the first place, French says. Regulations in fields like health care change all the time, he notes.

“A decent portion of what we do is communicate with our clients and make sure they understand the current regulatory framework,” he says.

Hiscock & Barclay’s new white-collar defense and government-investigations practice includes nine attorneys, including former prosecutors and a former regional director of a state Medicaid fraud unit. The group will also work with attorneys in other Hiscock practice areas if needed.

“It complements a lot of different areas,” Nugent says.

Hiscock may look to add more lawyers to the group in the future, especially in areas that require specialized expertise like cybercrime and matters involving imports and exports, Nugent adds.

In addition to his work as U.S. attorney for the Northern District of New York, French was an assistant U.S. attorney as well as a law clerk for a federal judge. He has also served as a deputy staff director to the U.S. Senate Finance Committee and executive assistant to U.S. Sen. Daniel Patrick Moynihan.

Alcott previously served as director of the litigation department at another Syracuse law firm and was also chief trial counsel for the city of Syracuse.

Hiscock & Barclay has 200 attorneys in 31 practice areas. The firm has offices in Albany, Buffalo, New York City, Rochester, Boston, Toronto, and Washington, D.C.

Make-A-Wish of CNY reaches 1,300 wishes

Nonprofits, Subscriber Only

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EAST SYRACUSE — The Make-A-Wish Foundation of Central New York celebrated a landmark year in 2011 with its 1,300th wish since its inception in 1985. The foundation fulfilled 50 wishes last year and is on track to grant 80 wishes this year with a budget of $1.4 million. Still, the organization knows it’s not reaching all the eligible children and its goal is to clear up some of the public misconceptions of Make-A-Wish to fulfill the wishes of all qualified children.

Each year, 125 children diagnosed in the Central New York region become eligible for a wish, according to a recent epidemiological study from Make-A-Wish Foundation of America. “We’re granting 100 percent of wishes for kids referred to us, but we’re not granting all that are eligible for wishes,” says Diane Kuppermann, president and CEO of Make-A-Wish Foundation of Central New York.

Several factors might contribute to the reason that Make-A-Wish doesn’t receive referrals for the eligible kids. One is that many believe it only caters to the Syracuse area. While its office is located in Syracuse, the foundation serves 15 counties, including those in the North Country, Mohawk Valley, and the Southern Tier.

Another reason is that some parents may feel that because they have the financial means to provide for their children’s wants, they don’t need Make-A-Wish. “It’s so not about the money,” says Kuppermann. In some cases, money cannot buy a wish. For example, if a child wants to go to Give Kids the World, a 70-acre nonprofit resort in Central Florida for children with life-threatening illnesses and their families, the only way to obtain access is through a qualified wish-granting organization. “However, Make-A-Wish Foundation is the largest wish-granting organization in the world and sends the largest number of kids to Give Kids the World,” says Bethann Kistner, PR/communications manager for Make-A-Wish Foundation of Central New York.

There’s also the misconception that Make-A-Wish only accepts referrals for terminally ill children. While its mission is to grant wishes to children with life-threatening conditions, the conditions do not have to be terminal. In fact, the foundation does not use the term “terminal” in any of its material. “It’s about empowering kids to be in control of one thing and giving hope,” says Kuppermann. “Tomorrow is uncertain for these kids. You can really see the difference that a wish makes.”

A child has to meet three criteria to be considered a Wish Kid — be between the ages of 2-1/2 years and 18 years old; have a life-threatening medical condition; and not have had a wish from another wish organization. If multiple children in one family have a life-threatening illness, each child is eligible for a wish; the child does not have to share a wish with a sibling.

Referrals generally come from the parents, though physicians or extended families may make the referral. In any case, Make-A-Wish says it needs to know it is being invited into the lives of the family. This is a difficult time for the families and they have to trust that Make-A-Wish will bring them hope. “We have one shot to make magic with these families,” says Kuppermann.

It’s also important that kids be referred to Make-A-Wish as soon as they are eligible, especially if a child is approaching an 18th birthday. And while it doesn’t happen often, there have been a few cases where the Wish Kid succumbed to the illness before his/her wish could be fulfilled. “That’s the worst feeling in the world,” says Kuppermann. “We didn’t deliver on the mission.”

Wish supporters

Kuppermann acknowledges that it is the board, volunteers, and the community that make it possible for Make-A-Wish to do what it does. Volunteers are the “lifeline of the organization,” says Kuppermann.

This year marks her 20-year anniversary with the foundation, but Kuppermann recognizes some members of the community that have been huge supporters for just as long, like Onondaga Beverage Corp./A.L. George LLC, Hafner’s Restaurant, and Jim and Juli Boeheim. For instance, the Ms. Orange Fan Luncheon, created by the Boeheims, has raised more than $1 million for the foundation during the past 20 years. “They don’t just lend their name, they roll up their sleeves and make the event a success,” Kuppermann says of the Boeheims.

She also notes other members of the community, like Sugarman Law Firm, Applebee’s, and Dunkin’ Donuts, to name a few, that have been champions for the foundation. In fact, 50 local Dunkin’ Donuts franchises are currently raising money for Make-A-Wish with its spare-change program. Dunkin’ Donuts raises money for different charities in the region each quarter during the year with this program. Make-A-Wish was a first-quarter recipient in 2011, receiving more than $19,000.

“This community is incredible. I would put it up against any community in the country. There’s a lot of good here,” says Kuppermann.

Another example of the community at work? How about when Michael J. Falcone, chairman emeritus and founder of the Pioneer Companies, donated the building on Campuswood Drive in DeWitt, the present home for Make-A-Wish, on his birthday in 2005. Previously, the foundation was located in the former Hotel Syracuse building. The new DeWitt location needed major renovations, and while the organization had a $100,000 cash budget for the work, it didn’t spend any of it. It was the help of 89 local companies, who donated funds, materials, and had staffers volunteer their time to renovate the building, that made it possible for Make-A-Wish to move into its new home in 2007.

Inside the 7,500-square-foot building is the Wish Child Wall of Honor that was unveiled in 2008. It is a wall of stars with the name of each Wish Kid on it. Former Wish Kids and their families are welcome to visit the wall.

Behind the wishes

Make-A-Wish covers all costs of a wish, including medical expenses. The wish is a gift to the family, so there are no strings attached.

The average cost of a wish is $9,000. The funds for the wishes come from special events, corporate donations, individual gifts, grants, and fundraising programs like Adopt-A-Wish, Kids for Wish Kids, and Campus Wishmaker. The foundation aims to raise at least 30 percent of the cost of the wish with in-kind donations. These are gifts and services for which the foundation doesn’t have to pay. All the funds raised stay local to meet the wishes granted in the region. The organization does not raise dollars outside its 15 counties region, as that would infringe on another chapter’s territory, says Kistner.

For the fiscal year ending Aug. 31, 2010, Make-A-Wish produced total revenue of just under $1.2 million, with the largest sources being special events and corporate donations. Also, 75 percent of the operating budget went towards granting wishes, the organization’s main service program. The national Make-A-Wish Foundation mandates that no less than 75 percent of the operating budget goes towards wish-granting. In 2009, 82 percent of the CNY Make-A-Wish budget went to wish-granting, and although the numbers aren’t finalized yet, Kistner believes that for 2011, it was in the 80 percent range.

The foundation recently re-organized the responsibilities of the staff and hired three new staff members, two for newly created positions. In August, Amanda Timmerman filled the new program service coordinator position, and then in September, Kistner began in the new position as PR/communications manager. Christine Corbett started in January as director of development.

Now with a full-time staff of eight, this is the largest the staff has been since Kuppermann started in 1992. She was the first paid employee for the organization. Her first title was executive director, but it changed over the years to president and CEO to mirror business titles. She’s now been with the organization for 20 years, quite a haul for someone who thought she was going to be a stay-at-home mom. What made her stay? She said then and says now, “My work isn’t done here.”

——————————————————————————————————————————————–

Make-A-Wish Foundation of Central New York

5005 Campuswood Drive

East Syracuse, NY 13057

Phone: (315) 475-9474

www.cny.wish.org

Key Staff

Diane E. Kuppermann, President & CEO

President’s compensation: $64,000

Christine Corbett, Development Director

Bethann Kistner, PR/Communications Manager

Amanda Timmerman, Program Services Coordinator

Robin L. Mulpagano, Director of Finance & Administration

Debbie L. Simon, Events Manager

Olivia Colabufo, Program Services Manager

Jodi L. Hagan, Donor Relations Coordinator

Board of Directors (Officers)

President

Joseph Chirco, Carrier Corporation

Chair Elect

Frank Mento, Clough Harbour & Associates, LLP

Co-Treasurers

Diana Kanfer, Testone, Marshall & Discenza, CPAs

Lauren Kincaid, Firley, Moran, Freer & Eassa, PC

Secretary

Robin J. Toia, RJT Associates, Inc.

Board Members

David Ayoub, Bowers & Company, CPAs

Anne Bazydlo, retired

Janet Callahan, Hancock Estabrook, LLP

Paul Dodd, Northwestern Mutual Financial Network

Rob Dwyer, Sugarman Law Firm

Colleen Julian, Carrier Corporation

Diana Kanfer, Testone, Marshall & Discenza

Lauren Kincaid, Firley, Moran, Freer & Eassa, PC

Daniel Kosick, Susquehanna Valley School District

Frank Mento, Clough Harbour & Associates

Michael Murphy, First Niagara Bank

Christopher Pinckney, Pinckney Hugo Group

James Reed, Excellus BlueCross BlueShield

Greg Scagnelli, MD, Binghamton Gastroenterology Associates

Roxanne Taylor, SUNY Upstate Medical University

Robin Toia, RJT Associates

Thomas Uva, WYNIT Distribution, LLC

Jessie Verna, ConMed Corporation

Mission

“Incorporated in 1985, the Make-A-Wish Foundation of Central New York, Inc. is a nonprofit, tax-exempt organization dedicated to granting special wishes to children between the ages of 2-1/2 and 18 who are living with life-threatening medical conditions to enrich the human experience with hope, strength, and joy.”

Programs

• Corporate Adopt-A-Wish Program

• Wishes in Flight (donation of airline miles)

• Kids for Wish Kids (K to grade 12, raise funds for wishes)

• Wishmakers on Campus (college groups/clubs hosting events to raise funds for wishes)

• Annual Giving & Stewardship Program

• Wishes Forever Endowment (an endowment campaign that will carry the foundation to its goal of granting the wish of every eligible child)

Planning/Fundraising Outlook for 2012:

All fundraising programs increase the percentage of revenue, which allows the foundation to grow the number of CNY Wishes to 100 annually.

• Roll out Annual Giving & Stewardship Program

• Launch Wish Wednesdays Corporate Sponsorship program

• Set $1 million goal for the Wishes Forever Endowment Campaign

• Increase revenue sources in outlining geographic footprint and build greater individual giving

• Annual Walk for Wishes: Syracuse (May, 5, 2012) and Binghamton (April 30, 2012)

• Annual Golf Opens: Syracuse (June 4, 2012) and Binghamton (June 11, 2012)

• Sugarman Law Firm Wish Ball (Sept. 8, 2012)

• Ms. Orange Fan Luncheon (Oct. 28, 2012)

Revenue Sources

Contributions and grants $1,142,375

Program Services $300

Investment Income -$3,898

Other $60,252

Total Revenue $1,199,029

Expenditures

Grants and similar amounts paid $486,003

Salaries & Employee Benefits $312,525

Other $217,018

Total Expenses $1,015,546

Surplus for the Year $183,483

New Sensis CEO expects growth

Insurance & Financial Services, Manufacturing & Engineering, Subscriber Only, Technology

DeWITT — After acquiring Sensis Corp. in August, Saab made its new subsidiary the global head of its aviation business. Two Saab units in Sweden now report through Sensis, and the DeWitt–based company is also responsible for Saab’s North American radar business. Those actions should be a good indicator of Saab’s intentions, Sensis President and

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DeWITT — After acquiring Sensis Corp. in August, Saab made its new subsidiary the global head of its aviation business.

Two Saab units in Sweden now report through Sensis, and the DeWitt–based company is also responsible for Saab’s North American radar business. Those actions should be a good indicator of Saab’s intentions, Sensis President and CEO Marc Viggiano says.

“They didn’t buy it to close it. They bought it to grow it,” he says. “This is foreign direct investment in the U.S.”

Viggiano took over as president and CEO in August after Jud Gostin, who founded the company in 1985, stepped down.

Saab AB, a defense and security company based in Sweden, paid $150 million in August for Sensis, which now operates as Saab Sensis Corp. The deal could be worth up to $190 million if Sensis meets certain earnings targets in the next few years.

Sensis provides sensor technologies, radar systems, modeling, and simulation for defense, civil aviation, airport, and airline customers.

Viggiano was previously senior vice president and director of corporate development at Sensis, where he was responsible for leading the company’s strategy and business development. He also served as chief operating officer and, before joining the company, worked in advanced sensor systems at General Electric’s Aerospace Group.

The acquisition by Saab will lead to more work, more exports, and more jobs at Sensis, Viggiano says.

Saab’s global presence will mean greater access to foreign markets, he notes, adding that he has long been focused on exports. Saab has more than 30 locations around the world and has been doing business globally for years.

“We’ve really just begun to scratch the surface of tapping the potential of everything that Saab can do for us here in Central New York,” Viggiano says. “It makes doing business around the world a lot easier for us.”

Looming cuts in U.S. defense spending shouldn’t hurt Sensis’ domestic sales, according to the company. About 75 percent of its business is in aviation with the remainder in defense.

And Sensis specializes in work like upgrading and extending the life of existing systems that will be valuable in the confines of a smaller Pentagon budget, Viggiano says.

“We probably have as much potential for growth on the defense side as anywhere,” he says.

Saab has been in the U.S. since 1950, but several years ago company leaders decided they needed to do more in the North American market, Saab North America President Dan-Ake Enstedt says. The firm needed a stronger local presence and more people here, he says.

The U.S. represents more than 40 percent of the world market for defense and homeland security, Enstedt notes. And the strict requirements for work here can help a company like Saab with sales elsewhere, he adds.

Saab’s long-term goal is generating $1 billion in U.S. sales. The company is about halfway there now and Sensis will play a key role in helping reach that total, Enstedt says.

The company’s expertise in radar and air- traffic systems was a perfect fit, as those were two areas of focus for Saab already. In the future, Enstedt expects Sensis’ work to expand into other Saab business areas like command and control and homeland security.

“When they are ready, we really want to broaden the business in Sensis and build the company up and recruit more people in other areas,” he says.

Sensis accounts for Saab’s largest presence in the U.S. and carries major potential, he adds.

Although Sensis doesn’t provide projections on future employment levels, Viggiano says the expectation is expansion. Plans call for stable employment in the next few months and then for growth.

Sensis currently employs about 600 people at eight locations and serves more than 60 customers in 35 countries. It has about 500 employees in Central New York.

The firm did suffer job cuts after the acquisition by Saab. Seventy-two employees, including executives, support staff, and technical professionals, lost their jobs.

The job cuts were meant to bring the firm’s work force in line with its current business prospects, Viggiano says. Financial challenges originally sparked the sale to Saab.

Sensis lost money in 2011 as revenue shrank significantly. Sensis will turn a profit in 2012, Viggiano says.

Since the acquisition closed, the company has won about $40 million in new business, he adds, and is projecting revenue growth of 5 percent in fiscal 2012. Sensis isn’t expecting further job cuts.

“They are absolutely here to stay,” Viggiano says of Saab. “This is an investment in Central New York.”

Survey: U.S. workers’ confidence about retirement savings rose in 2011

Employee Benefits & Human Resources, Health Care, Subscriber Only

U.S. workers are becoming more confident that they will have enough money to retire comfortably, but know they still have work to do, according to a recently released survey from Towers Watson, a global employee-benefits consulting firm. In 2011, 68 percent of survey respondents reported they were very or somewhat confident they will have enough

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In 2011, 68 percent of survey respondents reported they were very or somewhat confident they will have enough resources to live comfortably 15 years into retirement, up from 62 percent in 2010. The survey found 47 percent of respondents said they were very or somewhat confident about having enough resources to last 25 years into retirement, up from 40 percent in 2010.

Survey data also indicates fewer employees are experiencing significant declines in their pension and retirement savings — 47 percent in 2011, down from 55 percent in 2010. Workers’ satisfaction with their household finances continued to rebound in 2011, rising 8 percent to 41 percent. However, 59 percent of employees remain generally unsatisfied with their financial situation, according to Towers Watson.

“As the economy shows periods of stable ground, employees are slowly beginning to be more optimistic about retirement,” Kevin Wagner, a senior retirement consultant at Towers Watson, said in a Jan. 19 news release. “However, the financial crisis was jolting to American workers. As a result, many employees are more financially conservative today and have a renewed interest in improving their financial decisions and planning and saving for retirement.”

Despite that, 39 percent of surveyed workers said they plan to delay retirement, with older employees (46 percent) and those in poor health (42 percent) most likely to retire later. The survey found 60 percent of employees delaying retirement said they expect to work at least an additional three years.

The survey also notes that after two years of cutting back on daily spending, paying off debt, and saving more for retirement, some respondents indicated they plan to take additional steps this year to get their financial houses in order. These steps include: review the amount they need to save for retirement, increase monthly savings, review their financial situation, obtain professional advice, reduce daily spending, pay off debt, defer major expenditures, and adopt a less risky investment strategy.

Local reaction

Theodore Sarenski, CEO of Blue Ocean Strategic Capital, a Syracuse–based company that provides wealth-advisory services, says that investors are not showing confidence about retirement because they worry about losing money in the stock market.

“People have scaled back on their tolerance of risk, and they are more conscious of risk now than they were a few years ago,” he says.

Sarenski says the market volatility of the past four years has increased doubt.

“There has been a lot of volatility in the stock market in the past four years, along with the uncertainty of not just the stock market, but in government’s ability to meet their obligation,” he says. “That uncertainty is leading some people to feel unstable. That gets them concerned because they are not reaching the goals that they thought they were going to reach.”

More survey findings

Employees’ confidence in retirement also depends on their plan. According to Towers Watson, the percentage of employees with defined benefit (DB) pension plans who are satisfied with their household finances sharply rose from 29 percent to 49 percent in the past two years. DB participants are more than twice as likely to feel “very confident” about the first 15 years of retirement and 2.5 times as likely to feel confident about a 25-year retirement, compared to workers with only a 401(k) plan.

The survey also examined younger workers’ attitudes, finding 47 percent of employees under age 40 reported they were satisfied with their household finances last year, up from 28 percent in 2009. Yet, about two-thirds of these workers said they would need to save much more in the future to retire comfortably. They are taking steps to do it, the survey found. The percentage of young employees who carefully reviewed their retirement plans increased by more than 40 percent between 2010 and 2011.

“While the depressed economy may have triggered some of these prudent behaviors, increased attention to retirement planning, especially for younger workers, can be a helpful step for employees to save for a secure retirement,” Bill Daniels, a senior retirement consultant at Towers Watson, said in the news release.

The Towers Watson Retirement Attitudes Survey was conducted in June-July 2011 and includes responses from 9,218 full-time U.S. employees at non-government organizations.

Managed care: “of the people, by the people, and for the people”?

Business Mentors, Subscriber Only

Listen carefully, quiet, shh … did you hear? New York State is approaching bankruptcy. And Gov. Cuomo, with the cooperation of the state Senate, the Assembly and every New York State resident is attempting to avert a Greece-like collapse of the state’s credit status and governmental system of providing necessary services in a fiscally responsible

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Listen carefully, quiet, shh … did you hear? New York State is approaching bankruptcy.

And Gov. Cuomo, with the cooperation of the state Senate, the Assembly and every New York State resident is attempting to avert a Greece-like collapse of the state’s credit status and governmental system of providing necessary services in a fiscally responsible manner.

For the record, I am a lifelong baby-boomer Democrat, and a fiscal conservative. Yes, one does not have to be a Republican to be anointed with a conservative fiscal bias.

On Jan. 14, Gov. Cuomo released his 2012-13 state budget proposal, which is due to be approved by the above referenced legislative bodies by April 1, 2012, the beginning of the state’s fiscal year. From a 10,000-foot view, the budget is impressive. It offers the first back-to-back total spending reductions in decades, with total spending proposed at

$132.5 billion — down $225 million from the prior year.

For a state with a total population of just under 19.5 million in 2010 with a 2.1 percent increase in population from the 2000 census, New York has virtually no growth and, courtesy of the Great Recession, more demands for services than tax revenue can support.

My focus, after 37 years of professional, volunteer, and philanthropic service to charitable organizations, is on the tax-exempt health and human-services sector. Decades of service to, and experience with, these organizations has demonstrated that tax-exempt organizations provide valuable and needed services to vulnerable populations, generally at a cost much less than their government counterparts. However, as the governor knows, the current cost of these services cannot be supported or sustained.

Managed care

So, this year’s budget continues the aggressive approach of applying managed-care principles to New York’s most vulnerable populations. Individuals with disabilities, mental health, substance abuse, and the elderly must all embrace the concept of managed care.

I should say that those of us who experienced the managed-care initiatives of the 1980s, 90s, and early 2000s know that it is a euphemism for rationing, reduction of cost, restructuring of delivery systems, reallocation of resources, and transfer of financial risk from the payer (government/insurer) to the provider. Fundamental structural change of this nature must be implemented, but traditional managed-care principles are doomed to failure, if we fail to recognize the need for flexibility in care delivery and financing of services.

Basic principles of managed care applied to the health-care sector date back to the Kaiser Corporation of the 1930s. Four fundamental characteristics must exist in order to have managed care achieve the desired result of a healthier population at a lower cost with greater efficiency:

1) The people covered under managed care must have a direct interest in and concern for their health and well-being;

2) The people covered must have a direct financial interest in the cost of services they consume as these services are provided;

3) The individuals covered must have the ability to influence and control their utilization of health and human services with particular emphasis on maintaining a healthy life style;

4) The managed-care population must be of sufficient size and numbers (generally in the tens of thousands) to provide for the spreading of the financial risk associated with “high-cost outliers.”

This is where the details of the governor’s budget proposal diverges from the reality of the populations being forced into “managed-care plans.”

Ten observations from me to you, the governor, and the legislative rule-makers in this managed-care restructuring must be addressed now in order to avoid a managed-care “train wreck” several years from now.

First of all, don’t shoot the messenger. Gov. Cuomo is, in my opinion, taking a great risk in proposing a solution to a problem that has existed for decades. We must work in a cooperative manner, with give and take and reasonable compromise, to develop a system of health and human-service delivery that can be a model for others to emulate.

Next, be even handed and do not discriminate in the restructuring of the delivery and financing systems. For example, when you know that the greatest cost savings can be achieved by privatizing services provided by state employees, share the sacrifice appropriately in both the public and private sectors. Most citizens do not know that state-provided services to the vulnerable populations mentioned above routinely cost 30 percent to 50 percent more than the same comparable services in the voluntary tax-exempt sector.

In 2011, the governor implemented a masterful stroke of political genius called the Medicaid Redesign Team (MRT). He appointed private-sector employers, health and human-service providers, government representatives and others to develop a series of 79 recommendations for government consideration. In doing so, he deflected the traditional process of stalemate and inertia in the much desired direction of looking for solutions.

However, if you read the recommendations, they are long on objective ideas and short on specifics for achieving desired savings. As is true with any major service delivery restructuring by government, the “devil is in the details.”

One of the fundamental flaws of the managed-care initiative is the failure to address the excessive expectations of our citizens, both those that receive and those that provide care, whether through government or the private sector. This is what is known as shared sacrifice, something that this country has not demonstrated broadly since World War II. I am not optimistic that without a EuroZone-like credit crisis in New York State, the necessary call to action and rallying of the masses to “do what is right” will occur.

New York State now has more than 5 million residents eligible for Medicaid, or 26 percent of the population. These individuals and the millions of others at or below the poverty line have to make difficult decisions every single day. Where and how do I get my next meal? Do I feed myself or my children? And, dozens of other gut-wrenching questions that those of us who are fortunately employed never give a second thought to. The vast majority of the vulnerable Medicaid populations do not have the ability to make these decisions for themselves.

Ok, on to some ideas and solutions.

Fundamental to any managed-care structure is a managed-care organization (MCO). The state has designed four primary models of MCOs. Their names are self-explanatory. Health Homes for traditional health-care services, Behavioral Health Organizations (BHOs), Developmental Disabilities Individual Service Care Organization (DISCOs), and Managed Long Term Care (MLTC).

These organizations must be a public and private-sector initiative including all stakeholders. If, as is true in most previous initiatives, these MCOs are left to the responsibility and control of the typical insurance company, forget it. Without a decision-making balance between the payer (the state), the manager of care (insurance company), and the service providers (tax-exempt hospitals, nursing homes, physicians, and other for-profit providers), managed care will not work.

In the absence of decision-making balance, compromise, and shared sacrifice, New York will experience what I refer to as the “chaotic dismantling” of the health and human-service sector that this state has built since the 1960s. Bankruptcies will be common place, service recipients will be pinballed or excluded from receiving services, and the “safety net” infrastructure could be destroyed. If my assessment is correct, then the result will include the loss of valuable service providers, success for certain providers who learn how to game the system, and, most importantly, a reduction in the volume and quality of services to the
vulnerable citizens of our great state.

So, before the government allows the proverbial managed-care train to leave the station, take a look in the mirror, revise expectations, involve all stakeholders, and, most importantly, balance the need for fiscal discipline with the needs of our citizens.

Finally, I applaud the governor for his bold leadership in his budget proposals. At the same time, government must remain “of the people, by the people, and for the people.” Traditional managed-care models do not measure up to this objective, particularly for vulnerable populations who have virtually no ability to advocate on their own behalf.

Gerald J. Archibald, CPA, is a partner in charge of the management advisory services at The Bonadio Group. Contact him at (585) 381-1000, or via email at garchibald@bonadio.com

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