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Schumer calls on feds to end delay of care and benefits for Vietnam vets with Agent Orange conditions

By Billie Owens

On Monday, U.S. Senator Charles E. Schumer called on the Office of Management and Budget (OMB) to finally prioritize the health and well-being of Upstate New York veterans and finally end the years-long delay of the Department of Veterans Affairs’ (VA) effort to add additional diseases to the Agent Orange presumptive conditions list.

In Western New York, there are approximately more than 32,000 Vietnam-era veterans. Statewide, there are more than 240,000 of them.

2016 National Academies report found suggestive evidence that bladder cancer and hypothyroidism were associated with veterans’ service, as well as clarified that veterans with “Parkinson-like symptoms” (Parkinsonism) should be considered eligible under the presumption that Parkinson's disease and the veterans' service are connected.

Following this report, former VA Secretary David Shulkin announced that he would add these conditions to the Agent Orange presumptive conditions list in the near future, which would allow Vietnam War-era veterans stricken by these illnesses to receive additional health care benefits, disability compensation, and care benefits to surviving spouses and dependent children and parents.

But that announcement never came after OMB blocked the move.

In addition to the failure to include bladder cancer, hypothyroidism, and Parkinsonism on the Agent Orange presumptive conditions list, the VA has also yet to act on a 2018 National Academies report that found sufficient evidence of association between exposure to herbicides and hypertension.

Even though Schumer secured a provision in the recently passed budget deal requiring the VA to issue a report to Congress in consultation with OMB on the delay in adding these conditions to the presumptive conditions list, he said this is not nearly enough. He urged the agencies to take the necessary steps to ensure that the over 240,000 New York veterans, who risked their lives to defend their country, receive the health care and benefits they need and deserve.

Just last week, Schumer called recently confirmed OIRA Administrator Paul Ray directly and implored him, as the chief overlooking all federal government regulations, to immediately prioritize our veterans’ healthcare, take a personal interest in expanding their health benefits and add these conditions to the Agent Orange Presumptive Conditions List.

“It’s unfathomable that the administration is refusing to do right by our nation’s veterans, including the more than 240,000 New York veterans that bravely served during the Vietnam era, and has unilaterally blocked the VA from expanding healthcare benefits to those exposed to Agent Orange,” Senator Schumer said.

The Right Thing to Do

“After years and years of kicking the can down the road, it is high time for the federal government to accept the substantial proof linking bladder cancer, hypertension, hypothyroidism, and Parkinsonism to Agent Orange exposure, and add these conditions to the Agent Orange presumptive conditions list.

"It is absolutely incumbent on the administration to do everything within its power to clear a path for the VA, add these conditions to the list of Agent Orange illnesses, and finally allow veterans who are currently suffering access to the healthcare and benefits they rightly deserve; it’s not just the right thing to do, but it’s the very least we owe the brave New Yorkers who served and defended our country.”

In March of last year, Dr. Richard Stone, the executive in charge of the Veterans Health Administration, testified before the Senate Veterans Affairs Committee that the recommended new presumptive conditions would be added within 90 days, which also never happened.

Furthermore, this past October, email communications between the VA and the White House revealed that the delays were at the behest of the OMB Director Mick Mulvaney and White House advisors, who were reportedly concerned about the potential cost of adding diseases to the Agent Orange presumptive conditions list.

Emails explaining the decision to hold off on adding the conditions to the presumptive conditions list can be found here.

Exposure to Herbicide 'Agent Orange' Inflicts 'Presumed Diseases'

Schumer explained that per the Agent Orange Act of 1991, the VA automatically accepts that if a Vietnam Veteran physically served in Vietnam between January 1962 and May 1975, it is probable that the veteran was exposed to an herbicide agent like Agent Orange.

Furthermore, the Act established a list of “presumed” diseases that the VA stipulates are caused by Agent Orange exposure. Therefore, if a veteran served in Vietnam at any time between 1962-1975 and is diagnosed with one or more of the diseases VA recognizes as service connected, the VA will compensate the veteran and his or her family.

However, even though there is scientific evidence linking Parkinsonism, bladder cancer, hypertension and hypothyroidism to Agent Orange exposure, they are not currently on the VA’s list of recognized conditions.

Schumer said that is absolutely crucial that the roughly 240,000 Vietnam-era veterans in New York State receive the healthcare benefits they need and deserve.

“Adding these diseases to the Agent Orange Presumption List would only benefit the brave service members who were exposed to this chemical during the Vietnam War and are suffering from its harmful effects,” Veterans Outreach Center Executive Director and Army veteran Laura Stradley said. “Veterans Outreach Center stands with our veterans, and we support the laws that allow our brothers and sisters to access much-needed healthcare, services and support.”

Car show and veterans health system and benefits enrollment event is Sept. 14 at Batavia VA Center

By Billie Owens

Press release: 

VA Western New York Healthcare System’s Batavia site will host a car show and veterans enrollment event from 11 a.m. to 3 p.m. on Saturday, Sept. 14..

Veterans will have the opportunity to enroll in the VA health care system and have access to information to apply for other Veteran benefits.

To streamline applications and determine eligibility, veterans are highly encouraged to bring their DD-214 discharge papers and tax return from 2018.

The "Cruising for Veterans" car show will be staged behind Building 5 of the Jack Wisby Jr. Post-Traumatic Stress Disorder (PTSD) Building.

Merchandise and food will be available for sale starting at 10 a.m. through the Batavia Medical Center’s Veteran Canteen Service located on the ground floor of Building 1.

In the event of rain, the car show’s makeup date is the following day, Sunday, Sept. 15. The public is encouraged to attend.

The Batavia VA Medical Center is located at 222 Richmond Ave. in the City of Batavia.

UMMC receives award in recognition of its commitment to quality stroke care

By Billie Owens

Press release:

United Memorial Medical Center (UMMC) has received the American Heart Association/American Stroke Association’s Get With The Guidelines® -- Stroke Silver Plus Quality Achievement Award.

The award recognizes the hospital’s commitment to ensuring stroke patients receive the most appropriate treatment according to nationally recognized, research-based guidelines based on the latest scientific evidence.

UMMC earned the award by meeting specific quality achievement measures for the diagnosis and treatment of stroke patients at a set level for a designated period.

These measures include evaluation of the proper use of medications and other stroke treatments aligned with the most up-to-date, evidence-based guidelines with the goal of speeding recovery and reducing death and disability for stroke patients.

Before discharge, patients should also receive education on managing their health, get a follow-up visit scheduled, as well as other care transition interventions.

“We are dedicated to improving the quality of care for our stroke patients by implementing the American Heart Association’s Get With The Guidelines-Stroke initiative,” said UMMC Stroke Director, Dr. Sara Connolly. 

“The tools and resources provided help us track and measure our success in meeting evidenced-based clinical guidelines developed to improve patient outcomes.”

According to the American Heart Association/American Stroke Association, stroke is the number five cause of death and a leading cause of adult disability in the United States. On average, someone in the United States suffers a stroke every 40 seconds and nearly 795,000 people suffer a new or recurrent stroke each year.

Dispute over how new mental health coalition gets paid has delayed nonprofit startup

By Howard B. Owens

An effort led by Genesee County Mental Health Director Ellery Reaves to create a first-of-a-kind a nonprofit mental health care coalition among five counties has hit a bureaucratic roadblock.

It's caused a six-month delay in the project though Reaves believes it will soon be resolved, he told members of the Human Services Committee at a meeting Monday.

"The hang-up is really a bizarre thing," Reaves said. "New York State, in its wisdom, in order to draw the maximum amount of dollars for this project, passed it through a managed care company. Well, they passed it through a managed care company as a premium. If it’s an insurance company, you have to pay out premiums based on services. It can’t be paid as a project."

And this, Reaves said, is a project.

If the federal government were later to question reimbursements, the question is: Who will pay back the federal government if required?

At first, there was an effort to make the counties responsible for any such return of funds.

"Our attorney basically said, 'That’s not going to happen,'" Reaves said. "'Once we’ve received the money in good faith for the project and we’ve met our deliverables, you’re not getting anything because we’ve met our deliverables.'"

Reaves said in a sense the project is in a state of limbo. There are still operational tasks to be completed to get the new company up and running.

None of this, he says, has affected patient care.

"We think the state is going to agree with the managed care companies and indemnify them from any future potential loss, so we hope it’s going to resolve itself soon," Reaves said.

Previously: County Mental Health Services planning to enter coalition with five other counties to form new nonprofit

BEST Center offers healthcare professional trainings

By Billie Owens

Press release:

With a projected 18 percent growth in job opportunities in the next five years, it is an exciting time to be in or entering the medical profession. To meet the workforce demand, The BEST Center at Genesee Community College is offering three exciting professional training opportunities with tuition scholarships available! With registration deadlines just two weeks away, interested applicants should apply today! 

Patient Access & Registration Professional -- This 90-hour comprehensive program prepares students for patient intake and healthcare experience coordination including patient confidentiality, medical ethics and law, medical terminology, insurance billing and coding basics, appointment scheduling, medical records management and much more! This course costs $1,950 which includes required textbooks. Registration deadline is Feb. 26 and the course runs Mondays and Wednesdays, March 5 through May 14!

Clinical Medical Assistant -- This 140-hour course includes an optional 160-hour clinical externship. During the course, students will train to assist physicians by preparing patients for exams and treatments, routine laboratory procedures and diagnostic testing. Students will review technical aspects of phlebotomy, pharmacology, the proper use and administration of medications, taking and documenting vital signs, cardiology including proper lead placements and the legal aspects of healthcare. This course costs $2,599 which includes required textbooks. The optional externship costs an additional $350 which includes CPR Certification, background check, immunizations, drug screening, uniforms and more. Registration deadline is February 26, 2018, and the course runs March 5 through June 11, 2018!

Phlebotomy Technician -- This 90-hour hands-on program prepares students to collect blood specimens for laboratory analysis. Classroom and lab work includes coverage of medical terminology, anatomy and physiology, blood collection procedures, and skills and techniques for performing puncture methods. This course costs $1,799 which includes required textbooks. Registration deadline is Feb. 27 and the course runs Tuesdays and Thursdays, March 6 through May 6!

All of these training programs take place at GCC's Batavia Campus located at One College Road in Batavia. Registration for these programs requires a high school diploma, GED, or equivalent.

Additional information on each of these programs is available at www.genesee.edu/cms/best/development/certificate-programs/healthcare-certificate-programs/. All participants can register under "View our classes now" at www.genesee.edu/best

Those who are underemployed, unemployed and under skilled may be eligible for tuition scholarships through NY INSPIRE. GCC is part of the statewide program that focuses on training qualified candidates for high demand growing industries in the areas healthcare, advanced manufacturing and information technology.

The $20,000 grant to GCC will help offset tuition costs qualified recipients in this year's healthcare training programs. Scholarships are designated for those who are over 17 years of age and do not exceed the income threshold of $40,000 per year.

Don't delay! Contact The BEST Center at (585) 343-6868 or visit www.genesee.edu/best to find out if you are eligible!

An interview with Rep. Chris Collins on health care policy

By Howard B. Owens

chriscollinswithdonaldtrump2017.jpg

President Trump at a meeting with Chris Collins, right, and other members of Congress.
Photo: Getty Images. Copyright 2017. Published with permission.

The future of health care coverage for some Americans has become uncertain. If your employer provides health coverage through an HMO or PPO, you're probably OK. If you're on Medicare or Medicaid, you're probably OK. But if you're one of the 51 million of U.S. residents who must buy your own coverage, you might be watching the news coming out of Washington with concern.

After seven years of promising to repeal and replace the Affordable Care Act, the Republicans in Congress have been unable to do either. Now, President Trump is threatening to defund the CSRs (cost sharing reductions) that help insurance companies contain coverage costs. He may not be able to do that, at least in New York, but there are other actions Trump can take to hamper the health care exchanges. The funding reductions and uncertainty are creating turmoil for insurers and consumers alike.

There are a reported 5,074 Genesee County residents who purchased their health insurance through the New York exchange for 2017.

A month ago, The Batavian spoke with Rep. Chris Collins at length about his views on health care, with a follow-up interview last week, and learned that Collins doesn't think anybody needs worry about their coverage. When the House repeal and replace bill, the American Health Care Act was still alive (at the time of our first talk), he was confident that bill would be better for New Yorkers. Last week, when the so-called "skinny repeal" was still on the table (it since failed in the Senate), he thought whether it passed or not, New Yorkers would still have no trouble getting the coverage and care they needed.

The Congressional Budget Office has issued reports saying from 15 million to 25 million Americans could lose health benefits if either of those bills passed, but when pressed, Collins maintained there remained viable ways for anybody who needed coverage to get coverage.

Collins believes we have the best health care in the world, that Medicaid should be the same in all 50 states, that Republicans will never support universal health care, and he plans to continue the push to shift the cost of Medicaid from county taxpayers to the state.

"My buddy just had two grandchildren that were born twins two and a half pounds each," Collins said. "They finally just came home at six pounds. In days gone by the outlook for those kids would not have been good. The advances are tremendous in this country. I think we stand alone in this country with many of those and there's a cost that goes with it. We can get better everywhere. We have to go step by step but we've got to get rid of Obamacare (the Affordable Care Act). That's imploded."

That implosion, Collins said, is not because of anything the Republicans did -- eliminating support for risk corridors, creating uncertainty about the future of funding for individual market insurance, blocking the expansion of Medicaid, and not working on amendments to the original language of the act; rather, Collins said, it is because the ACA was doomed to fail.

"It was a house of cards that was never realistic," Collins said. "I called it out for what it was on day one."

On risk corridors, that was a flawed plan from the beginning, he said.

"I'm saying they (insurance companies) gamed the system," Collins said. "They priced the product low when they knew they would be reimbursed by the government. That all turned to mask how bad Obamacare was. It was masked for three years through this risk corridor reimbursement. Well, now the emperor's got no clothes and we see him standing there naked. That's what ended up happening when we stopped (the risk corridors). Now they have three years of actuarial data to know where it's got to be priced and sure enough, Blue Cross Blue Shield just announced a 47-percent price increase."

There are reports that the insurance companies are owed an more than $5.8 billion. Collins said they are owed nothing.

"They got their money," Collins said. "They got their money and now they have three years of actuarial data. They should be on their own."

Provisions in the Affordable Care Act such as risk corridors were meant, according to groups such as the Kaiser Foundation, to provide safe guards for insurance companies against taking on a wave of people with pre-existing conditions.

Remember, before the ACA, those $51 million Americans in the individual pool could be denied coverage if they didn't already have insurance or changed insurance -- such as going from an employer-based plan to an individual plan -- if they had a pre-existing condition, or that condition might not be covered. The ACA, which became law in 2009 and took effect in 2014, made that practice illegal. Risk corridors were intended to recognize a period of instability while insurance companies took on millions of people who had been denied coverage because of pre-existing conditions all in a short period of time.

The risk corridors were not directly funded by the Federal government. It was expected that some insurers would under estimate and some would over estimate their costs. The risk corridors set a range of acceptable variance and then used profits from above that range to reimburse insurers who fell below that range.

Collins contends no insurance companies were profitable in the first three years of the ACA, or profitable enough to fund the risk corridors. 

"The young and healthy did not sign up," Collins said. "They are not signing up. Therefore the people in these plans are sicker. Those are the ones who flocked to them. There was never any money on the surplus side to give to the companies who all, in a race for the most patience, I would say negligently, priced their products knowing their losses would be covered by the federal government for a period of time. That was the house of cards. Set to fail. And it has failed. It was not anything the Republicans did."

According to a study by Common Wealth Fund, some insurers lost their shirts under the ACA while others raked in record premiums. Then, in the first quarter of this year, health insurance providers had their most profitable quarter ever. The volatility over the past three years in the health care exchanges is exactly what you would expect to find in a newly created market, according to a paper co-authored by conservative economist Craig Garthwaite.

The loss of risk corridor protection isn't the only shoal in the storm weathered by the Affordable Care Act.

There were more than 100 lawsuits filed against the ACA, some of them backed by Republicans. The fact that some of those challenges prevailed is evidence, Collins suggested, that the health care insurance law was bound to fail.

"This was a fundamentally flawed plan trying to get universal health care," Collins said. "The biggest issue was the Supreme Court struck down the exchanges being mandated across the country. That was the beginning of the end. That was not the Republicans. That was the Supreme Court ruling on an unconstitutional aspect of Obamacare. This thing was bound to fail."

The Affordable Care Act was meant to help lower the cost of health insurance for the approximately 51 million Americans (in a nation of 302 million adults, or 17 percent of the population) who are not covered by employer-provided health insurance or already receiving Medicaid or Medicare. Most of these Americans, prior to the ACA, did not have health coverage.  Since passage of the ACA, an additional 20 million people in the United States now have health insurance.

The ACA expanded Medicaid (though some states rejected the expansion) to include low-income workers (that's about six million of the 20 million mentioned above). There are also more people covered under their parents' plans because the law extended required coverage for children up to age 26.

A key provision of the ACA -- and one most reviled by conservatives -- is the individual mandate. The mandate was intended to push healthy young people toward signing up for insurance so their premiums (because on average they wouldn't require care resulting in claims) would help keep costs down for people with more health concerns.  People in the individual market who don't buy insurance can be assessed a tax penalty. 

The bill also required companies with more than 50 employees to provide insurance. Like the individual mandate, this provision has been unpopular and one report said as many as 22 percent of small businesses are hiring few workers as a result.

One thing Collins believes about the ACA is that the bill was really a trick to institute universal health care in the United States.

"The Democrats want universal health care," Collins said. "No if ands, or buts. Hillary Clinton wanted that. Barack Obama wanted that. They never could get there and that's when we ended up with the abomination that I call Obamacare."

At the time the ACA passed, the Democrats controlled the House and the Senate, with enough votes in the Senate (58 Democrats and two Democrat-leaning independents) for Obama to get through just about any legislation he wanted, including single-payer, Medicare-for-all, or any other universal system.

The ACA seems to be largely based on proposals first put forward by the conservative think tank, the Heritage Foundation. That that is not an indisputable fact. Stuart Butler, a Heritage director, says it's not true but there are documents out there that show Heritage and Butler pushing coverage for all Americans with an individual mandate.

At the time Butler was offering any kind of proposal for health care, Bill Clinton was president and Hillary Clinton was heading a commission aimed and creating universal health care for the nation. To counter the Clinton plan, Republicans were proposing alternatives, including the Heritage plan.

Republicans remain steadfastly opposed to universal health care, Collins said, even though Trump has seemingly promised just that during his campaign for president.

“We’re going to have insurance for everybody,” Trump said on Jan. 11. “We’re going to have a healthcare that is far less expensive and far better.” 

In an interview with 60 Minutes in September 2015, he said, “I am going to take care of everybody. Everybody’s going to be taken care of much better than they’re taken care of now.”

Collins deflected questions about Trump's promises.

"I don't speak for the president," Collins said. "I would say on the campaign trail he talked about a lot of different topics."

And in response to a follow-up question, Collins said, "The life I live is here now, and Republicans will never support universal health."

Interestingly, not all conservatives agree. The American Conservative has recently published two columns suggesting that within five years Republicans will embrace universal health care and that universal catastrophic coverage is what is best for the nation.

Collins is opposed to universal health care, he said, because he believes it's inferior to what we have now.

"(I) would point to the situation in Europe certainly the situation in Canada where we have Canadians pouring over the border to get health care that's just not available within their universal health care system," Collins said. "You look to Europe; the elderly are denied health care. The ROI is not there, whether it's a new hip for it or something else -- how old are you? What's your life expectancy? Some of the life-saving cancer drugs are not available in Europe from a cost perspective because those nations budget health care." 

According to this op-ed in the Denver Post from 2009, the idea that Canadians come here for routine coverage is a myth, through when Canadians do come to the U.S. for care, for whatever reason, their universal healthcare plan covers their medical expenses. (Colby Cosh, a journalist in Canada, read the Denver Post piece after I sent him a link on Twitter and he said, "Some of its plain nonsense, like 'no waits for urgent care', obviously."

There does seem to be some issue with the elderly being denied care in Great Britain (care rationing), but apparently, that is not how their care should be handled since they can sue if denied care.  

While there is a report in England recently of patients being denied expensive treatment, those same treatments are available elsewhere in Europe, and American pharmaceuticals tend to be substantially less expensive in Europe than the United States.

The idea, however, that drugs make health care more expensive for Americans, is a myth, Collins said.

"There's so much misinformation out there," Collins said. "For instance, if you surveyed the average American they will tell you the biggest cost driver and the biggest problem we have are prescription drugs. That's what they say. But that's not the reality. As I understand that prescription drug coverage is nine percent of health care cost. Ninety-one percent is everything else. So if all these, and they are expensive drugs, and as I just illustrated through my ill-venture down in Australia, nine out of 10 drugs are going to try and fail, there's a huge cost. It's got to be recovered one way or the other but you're simply not going to have new R&D and new drugs to cure the next disease."

Pharmaceutical research, however, is not a totally free-market system. While drug companies fund about $60 billion of the $100 billion spent on R&D each here, about 1/3 of that tab is paid for by taxpayers (with the rest covered by charitable contributions). Many drugs are formulated based on publicly financed research and some drugs are developed through a public-private partnership.

Even so, Collins expressed no interest, when asked, about reforming the current patent law system that gives drug makers monopoly pricing on drugs, though he did say he supports making it easier for patent-expired drugs to enter the generic market.

"None of us would ever suggest that anything's perfect," Collins said.

He said he's especially interested in reducing the approval process around what is called "biosimilar" drugs. Biosimilars are the same in every respect to FDA approved drugs, except for some inactive ingredients. The process for biosimilars was supposed to be reformed under the ACA.

While not addressing the patent issue, he said he would like to see new drugs get to market faster.

"It begins with things that we've done, that I helped with, with the FDA and the 21st Century Cures Act, to get drugs to the market quicker," Collins said. "I sat down with the administrator of the FDA and asked her about her personnel needs and the skill set she needs to get drugs to market quicker, to save lives, to treat illnesses, to treat debilitating diseases because the quicker they get to market the cheaper they'll be. There's a cost. Whatever it does and it takes you eight years to get it to market, and we can get it down to five years, we can save the net cost, and I believe it will be substantially reduced."

Whether the Republicans the Republicans let the ACA die, repeal it outright, repeal and replace it, Collins doesn't believe that people are going to die for lack of health insurance.

The poor, he said, will continue to be covered by Medicaid. As for people not eligible for Medicaid, nobody will face bankruptcy because they can't afford health care.

"We, Republicans, and everything we've said are they don't have to go bankrupt," Collins said. "That's was the old system. The old system said, because it was no safety net whatsoever, you have to go on Medicaid. The only way to get on the Medicaid was to go bankrupt. Well, that's not where we are today. Where we are today -- we don't know where it's going to end but certainly, American Health Care Act said very simply, you can get insurance."

It might be expensive insurance because if you were without insurance when you developed what carriers would consider a pre-existing condition, the insurers could charge you premiums that are 30 percent higher for 12 months.

"You are perhaps in that uncomfortable slice of working poor and your numbers didn't work and you did not have coverage through your employer and you made the decision to not carry that insurance," Collins said. "There were other things that took priority in your life. We're not going to now force you into bankruptcy, which was the old way. What we said is there would be a 30 percent added cost for 12 months then you would go back into the community rate. Personally, I think that is a pretty fair compromise."

The AHCA seems to be dead, at least for now, and Collins defended it at length during our conversation. You can read his comments in the transcript (links to the full interviews below).

Even with the AHCA seemingly consigned to legislative history, Collins said the proposal he backed to provide mandate relief for cash-strapped counties hit with the high costs of supporting Medicaid isn't dead. He will continue to pursue that legislation, he said.

"John Fasso and I are going to continue to pursue our Medicaid language and find something else to attach it to because we have some other must pass stuff," Collins said. "We've got S chip that's got to pass. We've got some extenders that need to pass, so let's just say John Fasso and I are not giving up on the Medicaid piece regardless."

Many economists have raised concerns about the lack of free market mechanisms in health care, a key factor in driving up costs. Employer-provided health insurance distorts the market, creates what economists call the principle-agent problem (the ultimate consumer isn't making the key buying decisions) and information asymmetry (buyers have less information than sellers). Liberal economist Dean Baker has been especially vocal about the American Medical Association, which he labels a "cartel."   The "cartel" he contends, is able to artificially reduce the number of hospitals and doctors in the United States. to constrict supply and drive up costs.

The United States has only 3.3 hospital beds per 1,000 people, compared to 3.7 in Canada and 4.2 in the United Kingdom. At 2.2 physicians per 1,000 people, the United States ranks 52nd in the world, though a tad higher than Canada or the United Kingdom. The United States spends more, much more, per capita on health care than any other nation on earth, yet ranks 43rd in life expectancy.

We asked Collins about the underlying causes of high health care costs in the United States and he didn't answer the question directly.

"Well there's one big issue and it's lifestyle," Collins said. "Two-thirds of our country is obese. Through that, all kinds of things happen whether it's diabetes, whether it's joints, whether it's heart, or whether it's cardiovascular. If you want to look up and down in health in the U.S., it's we got a weight problem. So what can we do? We got to talk about it. We've got to remind people of it. Health insurance companies now have fitness plans. Government plays a role and then people play a role. I'm just a firm believer in personal accountability. We make decisions good and bad. Certainly, our health decisions are more under our control, not to say that bad things genetically don't happen but there's an awful lot of the health care world that we do control individually. We're not doing a very good job."

PDF transcripts for full interviews:

Collins says New York provision to Medicaid funding included in Senate version of healthcare insurance bill

By Howard B. Owens

Press release:

Congressman Chris Collins (NY-27) today hailed the inclusion of his amendment to the House passed American Health Care Act into the Senate version of the bill. The amendment, introduced with Congressman John Faso (NY-19), would require New York State to take over the county portion of Medicaid by 2020 and would provide the largest property tax reduction ever to Western New York.
 
“This was a long fought battle against the injustice in Albany and is a big victory for taxpayers,” Congressman Collins said.
 
Federal law now permits states to share some of their costs with local governments, but New York is the only state that has imposed this level of burden on property taxpayers. Counties currently have no say in how local revenues are spent on Medicaid; they’re simply required to foot part of Albany’s bill. Local state leaders agreed that the inclusion of the amendment is important and welcome news for Western New York residents.
 
"Mandate relief has been talked about in Albany for as long as anyone can remember - it certainly wasn't new when I was talking about it as mayor. It's not a headline-grabbing or attractive issue, so meaningful proposals on mandate relief are generally swept aside. But I can tell you that it's real. It's real for the local governments who deal with tight budgets and it's real for taxpayers who pay some of the highest property taxes in the nation. I applaud Congressman Collins for bringing this issue to the forefront. Ideally, this would have been a serious discussion at the state level, but having failed that, I'm pleased that we could possibly address the crippling burden placed on our local governments as part of larger, federal health care discussions,” said State Senator Ortt.
 
“As a long-time supporter of curbing the costs of Medicaid, which would take a heavy burden off of local governments, I am proud to support Congressman Collins’ amendment. The impact on my assembly district and local taxpayers will be tremendous with estimated tax reductions of 49 percent in Orleans County and 35 percent in Genesee County. It is clear that New York’s outrageous Medicaid spending is one of the driving forces behind property and school tax increases and it is time for government to take that burden off our residents’ backs,” said Assemblyman Steve Hawley.
 
"Western New Yorkers pay some of the highest property taxes in the state. Rep. Collins' amendment fixes this problem and protects upstate taxpayers from Albany’s unfunded mandates. Removing the unfunded county Medicaid mandate is key to reducing local property taxes and growing our economy,” said Assemblyman Ray Walter. 
 
"This amendment is a blessing for upstate families, small businesses, and farms that’ve been crushed by the high taxes and unfunded mandates coming from Albany. The inclusion of this amendment is a win for our towns and villages and I appreciate Rep. Collins efforts to stand up for our taxpayers,” said Assemblyman Joseph Errigo.   
 
"I'm pleased that the Senate has included Rep. Collins's amendment in the healthcare reform bill. This promises real relief for property taxpayers in communities like Niagara County, and holds state government accountable to fund their mandates instead of passing on costs to the local level. Americans deserve access to the best healthcare possible, but it shouldn't fall to just homeowners to fund the system,” said Niagara County Legislature Chairman Wm. Keith McNall.
 
"Congressman Collins' Medicaid proposal will provide historic “real” property tax relief for hardworking local taxpayers. Currently over 30 perfect of the Ontario County property tax levy currently goes towards paying for New York's unfunded Medicaid mandate. I look forward to working with Rep. Collins and the members of the Board of Supervisors as we continue our efforts to reduce the burden on hardworking taxpayers in our community," said Jack Marren, Chairman of the Ontario County Board of Supervisors. 
 
"This is an important step forward in our fight to reduce unfunded mandates and protect local taxpayers. This measure will reduce local property taxes and help ensure that our seniors can afford to stay in their homes," said Bob Green, Vice Chairman of the Ontario County Board of Supervisors.
 
“We as a board supported a resolution in support of this measure because protecting property taxpayers is one of our prime concerns. This legislation will reduce an unfunded state mandate and help us deliver real tax relief to local homeowners,” said Eric Gott, Chairman, Livingston County Board of Supervisors.  
 
“We appreciate Rep. Collins efforts to relieve the counties of this extraordinary unfunded mandate. This will be a tremendous relief to local county property taxpayers and will allow us to invest in our infrastructure and other county services,” said Raymond Cianfrini, Chairman, Genesee County Legislature.  
 
“For years counties in New York have decried the use of property taxes to fund New York State’s expansive Medicaid program. We are optimistic that changes at the federal level can result in real, substantive, positive changes to the bottom line for county property taxpayers,” said David B. Callard, Chairman, Orleans County Legislature.
 
The Senate is expected to vote next week on their version of the Obamacare repeal bill.

Collins criticizes insurance companies for increasing costs

By Howard B. Owens

Press release:

Congressman Chris Collins (NY-27) today reacted to news of anticipated steep increases in the price of BlueCross BlueShield plans available to New Yorker’s through the New York State Insurance marketplace.

“Not only has Obamacare been a failure for most of America, it is now failing the people of Western New York by making basic healthcare completely unaffordable and inaccessible,” said Congressman Collins.  “I am absolutely appalled a BlueCross BlueShield plan in Western New York would increase by almost fifty percent in the marketplace.”

BlueCross BlueShield pointed to the failed Obamacare policies that have cost insurance companies millions of dollars, driving up costs for Americans.  Regulations put in place under Obamacare have made the insurance marketplace less competitive, thus increasing costs for consumers.

While President Obama promised that premiums under his plan would decrease during these last few years, a May 23, 2017 report from the Department of Health and Human Services showed that Obamacare increased premiums across the country by 105% between 2013 and 2017.

“Obamacare’s chief cheerleader in our state, Governor Andrew Cuomo, owes our community an apology,” added Congressman Collins.  “Cuomo is part and parcel to Obama’s promises that ‘you can keep your plan’ and premiums will be lower.  Those have turned out to be lies.”

Collins said there was help on the way.  The American Health Care Act (AHCA), which passed the House of Representatives on May 4, 2017, repeals and replaces Obamacare and removes more than $800 billion in onerous taxes and fees that have been stifling the economy and eliminating job growth.

“I am working with my colleagues in Congress to implement policies that allow the people of Western New York the opportunity to make their own choice when it comes to healthcare and provide lower premiums.  Americans deserve to be able to pick which plan works best for their family, and I’m urging the senate to take up the American Health Care Act so we can get ourselves out of this mess.”

The American Health Care Act:

·         Eliminates the individual and employer mandate, which forced millions of workers, families, and job creators into government mandated plans that did not work for their needs.

·         For Western New Yorkers, the bill also includes the largest property tax reduction ever to be enacted. The legislation includes an amendment Congressman Collins introduced that would bar federal reimbursements for New York State Medicaid funds raised from local governments.

·         Guarantees protections for individuals with pre-existing conditions by prohibiting insurance companies from denying coverage on the basis of a pre-existing condition, banning insurers from rescinding coverage based on a pre-existing condition, and preventing insurers from raising premiums on individuals with pre-existing conditions who maintain continuous coverage. Additionally, New York state law fully protects individuals with pre-existing conditions.

·         Modernizes and strengthens Medicaid by implementing a “per capita allotment” which provides more flexibility for states and results in the largest entitlement reform in decades.

·         Provides Americans access to affordable care that works for their needs by delivering monthly tax credits of $2,000-$14,000 a year, which individuals and families can use to purchase private insurance of their choice.

·         A provision within the American Health Care Act (AHCA), The Patient and State Stability Fund, would provide solutions to help lower costs and repair insurance markets damaged by Obamacare. CBO estimates this would significantly reduce premiums in the nongroup market and encourage participation by insurers.

The American Health Care Act is with the Senate where it will need to be approved before heading to President Trump’s desk to be signed into law.

 

County Mental Health Services planning to enter coalition with five other counties to form new nonprofit

By Howard B. Owens

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Genesee County is joining with five other counties that have service-providing mental health departments to create a new nonprofit that should help improve services and lower costs, Mental Health Director Ellery Reaves told members of the County Legislature yesterday.

The new 501(c)(3) will be called Integrity Partners for Behavioral Health.

It's being formed both because regional mental health leaders see the need and because the state is pushing for more consolidation and more shared services. The state has made available $60 million for such consolidations in mental health services and Integrity Partners is the first of its kind in the state.

"So while other parts of the state are sort of scrambling to get themselves together, we’re literally going to submit our application with all of our providers, affiliate providers, and network providers, and it’s going to cover literally a six-county group so far," Reaves said.

Genesee County's Mental Health Services has a staff of more than 65 people, including doctors, therapists, counselors, and care managers. The service provides care to patients who either come to it through the Genesee County Jail, schools, other agencies, or just walk through the front door. The cost of care is either covered by private insurance or programs such as Medicaid or Medicare.

The goal of Integrity Partners will be to reduce costs through greater efficiency and improve care outcomes by sharing resources and knowledge.

"This model we’re moving to is more of a value-based, performance-based model," Reaves said. "We’re all going to get together and decide on what the matrix is going to be for what’s quality care. Then we as providers are going to try and meet those matrixes and get paid based on the efficacy in keeping folks out of hospital beds and providing service immediately, same-day access."

The six counties participating -- Genesee, Niagara, Cattaraugus, Chautauqua, Livingston, and Orleans -- all have county-run mental health services. The coalition will also include non-government providers within the region.

The partners have retained legal counsel to help set up the tax-exempt, 501(c)(3) corporation, as well as ensure the organization complies with all state laws and the requirements of the state incentives to organize it.

“If we can pull that off then this corporation will literally be on par with some of the larger health entities in the state,” Reaves said.

Lower costs and improved efficiency comes at a time when the county and the region need it, Reaves said.

So far in 2017, mental health services is on pace to serve more clients than in 2016.

Much of the increase is driven by the decreased stigma associated with seeking mental health care, but for children, social media is creating more problems, and opioid use leading to more mental health patients.

Reaves said the opiate crisis locally is "massive." 

"It's beyond what people can comprehend," Reaves said.

He added, "If you look at the stats on drug use, it's going to have a peak and once it peaks then it will start to abate once we can get more services in place. We haven't reached that point yet."

Collins votes in favor of changes to healthcare insurance law

By Howard B. Owens

Press release:

U.S. Representative Chris Collins (NY-27) today voted to repeal Obamacare and replace it with the American Health Care Act, which will improve access, reduce costs, and provide Americans with the health care system they deserve.

“This puts us even closer to ending the Obamacare nightmare that has plagued Americans for the last seven years,” Congressman Collins said. “The legislation passed today increases competition and gives people the power to make their own choices with their own health care. The American Health Care Act is a drastic improvement over the failing health care system Obamacare has left us with.”

For Western New Yorkers, the bill also includes the largest property tax reduction ever to be enacted. The legislation includes an amendment Congressman Collins introduced that would bar federal reimbursements for New York State Medicaid funds raised from local governments.

“My commonsense proposal will fix the finances of counties across New York for decades to come and most importantly keep money in the pockets of hardworking Western New Yorkers,” Congressman Collins said. “This puts a stop to this massive unfunded mandate coming out of Albany once and for all.”

For residents in New York’s 27th Congressional District, it would result in more than $470 million in property tax savings. The proposal would only apply to the $2.3 billion being raised from counties outside of New York City to pay for the state’s Medicaid share. New York State currently raises $7 billion from its local governments to fund its $27 billion Medicaid liability, which is the largest such mandate in the nation.

Beyond the property tax savings for New Yorkers, the legislation improves access and affordability, and removes more than $800 billion in onerous taxes and fees that have been stifling the economy and eliminating job growth.

Congressman Collins indicated these improvements are absolutely necessary because the current health care system has completely failed. In 2017, 33 percent of counties nationwide only have one insurer on their exchange, and many counties are being left without any insurance providers.

He also noted that Obamacare has unsustainably raised insurance premiums by nearly 40 percent in the last three years. Recently, thousands of New Yorkers experienced the pain of Obamacare when they were kicked off their insurance plans because their provider, Health Republic, collapsed.

The American Health Care Act:

  • Eliminates the individual and employer mandate, which forced millions of workers, families, and job creators into government-mandated plans that did not work for their needs;
  • Guarantees protections for individuals with pre-existing conditions by prohibiting insurance companies from denying coverage on the basis of a pre-existing condition, banning insurers from rescinding coverage based on a pre-existing condition, and preventing insurers from raising premiums on individuals with pre-existing conditions who maintain continuous coverage. Additionally, New York state law fully protects individuals with pre-existing conditions;
  • Modernizes and strengthens Medicaid by implementing a “per capita allotment,” which provides more flexibility for states and results in the largest entitlement reform in decades;
  • Provides Americans access to affordable care that works for their needs by delivering monthly tax credits of $2,000-$14,000 a year, which individuals and families can use to purchase private insurance of their choice.

The American Health Care Act now heads to the Senate where it will need to be approved before heading to President Trump’s desk to be signed into law.

Teddy Bear Clinic introduces young children to medical care

By Howard B. Owens

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Four-year-old Layla Holbrook, with her mother Amanda, talks with a nurse about the care of her stuffed companion during the Teddy Bear Clinic at UMMC's Cary Hall facility today.

Preschool, kindergarteners and first-graders were able to attend the event with their favorite stuffed toy and learn about medical care through several interactive stations. After registration, the children went through the clinic set up to resemble hospital departments such as the emergency room, radiology and dietary. If necessary the “patient” received a bandage, cast or stitches. 

Many of the doctors and nurses were high school seniors from throughout the county enrolled in the Health Career Academy, a college-credit program that gives the seniors a chance to learn about every aspect of the healthcare career field.

Also participating were staff from UMMC, members of the United Memorial League, United Memorial Guild and Mercy EMS.

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Logan McAndrews was watching a doctor give stitches to a friend's stuffed dinosaur.

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Amy Miller talks about a hospital bed and a stay at a hospital.

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With Collins and Hochul locked in fight over Medicaid expense, county manager not counting on cost savings yet

By Howard B. Owens

A proposal to block New York from using county taxpayer money to pay for Medicaid sounds good on paper, but as always, the devil is in the details, says County Manager Jay Gsell.

Gsell's biggest fear is that even if the proposal is passed by Congress, Gov. Andrew Cuomo's office would just find a way to shift other expenses to the counties.

"My sense of the reaction from the governor and the lieutenant governor over the last week is that it is very likely how they would respond," Gsell said. "They’re still putting a state budget together. Things could change on a dime."

The proposal comes from Rep. Chris Collins, who is having it added as an amendment to the House GOP's health care bill aimed at replacing the Affordable Healthcare Act.

From a Collins press release put out earlier today:

The Medicaid Local Share Limitation, which was proposed by Congressmen Chris Collins and John Faso, would bar federal reimbursements for New York State Medicaid funds raised from local governments. The proposal would only apply to the $2.3 billion being raised from counties outside of New York City. New York State currently raises $7 billion from its local governments to fund its $27 billion Medicaid liability, which is the largest amount in the nation.

“This is a huge win for our constituents,” Congressman Collins said. “I want to thank President Trump, House leadership, Congressman Faso, and the rest of my fellow New Yorkers for getting this key provision included. Year after year, Albany’s leadership relies on counties to foot the bill for New York State’s out-of-control Medicaid costs. Enough is enough.

"This amendment will stop Albany from forcing its unfunded mandate down the throats of taxpayers, and help counties lower the property tax burden on hardworking families. We understand the devastating impact New York’s reckless spending is having on everyday New Yorkers, and I’m proud to join with members of our delegation to bring vital tax relief to our constituents.”

In a tweet today, Collins said his amendment to the bill, called "Ryancare" by some, and "Trumpcare" by others, would save Genesee County taxpayers $9.4 million that the county currently pays as a local share of Medicaid expense.

Gsell said it's more than $9.6 million of an overall $68 million expense, with the Federal government and state government picking up the balance of the cost. 

The proposal from Collins has brought forth blistering attacks from Gov. Andrew Cuomo and Lt. Gov. Kathy Hochul.

Last week, Hochul said in a statement:

"What’s worse, a New York Republican Congressman, Chris Collins, is offering an amendment that would wreak havoc on the state. While I understand that the Democrats in Washington are attacking Collins on ethics issues and are having a heated political fight, they shouldn’t be played out at the expense of everyday New Yorkers.

“Here are the facts: The overall Medicaid plan would cost the state billions of dollars of lost federal funds and jeopardize hospital stability."

She said the Collins proposal would amount to a $4.7 billion tax increase on the people of New York.

According to a report in the Democrat and Chronicle, Cuomo ripped the bill as a "death trap" that would devastate hospitals, nursing homes and assisted living facilities in Upstate New York.

"My greatest fear from last year’s election has actually come true, which is you have a rabid, conservative ideology in Washington that would tell New York to drop dead, and that is exactly what is going on," Cuomo said.

At $60 billion per year, New York is topped only by California (at $85 billion) in total Medicaid spending. In New York, counties cover $7 billion of the state's share of the Medicaid expense, by far the highest share of any state in the union.

This for a program that is defined by the Feds as a "Federal and state" (not county) medical coverage benefit for people with limited income.

In her statement last week, Hochul offered up a history of how counties came to help pay for Medicaid, saying the counties agreed to take on this expense, but Gsell said that's not his understanding of the history.

Gsell said the counties got roped in against their will in the 1960s when Congress created a long-term care program and ordered states to help pay for it and New York turned around and told counties they would share in the expense. Then when Medicaid was created a few years later, New York told the counties they would pick up 25 percent of the tab, though at the time, the program was a lot less expensive than it is today.

"I saw some comments by Ms. Hochul last week that said, ‘oh, the counties have nothing to be grousing about -- they've been funding Medicaid forever,' " Gsell said. "She alluded to this one- or two-year-old piece of Federal legislation from the early '60s and says, ‘yeah, the counties volunteered to do it.’ No, even then, the state told the counties, 'you will fund this program.' "

New York's Medicaid bill is so high, Gsell said, because the state covers the full smorgasbord of coverage. Whereas the Federal government has only about 15 services that are mandated, New York offers the full slate of available options, more than 30 altogether.

At no time, Gsell said, have states been given any opportunity to have a say in who is covered, how they are covered or what is offered. Everything is mandated by the Federal government or the state.

When Gsell became county manager 23 years ago, the county share of coverage was about $4 million, but the expense started increasing at 5 to 10 percent per year until the county share was capped a few years ago.

The Collins amendment is designed, in part, to help secure support from New York's congressional delegation. That overt political maneuver prompted another statement from Hochul today:

"Mr. Collins has perpetuated a political scam on New York. As Mr. Trump’s bag man he has had to buy votes to pass the Affordable Care Act and did it by promising counties relief from their share of Medicaid. He now wants New York State to pay his $2.3 billion political IOU.

"The state cannot and should not. If Mr. Collins wants to buy votes let the federal government pick up the share rather that the people of New York. Local county taxes or state taxes New Yorkers still pay. One way or another, it is still coming out of New York taxpayers’ pockets. Let Mr. Collins help New York State and his district by having the federal government pay – that is why he is in Washington.

"He could easily help pay by reducing the $150 billion tax cut to the richest 1 percent of Americans or buying one less tank from Trump’s record defense budget. Why make the people of his district pay for his politics. We do know Mr. Collins is adept at corrupt financial schemes but this is the ultimate insider trading scam."

Ryancare/Trumpcare is by no means assured of passing. It will obviously receive Democratic opposition, but a number of House conservatives also oppose it. It will also face a tough fight in the Senate.

Still, if it does pass, Gsell is far from certain it will lift the burden from Genesee County for unfunded mandates. He believes, based on the stern opposition to the cost shift from Cuomo and Hochul, that Albany will just pull the purse strings tighter on other programs with county-state cost shares, such as indigent defense, Safety-Net, Pre-K early intervention and probation assistance. The state share of a total of nine state-mandated programs exceeds the potential $9.6 million in cost savings offered by Collins amendment.

"The money that the state has to start absorbing could turn on our budgets in these other areas with less state aid," Gsell said. "The state is not going to go quietly into the night."

Michael McAdams, a spokesman for Collins, rejected this contention outright.

"That's an unfounded hypothetical," McAdams said. "There's no basis for thinking that would actually occur."

The ironic piece of this fight between Collins and Hochul (who lost the congressional seat to Collins after one term) is Hochul has long been a strong proponent of local communities, making a point to shop local every holiday, for example, even stopping in Batavia stores.

Through the governor's press office and on Twitter, we reached out to Hochul to ask her to address the seeming contradiction of supporting local communities while backing an unfunded mandate, but we haven't received a response.

Gsell thinks Hochul's position may not be entirely her own.

"It struck me as she was being instructed," Gsell said. "This didn’t sound like a Kathy Hochul thing. It mirrored very much what the governor’s thing is, which is, ‘counties, shut up. You’ve got your Medicaid cap. We’ve given you pension reform with Tier 6. You’ve gotten enough. Go away. We’re not going to cost shift from counties to the state.' ’’

Batavia Urology announces new prostate treatment available locally

By Howard B. Owens

Press release:

Batavia Urology today announced that its first patients have been treated with the UroLift® System, an innovative new treatment for benign prostatic hyperplasia (BPH), also known as enlarged prostate. The UroLift System is designed to relieve symptoms caused by an enlarged prostate, while preserving sexual function.

Delivered during a minimally invasive procedure, the UroLift permanent implants act like window curtain tie-backs to hold the lobes of an enlarged prostate open. Patients recover from the procedure quickly, and return to their normal routines with minimal downtime. The cost of the UroLift System procedure is covered by Medicare in New York.

“We are committed to providing patients with the highest-quality, most effective options to address their urology needs,” said Jason Donovan, P.A., who was present for the first procedure. “The UroLift System has an excellent safety profile and provides men suffering from an enlarged prostate a beneficial first-line treatment alternative to drug therapy or more invasive surgery. Importantly, the UroLift System provides fast and meaningful relief from BPH symptoms, improving overall quality of life for our patients.”

Benign prostatic hyperplasia (BPH), also known as enlarged prostate, affects more than 37 million men in the United States alone. Twelve times more common than prostate cancer, BPH occurs when the prostate gland that surrounds the male urethra becomes enlarged with advancing age and begins to obstruct the urinary system. Approximately one in four men experience BPH-related symptoms by age 55, with 90 percent of men over 70 symptomatic.

Data from clinical trials showed that patients receiving UroLift implants reported rapid symptomatic improvement, improved urinary flow rates, and sustained sexual function. Patients also experienced a significant improvement in quality of life. Most common adverse events reported include hematuria, dysuria, micturition urgency, pelvic pain, and urge incontinence. Most symptoms were mild to moderate in severity and resolved within two to four weeks after the procedure.

Dementia Care Conference for families and loved ones is Oct. 27 at Terry Hills, it's free but registration is required

By Billie Owens

A Dementia Care Conference for families and loved ones will be held from 1 to 4 p.m. on Thursday, Oct. 27, at Terry Hills Restaurant & Banquet Facility in Batavia.

It is free and open to the public but registration is required. Call 1-800-272-3900 to register.

Terry Hills is located at 5122 Clinton Street Road.

The event is offered by the WNY Chapter of the Alzheimer's Association and it is sponsored, in part, by a grant from the New York State Department of Health.

Vendor tables and sponsorship opportunities are available.

There are three areas of focus:

  1. The Basics of Alzheimer's Disease & Dementia
  2. Legal & Financial Planning for Dementia
  3. Caregiver Resources

Office for the Aging to offer four vendor fairs to help people make sense of Medicare maze

By Billie Owens

According to a specialist in aging services and Medicare at the Genesee County Office for the Aging, "this year is utter chaos with Medicare Advantage Plans as FIVE out of six companies selling in Genesee County have dropped at least one plan."

"We have been slammed with calls (as many as 43 within hours!) from people seeking guidance on what to do," she says.

So they are holding four Medicare Open Enrollment Vendor fairs during Medicare Open Enrollment (Oct. 15 through Dec. 7) to help people sort through the maze. ​The fairs are provided through grant funds from the NYS Office for the Aging, the Federal Older Americans Act, and generous support of the Genesee County Legislature.

Charts will be available at the vendor fairs (and in the Office for the Aging) comparing ALL available plans for 2017. Reps from local Medicare Advantage Plans and AARP Medigap will be present to help attendees understand the changes for 2017. They can help sign you up if you wish to choose a different plan or company. And Medicare trained/certified counselors from the Office of the Aging will be there to answer questions and offer unbiased assistance.

The fairs are scheduled as follows:

  • Monday, Oct. 17, from 10 a.m. to 3 p.m., in the Paddock Room at Batavia Downs, 8315 Park Road
  • Wednesday, Nov. 2, from 10 a.m. to 3 p.m., in the Oakfield Community and Government Center, 3219 Drake St., Oakfield
  • Tuesday, Nov. 22, from 10 a.m. to 3 p.m., at the Office for the Aging, 2 Bank St., Batavia
  • Tuesday, Dec. 6, from 10 a.m. to 4 p.m., at the Office for the Aging, 2 Bank St., Batavia

GCC hosts ninth annual Fall Nursing Job & Transfer Fair on Oct. 27

By Billie Owens

Press release:

Genesee Community College continues to demonstrate a commitment to student success and community connections on Thursday, Oct. 27, when more than 25 of the area's top healthcare employers and four-year universities will attend the ninth annual Fall Nursing Job & Transfer Fair to explore career and educational opportunities.

The event is open to the public and will be held from 10 a.m. – 12 p.m. at the Batavia Campus of Genesee Community College in the Forum. Parking and attendance are free.

The fair is designed to introduce potential new employees and/or transferring students to four-year nursing colleges or a future employer, and also provides healthcare businesses an opportunity to present their trade and services to the local community. It is free and open to all community members.

As of today (Oct. 6), the following employers and universities represented will include:

ArnotHealth, Elmira

Elderwood, Williamsville

Nursefinders Inc., Rochester

The Arc of Monroe County, Rochester

GreenField Health & Rehab Center, Lancaster

Visiting Nurses of Rochester

Guthrie Healthcare System, Sayre, Pa.

Jewish Home of Rochester

Campanion Care, Rochester

Livingston County Center for Nursing, Mt. Morris

Kaleida Health, Williamsville

Medical Staffing Network, Rochester

Newfane Rehab & Health Care, Newfane

Air Force

Highland Hospital, Rochester

Rochester Psychiatric Center, Rochester

Lifetime Care, Rochester

HomeCare & Hospice, Warsaw

Chamberlain -- College of Nursing

The College at Brockport

D'Youville College -- School of Nursing

Grand Canyon University

Keuka College

Nazareth College -- Nursing Dept.

St. John Fisher College -- Wegman's School of Nursing

Roberts Wesleyan College

SUNY Alfred State

SUNY Delhi School of Nursing

Trocaire College

Participants are encouraged to dress prepared for an interview and to bring their resume. Students will have the opportunity to access real jobs, promote themselves and get their "foot in the door" at several local health centered organizations. This is also an opportunity to obtain information about furthering their education to obtain their BSN. For a full list of attendees, please visit www.genesee.edu/career and log into and/or create an account with Purple Briefcase.

For directions and additional details, please contact the Career Services office at 585-345-6888.

Nurse becomes healthcare innovator and wins venture capital competition in Rochester

By Howard B. Owens

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Besides a potentially great idea, Georgann Carrubba has one of the key things investors look for in a startup CEO -- passion for an idea that she thinks will make a big change in people's lives.

Though the product she hopes to bring to market is decidedly less sexy than some tech gadget, she thinks her sincerity is what swung a panel of judges in her direction two days ago when they awarded her the $25,000 top prize in the 2016 Rochester Venture Challenge.

The lifelong Batavia resident said she could hardly believe she won, standing on stage in front of 300 people with young men who came to pitch ideas for drones, mobile phones and gaming. 

She had been through this kind of competition before, at Buffalo's 43 North, where tech inventions carried the day.

"I was in complete shock," Carrubba said. "I'm looking at each side of me and it's all technology again. And they're good people and they believe in their products as much as I do, so I was completely caught off my game. When they asked me to speak, I cried. I had to compose myself to say a couple of sentences because I truly did not think we would win. It was a tough competition."

Not only is Carrubba's product less sexy than a tech gadget, it addresses an issue that doesn't even get a lot of attention among the pantheon of people's medical issues that are the subject of telethons, ribbon wearing and 5K races.

We're talking about colostomy and ileostomy patients, people who have bags attached to a hole in their abdomen to collect their bodies' waste.

There are some 800,000 ostomy patients in the United States (perhaps as many as 5 million worldwide), and another 50,000 to 65,000 are given the procedure each year. The surgeries are the results of cancer, disease or accidents and the range of ages includes the very young and the very old.

Up until now, these patients have been saddled with a bulky bag that is prone to leaks and odor and reduced mobility and activity, including sexual activity.

Carrubba became a visiting nurse in 2004 and dealt with many patients who struggled with their ostomy equipment and dealt with the embarrassment of their situation often by avoiding socializing and outside activities. 

She thought in this day and age, why hasn't something better come along?

There had been no significant advance in ostomy care in 60 years.

One evening in 2011, she was sipping coffee at her sister's house and glanced down at a bowl and an idea popped into her head.

"I went home, went to bed, said my prayers and the next day made it in my garage," Carrubba said.

What Carrubba invented -- and secured a patent on -- is a cup-like device that attaches to the diaphragm in the patient's abdominal opening and collects waste. It is secure, airtight and waterproof.

She has a patent pending on a sensor that will be included in the cup so patients will be alerted on an iPhone or iPad when the bag inside the cup needs to be changed.

To go along with the device, called a Choice Cap, patients will be able to purchase biodegradable bags, and perhaps eventually, bags that can be flushed down any toilet, and decorative covers that can match anything from a wedding dress to swimsuit to boxers or a slinky nightgown.

After six design changes in the prototype, Carrubba is ready for the Choice Cap to go through trials with actual patients. Even though the product doesn't require FDA approval, she wants that kind of rigor in the trials so she and her team can collect the feedback and make any design changes  needed before going into production.

She hopes to have the Choice Cap on the market by early 2017.

A journey that began with a spark of inspiration hasn't necessarily been easy or straightforward. Carrubba has never run a business and didn't really know the first thing about starting a business.

She got together with her cousin, Eugene Tenney, an attorney in Buffalo, to help form a company, originally to be called Carten, but it turned out that name wasn't available, so it became Tencar, a company she plans to keep based in Batavia.

She then went to the Innovation Center at the Med-Tech Center, where the Genesee County Economic Development Center staff helped her form an advisory board, provided information and introductions for the startup communities and services in Buffalo and Rochester.

The competitions taught her a lot about the business world, she said, but admits that while she'll remain CEO, she really isn't qualified to be COO or CTO or CFO or any of the other C-suite positions. 

She was particularly grateful to High-Tech Rochester for the training and mentoring program that preceded the competition, and she said the encouragement she received from Theresa Mezzullo and Rami Katz of the investment firm Excell Partners was particularly helpful.

It was Katz who advised Carrubba to just be herself during the pitch, so she showed up in her nurses scrubs and spoke from her heart.

What drivers Carrubba, she said, isn't the allure of entrepreneurial success, or even the potential $2.4 billion domestic market for her product, but the hope of making people's lives better.

"I was never one of those, 'I'm going to invent something and be a millionaire,' " Carrubba said. "No, no, no. I was a nurse. I've always been a nurse. Truth be known, probably a lot of my employers don't like me because I've always been on the side of the patient, whatever is best for the patient. I've always been a patient advocate."

Dr. Victor Desa dies at age 72

By Howard B. Owens

Dr. Victor Desa, a renowned surgeon who contributed his expertise and his time to the local community, has died at the age of 72.

Desa died in Rochester this morning, reports WBTA.

Funeral arrangements are pending.

Among Dr. Desa's service to the community was time spent on the boards of United Memorial Medical Center and HomeCare & Hospice.

He was also always open to sharing with local residents his knowledge of the healthcare system, making frequent public appearances to speak on the topic.

Previously:

Jack Davis says he supports a plan to send healthcare control to states

By Howard B. Owens

Press release:

Jack Davis, independent candidate for Congress, set out a plan to replace Obamacare and give states power to address out of control health care costs. States would have greater flexibility to devise model health care programs and spend money allocated under federal programs by joining interstate compacts.

“For those like myself that want to replace Obamacare, the interstate Healthcare Compact is a realistic and viable strategy. States, not Congress, the White House, or federal bureaucrats, should set the rules for healthcare from top to bottom. In addition, individuals should be able to deduct the cost of health insurance from their federal income taxes just as corporations can,” Davis said.

“Healthcare is simply too large and complex to manage at the federal level. Our federal healthcare system impacts 300+ million people and healthcare spending exceeds 2.3 trillion dollars annually. Centralized planning of an industry that is this large and complex is not possible and has never been successful,” said Jack Davis.

The Healthcare Compact would make it possible for Americans to exercise greater control over their healthcare options. It would relieve the federal government of the responsibility for healthcare policy and return it to the states. As decision-making is transferred from the federal government to the states, so would control over federal healthcare dollars.

The Healthcare Compact does not impose one model of healthcare reform on an immense and diverse country. It does not presume that there is one Band-Aid solution to solve the healthcare crisis. Exactly how specific compacts would work - how they would function - would be determined by the states that enter into them. 

New York state taxpayers send more dollars to Washington than they receive in return from the federal government. Overall, government checks flow from affluent states, generally in the Northeast and West, to less affluent states, especially in the South.

Medicare For All

By Janice Howard, RN MS

As a retired registered nurse, member of the New York State Nurses Association and member of the coalition with Physicians for a National Health Plan, I am very concerned about the healthcare "reform" currently underway in Congress. 

I am convinced that the route to comprehensive and affordable health care has taken a dramatically wrong turn. 

The main features of the legislation have often seemed obscure; for instance, neither a "government takeover" nor a "public option" really have anything much to do with the final bills.  Both bills will make being uninsured a crime, punishable by an annual fine of up to 2.5 % of adjusted income under the House bill and $95.-$750. under the Senate bill. 

To make insurance affordable, tax money will be used to subsidize private insurance premiums, but even with these subsidies, families will be required to spend 8-12% of their income to purchase insurance.  Meanwhile, the insurance companies stand to gain tens of millions of new customers and at least $447 billion in taxpayer subsidies. 

The bills in Congress offer no meaningful cost controls, will leave 17-24 million uninsured and do nothing about the high cost of prescription drugs.

Mild promises to "bend the cost curve" fall short when even middle-income people will still end up being saddled with huge, unsustainable health care costs. 

One example of a measure that promises cost-savings is a health insurance "exchange" that each ill could create (4-5 years in the future). This has been tried without success in Massachusetts, where it has added, not reduced, costs.   

I agree with Congressman Massa from Rochester who states these "solutions" will not fix the problems we face.  We do not need "insurance reform." We need healthcare, comprehensive and affordable for everyone and we need it now--not over the next four to ten years.  Congress should reboot the process and start with a proposal for workable reform: a single-payer national health program, an expanded and improved Medicare for all.

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