Monday, March 25, 2019

Ambulance companies are responding to some existential emergencies

Ambulance companies across New York are facing significant threats from the federal and state governments. It’s something that citizens should pay attention to because the availability -- if not the very existence -- of ambulance services could be compromised, putting entire communities at risk.

Let’s begin with a look at an experiment undertaken by the Trump Administration.

The Department of Health and Human Services (HHS) is launching a pilot program in select municipalities that looks to cut costs of Medicare by having responders determine if the patient can forgo a trip to the emergency room and be taken to a far less expensive doctor’s office or urgent care center.

It’s a well-intentioned idea as it mirrors what those under private insurance are encouraged to do by their insurers and employers and their own personal finances – everyone of us is charged to not go to ERs to save considerable money on premiums, deductibles, and copays. If an illness or injury is not limb- or life-threatening, you’re better served by skipping the trip to the hospital.

Despite the intentions of the HHS plan, there will be unintended consequences.

Here’s the kicker: With skin in the game due to those aforementioned costs as well as the hefty bill for an ambulance ride, the privately insured drive themselves or have someone drive them to a provider for non-emergent care. Under this fed’s proposed plan, Medicare users will be encouraged to have someone drive them to the doctor or an urgent care facility – that “someone” will be the local ambulance company. In this case, the ambulance becomes a glorified taxi service.

As more and more seniors hear of this program and it becomes regular practice (which is HHS’s goal) an entire generation of Americans will utilize first responders to take them to physicians and care centers for minor maladies and even appointments.

Such abuses are already happening.

Talk to any emergency medical technician or driver or pay close attention to recurring addresses on the police scanner. There are repeat offenders who once or twice a month feign a significant illness when calling 911 so an ambulance can drive them to the hospital for a pre-scheduled appointment or to treat a cold or headache. Some play ignorant about it while others openly admit to EMTs that’s what’s happening. You can do that without shame or guilt when Medicaid or Medicare is paying for that super-expensive shuttle service.

Realize that every time this happens, an ambulance is removed from serving its community for an hour to three at a time. In rural areas, where volunteer crews are small and spread thin, the town is put at great risk. If a real emergency occurs -- like a car accident, heart attack, or industrial or sports injury -- there’s no one to respond because they were forced into providing an unnecessary ride.

Now, if this happens quite regularly from abusers of the system, imagine what will happen when a system is in place that encourages a call to 911 for run-of-the-mill ailments. Understaffed ambulance crews will constantly be called into action for non-emergencies. They could be out of their districts many hours of the day. What this will do to public safety is pretty scary.

What’s also scary is Governor Cuomo’s budget proposal which would change the payment model for ambulance companies.

Currently, if they serve a patient who is on both Medicaid and Medicare, the ambulance company is reimbursed for the service by both government programs – 80 percent by Medicare, 20 percent by Medicaid. Cuomo would like the Medicaid reimbursement scratched entirely.

Volunteer ambulance companies will be hard hit. While lacking labor costs they still have to cover gas, vehicle and building maintenance, medical supplies, insurances, training, and investments in new equipment.

Paid services will take a more significant beating, one that puts them at risk of folding. Not only do they have all of those overhead costs, but they have to also pay their workers while providing competitive wages and benefits. It’s not an inexpensive undertaking.  

The United New York Ambulance Network (UNYAN) claims that paid, non-government emergency services will be denied $14 million annually.

Mind you, this is on top of the $31.4 million a year that they are already shorted by New York’s deficient Medicaid reimbursement policies.

So, when you ask why EMTs seem so underpaid relative to their responsibilities, the state’s underfunding is a major -- if not the -- reason why: The state is shortchanging them by $31.4 million now and if Cuomo’s proposal passes it will surpass $45 million. That’s not chump change.   

Many of UNYAN’s member organizations say that if the Legislature buys-in to this plan they will have to cut back on staffing and some companies in upstate – where there is an inordinately high population of senior and low-income residents -- might have to close altogether due to insurmountable funding gaps.

Underserved, or entirely unserved, communities are a very real possibility if Trump’s and Cuomo’s plans go through. If they do, pray to God you never need to dial 911.  

From the 25 March 2019 Greater Niagara Newspapers and Batavia Daily News

Monday, March 18, 2019

Open doors, open minds: Investing in our future

You might have seen me on WKBW’s newscast last week. The station was at Confer Plastics to do a story about seventh graders from West Buffalo Charter School who came to the plant to film footage of our processes and interviews of our people as a part of a contest called “What’s So Cool About Manufacturing?” which pits middle schools against one another in producing a flashy video about local factories.

The contest is a wonderful thing. It gives young men and women the chance to intimately explore a workplace on the plant floor and behind the scenes, giving them an understanding of what drives our economy and what is there for them in the future, showing them a clearer path to personal and professional success and fostering ideas about educational paths to pursue, be it college or trade school.

Kids need more of those experiences.

So do employers.   

Here is my challenge to the latter: Business owners and managers who routinely complain about the deficient workforce and the lack of available personnel need to do something other than whine. Get involved.

There is no doubt a crisis in the job market. Well-paying full-time jobs with good benefits are go unfilled with managers of blue-collar companies (factories, farms, trucking firms, the building trades) having a difficult time finding skilled workers or even apprentices interested in that line of work.

It’s an outcome of a few decades of misplaced priorities in society and education. Adults, whether in the home or in the classroom, had purposely driven kids away from the trades, thinking that such careers are demeaning and low-paying, on the path to extinction, and that college is the unquestioned key to success.

None of those beliefs are true nor have they ever been. Now, the adults who once believed them are waking up to that, especially since recent college grads find themselves crushed by debt and unable to find a good job due to an overabundance of college degrees, alleged over-qualification, and a lack of opportunity.

Teachers, counselors, policymakers and parents have done a 180 over the past half-decade or so, changing the culture that their predecessors had put into play for far too long. They are seeing the value in all work and all trades and doing what they can to promote them among today’s students.

But, after decades of society going in the other direction, it’s a tough sell and a slow one.

That’s where employers can help out.

They need to do as they do in their workplaces – get their hands dirty, get involved. They need to reach out to the schools and put themselves out there. Guidance from real world people can go a long ways in getting students interested in skilled work and settled on a career that will keep them comfortable for life.

It’s an easy and effective pursuit, one that we’ve practiced for some time at the plant and I strongly encourage other employers to follow suit. There are two simple ways that you can do this: host tours and let kids shadow.

Experiential learning is the best way to garner interest and that’s why tours are so effective. The kids can see people working, machines functioning, and goods being produced. The awesomeness of what you do every day can be an attention-grabber. It doesn’t matter if you manufacture kayaks, milk cows, or build houses – kids will eat it up. I’ve had students from fifth grade through college students go through the factory, all of them with wide eyes and keen interest.

Shadowing takes tours to another level and to make it happen it generally requires a full day and your willingness to share a lot of your time and knowledge -- and that of your coworkers – with students. We’ve done this quite a few times with students from schools like Barker and the former Niagara Catholic and with an Explorer Post we hosted on-site. They were able to choose from various career paths and observe what our folks do while hearing of the finer details of why they do it from various mentors.       

While most employers won’t directly benefit from such activities -- the chances of you recruiting someone for your company is slim (and it should not be your goal) – those kids with whom you speak will. It will give them interest, purpose, and direction.

If you are serious about the quality of our workforce, the future of our kids, and the health of our economy, partner with our local schools and open your doors and open your hearts -- doing so will open the students’ minds. Your investment of time is in an investment in the future.

From the 18 March 2019 Greater Niagara Newspapers and Batavia Daily News

Friday, March 8, 2019

Proposed overtime rules will hurt New York’s farm economy

There’s a bill up for discussion in Albany that would bring dramatic changes to New York agriculture. S2837/A2750 is a multi-faceted proposal that would change how farm labor is managed, from allowing collective bargaining to mandating a day of rest.

The most troubling aspect of the bill is the introduction of overtime pay to the state’s ag economy.

When the New Deal’s Fair Labor Standards Act was passed in 1938 it mandated overtime for work over 40 hours. Farm workers were excluded from this benefit because lawmakers wanted to ensure higher labor costs did not drive up the cost of produce, meats, and dairy so consumers could afford those life-sustaining necessities.

No states have made exceptions to that rule except for California where Governor Jerry Brown signed a bill in 2016 that entitles farm workers to the same overtime standards afforded other workers. The impact of that legislation has not yet been felt as it is being phased-in over a 4-year period beginning this year. It will be in full effect for the majority of California farms by 2022, and 2025 for enterprises with 25 or fewer employees.  

If New York State were to join California as the only states to set such rules it would be a long time before they would be joined by others, if ever: Other agriculturally-focused states aren’t entertaining the idea at all. The only thing that could bring about wholesale change would be an amendment to the aforementioned FLSA in the federal government and that’s not happening anytime soon.  

So, until something does change the realm in which those increased labor costs exist – costs mandated by the state and not market factors – New York farms will be at a disadvantage against farms from other states and other countries with lower input costs. That imbalance would especially manifest itself in labor-intensive goods that can’t be prepared and harvested by a machine such as apples, peaches, cherries, and milk.  

In order to properly compete across state borders New York farms would find it difficult if not impossible to pass the newfound costs onto food processors and consumers. New York growers and ranchers would have to eat those costs.

In consort with New York’s dramatically-rising minimum wage rates – which, as a domino effect, still impact farmers even though they pay well above the minimum – the loss of profits will have a detrimental effect on their bottom line. Estimates revealed by Farm Credit East and the New York Farm Bureau show that in frightening ways: Looking at a five-year average of financial results it has been determined that the bill would increase ag labor costs across the state by $300 million, a 17 percent leap.

What does that mean to individual farming sectors, specifically those mentioned earlier? Greenhouse and nursery operations will see their profits drop by 58 percent. Fruit growers will see theirs decline by 74 percent. Dairy farms will see all of their profits wiped out.

This could not come at a worse time. This columnist has written before of the dire straits faced by New York dairy farmers as a result of changing global demands and evolving import/export laws – over the past 5 years the Empire State has lost a fifth of its dairy farms and debt-buried farm owners have been taking their lives, or have contemplated doing so, at a rate that’s achieved crisis level. And, then, there are the vegetable and grain growers who have taken an absolute beating and are worried about the future due to international trade impasses created by the Trump Administration.

As a non-farmer you’ll feel the pain, too.

For the most part, the upstate agriculture economy doesn’t exist in a bubble as farmers are competing with others from around the world but smaller bubbles do exist at the local level where you, as the consumer, are into buying local from markets, co-ops, community supported agriculture (CSAs), and roadside stands. There, unlike with interstate and international trade, the costs have to get passed on to you. Will you enjoy shelling out a half to two-thirds more for the summer and autumnal bounties you so much enjoy?

And what of your neighbors? We often hear that the poor and those on fixed incomes cannot afford farm fresh foods -- this will only serve to drive them further from the marketplace.

Of course, this is a bill introduced by legislators from metropolitan New York City (Senator Jessica Ramos and Assemblywoman Catherine Nolan) who are totally disconnected from where their food comes from and how it is grown and raised. If they chose to actually understand and experience the farm economy they would know farm workers get paid a decent dollar, are granted extra cash for the quantity picked, and are provided housing and transportation. Those are great, and costly, investments in the workforce – let’s not drive them up higher.

This bill will be disastrous if it passes. It will only make worse an already-ravaged upstate economy by harming farmers, your community, and your pocketbook. 

From the 11 March 2019 Greater Niagara Newspapers and Batavia Daily News