Posts by admin

Do You Know Why You Buy The Insurance You Buy?

Posted on by admin

This is a very valid question given that very often when we speak with executives, they question what insurance coverage they have—and why they need it at all. We often buy insurance simply because that is what we have done in the past. In other cases, it may be because someone such as a lender or customer is requiring it. It’s important to understand that insurance is meant to finance risk. As such, it is a valuable exercise to consider the risks you want to mitigate with insurance and make sure you are purchasing the coverage that will help you a achieve that goal.

A simple example: Property Insurance is often purchased to replace the building, and Business Interruption Insurance to pay for lost profits while the building is being rebuilt after a disaster occurs. However, for most companies, the real goal is to retain their clients that might leave if they cannot be provided with services or products while facilities are being rebuilt. Therefore, a more focused approach is to work out a plan to continue providing your services or products during your rebuilding process, and purchase Extra Expense coverage to cover the extra expenses incurred to implement this plan.

Business leaders must also consider the ramifications of expanding litigation and legal system abuse. Unfortunately, this increases the chances of being sued even if you are not at fault.  Defending these cases can be expensive. Insurance is a strategy to pay for the cost of defense as well as any damages for which you may be liable.

Flood is another example of risk that is changing so we may need to alter our normal response to planning for flood as well as how we think about purchasing this coverage. Flood is typically only purchased in high-hazard flood zones like low areas near rivers and lakes. The world today is dominated by short periods of extreme rainfall that creates run-off and short-term flooding in areas that normally do not flood. Many more people are at risk that were never at risk before.  Questions to ask:  Are you in the path of rainwater run-off? Do you have methods of reducing the impact of flood? Should you purchase the Flood Insurance coverage?

Many businesses rely on controlled environments that, if they fail, can create loss. Some examples include cleanrooms that can take months to recertify if the environmental controls systems fail; or crop/food/livestock storage areas in which the food or animal could perish if the environmental controls systems fail. The leading risk for environmental control systems failure is human or computer error. Both are excluded from standard business interruption insurance. An insurance solution is to seek coverage that is customized to include these causes of loss, thereby protecting those specific risks.

Most liability insurance is based upon providing coverage when you cause property damage or bodily injury. But what if you cause financial harm only? That is where coverage such as Professional Liability and Directors and Officers coverage can be an important consideration.

Insurance names are not always what they appear. The name General Liability Insurance would suggest it covers General Liability. That is not the case. Many things are specifically excluded in this policy. It is important to understand if these exclusions are relevant to you and your business. For example, imagine a business that owned a truck that was used solely on its property. Owners often believe they do not need to purchase Automobile Liability coverage because their vehicle is not being registered and used on public roads. Many GL policies exclude the liability associated with vehicles that are meant to be driven on public roads. So, if an employee were to accidentally run over someone on the property, the loss could be excluded on the GL policy.

According to FEMA, 40 percent of businesses never reopen after disasters and another 25 percent fail within one year. The U.S. Small Business Administration found that over 90% of companies fail within two years of being hit by a disaster. These are truly alarming statistics that imply that companies can do better at risk management planning.

No matter how knowledgeable and experienced your insurance broker is they cannot provide you with the most effective risk management solutions without working closely with you to understand the specific risks associated with your business, your plans to mitigate that risk and your priorities in financing the risk either directly or with insurance.

Lippes Mathias LLP Combines with Syracuse-Based Health Care Firm CCBLaw

Posted on by admin

Lippes Mathias LLP Combines with Syracuse-Based Health Care Firm CCBLaw, Expands Lippes’ National Footprint to Include Every Major City in New York. The combination creates one of the largest New York health care teams outside of New York City.

Lippes Mathias today announced it has combined with CCBLaw, a Syracuse-based law firm with a respected national reputation for providing innovative legal services to clients in the areas of health care, business, labor and employment and real estate. Eleven attorneys, with two set to be admitted on June 17, as well as eight staff members, will join Lippes Mathias as part of the move.

With this combination, Lippes Mathias now has 197 total attorneys with 158 staff and 15 offices across the country.

“When we execute our growth vision, we continue to emphasize the right cultural synergies, and the match with CCBLaw is no exception,” Kevin J. Cross, Lippes Mathias’ managing partner and chairman, said. “The new Lippes attorneys bring exceptional experience and capabilities that pair perfectly with our health care team—creating one of the largest health care practices outside of New York City. I’m proud to note that this expansion also marks a significant milestone in Lippes Mathias’ growth story as our national footprint of 15 locations now reaches every major New York market.”

CCBLaw, one of only two Central New York law firms ranked Metro Tier I in health care law by Best Law Firms, provides legal and consulting services to health care clients, including group medical practices, private practice physicians, dentists, and allied health professionals, hospitals, ACOs, physician organizations, independent practice associations, ambulatory surgery centers, and other facilities throughout the United States.

“This is the right move at the right time, compounding value and opportunity for both groups,” Michael J. Compagni, former CCBLaw managing member and new Syracuse office leader, said. “Our entire team is excited to join Lippes Mathias—well-known and regarded for its people-first approach to the business of law. Lippes’ emphasis on culture creates an environment where attorneys and staff thrive. We’re thrilled to be a part of a growing firm that is doing it differently.”


Marc S. Beckman, a founding member of CCBLaw, will co-lead Lippes Mathias’ health care practice team alongside Brigid M. Maloney, partner, Lippes Mathias.

“Since we have been representing so many practices with respect to private equity-backed transactions in the health care field, we wanted to align ourselves with a firm such as Lippes that will benefit our clients by allowing us to bring greater breadth and depth to our team,” Beckman said. “Our footprint has always been larger than Central New York, and together with the diverse practice areas, resources, infrastructure, and geographical footprint of Lippes, this mutually beneficial integration allows us to provide a broader scope of legal services to our clients long into the future.”

Former CCBLaw attorneys are nationally recognized for their extensive background in complex federal regulatory and statutory issues, including the federal physician self-referral prohibition or Stark regulations, fraud and abuse and anti-kickback laws, professional license defense as well as compliance and repayment actions involving both entitlement programs and third-party payors. The team regularly handles mergers and acquisitions of professional practices, establishment of ambulatory surgical centers, development of joint ventures among healthcare providers (including both private practices and hospital systems), development and maintenance of large group practices, space sharing arrangements, employment matters including litigation and employee leases, professional services agreements, exclusive provider agreements, and telehealth arrangements. On numerous occasions, the team has successfully defended clients in government and third-party payor audits and investigations and in settlement negotiations of reimbursement issues with Medicare, Medicaid, TRICARE, and all other third-party payors.

Former CCBLaw attorneys and staff will continue to work out of their office space at 507 Plum St. in Syracuse. For more information about the combination or to learn more about Lippes Mathias’ health care services, call (716) 853-5100 or visit lippes.com.               

About Lippes Mathias LLP
Lippes Mathias is a full-service law firm with nearly 200 attorneys serving clients regionally, nationally, and internationally. With offices in Buffalo, Clarence, Albany, Long Island, New York, Rochester, Saratoga Springs and Syracuse, N.Y.; Greater Toronto Area; Chicago, Ill.; Jacksonville, Fla.; Cleveland, Ohio; San Antonio, Texas; Oklahoma City, Okla. and Washington, D.C., the firm represents publicly and privately owned companies, private equity and venture capital firms, real estate developers, financial institutions, municipalities, governmental entities, and individuals.

The Importance of Culture in Health Care

Posted on by admin

Kathy Ruscitto

A few months ago I had the opportunity to hear two physicians talk about their careers as they received recognition. Dr. Kara Kort, a surgeon, and Dr. James Tucker, a family physician.

Both are esteemed by their patients and colleagues. They are passionate about the profession they chose and the work they do as physicians and leaders in their disciplines.

As they spoke, the words, tone, and tears they shared all spoke to service to others. They chose medicine to help people.

In his remarks Dr. Tucker thanked to his patients for letting him be part of their villages, lives and families.

Dr. Kort talked about how being vulnerable in her own life experiences , enabled her to help patients at critical points in their lives.

Health professionals often choose their career to contribute to improving  the  health of others. Clinicians  value their  professional expertise, training, the ability to give their patients high quality care , and collegiality across a health care system.

The reality is they are facing complex systems that require automation, long hours to balance their complex demands, and frustrated patients with payer barriers. We knew we were going to face a large segment of retirements across physicians and nurses, COVID accelerated those trends. The current system feels broken to many clinicians and patients.

In an article in Medscape, Drs. Toprol, Verghese and Pearl discuss Physicians’ roles in accelerating  system changes to improve patient care. They all suggest some of the challenge is clinician resistance to letting go of old culture, and adopting new more efficient options like telemedicine. Changes that allow patient access and follow up during workforce shortages is better than delayed, or no care at all.

Other experts feel the most important investment we can  make is a shift away from fee for service care to value based care, aligning incentives around patient outcomes. 

While these examples may be part of structural system redesign, shared culture is equally important.

Medicine is a team sport. It requires collaboration across a spectrum of disciplines, workforces, and payers. We must listen and value the input of the health professionals if we are to rebuild our health systems culture and workforce to continue to provide high quality patient centered care. System redesign alone, in the absence of shared culture will not resolve our issues.

Right care, right time, right place, right cost is often included in marketing and headlines these days. The underlying assumption being we have a shared culture of achieving this care. 

As you plan retreats , strategy and future goal sessions, spend time discussing culture and clinician input into our future in health care. It is the most important thing we need to do to meet our challenges.

Resources:

Healing the Professional Culture of Medicine – Mayo Clinic Proceedings

To End Burnout, Doctors Must Change the Culture of Medicine

https://hbr.org/2022/09/5-steps-to-restore-trust-in-u-s-health-care

 

Thirty-five years and Growing

Posted on by admin

What’s next for CPS Recruitment? Strong presence in advanced manufacturing

By Martha Conway 

CPS Recruitment was founded in 1989 by Laurie Liechty under the names Contemporary Personnel Staffing and Professionals Incorporated. These companies were joined under the name CPS Recruitment in 2015. When Liechty was preparing to sell the business and retire, she approached Susan Crossett about doing some consulting work for her to help prepare for the transition. This consulting opportunity brought their relationship full circle, since Crossett’s first professional job out of college was in staffing and recruitment. She began her career as a recruiter at the J.W. Willard agency, hired by Liechty herself.

Crossett was born, raised, and educated in Central New York. A graduate of C.W. Baker in Baldwinsville, she earned her bachelor’s degree in political science and a master’s degree in public administration from Syracuse University. For the past four years, she has been the leader of CPS Recruitment headquartered in Liverpool, which is celebrating its 35th anniversary this year.

Crossett worked in recruitment for about 18 months before taking a position with Associated Builders and Contractors (ABC). While at ABC, Crossett honed her lobbying skills representing contractors’ issues before the state Legislature. From there, she continued her lobbying career working for the Manufacturers Association of Central New York (MACNY). As a result of her legislative work on Workers’ Compensation issues, Crossett was then appointed to serve as the First Special Assistant to the Workers’ Compensation Board Chairman. Building upon her lobbying career, Crossett transitioned to Carrier Corporation, representing the company in the states where Carrier had manufacturing facilities. Working closely with Niagara Mohawk on a new electric supply contract for Carrier led to her being recruited to work for Niagara Mohawk, heading up their government affairs department. Crossett had several roles at National Grid, ultimately as the officer responsible for U.S. economic development and community investment. After leaving National Grid, Crossett worked for the Sisters of Saint Francis of the Neumann Communities overseeing their incorporated ministries, including hospitals and long-term care facilities among others. She also consulted on energy matters for clients of Harris Beach, LLC.

Crossett did her homework during the consulting project with Liechty, saw the long-established business as a good turnkey investment and put in a successful offer against other contenders. She took the helm of CPS Recruitment Jan. 4, 2020 – right before the COVID lockdown.

“We had just had the best month in the history of the company,” Crossett said. “Then COVID hit, and the state mandated the vast majority of our clients to shut down operations. Our business experienced an immediate slowdown and companies stopped hiring.”

Through perseverance and tenacity, Crossett and her team made sure CPS Recruitment recovered. She expanded the business, adding staff to locations in Buffalo, Binghamton, Washington, D.C., and Charlotte, N.C. Over the years, the firm has grown to 30 people.

“We are a local company supporting local businesses while also growing outside of our region,” she said, explaining that CPS Recruitment also serves national clients.

“I can’t take a lot of credit for building the team,” Crossett said. “The team was in place when I bought the company. It’s one of the reasons I wanted to buy it; I felt it would be a nice fit for me. There are people with more than 20 years of history here, and the average length of employment among our employees is greater than 10 years.”

She said the reason the team is so successful is their commitment to clients and candidates, and she is doing whatever she can to cultivate that environment.

“Letting team members have the ability to do what they do best is the most important thing I can do,” Crossett said. “We set goals together, then I let them go.”

Crossett gives her staff the support and tools they need to do their jobs and provides a flexible hybrid work environment allowing for work-life balance.

Crossett said she embraces a collaborative leadership style. She is transparent about acknowledging areas that aren’t her strength and relies on her partnerships with her team – as well as industry colleagues – to help her promote an atmosphere of continuous learning and growth. She said she has held ‘team mix-up’ events where different staff are grouped together to brainstorm ideas for continuous improvement.

“They came up with some really great ideas, decided what they wanted to accomplish and developed plans for how to go about it,” Crossett said. “Everyone works very well together.”

Crossett said that teamwork doesn’t just evidence itself in theory or tabletop exercises, either. She said CPS Recruitment has had a number of situations where clients needed to ramp up staffing levels in a very short span of time.

“Rather than the client needing to hire additional human resources staff to fill hundreds of positions, our team bands together and works to get it done,” she said. “We all work to consistently exceed client expectations and satisfy their growth needs.”

Crossett said there is tremendous satisfaction in not only supplying staff to meet employers’ needs, but also in helping a wide array of people to find jobs.

“From placing a senior vice president to helping someone find their very first job – we work with a lot of new Americans to help them find jobs,” she said. “It’s incredibly gratifying.”

CPS Recruitment searches for potential candidates for short- and long-term temporary assignments as well as direct hires; their areas of expertise include software and hardware engineers, accounting professionals at all levels, supply chain professionals, administrative and call center roles, IT, technology and engineering, project management, supply chain, healthcare, warehouse fulfillment and manufacturing positions from production to senior management.

Crossett said she is bullish on the future of the region, as manufacturing is making a big come-back.

“We have already begun growing our specialized vertical in advanced manufacturing,” she said. “We have always served the manufacturing industry, but we are preparing additional dedicated recruiters – getting them the information and training they need – to focus on this specialty. I can’t emphasize enough the need for more workers in our region so we can match talent needs with skills needed.”

CPS Recruitment uses a variety of strategies to find the specialized staff they seek.

“We attend and host job fairs, connect with job-training programs, do extensive networking and sourcing, utilize all the major job boards and niche sites, such as ThisisCNY.com, and post to the major social media outlets, including Facebook, Instagram and LinkedIn,” she said.

Partnering with CPS Recruitment provides employers and employees with the opportunity to ensure a good fit before either party commits to permanent employment.

“We can also provide help for project work,” Crossett said, “and these employees work until the project is done. This is an ideal situation for people who only want to work for a limited time, or, say, only want to work winters. There are professionals who may want to work on certain projects that can expand their resume, but not necessarily commit to a single company and doing the same thing for many years.”

CPS Recruitment, through relationship-building and team development, has cultivated a network of long-term relationships that has positioned them as a trusted partner to their clientele.

“One of the ways we do this is by really listening to our clients’ needs,” Crossett said. “We take the time to truly understand the nuances of the job, and we do the same thing for potential employees. We work with firms of all sizes, and they appreciate that we are all trying to do a good job for them. Being here 35 years later, we must have gotten a lot of things right.”

Crossett believes there are clients who are familiar with one facet of what CPS Recruitment does but aren’t aware of the other services they provide.

“Professional staff may not know we do temporary and contract work.” she said. “There are a lot of different aspects of the business. We pride ourselves in being partners with our clients and candidates, rather than just having transactional relationships. Our efforts to be an extension of the team on the client side and to truly partner with candidates has served us very well, and if we don’t have anything that seems like a good fit on one side or the other, we’re honest about that and tell them we’ll keep looking. These efforts cultivate the relationships that truly set us apart from others.”

For more information, call 877.457.2500 or visit cpsrecruiter.com/.

Embracing Growth Together:

Posted on by admin

Empowering Talent and Embracing Opportunities in CNY Manufacturing

Meghan Durso, Senior Human Capital Manager, TDO

In Central New York (CNY), the manufacturing industry isn’t just a sector; it’s the heartbeat of our community, pulsating with endless possibilities for those seeking meaningful careers. Yet, amidst the bustling production lines and innovative technologies lies a treasure trove of untold opportunities waiting to be discovered.

Did you know that right here in CNY, millions of gallons of life-saving cancer drugs are crafted, alongside the assembly of luxurious 24k gold elevators? Every night, two million pounds of food journey from Syracuse to nourish countless families. And that’s just the tip of the iceberg. From cutting-edge military technology to the meticulous craftsmanship of electronic components, our region is a hub of excellence and innovation.

What sets us apart, however, isn’t just our impressive output—it’s our people. Our talent pool thrives on innovation and a commitment to quality, shaping not only the present but also laying the foundation for our future successes.

As we navigate the evolving landscape of manufacturing, it’s crucial that we adapt our approach to talent acquisition and development as well. Here are some key strategies I’ve observed leading to success:

Fostering Genuine Connections: Beyond conventional interviews, it’s essential to foster genuine connections with candidates. By offering insights into our facilities, allowing job shadowing, and engaging in meaningful discussions, we can ensure alignment not just in skills but also in values and purpose. Remember, hiring is not a race; it’s a journey of discovery, where investing time and intentionality pays off in the long run.

Cultivating Loyalty: In a world where job insecurity looms large, transparency and support are paramount. By openly communicating growth plans and investing in skill development, we can create an environment where employees feel valued and committed for the long haul. Let’s aim not just for a workforce but for a community of dedicated individuals who see their future intertwined with ours.

For more information on this topic, please contact Meghan Durso, Senior Human Capital Manager, TDO at Meghan@tdo.org or visit online at www.TDO.org to learn more about the services available at TDO.

 

 

Succession Planning…

Posted on by admin

Earl R. Hall, Executive Director – Syracuse Builders Exchange

Succession planning is never easy and generally not a topic construction industry employers want to think about – until they have to.  In my tenure as Executive Director of New York’s largest construction industry Association, I have assisted employers during their succession planning exercise, which has provided perspective on our members and what options they evaluate as they prepare to assure their business continues. 

Hanging up one’s hard hat for the last time should be a rewarding experience.  Whether you are a business owner, superintendent, foreman or journeyman, reflecting on your career and the industry you leave behind will generate a wide range of emotions.  For business owners, knowing you have a succession plan will provide peace of mind, financial security, and a sense of accomplishment, especially if family is involved in the plan.

Professionals such as accountants, attorneys, bankers, and investment advisors should be engaged during the due diligence process.  Obtaining professional advice is essential in developing a plan, identifying potential options, and avoiding unforeseen issues which might adversely impact the execution of a succession plan.   Additionally, such advisors will help one navigate how to implement the succession plan and what role, if any, the business owner will have during and/or after the transition.

Understanding the assets and liabilities of the business is essential, keeping in mind the company’s greatest assets may be the leadership team and employees.  Identifying potential successors to transition the business in many cases comes from within, so explore such options with those within the company, including employees and family members.  Communicating with those employees and/or family members will provide valuable feedback relative to interest in exploring a succession plan.  From there one can determine whether or not a business consultant or broker may be necessary to identify additional external options.

When to begin exploring a succession plan may vary depending on a range of unique facts and circumstances, so developing a plan with an adequate time frame is essential to obtain goals and objectives.  Planning for the unexpected is being proactive, so working with the company’s executive leadership team, family members and professionals will provide an initial strategic road map for the future.  While there is no certain age to begin succession planning, one should always have at a minimum a business plan in place which would address the “unexpected” event that would impact the ownership of a business.

While the process of succession planning may be similar for all construction industry employers, those employers’ signatory to one or more construction collective bargaining agreements must be aware of potential issues.  Such issues may impact one’s ability to sell the business and/or transition the business to family members.

Union contractors will need to evaluate the termination dates of all collective bargaining agreements and determine how such agreement may or may not impact a succession plan.  Generally, in a business transition or new ownership situation, existing collective bargaining agreements are also transitioned to the new owners of the business, unless the agreements have been properly terminated. Obtaining advice from an attorney familiar with the construction industry and labor agreements will be critical to assist in the decision-making process.

In determining whether or not terminating one or more collective agreements is necessary to effectuate the succession plan, one should consider the impact of any employer withdrawal liability relative to a signatory union’s pension fund or funds.  Determining the employer’s unfunded withdrawal liability should be done by requesting the union pension fund actuary calculate the employer’s withdrawal liability in the event such is triggered by terminating the collective bargaining agreement.  This disclosure may impact the decision-making process or impede one’s ability to implement a preferred or potential succession plan.

Developing a succession plan can be an arduous exercise; however, it is necessary if the desire is to continue the business in the unlikely event of an unexpected matter or while considering retirement.  Surrounding yourself with a great support team of professionals and other invested individuals who care about the employer will pay dividends during the succession planning process.

Why Insurance Rates Are Increasing and What To Do About It

Posted on by admin

Pierre Morrisseau

Please excuse the pun, but the insurance industry is in the midst of a “perfect storm.”

After rates across all classes have been relatively flat for a number of years, insurance carriers are facing dramatic increases in both risk and cost of claims forcing them to dramatically increase premiums to meet state and federal reserve requirements, and in some cases, to even remain solvent.

Let’s take a closer look at what is driving costs to insurance premium increases.

Weather: Climate change and major losses around the globe from severe winter storms, severe summer storms and flooding, vast wildfires, hail, tornadoes and of course, hurricanes impacting ever-larger coastal and city populations. According to the National Centers for Environmental Information, the U.S. sustained 377 climate disasters since 1980 where damages exceeded $1 billion. The total cost of these 377 events exceeded $2.6 trillion. As populations swell in severe weather zones, so, too, has the cost of insurance soared. By comparison, all of the 1990s (1990-1999) saw 57 weather disasters costing over $327 billion, or about $32 billion per year. Last year alone, there were 28 ranked storm disasters costing $93 billion.

Severity and Cost of Auto Accidents: According to Kelly Blue Book, the average price of a new car in 2023 was $48,008. The severity rate for auto accidents has increased for the first time in decades as the cost and complexity of vehicles increases. Distracted drivers increase the frequency rate of accidents adding to the dramatic increase in vehicle insurance rates.

Inflation: Homes, autos, home contents, repair costs all have risen dramatically since the pandemic amidst supply chain disruptions, employment stresses, general inflation, all of which impact the cost of claims.

Social Inflation: Liability risk has soared due to a less well understood phenomenon defined as social inflation (the belief that someone must pay), resulting in massive liability settlements and dramatically increased legal activity.

Investment in Lawsuits: Driven by social inflation, lawsuits have increased. Organizations with deep pockets are the targets. Have you noticed the amount of advertising by Attorneys? This is often funded by outside investors who will provide capital in exchange for a stake in the settlement. The result is larger settlements but much of that may not be going to claimants.  This has quickly become big business. In Florida, one of the primary drivers of increased property insurance was a law that allowed homeowners to sign their rights to the claim to contractors who, working with attorneys, threatened suit against insurance companies if they failed to pony up.  Homeowners were actively solicited by contractors, driving up insurance costs of claims to twice as much or more of what they would have been. According to the Insurance Information Institute, 79% of all homeowner’s insurance lawsuits are in the state of Florida alone.  Consumers pay for these increases. 

Reinsurance Markets: Reinsurance is the insurance that insurance companies buy to spread their risk. Reinsurers, too, are under severe cost pressure, drastically increasing rates that must be added to the carriers’ own premiums. In addition, they have reduced the available limits, reduced coverage of specific triggers like wind and flood in high-risk areas, limited the types of buildings and locations that carriers can insure and limited the amount of reinsurance available. This has resulted in insurance companies changing their underwriting criteria and charging more or limiting the ability to provide coverage.

So, what should you do? First, know the basis of your risk. If it is your personal insurance – the age of your roof and your ability to prevent water damage claims is critical. Modern technology can detect any water flow and turn your system off before damage is incurred. Dash cams have become an important defense in proving your innocence in car accidents.  For businesses, it is important for underwriters to know how you are controlling risk as it can significantly affect the cost. Are you able to tell them your story? Will the insurance carrier and broker work with you to improve your risk management systems and support your business goals? There are other important steps that you should explore with your insurance broker that can help mitigate insurance costs increases.

 

Paramedicine: Creating a First Line of Access and Follow-up in our Communities.

Posted on by admin

Definition: Community paramedicine is a relatively new and evolving healthcare model. It allows paramedics and emergency medical technicians (EMTs) to operate in expanded roles by assisting with public health and primary healthcare and preventive services to underserved populations in the community.” Rural Health Information Hub

Recently I wrote about new models developing in primary care. From telemedicine to urgent care, access for certain conditions can be met as an adjunct to the traditional primary care physician .

Paramedicine has been developing in many states since 2009. Every community has different needs, and Paramedicine programs look different from community to community.

What these programs have in common is identifying what will help the existing health care system in that area by addressing unmet needs.

A scan of existing programs suggests common focus areas include:

911 triage to prevent dispatching an ambulance crew.

Chronic Care management in the home, in collaboration with home care, hospice, health departments or primary care practices.

Preventing readmissions or ER visits by offering some chronic care education services in the home and facilitating communications with providers.

Helping patients get to the right setting and identifying resources to support them.

Immunizations.

Supporting the frail elderly in remaining at home with extra support.

In NYS there are pilots underway to look at Paramedicine as part of the health landscape. In others states these programs have long been a successful part of health care. Florida in particular has a compete manual for ambulances to approach certification and to train ALS paramedics.

The current demonstrations in NYS were funded by the Mother Cabrini Health Foundation, awarding grants to the Iroquois Association and the NYS Home Care Association. These pilots are about to expand from three to six. They have worked best in areas where a champion within the department takes lead in the community collaboration. Gary Fitzgerald the CEO of Iroquois notes, “EMS providers can be used more effectively in our communities.”

I spoke with the pilot in Jefferson County that is working in collaboration with their Health Department and home care agency. Paul Barter, the Jefferson County EMS Director was enthusiastic about the impact of their pilot program in Jefferson County. He stressed how excited his providers are in helping patients better understand their disease, medications, and have a better quality of life. A review of their data tells them they are reducing calls to 911 and transports to emergency rooms.

These pilots are particularly important in areas where primary care has contracted, or the local ER has closed. Workforce shortages have also hit Ambulance Corps and foundations and the Health Department should look at investments and incentives to help EMS providers expand through Incentives, including scholarships and tax credits.

There are so many positives to community based care in improving health outcomes. Paramedicine is one part of a growing system of options for communities to consider. The NYS Health Deportment should make these programs a permanent option in the NYS Healthcare landscape.

References:

https://www.ruralhealthinfo.org/topics/community-paramedicine

https://www.flexmonitoring.org/sites/flexmonitoring.umn.edu/files/media/bp34.pdf

https://paramedicnetwork.org/mce/

https://emsa.ca.gov/community_paramedicine/

https://www.iroquois.org/

Kathryn Ruscitto, Advisor, can be reached at linkedin.com/in/kathrynruscitto or at krusct@gmail.com

 

 

 

New Rule to Determine Worker Status Under the Fair Labor Standards Act

Posted on by admin

By: Allison B. Cherundolo, CCB Law

A new final rule from the United States Department of Labor (“DOL”) went into effect on March 11, 2024 that changes how to determine whether a worker is an employee or an independent contractor under the Fair Labor Standards Act (“FLSA”). Rescinding the 2021 rule under which two key factors – control over the work and opportunity for profit or loss – carried greater weight, the final rule applies a six-factor test to ensure that an employer’s classification of its workers complies with the protections of the FLSA, primarily appropriate minimum wage payments and entitlement to overtime.

The six-factor test applies a “totality of the circumstances” analysis of the “economic realities” of the work relationship meaning that each factor is weighed equally on a case-by-case basis. The DOL has stated that its intent is not to give one factor a predetermined weight over the others. Thus, no single factor listed is determinative.

The following provides an overview of each of the factors that must now be considered in classifying workers as employees or independent contractors.


1. The Opportunity for Profit or Loss for the Worker

When evaluating the opportunity for profit and loss, an employer should consider facts such as whether the worker determines or can meaningfully negotiate the charge or pay for the work provided; whether the worker accepts or declines jobs or chooses the order and/or time in which the jobs are performed; whether the worker engages in marketing, advertising, or other efforts to expand their business or secure more work; and whether the worker makes decisions to hire others, purchase materials and equipment, and/or rent space. The more of these things a worker does the more likely it is that they would be determined an independent contractor as opposed to an employee.

2. Investments of the Parties

This factor considers whether the worker’s investments “support an independent business and serve a business-like function, such as increasing the worker’s ability to perform different types of or more work, reducing costs, or extending market reach” – and how that compares to the employer’s investment in the business overall.

3. The Degree of Permanency of the Work Relationship

A work relationship that is “definite in duration, non-exclusive, project-based, or sporadic based on the worker being in business for themselves and marketing their services or labor to multiple entities” would weigh towards classification as an independent contractor whereas a work relationship that “is indefinite in duration, continuous, or exclusive of work for other employers” would weigh in favor of classification as an employee.

4. The Nature and Degree of the Employer’s Control Over the Work

When considering this factor, an employer should evaluate whether it sets the worker’s schedule, supervises the performance of the work,…explicitly limits the worker’s ability to work for others, uses technological means to supervise the performance of the work, reserves the right to supervise or discipline workers,…places demands or restrictions on workers that do not allow them to work for others or work when they choose [, and/or] controls economic aspects of the working relationship…, including control over prices or rates for services and the marketing of the services or products provided by the worker. The more control an employer exercises over a worker the more likely this factor will favor classification as an employee as opposed to an independent contractor. Notably, control within legal requirements for safety, quality, and customer/patient standards may not necessarily dictate an employer-employee relationship.

5. The Degree to Which the Work is an Integral Part of the Employer’s Business

This factor considers not whether the worker is an integral part of the organization, but whether the work being performed is “critical, necessary, or central” to the company’s primary business. The less critical the work is to the organization, the more likely this factor favors classification as an independent contractor.


6. The Worker’s Skill and Initiative

The final factor focuses on the worker’s use of specialized skills. Where “those skills contribute to business-like initiative” this factor will favor classification as an independent contractor. However, where workers rely on the company for training to perform the work this factor will favor classification as an employee.

Renaissance Groups: Celebrating 30 Years of Community-Centered Innovation

Posted on by admin

By Elizabeth Landry

Sandy Paben has always been drawn to work that helps improve the condition of people in high-needs communities, although that work has taken different shapes and forms over the years. When she came to Syracuse to attend LeMoyne College in the late 1970s, she participated in a program called Projects in the Community, which involved doing volunteer work in Syracuse’s inner-city neighborhoods. Paben eventually went on to teach at Lincoln Middle School, then served as Vice Principal and Prinicpal at several schools in Upstate New York, becoming involved in teacher and staff training focusing on technology in the classroom. In 1994, Paben created Renaissance Groups, an endeavor that allowed her to delve deeper into her true passion of helping people in high-needs communities.

“You’re going to find me in tougher neighborhoods and places where people need a lot of help. Looking back, I’ve realized I was always attracted to working in high-needs communities, but if you had asked me at the time when I started Renaissance Groups, I probably couldn’t have articulated that. This work really has such a huge social worker bent. It’s all about helping people become self-sufficient and independent and helping the world become a better place, even if it doesn’t seem like it has anything to do with that on the surface,” Paben explained.

Since those early days when Paben was finding her true calling and cultivating the company, Renaissance Groups has evolved and grown into the successful change-making force it is today, under her leadership as CEO. Celebrating its 30th anniversary this year, Renaissance Groups is a NYS Certified Woman Owned Enterprise with offices in Rochester, Syracuse, Buffalo, Albany, New York City and Stockton, California.

The company operates projects in all corners of the country, specializing in three main areas: compliance services, public housing services and educational services. In the construction compliance arena, Renaissance Groups assists clients with tracking minority and women labor utilization, minority and women business enterprise utilization and Section 3 utilization. The company’s public housing clients receive support relating to Section 3 compliance, family self-sufficiency and other ROSS (Resident Opportunity and Self Sufficiency) service coordination, in addition to many other programmatic needs. Stemming from Paben’s roots in teacher and staff training,

 Renaissance Group’s services in the educational realm involve 1:1 computer programs, curriculum and other resources that directly benefit both teachers and students alike.

Elevating Communities Through Affordable Housing

Although Paben began her journey with Renaissance Groups in the education and staff training fields, she has come to be incredibly passionate about the company’s work in affordable housing. By focusing on community development through compliance and oversight of projects that are building affordable housing and improving neighborhoods, Renaissance Groups is able to make a tangible, positive impact in high-needs communities. The company partners with housing authorities, developers, and contractors in many locations in order to carry out compliance management, working to track spending and labor requirements that come along with funding sources. Affordable housing projects over the past three decades have been completed in Florida, up the East Coast to Boston, throughout New York State and even in California.

For Paben, the drive behind this work is the immediate human impact these projects have within the community. “Affordable housing is my absolute passion because it helps folks who are usually incredibly rent burdened. We encounter folks who are one step away from being homeless. The opportunity to be able to work on projects that I know are going to give people safe, comfortable housing – it really is my passion,” Paben said.

When Renaissance Groups takes on a new affordable housing project, the local community is bolstered in many ways. It’s not only the local residents in need of affordable housing that are positively impacted, but also the local contractors who come from a diverse background, many of whom are women or minorities, that receive new opportunities that expand their professional horizons. Additionally, the local laborers who work on the construction site are often paid a prevailing wage that directly benefits their financial well-being.

Recalling moments when she has experienced the direct results of Renaissance Groups’ affordable housing projects, Paben further illustrated the human impact of the company’s work. “I can remember, 25 years ago a single mom who was able to move out of an extremely unfit, deplorable apartment into a beautiful, brand-new apartment, and it still makes me cry to talk about it. This work also allows us to help people of color and women to get opportunities to bid on these jobs, and it’s absolutely life-changing for them. Recently at a conference, I ran into a former client who we helped to start a janitorial business and is getting real jobs now. He said to me, ‘This would never have happened if it weren’t for you. You actually spend time with us,’ and that’s such a big deal for me. I’ve been so blessed that I’m able to make a difference in people’s lives,” stated Paben.

Opportunities to Advance Through Green Jobs

One of the most exciting and innovative projects underway at Renaissance Groups is the recent opening of a Green Economy Lab in Stockton, California in conjunction with the Housing Authority County of San Joaquin. Utilizing a 20,000-square-foot building purchased by the Housing Authority County of San Joaquin, Renaissance Groups is offering a 5-tier training program to help people get access to knowledge and skills needed to attain green economy jobs.

Paben explained the purpose of the training facility as well as the benefits to those who participate in the program. “It’s a place where folks who don’t have an invitation to the party can get involved,” she said. “Right now, we have a 5-tier program to get access to training. For example, if someone doesn’t have a high school diploma, we’ll help them get one. We offer a customer service class. We have an EV charging station installation and maintenance class. We have an EV car mechanic boot camp in which we offer an associate’s degree needed to become an EV car mechanic. Our goal is to get these folks ahead of the curve in this industry and it’s very exciting to get them trained on how to install an EV charging station, for example, because that’s really in its infancy right now.”

Going hand-in-hand with the innovation of the Green Economy Lab, Paben highlighted that the Renaissance Groups team regularly asks for feedback from high-needs communities to find out what they need in order to take advantage of the new opportunities at their doorstep. As part of a 2019 Jobs Plus grant for the Housing Authority in the County of San Joaquin, residents identified three needs they needed help with: transportation, training, and childcare. The grant wrapped up in August of 2023 and through the support offered to the residents that addressed their needs, the average income went up 44%.

Paben explained that this feedback from the community is what kick-started a new wave of strategy to help communities participate in cutting-edge technology and become more self-sufficient. “We started to tackle these needs one-by-one. The training piece is what led to the Green Economy Lab. We’re also really focusing on the transportation piece. By the end of next year, every single public housing site in the area will have a car share service. Even though it’s based in public housing, anyone in the community can rent a car for $4 an hour or $35 for 24 hours. This service, in addition to a van carpool we’re considering, is a huge benefit to the community because the public transportation system isn’t practical for these folks. How are you supposed to get a job if you don’t have reliable transportation? I would say these projects are what really make us innovative, because we’re helping them get what they need so they’re in a position to be at the cutting edge of technology coming down the pike,” Paben emphasized.

Keeping an Open Mind in an Ever-Changing Future

With 30 years of experience under her belt, Paben has learned that a good business plan includes the understanding that new innovations and compliance requirements can change things quickly. “Even though it’s uncommon in the world of business, I’ve never really had a master plan for Renaissance Groups,” said Paben. “In the compliance world, things can change really quickly. In terms of what the future looks and sounds like, I’m following my instincts in terms of what’s coming next. If you had told me five years ago that we’d be opening up a Green Economy Lab, I would have thought you were crazy.”

One plan Paben does have for the future is to hopefully take what the company has learned through its projects in California and implement similar projects in high-needs communities throughout Upstate New York. “I’m a Syracuse girl at heart. If I can figure out a way to bring some of this back to Syracuse and collaborate with people who are forward thinking, that would be monumental,” she said.

No matter what the future holds for Renaissance Groups, however, Paben is committed to remaining true to the goal of helping the people who are at the heart of every project. According to Paben, the way to continue doing just that is by keeping an open mind and being flexible when new challenges and opportunities arise.

“I want people to stop for a minute and think about what’s possible,” Paben said. “There are so many ways to change the world. We just have to think outside the box and be innovative, and really think about how we can use the infrastructure funding that’s out there to change people’s lives. If it’s important, you figure out a way.”