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County should come to the rescue of Hometown Health

   Is it possible that our elected leaders really don’t care about the poor? I am beginning to believe this is true. When I learned that Gov. Eliot Spitzer even considered taking money away from the Schenectady Free Clinic, which was money that would have been used to help the medically underserved, I was shocked and saddened.
   As board chairwoman and an advocate for Hometown Health Centers, it is also difficult for me to understand why our elected leaders refuse to help Hometown Health. The Gazette has been following the plight of Hometown Health and its financial struggles due to the dramatic increase in the uninsured population in the county.
   It’s true. In one year, Hometown Health has seen its pediatric uninsured patient visits increase over 250 percent. These are local children who have no health insurance. It’s become such a critical issue that we are holding an uninsured crisis forum on Oct. 30 at Sacred Heart-St. Columba Church in Hamilton Hill, so we can voice our concerns and seek solutions.
   Where are the county leaders on this issue? I am troubled by their familiar “there is only so much we can do” tone. Are they all heartless? We know help is available. Schenectady County somehow found a way to fund the arts through tax revenue — and yet has done next to nothing to assist Hometown Health and the patients we serve. Shouldn’t a similar investment be directed to help provide health care to children and families who are most in need?
   Hometown Health Centers, which serves the most vulnerable members of our community, is projected to provide $2.7 million in uncompensated care or charity care this year. This is up from $2.5 million last year and $1.9 million in 2005 When a health center provides more than $7 million in uncompensated care to its nearly 22,000 patients over a three-year period, this is a major problem.
   Schenectady County needs to make an investment now — to save a fortune later — and, most importantly, to save lives.
   Hometown Health is a critical component in the Schenectady County health care system. Let’s save the only primary care safety net this county has.
   CAROLYN MICKLAS
   Glenville  

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Donors rally to health clinic
Temporary help critical until new budget year arrives
BY BOB CONNER Gazette Reporter
Reach Gazette reporter Bob Conner at 462-2499 or bconner@dailygazette.net.

   Private donations are coming in to the Schenectady Free Health Clinic, although far from enough to make up for budget cuts imposed by the administration of Gov. Eliot Spitzer.
   Assembly Minority Leader James Tedisco, R-Schenectady, will go to the clinic today to present a $10,000 check from a Capital Region donor who wishes to remain anonymous. The donor sent the check, made out to the clinic, with a cover letter to Tedisco's office in Schenectady.
   Tedisco had previously announced a $100,000 member item for the clinic, but funding for that and other of his projects was blocked by Spitzer, who said Tedisco was not entitled to distribute it. Tedisco has accused Spitzer of targeting his projects as an act of political vengeance.
   The clinic is staffed by volunteer doctors, nurses and other personnel, and serves the working poor, typically those without health insurance. Under former Gov. George Pataki, it was getting an annual $200,000 from Health Department discretionary funds, but those funds were eliminated across the board in Spitzer's fi rst budget this year.
   Bill Spolyar, the clinic's executive director and sole paid employee, said it has recently received another private donation of $5,000, three of $1,000 each, and a number of smaller donations amounting to approximately $1,000. That money has come in since last week, he said, when the news broke about the clinic not getting the Tedisco member item.
   Tax-deductible donations can be sent to the Schenectady Free Health Clinic, 600 Franklin St. Room 205, Schenectady, NY 12305.
   The status of government funding for the clinic is uncertain. Spolyar said he was told Thursday by the Health Department that it would be contributing $35,000, not the previously stated $25,000, to help meet medication costs. But Spitzer spokesman Jeffrey Gordon said that was incorrect, and the $25,000 figure still stands. The Health Department could not be reached for comment.
   Spolyar said the Health Department also has encouraged him to apply for funding in next year's budget, for a contract worth between $350,000 and $400,000 to provide care for people without health insurance in Schenectady County.
   The Spitzer administration has indicated it wants to provide aid as part of a program, rather than for individual institutions. At a budget hearing Thursday, Health Commissioner Richard Daines did not mention the Schenectady clinic, but supported "a renewed investment in a public health agenda" along with efforts to increase health insurance coverage.
   The state fiscal year starts April 1, and the clinic needs funding in the five months leading up to that if it is to keep operating. Spolyar said it needs to replace the $100,000 Tedisco had pledged, in addition to getting the $35,000 for medications. And he has said it may be hard to start the clinic up again if it shuts down.
   Sen. Hugh Farley, R-Niskayuna, a longtime supporter of the clinic, said he does not have any access to Senate funds for it at this time.
   Joshua Fitzpatrick, a spokesman for Tedisco, said his office is referring callers to the clinic itself if they want to donate.  

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Anonymous donation rescues clinic
$10,000 gift helps fill gap left by $100,000 state aid that fell through  
  
By JIMMY VIELKIND, Staff writer
First published: Saturday, October 27, 2007

SCHENECTADY -- A health clinic, whose operations were imperiled when $100,000 supposedly promised by Gov. Eliot Spitzer was cut earlier this month, received an anonymous $10,000 donation Friday that will allow it to keep operating for the time being.
The Schenectady Free Health Clinic serves 2,500 uninsured patients who make about 7,500 visits per year. It is funded by a mix of donations and government grants and is located within the district of Assembly Minority Leader James Tedisco, R-Schenectady.

  
Tedisco had requested $100,000 from the budget to fund clinic operations, but it was revoked by Spitzer. The two are locked in a political feud regarding the governor's proposed plan to allow undocumented immigrants to apply for driver's licenses. Spitzer has said the money was never promised; Tedisco has produced e-mail records he claims show differently and says the funds were withheld in retribution.

"Ever since it was announced that Governor Spitzer eliminated the $100,000 in funding Leader Tedisco secured for our clinic, we've received numerous donations totaling in the thousands, all from private funds, not taxpayer dollars," said Bill Spolyar, executive director of the clinic.

"I think these donations, along with today's $10,000 contribution, show just how important this clinic and the volunteer doctors, nurses, technicians and support staff who are its heart and soul are to our Schenectady community."

Tedisco lauded the donation at a Friday afternoon announcement.

"The Bible tells us that we are our brother's keeper -- that we have a duty and an obligation to care for the sick, needy and less fortunate among us," he said. "Today, someone stepped up to the plate and showed the true meaning of those words through an act of tremendous kindness."

Last week, Spolyar also said he had entered discussions with the state Department of Health, where officials said they had located extra funds to keep the clinic going too.

Jimmy Vielkind can be reached at 454-5043 or by e-mail at jvielkind@timesunion.com.

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How do legislators always get a hold of so much pork?

   Re Oct. 18 Gazette article by Bob Conner, “Spitzer blocks local funding”: It was quite revealing to see that state Assembly Minority Leader James Tedisco had nearly a half-million dollars of taxpayer money to give away in discretionary spending, including $90,000 for a bicentennial celebration, $71,000 to his high school alma mater, $50,000 to a closed ethnic association and $25,000 for playground equipment for one school.
   How much are the other state assemblymen and state senators giving out? We already know a little bit about the federal “pork barrel,” led by Alaska Sen. Ted Stevens and his $223 million bridge to nowhere. Is this arbitrary spending also at the city, county and township levels? (You know that it is, the question is how much?)
   Forget about the budget, line-item spending is a myth in most government agencies. Tell us where the money actually went!
   GENE WHITNEY
   Niskayuna

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http://www.dailygazette.com
How do legislators always get a hold of so much pork?

   Re Oct. 18 Gazette article by Bob Conner, “Spitzer blocks local funding”: It was quite revealing to see that state Assembly Minority Leader James Tedisco had nearly a half-million dollars of taxpayer money to give away in discretionary spending, including $90,000 for a bicentennial celebration, $71,000 to his high school alma mater, $50,000 to a closed ethnic association and $25,000 for playground equipment for one school.
   How much are the other state assemblymen and state senators giving out? We already know a little bit about the federal “pork barrel,” led by Alaska Sen. Ted Stevens and his $223 million bridge to nowhere. Is this arbitrary spending also at the city, county and township levels? (You know that it is, the question is how much?)
   Forget about the budget, line-item spending is a myth in most government agencies. Tell us where the money actually went!
   GENE WHITNEY
   Niskayuna

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A peep-hole into New York's pork barrel
April 03, 2006
The newly adopted state budget for 2006-07 includes a $200 million lump-sum appropriation for "services and expenses, grants in aid, or for contracts with certain not-for-profit agencies, universities, colleges, school districts, corporations, and/or municipalities."

The phrase is New York's budgetary euphemism for what is known in Washington, D.C., and other state capitals as "pork" or "earmarks." In Albany terminology, these kinds of expenditures are known as "member items."

The annual member-item allocation is divided among the two houses of the Legislature ($85 million each) and the governor ($30 million). Until the late 1990s, the items were routinely listed in budget bills or in legislative reports--which is how the rest of world came to know about state subsidies for projects like the state Museum of Cheese.

But in more recent years, the grants have been lumped together in a single appropriation, funded out of a special "Community Projects-007" account, and distributed according to a memorandum of understanding (MOU) executed by the governor, the Senate majority leader and the Assembly speaker.

Under the current allocation system, no comprehensive list of projects is released. New York State's pork-barrel MOU list has not been readily available for widespread public scrutiny.

Until now.

Based on a Freedom of Information Law (FOIL) request filed with the governor's Budget Division, the Manhattan Institute's Empire Center for New York State Policy has obtained complete lists of member items for each of the past three years. The documents amount to 1,154 pages, listing 22,980 individual grants totaling just over $479 million. They have been converted into three separate "pdf" files that can be opened with Adobe Acrobat Reader software.

To download one or more of the annual lists, click on the links below:
* 2003 (439 pages, 1.4 MB)
* 2004 (375 pages, 1.1 MB)
* 2005 (340 pages, 1.0 MB)


What you'll find -- and what's missing

For each member-item grant, the lists include:
* the name of the organization or program receiving the money,
* the amount of the grant,
* the date the grant received Budget Division "certification," which authorizes money to be spent out of the appropriation,
* the "account" authorizing the grant (identified as governor, the Senate, or the Assembly), and
* the agency administering the funds.

Missing from the list are such details as the purpose for which the grant has been awarded and the name of the legislator sponsoring a Senate or Assembly request. While many grants will end up being publicized by legislative news releases, neither house releases the internal forms used to request member items; nor does the governor release more detailed information on explaining his own items.

In the absence of such information, a team of researchers would need months to follow up on the thousands of FOIL requests necessary to conduct a comprehensive review of each member-item expenditure. Since legislators generally seek to bring home pork to their own districts, it's not to hard to guess at the source of items designated for specific towns, cities or villages, or for non-profit groups named after the communities they serve.

Pending further analysis, a quick perusal of the list reveals that groups serving senior citizens, veterans and children (including 83 Little League grants in 2005 alone) remain popular objects of member-item funding. The Office of Children and Families was assigned to administer the most grants in 2005--1,566 out of a total of 6,798 grants for that year. Department of State was assigned to administer the second-largest number--1,036 grants, mostly for municipalities.

Of course, the Community Projects member-item fund isn't Albany's only discretionary pork-barrel account. Individual appropriations motivated by the political priorities of the two majority legislative conferences--Republican in the Senate and Democrat in the Assembly--are salted throughout the budget. Moreover, the last decade has seen the emergence of a whole new category of what's become known as "capital pork": economic development projects financed by state bonds.

A report itemizing such projects and showing how they are distributed on a regional basis was issued recently by the Center for Governmental Research. The best in-depth analysis of capital pork was published in an October 2004 series in the Syracuse Post Standard.

Calls for reform

In a January 2006 report, state Comptroller Alan Hevesi noted that over $1 billion in the 2005-06 budget, including a $200 million member-item appropriation, was divvied up through MOUs between the governor and legislative leaders. Among other accountability reforms, Hevesi has proposed requiring that the intended recipients of lump sum appropriations be identified at the time of enactment and that quarterly reports be issued on lump-sum allocations. Senate Democrats have also proposed mandatory disclosure of MOU details.

These proposals would represent an improvement, as far as they go, but more reform is needed to ensure true accountability and transparency. Assuming that politically motivated pork-barrel spending will persist no matter how much is done to discourage it, additional sunshine proposals would include the following:

* State grant awards should be based on clear program criteria and linked to performance standards set forth in enabling legislation.
* Member items shall be made as individual line-items in the budget.
* Grant contracts should be awarded on a competitive basis, and should require some level of matching funding from the recipient.
* Contractual details for all grants--including the name, address and name of the principal officers of the recipient organization--should be posted on the Internet and made available to the public and posted on the Internet at the time a contract is awarded.
* State agencies should issue quarterly updates on all programs they administer pursuant to such grants.
* The state comptroller should conduct random audits of community projects grants.

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SCHENECTADY ACCESS CABLE COUNCIL, INC. $5,000 6/3/2005 Assembly State Education Department 1
SCHENECTADY AVENUE BLOCK ASSOCIATION, INC. $3,000 6/3/2005 Assembly Division of Criminal Justice Services
1
Schenectady County $25,000 12/21/2005 Senate Department of State 1
SCHENECTADY COUNTY COMMUNITY COLLEGE FOUNDATION, INC. $5,000 6/3/2005 Assembly Department of State 1
SCHENECTADY COUNTY DEPARTMENT OF ECONOMIC DEVELOPMENT & PLANNING $1,500 6/3/2005 Assembly Office of Parks, Recreation and Historic Preservation
1
SCHENECTADY INNER CITY MINSTRY $10,000 6/3/2005 Assembly Office of Children and Family Services
1
Schenectady Police Department $20,000 6/24/2005 Senate Division of Criminal Justice Services
1
SCHENECTADY SYMPHONY ORCHESTRA ASSOCIATION $6,000 6/3/2005 Assembly Office of Parks, Recreation and
Historic Preservation
1
Schenectady Youth Hockey Association $2,500 12/21/2005 Senate Office of Children and Family Services
1

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SCHENECTADY
State funds ease strain
Struggling clinics, St. Clare’s will share in payouts
BY BOB CONNER Gazette Reporter

   After a year of state cuts aimed at local health-care institutions, Schenectady County finally got some good news Thursday from the administration of Gov. Eliot Spitzer.
   The state Health Department will announce today that it is providing a $400,000 grant to Hometown Health Centers and a $100,000 grant to the Schenectady Free Health Clinic. In addition, it is joining with the state Dormitory Authority to provide a $3 million loan to St. Clare’s Hospital.
   Hometown Health Centers has a clinic at 1044 State St. in Schenectady and had recently announced plans to close its satellite clinic at Ellis Hospital because of financial difficulties.
   The Free Health Clinic, at 600 Franklin St., has been in danger of closing altogether because of Spitzer administration funding cutbacks. Its director, Bill Spolyar, said he hopes this funding, along with continued private donations, will allow it to remain open.
   Dennis Whalen, deputy secretary for health and Spitzer’s top aide on health care issues, said the Free Health Clinic funding is an addition to $25,000 pledged last week by the Health Department to pay for medications. Whalen said the grants are part of the administration’s commitment to supporting primary care for poor people. Most of the state’s health care costs involve services to the poor.
   Whalen said it makes sense in both fi scal and public health terms to link people up with doctors rather than having them rely on hospital emergency rooms.
   Whalen said St. Clare’s has by far the dominant role in the county in providing services to poor people and is in worse fi - nancial shape than Ellis. He said the $3 million loan is to stabilize St. Clare’s finances while discussions continue between it, El- lis and the state about the two hospitals adopting a joint governance structure.
   The Ellis-St. Clare’s link is mandatory under provisions of a state law that became effective this year, implementing the recommendations of a commission headed by Stephen Berger. That law also called for the closure of Bellevue Woman’s Hospital in Niskayuna, which has now been taken over by Ellis.
   Whalen said the state is not inclined to fund the Ellis-St. Clare’s proposals for an entirely new hospital or a new women’s and children’s center at Ellis. However, the hospitals are still eligible for some Health Department funding to implement the Berger law.
   St. Clare’s CEO Robert Perry issued a statement saying, “This is interim funding, intended to help St. Clare’s continue its healing mission, in particular, its care of the uninsured and working poor. We are most grateful to the Department of Health for recognizing the important role St. Clare’s plays as Schenectady’s safety net hospital. We look forward to our continued discussions with the Department of Health as we work toward resolving the funding needs relative to the Berger commission mandate.”
   Assembly Minority Leader James Tedisco, RSchenectady, whose proposed $100,000 member item for the Free Health Clinic was cut by the governor, issued a statement saying: “Governor Spitzer is right, there is a health care crisis in the city of Schenectady. He caused it when he slashed previously approved funding I secured for the Schenectady Free Health Clinic. I’m glad he finally realized the error of his ways and changed course. This … is great news and a true victory for uninsured families in the city of Schenectady.”
   Spitzer’s fellow Democrats, county Legislature Chairwoman Susan Savage and Schenectady Mayor Brian Stratton, praised him. Stratton noted that he spoke to the governor after Tedisco’s funding was cut and was assured by him and his staff that the money would be restored.
   Savage said county officials have been in constant touch with the governor’s office and the Health Department to address these funding issues. She said she would like to see the Bellevue campus remain open indefinitely.  

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SCHENECTADY
Grant saves clinic — for now
BY BOB CONNER Gazette Reporter
Reach Gazette reporter Bob Conner at 462-2499 or bconner@dailygazette.net.

   The Ellis Hospital clinic operated by Hometown Health Centers is no longer scheduled to close, thanks to a promised infusion of $400,000 in state funding.
   But President and CEO John Silva said Hometown Health remains in financial jeopardy, and is hoping for a longer-term solution early next year. Hometown's main clinic is at 1044 State St. As for the Ellis clinic, Silva said, it is now safe until about February.
   Claudia Hutton, spokeswoman for the state Health Department, said the grant was made because Hometown was having difficulty meeting payroll, and is intended to stabilize it temporarily. The Health Department is discussing with Schenectady health-care institutions how to implement a state law that became effective Jan. 1, implementing the recommendations of a commission chaired by Stephen Berger. Within the next couple of months, Hutton confirmed, the Health Department will announce new funding to help institutions comply with the law, and Hometown could be included in that funding and restructuring. Ellis and St. Clare's hospitals are required to enter into a joint governance structure under the law, which could be extended to include Hometown.
   Silva said Hometown's previously announced plan to end services at the Schenectady County Jail remains in effect.
   Silva said Hometown's financial problems are in large part due to the number of its 21,000 registered patients who do not have health insurance. About 2,000 of those patients who were on Medicaid last year are now uninsured, he said.
   This week's announcements of state aid to Hometown and other Schenectady institutions are part of a program to deal with the problem of people without insurance needing medical treatment, according to Spitzer administration officials. The other institutions are the Schenectady Free Health Clinic, which is getting a $100,000 grant, and St. Clare's Hospital, which is to get a $3 million loan. All three institutions treat a high proportion of poor and uninsured patients.  

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Whalen said it makes sense in both fi scal and public health terms to link people up with doctors rather than having them rely on hospital emergency rooms.

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the Health Department will announce new funding to help institutions comply with the law, and Hometown could be included in that funding and restructuring. Ellis and St. Clare's hospitals are required to enter into a joint governance structure under the law, which could be extended to include Hometown.

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Another health care miscue in Schenectady

   While most of the public’s attention has been directed at the Berger Commission’s recommendations for closing or consolidating hospitals and nursing homes, it should be remembered that all the pain is supposed to have a greater purpose: transforming the system to make it more efficient and responsive to people’s health-care needs today. Unfortunately, two recent cases in Schenectady suggest that this last part of the equation is not yet a priority in Albany.
   The first example, of course, is the games that Gov. Spitzer played with the free downtown health clinic staffed by volunteer doctors and nurses. First he took away its Health Department grant, then blocked Assemblyman Jim Tedisco’s member item that would have replaced the grant, before finally coming through last week with the money needed to keep the clinic operating. Rather than jeopardizing one of the few such clinics in existence, the state should be encouraging more of them.
   The second example is the state’s failure to provide enough money for an assisted-living program for frail, impoverished seniors, run by Family & Child Service of Schenectady, forcing it to close in January. The facility, located at the Schenectady Municipal Housing Authority’s Ten Eyck building, is very basic, but it’s home to the 14 seniors who still live there, who are friends and family to one another. Dispersing them to other low-income adult homes in the area will disrupt their lives, and could even hasten their decline, requiring more expensive kinds of care.
   The monthly rate for the program is $1,100, with the state subsidizing whatever part of that amount the resident’s Social Security income doesn’t cover. The program has been running a deficit lately, according to Executive Director Maria Sunukjian, because the rate hasn’t been raised in 20 years, while costs have continued to climb. But the final straw, she says, is that a $30,000 Health Department grant that has helped keep the facility afloat will be pushed back from January, when it usually comes, until April next year. Contacted by a Gazette reporter last week, the Health Department was unaware of the problem.
   Since the story about the program was published Saturday, many people have called and said they would donate money. But if the state is going to have the “continuum of care” that it says is the goal, it will take continued attention and commitment of resources on its part. Programs like these can’t be left to the mercy of member items, emergency allocations and private donations.  

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Since the story about the program was published Saturday, many people have called and said they would donate money. But if the state is going to have the “continuum of care” that it says is the goal, it will take continued attention and commitment of resources on its part. Programs like these can’t be left to the mercy of member items, emergency allocations and private donations.