Each winter, New Yorkers and families across the country are directly confronted with one of the most crucial financial concerns regarding their teenage children – how to pay for their college education.
The New York Press Association Foundation funds twelve paid summer internships for college journalism students. Students must apply to a community newspaper to be considered for acceptance into this 8-week summer 2010 program. These internships pay a net stipend of $2,500. NYPA is an association of weekly community newspapers in New York State. Anton Community Newspapers is a member of NYPA. Students who are interested in applying for this internship opportunity, can find an application on www. nynewspapers.com. Applications should be sent to: NYPA Internship Program, Anton Community Newspapers, 132 East Second St., Mineola, NY 11501. The deadline to get this application to Anton Community Newspapers is March 1, 2010.
In 1991, New York State implemented a plan to use Medicaid dollars to fund outpatient community-based mental health services. That two-decade-old approach, also known as Medicaiding-the-system, is on its way out.
Medicaiding-the-system was a combination of (1) a base Medicaid rate applied for each outpatient mental health visit for Medicaid recipients only and (2) supplemental or bonus dollars paid on top of each base payment to subsidize non-Medicaid recipients. This approach to support community-based agencies was developed to replace local assistance or deficit-financing.
Local assistance was a simple and sensible public-private financing partnership. The partners were the State and County governments (through government contracts), mental health consumers (through fee-for-service payments) and the local community (through fund-raising).
Local assistance funding insured that all stakeholders chipped in a fair share to support an essential community-based service. However, New York State decided that if Medicaid could cover these costs, that they could systematically reduce and ultimately eliminate the amount that they chipped in through local assistance contracts.
If New York State will not support essential community-based mental health services for the most vulnerable members of our communities, who will?
In recent years, New York State recognized that the Medicaid bankrolled bonus-dollar approach of financing community-based clinics had the inadvertent effect of propping up commercial insurers that were paying substandard rates and limiting access to essential services. Having uncovered that festering wound, they got to work on creating a new financing plan that they refer to as clinic reform.
The clinic reform plan will raise the Medicaid-base rate and phase out bonus-dollars over a four-year-period. The Medicaid base-rate will apply only to those individuals who have what is known as straight Medicaid insurance; that is, Medicaid that is not managed by a commercial insurance company. There will be no reliable funding stream to replace the lost bonus dollars except for a finite pool of funds, presumably to cover services for indigent consumers.
In discussions with State officials about the devastating consequences of the clinic reform plan for the middle class and working poor, I was told that clinics must re-negotiate rates with commercial insurers. That is nothing new. It is common practice. The State officials advised me that if the commercial insurers do not raise their rates to sufficient levels that will help to cover the cost of services provided, then we should terminate our contracts with them.
Community-based providers routinely re-negotiate rates with the managed-care companies that represent the commercial insurers. However, they rarely agree to rates that will cover the cost of service. As one such managed-care company representative recently told us, “C’mon, we are hurting too.” For more information on public and private insurance markets in New York, I refer you to the following website: http://www.uhfnyc. org/publications/880618.
If we drop the commercial insurers, as I was advised to do, it means that middle class and working-poor families are out of luck. They will not be able to afford to pay out of pocket to access community-based outpatient mental health services that are structured to meet their families’ needs. For example, at North Shore Child and Family Guidance Center, almost 30 percent of all evaluations in 2009 were emergencies that were seen within 24 to 48 hours. Who will take care of these emergencies? Private practitioners?
Clinic reform is nothing more than a downgraded version of Medicaiding-the-system. With clinic reform, the term community-based mental health center becomes a thing of the past as only a small segment of the local community will be able to access needed services.
New York State is throwing in the towel at a time when there is unprecedented need for community-based mental health services. As the complex funding history described above is demystified, more and more families are advocating for a freeze on clinic reform. I urge you to call your local New York State legislators and tell them to extend the projected clinic reform start date of April 1, 2010 and to restore local assistance financing.
Don’t accept, “But there is no money!” for an answer. Please listen; the fact is that the cost to place a child or teenager in a psychiatric or juvenile detention center or a young adult in jail is far greater than what it costs to support quality community-based mental health care that will keep them at home.
We all know that familiar refrain, pay now or pay later.
1948: It is revealed that New York State has laid out the route of a six-lane “super highway” that will run from the city line at Lake Success to Farmingdale (following the railroad tracks through Albertson, Mineola and Garden City) and then on to Riverhead in Suffolk County. A giant cloverleaf is planned at Shelter Rock Road, where a second super highway will branch off to Franklin Square and go on to meet Sunrise Highway at Valley Stream. The highways will be divided by a landscaped island with exits approximately every mile. Towns and villages through which the new highways will pass are asked not to approve any new building along the anticipated route. State highway officials include funding for the massive project in their legislative program, but it will not be approved by the legislature and only the Lake Success-Herricks section will ever be built, a decade later.
In late November, columnist Robert McMillan wrote a piece entitled “A Story About One Illegal Immigrant,” which questioned the enforcement of federal immigration laws. Immigration enforcement policies affect the safety of all Nassau County residents, but perhaps not in the way that McMillan might imagine.
I have known Irene Parrino for more than 10 years now. She has shown remarkable dedication and caring for her community. Not only has she dedicated her life to servicing the public as a water commissioner, she also provides volunteer services as current and active president of the Albertson Square Civic Association.
What does 2010 have in store for people with hepatitis C? For the patient, it will likely be a year to wait and observe what happens with many of the new medications being evaluated in clinical trials. From the provider side, 2010 will be an exciting year. There are several new medications being introduced into clinical trials and some of the more advanced new medications are likely to complete their pre-approval evaluation this year.
1930: William Chatlos, developer of the original Williston Park sections, actively encourages the purchase of lots by church groups as a way of creating a “home community.” The village of 4,400 residents is now home to the Roman Catholic Church of St. Aidan, St. Andrew’s Episcopalian Church and the Williston Park Reformed Church. St. John’s Lutheran Church will open soon. Other home developers see the economic value in having churches within developments. In 1941 and 1942, the developer of Hyde Park Manor, east of New Hyde Park Road, will sell plots to Roman Catholic and Lutheran churches and include this in marketing information. In September 1942, Hillside Methodist Church is dedicated amid the new houses of Hillside Heights. Three years later, land for Christ Lutheran Church is purchased and the new church will open just as hundreds of new homes go on sale on the south side of Hillside Avenue
Back in the day, Long Island was a land of movers and shakers.
People came here with vision and purpose. They saw opportunity, and seized it.
2010 promises to be a better year than 2009. With the onset of a new year and a new decade, we are filled with renewed hope and promise that things will get better. This New Year will bring lots of change. We will see new leaders, new policies and hopefully new peace and prosperity. With all this hope, my thoughts turn to liver transplantation and all of our neighbors out there who could benefit from this medical miracle.
Liver transplantation has rapidly advanced over the past two decades to become standard therapy for patients with end-stage liver disease. Children and adults with congenital and acquired disorders are candidates for transplantation. The most common indications for liver transplantation in the United States include viral hepatitis B and C, non-alcoholic fatty liver disease, primary biliary cirrhosis, primary sclerosing cholangitis, alcoholic liver disease, in-born errors of metabolism, autoimmune disease, fulminant hepatic failure and liver tumors.
Liver transplantation involves removing the diseased liver from a patient with advanced liver disease and replacing it with a new, healthy liver from a donor. The surgery is performed in very specialized centers by surgeons dedicated to this operation. Unfortunately, the number of people waiting for a liver transplant far outnumbers the supply of donor livers. This leads to long waiting times and many patients do not survive their liver disease while on the list awaiting liver transplantation. We are getting better, however.
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