SYRACUSE  —  AIDS Community Resources has some major changes on its plate as it prepares to move into a Medicaid Health Home.

Those changes include a broader mission and possibly a new name for the not-for-profit, which helps individuals with HIV/AIDS and those affected by it. And AIDS Community Resources may also have to hire more employees and grow into more space over time.

That’s because the organization will become part of a Medicaid Health Home starting July 1. A Medicaid Health Home is not a brick-and-mortar facility — it is a new model under New York’s Medicaid program that was spurred by the 2010 federal health-care reform law.

A Health Home is a model of care management that has all of a Medicaid recipient’s caregivers communicating, according to the New York State Department of Health. Health Homes, which are being rolled out for individuals with chronic conditions, will be made up of health-care providers, health plans, and community-based organizations.

Within the Health Home structure, a care manager oversees an individual’s care, helping that individual stay healthy and out of the hospital. The model also aims to spur providers, health plans, and community organizations to share medical records to help prevent medical services like tests from being duplicated.

AIDS Community Resources, which currently has a Medicaid case-management program, will fill the role of a community-based organization in the new Health Home model. The organization must adapt to the new model in July if it wants to continue
offering case management to people on Medicaid with HIV/AIDS, according to its executive director, Michael Crinnin.

“If we don’t participate in this program, then our case management will go away in two years,” he says. “That’s not acceptable to me. It would be a terrible blow to the people we serve.”

However, to participate in a Health Home, the organization will need to offer case management for people with chronic diseases other than HIV/AIDS, Crinnin says. So AIDS Community Resources is preparing to work with patients with chronic diseases like diabetes, chronic obstructive pulmonary disease, and high blood pressure.

The not-for-profit already has some experience with those diseases, according to Crinnin. It commonly encounters a range of chronic diseases when helping individuals manage HIV/AIDS.

“A majority of our clients have these other chronic diseases,” Crinnin says. “You can’t manage HIV out of the broader context. We’re already experts in this without meaning to be.”

AIDS Community Resources has one of its staff members working on generic health issues like health insurance and prescriptions. That staff member is in the process of developing curriculums about different chronic diseases, Crinnin says. The not-for-profit plans to continue to expand its expertise in chronic diseases and train its case managers in those diseases, he adds.

New name

The new, wider-ranging care-management role will likely spur a name change at AIDS Community Resources. The organization will maintain its expertise helping people with HIV/AIDS but will also need to be accessible to others, Crinnin says. And he recognizes that some people may balk at receiving services from an organization with AIDS in its name.

“The stigma is so intense,” he says. “We understand that for us to participate, we either need to change the name of the agency or come up with a whole new division.”

Crinnin isn’t sure whether the organization will choose to change its name or operate two divisions. He also hasn’t established a timeline for making that decision.

Possible growth

The Health Home changes may also lead to growth at AIDS Community Resources, according to Crinnin. Chronic-disease case-management programs are relatively scarce in the not-for-profit’s nine-county coverage area, which includes Cayuga, Herkimer, Jefferson, Lewis, Madison, Oneida, Onondaga, Oswego, and St. Lawrence counties, he says.

“There are a number of behavioral-health targeted case-management programs,” he says. “There aren’t many chronic-disease programs.”

Crinnin does not know how many additional patients to expect because of the Health Home model. AIDS Community Resources currently has a caseload of about 250 clients at any one time, although some of its case-management clients are not on Medicaid, he says.

New York State has essentially guaranteed the organization will have a minimum of 229 Medicaid clients for about two years, Crinnin says. But it could receive additional clients any time after July 1, he says.

Crinnin could not provide any estimates for the number of new patients AIDS Community Resources will receive. He has been in touch with organizations Downstate, where the Health Homes initiative was implemented in January, but still is not sure exactly what to expect.

“The people in the first phase, they haven’t gotten contracts,” he says. “And they’ve gotten no Health Home assignments. I’m thinking probably we’re not going to get any [new] clients assigned to us until the fall.”

If AIDS Community Resources does receive new clients, it will probably have to hire more staff members and lease additional facility space. It currently employs 78 people and has locations in Syracuse, Utica, Watertown, Auburn, Oswego, and Canton. The not-for-profit leases a 9,000-square-foot headquarters at 627 W. Genesee St.

The organization will not leave its Syracuse headquarters if it needs more space, Crinnin says. Instead, it will search for a location to augment its current facility.

AIDS Community Resources does not know what its Medicaid reimbursement rate will be under the new Health Homes program. That’s a big question mark for the organization — Medicaid provides nearly a quarter of its revenue.

The not-for-profit’s revenue totaled $3.8 million in its last fiscal year, which ended June 30, 2011. Its budgeted revenue for the current fiscal year ending in June 2012 is $4.4 million.

Crinnin says it’s difficult to plan ahead for Health Homes with so much uncertainty. But he’s trying to position AIDS Community Resources to act quickly when more information is available.

“I think people are still kind of scrambling to catch up,” he says. “I’ve never been in a situation where it’s so volatile.”                 

SYRACUSE — The Americans with Disabilities Act (ADA) passed in 1990 with the aim of barring discrimination against disabled people in everything from employment to transportation.

Not enough has changed since then, says Stephanie Woodward.

“There are lots of people who still think it’s OK to discriminate,” says Woodward, who was born with spina bifida and uses a wheelchair. “There are lots of bus drivers who still won’t stop for someone with a wheelchair. These are problems that we shouldn’t have after 22 years of this law.”

Woodward is a second-year student at the Syracuse University (SU) College of Law and a research assistant at SU’s Burton Blatt Institute, which works to advance the civic, economic, and social participation of people with disabilities. She is also the first recipient of the Olinsky Law Group/Burton Blatt Institute Fellowship.

The fellowship will give Woodward the chance to learn about disability cases at the Olinsky Group during her third year of law school and continue as a research assistant at the institute. She’ll have the chance to join the law firm at the end of the program.

The fellowship program was formed with a $100,000 gift from Howard Olinsky, an alumnus of SU’s law school and the owner of the Olinsky Law Group, which specializes in disability cases.

Woodward is pursuing a joint degree in law and education. She became interested in law after working with the Center for Disability Rights in Rochester. She hopes to work on cases related to the ADA with her law degree.

Companies must realize that providing access for the disabled is not an optional add-on, but a standard cost of doing business, Woodward says. She hopes to see more enforcement of the law in the future.

Woodward is president of the Disability Law Society at SU College of Law. She is also student representative for the Accessibility and Universal Design Committee for the new College of Law building.

For Olinsky, the fellowships will help train a new generation of disability lawyers. He notes his firm has been growing recently and just hired its 11th attorney. That’s up from six lawyers in early 2011.

The Olinsky Law Group also has more than 30 support staff members.

Woodward will rotate through different practice areas at the firm, Olinsky says. He’s hoping fellows will come in with an idea of
what types of cases they’d like to work on in the future.

“We’re always open to picking up new practices areas in the disability field,” he says.

For someone interested in practicing disability law, it would be tough to find better practical experience than working with a firm like Olinsky’s, says Peter Blanck, Burton Blatt chairman.

The entire firm is focused on different aspects of disability law including Social Security disability, workers’-compensation cases, long-term disability, and ADA cases. At other firms, that area of law might be just a small slice of the overall business.

Woodward, Blanck adds, is part of the first generation of Americans who have grown up only knowing a post-ADA world. They’ll come to own the law and advocate for it strongly, he says.

Woodward notes that the law itself doesn’t do any good if no one follows it and it’s not enforced.

SENECA FALLS — You can count Generations Bank among those that have been able to thrive despite the worst economic downturn in decades, President and CEO Menzo Case says.

The bank never saw demand for loans sag and has been looking at expanding into new markets. Generations, formerly known as Seneca Falls Savings Bank, was a participant in the U.S. Treasury Department’s Small Business Lending Fund — a $30 billion fund created in 2010 to provide capital to community banks with under $10 billion in assets.

Generations Bank received $5 million through the program, which aims to spark more lending at community banks. The bank was quickly able to reach its lending commitments under the program, Case says.

“That was really the right thing to do from the federal government side,” he says. “They needed to look at community banks and provide them with capital so we can expand business lending. To get that additional capital was a big part of our growth. It provided us the means to grow in a measured way.”

Generations Bank began expanding its commercial lending and insurance services about five years ago, Case adds. And while most of the bank’s customer base is families, he expects more commercial growth in the years ahead.

Family-owned businesses in particular will be an important growth segment for Generations, he says. The bank has been heavily involved in lending to the Finger Lakes wine and cheese industry, Case says.

It was the lead lender for Magnus Ridge Vineyard and Winery, a new winery on Seneca Lake.

Case expects growth on the retail side of the business as well. He notes the bank is seeing strong demand from consumers for auto loans.

“We’ll plod along,” he says. “We won’t grow as fast as some others, but we will grow in a measured, methodical way. That’s how we’ve done it for 140 years.”

New markets are on the drawing board for Generations, but Case declined to discuss specific locations for new branches. He adds that the bank’s leadership believes strongly in the importance of a physical presence in its communities.

As much as possible, Generations tries to staff its locations with people from is local markets, Case says.

“We go where the need is,” he says.

Based in Seneca Falls, Generations Bank has total assets of $255.3 million and nine locations in Seneca Falls, Auburn, Waterloo, Geneva, Union Springs, and Phelps. Generations announced its name change from Seneca Falls Savings in April.

In addition to the Seneca Falls Savings name, the bank used additional names in its other markets, such as the Bank of Phelps. Changing to a single name will allow the company to present a more cohesive identity, Case says.

The bank’s insurance business also changed names to Generations Agency from Royce & Rosenkrans.

The bank was running into some confusion over the word “savings” in its name, Case adds. That sometimes led customers to think the bank only handled passbook savings accounts and residential mortgages.

The expansion of its commercial business made it important for the bank’s name to communicate the broader focus, Case says. The board settled on the Generations name to display its commitment to serving its communities for the long haul.

For the first quarter, net income available to common shareholders at the bank totaled $307,000, or 13 cents a share, down from $328,000, or 14 cents a share a year earlier. For 2011, net income available to common shareholders totaled about $1.3 million, or 57 cents a share, up from $1.1 million, or 50 cents a share, in 2010.      

SYRACUSE  —  Steve Forbes says not to trust your gut when it comes to drawing up a financial game plan.

“The gut is a bad guide,” says Forbes, the chairman and editor-in-chief of New York City–based Forbes Media. “The key is, don’t let your emotions take over.”

Forbes was at the Oncenter in downtown Syracuse May 2 as part of a seven-city tour titled, “The Power of a Game Plan.” The tour had Forbes and Northwestern Mutual Life Insurance Co. Chairman and CEO John Schlifske discussing the economy, financial markets, and financial planning.

Their stop in Syracuse concluded a day when Forbes and Schlifske spoke earlier in Boston and Manchester, N.H. Later in the week, on May 3, the tour hopped to Grand Rapids, Mich. and Pittsburgh. It wrapped up May 4 with visits to Memphis, Tenn. and Cincinnati.

“We travel to these cities and we do a presentation, and we’ve found it’s very helpful to people,” Schlifske says. “The notion of a game plan is very simple. What you’ll hear us talk about is how important a plan is in terms of achieving what you want.”

The tour covered components of a financial game plan including insurance for protection against unforeseen events, investments to help grow assets, and retirement savings. Other components include tax preparation, estate planning, and intergenerational planning.

Some of the advice may sound as if it is tailored for individuals. But Schlifske stresses that business owners should also consider it.

“The things we talk about really make sense for a small business as well,” he says. “The idea that you need to have a plan around your financial health — that you probably need some level of insurance because you probably have one or two key employees that are vital to the success of your company. And then there are all the issues that go with passing the business on from a generational perspective.”

The stock market can be a risk for financial game plans, because volatility can affect investment income, Forbes says. He recommended investing a certain amount each month and not jumping in and out of the market.

He also endorsed a diversified approach that includes reliable investments like permanent life-insurance policies.

“That kind of diversified approach, it’s not going to excite people at the cocktail party,” Forbes says. “But what you end up with is something that’s going to provide you with a very solid foundation as you move forward. Over time, those things do accumulate cash, and it’s nice to know that you have something that’s not going to drop out if the market does take a hit.”

Economic projections

Schlifske and Forbes predicted better economic times in the future, both for the United States and for regions like Syracuse and upstate New York.

Short-term pain is likely to persist, according to Schlifske, who did not give an exact time frame. However, he added that he’s “bullish” on the long-term future of the economy.

“I don’t know about Syracuse, but we’re headquartered in Milwaukee, which is oftentimes referred to as an old rustbelt city,” Schlifske says. “What we see in Milwaukee, it’s very encouraging. 

“One of the reasons I think many cities in the Midwest are going to have an upswing is this notion of reinvention and innovation,” he says. “Milwaukee has moved away from being strictly a manufacturing-of-heavy-equipment kind of city to being a city that’s got a high financial services sector that’s growing and is very robust.”

Forbes says he thinks an economic turnaround is inevitable.

“This is not going to last,” he says. “This is highly unusual in American history. And there is no reason why upstate New York should be depressed.”

Changes in public policy could play a role in boosting economic prospects in Upstate, according to Forbes. Gov. Andrew Cuomo has shown some positive signs on that front, he says.

“I hope Cuomo follows through,” he says. “I say, ‘Pretend you’re a business person. What is standing in the way of doing well in New York, in upstate New York?’ [Fix that,] and you’ve got a pretty good policy.”

The Northwestern Mutual Life Insurance Co. has $1.2 trillion of life-insurance protection in force. The company’s network office in DeWitt, called The Greater New York Group, hosted the tour stop in Syracuse. A total of 67 people work at the firm’s DeWitt office.  

With youth comes a high rate of not having health insurance.

That’s one of the findings of an Excellus BlueCross BlueShield report released in April. The report, titled “Uninsured Adults in Upstate New York,” used U.S. Census Bureau surveys taken from 2008 to 2010 to profile the region’s 18-year-olds to 64-year-olds who have no health insurance.

“By identifying the at-risk individuals, it allows us to focus more attention there,” says Dr. Arthur Vercillo, regional president of Excellus, a nonprofit based in Rochester that is Central New York’s largest health insurer. “We think it’s important for our community, just as it’s important for all communities, to spot opportunities to enhance access to coverage.”

The report found that nearly a quarter of adults between the ages of 19 and 25 were uninsured — 24.7 percent. And 18.5 percent of those ages 26 to 34 had no health insurance, it said.

“Sometimes we call them the young invincibles,” Vercillo says. “And it would be helpful bringing them into the insurance pool. It would help everybody. Even the young invincibles develop appendicitis or have an accident sometimes. And then they have to face the unhappy reality that those bills are quite high if you don’t have insurance.”

Uninsured rates declined in older segments of the population. Just 12.6 percent of those ages 35 to 44 were uninsured. 

The uninsured rate fell further to 10.1 percent for those ages 45 to 54. And it was only 9.5 percent for those ages 55 to 64.

Marital status also played a role in uninsured rates, the report found. Single upstate residents had higher uninsured rates than those who were married. Single men’s uninsured rate stood at 25.3 percent, and single women’s was 18.1 percent.

In comparison, 9 percent of married or widowed men were uninsured. Among married or widowed women, 7.8 percent had no health insurance.

Those who were divorced or separated had higher uninsured rates as well. Divorced or separated men had a 22.7 percent uninsured rate. Divorced or separated women’s uninsured rate was 15.6 percent. 

Marriage probably lowers uninsured rates by giving many individuals access to health insurance through their spouses,
according to the report. In addition, wedding vows often lead to higher household incomes, it said.

And higher household incomes mean lower uninsured rates, the report found.

The uninsured rate checked in at 24.5 percent among those living in households with incomes of less than $25,000. It slipped to 21.3 percent for those with household incomes falling between $25,000 and $49,999.

The uninsured rate took a major dip to 12.7 percent for residents living in households with incomes of $50,000 to $74,999. It fell to 9.1 percent for incomes between $75,000 and $99,999, and then dropped further to 6.4 percent for those in households making $100,000 or more.

Uninsured rates varied depending on work-force participation. A higher portion of unemployed workers were uninsured compared to those who had jobs. 

For unemployed workers, the uninsured rate was 30.1 percent. It was 21.4 percent for part-time workers.

The rate slid to 10.3 percent for full-time workers. However, it was also only 14.8 percent for those not in the labor force, a group that included retirees, students, family members taking care of children, and residents who were not working or seeking work.

The Excellus report noted that a majority of residents without insurance actually had jobs. That’s possible even though uninsured rates were highest among the unemployed because a majority of adults ages 18 to 64 worked — 70.2 percent of upstate New York adults had a full-time or part-time job.

“There’s a segment of the population that I will call the working poor,” Vercillo says. “They work very, very hard. Sometimes it’s hard to afford health insurance.”

People with jobs made up 62.6 percent of all uninsured residents. The report found 40.1 percent of uninsured residents held full-time jobs and 22.5 percent had part-time jobs.

The unemployed accounted for 12.8 percent of those without insurance. Those not in the labor force made up the final 24.6 percent.

Uninsured rates dropped as education increased, the Excellus report found. Residents without a high-school diploma were uninsured at a rate of 29.7 percent. The rate slid to 17 percent for those with a high-school degree or GED.

It descended to 13 percent for residents who had attended some college or earned an associate degree. And it was only 7.6 percent for residents with a bachelor’s degree or higher.

Racial and ethnic minorities had higher uninsured rates, according to the report. Hispanic residents had an uninsured rate of 27.6 percent. Black residents’ rate was 21.9 percent.

Residents falling into an “other” category that grouped together those with Asian, American Indian, Pacific Islander, and mixed racial and ethnic backgrounds had an uninsured rate of 18.3 percent. White, non-Hispanic residents were uninsured at a rate of 13 percent.