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UnAffordable Care Act
(Some information in this article is sensitive, so individual names are withheld for their security and privacy).
SARATOGA COUNTY – Touted as a victory for the uninsured, the Affordable Care Act is now in its third year and still getting mixed reviews. Here in Saratoga County, low-income individuals and families are receiving inarguably much-needed benefits, but anyone wanting to lift themselves into the next tax bracket – and the small business owners that want to help them do it – are being left behind.
Recusal Or Refusal?
Mayor/Hospital Communication Submitted to Board of Ethics
Introduction: This is a story about transparency in government, overlaid on a timeline.
Warm Winter's Impact on Disease Carrying Pests
SARATOGA SPRINGS – This past winter in Upstate New York was one for the record books. According to data from the National Weather Service, Albany was one of the fourteen cities in the United States that had its warmest winter to date. Upstate New York also broke its record for least amount of snow – just 10.3 inches, three feet below average.
While the unseasonably warm weather may have been great for getting outdoors, warm winters and early springs can have a serious impact on wildlife. What is concerning is that certain species that spread diseases to humans, such as ticks, flourish in these conditions.
The most recent New York ClimAID study, conducted by the Department of Environmental Conservation (DEC) to monitor the impacts of climate change, shows how rising temperatures are affecting ticks and other pests.
“Vector (disease-carrying) species, such as mosquitoes, ticks, midges (gnats), and other biting insects, respond dramatically to small changes in climate, which in turn alters the occurrence of diseases they carry,” read a quote from the NY ClimAID study. “For example, Lyme disease, erlichiosis, and other tick-borne diseases are spreading as temperatures increase, allowing ticks to move northward and increase in abundance.”
The Centers for Disease Control (CDC) details the geographic location of different species of ticks across the United States (CDC.gov/ticks). While many in the southeast and on the west coast have to worry about ticks spreading diseases such as Rocky Mountain spotted fever, New York’s main tick-borne illness is Lyme disease.
“We haven’t seen anyone yet come in with a tick, but it’s right around the corner, so we’ve been warning people,” said Raveen Saluja M.D., an internal medicine practitioner at Saratoga Family Physicians at Saratoga Hospital. “During peak season, ticks are an everyday conversation in our office. But we’re already out in our shorts some days, so it’s already time to be careful.”
Dr. Saluja urges people to check themselves immediately after spending any time outdoors.
“You have got to check your body. Get naked, get a mirror, and look for ticks,” said Dr. Saluja. “Then call the doctor immediately if you find one.”
It’s vital to contact your doctor as soon as possible because time-sensitive measures can be taken to prevent Lyme disease. Within 72 hours after being infected, patients can get a one-time dose of the antibiotic Doxycycline that acts as a prophylaxis again Lyme. After that 72 hour window, Lyme disease must be treated with a regular, full-course of antibiotics.
According to Dr. Saluja, the most common identifier for Lyme disease is a bull’s-eye rash, which occurs in most, but not all cases. While a bull’s-eye rash is a sure sign of Lyme, other symptoms can include fever, muscle aches, and other flu-like symptoms. Lyme disease can also have long-term consequences called Post-Treatment Lyme Syndrome, which can cause chronic symptoms – even more of a reason to prevent ticks in the first place (see sidebar for more prevention tips.)
Dr. Saluja recommends using a repellent with 20-30 percent DEET, and reapplying it regularly. She also noted that some prefer more natural methods of tick repellent. Oils that contain rosemary, geranium, lemongrass, cedar or lavender are an excellent way of repelling ticks, and many natural oil recipes are available online.
For more information about ticks, the diseases they spread, and how to prevent them, visit cdc.gov/ticks. To learn more about how climate change is impacting wildlife, including harmful pests like ticks, and to read the full New York ClimAID study, visit dec.ny.gov under “Energy and Climate.”
- Avoid wooded and brushy areas with high grass and leaf litter.
- Use repellents that contain 20 to 30% DEET (N, N-diethyl-m-toluamide) on exposed skin.
- Use products that contain Permethrin on clothing
- Bathe or shower as soon as possible after coming indoors (preferably within two hours) to wash off and more easily find ticks that are crawling on you.
- Tumble clothes in a dryer on high heat for an hour to kill remaining ticks.
- Check your pets for ticks daily, especially after they spend time outdoors.
- If you find a tick on your dog, remove it right away.
- Ask your veterinarian to conduct a tick check at each exam
- There are certain products that can kill and repel ticks on dogs. Talk to your veterinarian first about these options.
Protecting your Yard
- Pesticides can be used to prevent ticks on your property. Identify rules and regulations related to pesticide application on residential properties in your area first (Environmental Protection Agency).
- Remove leaf litter and clear tall grasses and brush around homes and at the edge of lawns.
- Mow the lawn frequently.
- Place a 3-ft wide barrier of wood chips or gravel between lawns and wooded areas to restrict tick migration into recreational areas, and always keep playground equipment, decks, and patios away from yard edges and trees.
How to Remove a Tick:
- Use fine-tipped tweezers to grasp the tick as close to the skin's surface as possible.
- Pull upward with steady, even pressure. Don't twist or jerk the tick; this can cause the mouth-parts to break off and remain in the skin. If this happens, remove the mouth-parts with tweezers. If you are unable to remove the mouth easily with clean tweezers, leave it alone and let the skin heal.
- After removing the tick, thoroughly clean the bite area and your hands with rubbing alcohol, an iodine scrub, or soap and water.
- Dispose of a live tick by submersing it in alcohol, placing it in a sealed bag/container, wrapping it tightly in tape, or flushing it down the toilet. Never crush a tick with your fingers
Information provided by the Centers for Disease Control (www.cdc.gov/ticks/avoid/index.html)
City Council: Complete Streets Coming To Geyser Crest
SARATOGA SPRINGS –It will remain until the next Saratoga Springs City Council meeting (on April 5) for a scheduled vote (after a second public hearing) on the Saratoga City Center’s proposed lease of the High Rock parcel. The Council at its Tuesday, March 15 meeting did take action on a matter that recognized, regardless of what gets developed at High Rock - inevitably an invitation will be extended to have more cars on the city’s streets. Therefore, any action that the Council takes to preserve and increase Saratoga Springs’ standing as a pedestrian and bicycle-friendly town is worthy of note.
Through a series of motions and capital budget amendments, the Council funded a project that, when built out, will provide a pedestrian/bicycle trail for about five miles along the northern side of Geyser Road. The trail is forecast to be about eight feet wide from Spa State Park west to Cady Hill Road, and then widening to 10 feet to the Town of Milton. A total of $96,790 was dedicated to the project. It will entail new engineering and will impact 12 property owners, with about $50,000 of these funds pledged for right-of-way acquisition for the trail and buffer along Geyser Road.
While the primary beneficiary of this is the Geyser Road neighborhood, where access has been historically limited to motor vehicles and some bus service, this is a significant event for all city residents. When completed, this will provide another key link in the overall plan to have the city completely connected via a series of pedestrian and bicycle accessible trails, along the greenbelt and through the downtown core.
Attorney Matt Jones offered up an interesting gambit, speaking on behalf of Saratoga Hospital, during a public hearing about amending the new comprehensive plan’s designation of a parcel, upon which the Hospital wished to expand, back to the 2001 zoning as residential. Mayor Joanne Yepsen and Commissioner of Accounts John Franck have recused themselves from all discussions and votes on this matter. With Commissioner of Public Safety Chris Mathieson’s stated opposition, it had appeared to make any plan approval impossible (three votes are required to pass any Council measure according to the City’s charter).
Jones stated that the Hospital’s application will be kept open, and advocated that a mechanism be developed, similar to Courts of Appeals, in which replacements are appointed for those who recuse themselves due to conflicts – in effect, giving all applicants an opportunity to obtain a three-vote majority from a full five-person “council”.
It remains to be seen if this idea develops any traction, as it would involve at least some City Charter amendments. Yet, what appeared to be dead issue is anything but that, at least for now.
Finally, a shout-out to city resident Bonnie Sellers, who always provides some pithy perspectives during public comment time. Bonnie contributed the idea of the day when she suggested the City look into developing a night court as an alternative to building an annex, potentially on the valuable High Rock parcel. Commissioner Mathiesen said it was an excellent idea and the City was already looking into it, and though there may be some (unidentified) logistics difficulties, it was certainly worth pursuing.
Hot Potato at the Freezing Point:
Homeless Seek Shelter at Saratoga Hospital ER
SARATOGA SPRINGS – What you have here is a textbook case about an unfunded government mandate in action. Well intentioned, perhaps, but in this case it has to date led local organizations, also well intentioned, but in some cases underfunded, in others under-equipped, to scramble for an effective solution to fulfill the mandate. Meanwhile, the weakest segment of our society – our homeless – has their safety and very lives in limbo.
On Sunday, January 3, in advance of an anticipated drop in New York City’s temperature and large snowfall amounts, Governor Andrew M. Cuomo signed an executive order requiring local governments to take identified homeless people off the streets and into shelters, by force, if necessary, once the temperature reaches 32 degrees or below. While many statewide were quick to criticize the force component of the order, it became an economic issue locally this week.
The City of Saratoga Springs Code Blue Shelter is operated by Shelters of Saratoga at the Salvation Army on Woodlawn Avenue. The shelter is “triggered,” or goes into operation, when the temperature is expected to drop below 20 degrees, or when a foot of snowfall is expected. It should be noted that this is a benchmark that has been used by many similar organizations throughout the state. After the Governor’s mandate, the local Code Blue Shelter continued to operate under that same threshold, as they had no immediate way to secure the funding to keep it open more often.
“We’re certainly willing to look at (raising the threshold),” said Shelters of Saratoga’s (SOS) Executive Director Mike Finocchi. “We actually did raise it once, from 10 to 20 degrees. The issue with us is securing funding for the costs involved, and of course staffing. We are primarily a volunteer organization, and though we get some grant money, we are principally funded through generous donations from the community.” Finocchi said that the Code Blue Shelter accommodates an average of 38 people when open.
During the overnight hours of Tuesday/Wednesday, January 22/23, the temperature was below freezing, but not cold enough to activate the Code Blue Facility. A subset of the homeless population, 10 to 12 people, was transported to the emergency room at Saratoga Hospital to seek an alternative shelter. Some have speculated that a homeless volunteer transported this group; other sources have told Saratoga TODAY that a part time resident of the shelter had organized the group of people. Regardless, the people appeared on the hospital’s doorstep.
For it’s part, Saratoga Hospital did all it could to accommodate the unexpected people, despite the fact that it’s Emergency Department is not set up to do this kind of hosting. A statement released by Saratoga Hospital’s Vice President for Community Engagement, Amy Raimo on Wednesday, January 27 seemed to strike a proper chord: Caring and yet not possessing the proper facilities. The statement read in part:
“Last night, approximately 10 to 12 people from the homeless community were brought to our Emergency Department…. We have had this occur before, but this is the largest number we have accommodated.
The Hospital has a long-standing practice: If someone from the community comes to the Hospital, we will not turn them away. We will be as responsive as we can be to meet their needs. However, we are not equipped to be a shelter, and refer anyone in need to the local community organizations best prepared to help. As always, our primary focus is to take care of our patients, but we will continue to work closely with local authorities and organizations to identify the best solutions when there is a need and we can help.”
As stated above, Shelters of Saratoga’s people have more than expressed willingness to raise the threshold to activate Code Blue. Perhaps this is a good time to enlist the reader to consider making, or making another, donation to help fund this worthy cause. Visit SheltersOfSaratoga.org for information. Meanwhile, this remains a story in progress that is frustrating to well-meaning people that are seeking a solution. And the homeless remain in limbo.
Finocchi added a note of irony. “On that night,” he said, “we actually had six rooms available at our regular shelter (on Walworth Street), which operates year-round. But nobody called us.”
Rotary Brunch Fundraiser Honors Community Leaders
SARATOGA SPRINGS – The sixteenth annual Community Service Awards Brunch hosted by the Saratoga Springs Rotary Club took place Sunday, October 4 at the Saratoga Springs City Center.
The brunch was a fundraiser for the Saratoga Springs Rotary Education Foundation. The mission of the foundation is to assist students from the greater Saratoga community to advance their education and training by raising and managing funds in support of scholarships and general educational needs. In June, $53,000 in scholarships was awarded to 12 local students.
The fundraising brunch featured a silent auction, food donated by Longfellows restaurant, as well as musical performances by the chorus group “Dynamics” from Skidmore College.
Philip W. Klein and Reverend Jay and Judy Ekman were honored for their humanitarian services in the community.
Klein is currently vice president at Adirondack Trust Insurance in Saratoga Springs. He has lived in Saratoga Springs for more than 35 years and spent 18 of them as a supervisor for the City of Saratoga Springs. He also served as past chair of Saratoga County Chamber of Commerce, past board member of Saratoga Care, and past president for Saratoga YMCA. He is the current chairman of The Wesley Foundation and sits on the Saratoga Springs Planning Board.
When he was accepting his speech, he mentioned how he felt the most reward working with the board at Saratoga Hospital. “They have experienced well-paced growth, and medical care is of the utmost importance,” Klein said.
Klein inspired the crowd at the end of his speech by saying, “Volunteer. It’s good for you.”
Reverend Jay and Judy Ekman have been married for almost 50 years. Together they helped start the Rural Food Delivery Program and have been involved in youth-centered activities for many years. Judy helped start the Child Abuse Task Force (now the Center for the Family), while Jay chaired OASIS, a drug counselling effort. They both have organized many interfaith activities over the years in the community.
“If you’re trying to make the world a better place, going at it alone is not an option,” said Judy Ekman.
In regards to his wife, Jay Ekman said, “We have a shared purpose and a shared memory.”
For more information about the Saratoga Spring Rotary Education Foundation, visit saratogaspringsscholarships.org.
10,000 + Visits!
Community Health Center Meets Medical Needs
By Megan Harrington
For Saratoga TODAY
SARATOGA SPRINGS – While many lower-income residents may have health care that covers catastrophic illnesses and events, that insurance often doesn’t extend to routine medical services and dental work. Saratoga Hospital’s Community Health Center (CHC) is offering a remedy with a one-stop shop for individuals who need non-urgent medical and dental care and have limited or no insurance.
CHC’s Medical Director Dr. Renee Rodriguez-Goodemote says, “We’re one of the few programs in the area that is using an integrated model when it comes to behavioral health, dental services, and primary care.” This model is unique and effective because it removes some of the stigma often surrounding mental health care. People no longer have to obtain behavioral health services from a separate clinic – at CHC it’s all in one place.
Purchased for $1.95 million dollars two years ago, the facility opened at its 24 Hamilton Street location in September 2013. The Community Health Center is within walking distance to downtown apartments, businesses and a CDTA bus stop. The CHC also offers early morning and evening hours, essential for patients who need to come in before or after work. According to the CHC’s September 2014 Stewardship Report, in its first year, the Community Health Center provided services for 3,381 needy patients during 10,113 visits.
All services are provided regardless of an individual’s ability to pay; however, there is on-site staff at CHC that are available to assist uninsured patients apply for low-cost coverage and/or enroll in the Hospital’s financial assistance program. According to the recent CHC Stewardship Report, more than 250 previously uninsured patients now have coverage due to these efforts.
Amy Raimo, Executive Director of the Saratoga Hospital Foundation and VP of Community Engagement explains that the success of the Community Health Center has been a long-term project for the Hospital. “When they began to work on this project, they set a $3 million dollar goal which would allow them to buy the building at 24 Hamilton Street. The remaining money would go into an endowment fund to support the health center in to perpetuity.”
Currently the endowment fund is at a little over $700,000 and the investments have already begun producing dividends. Raimo explains that once the endowment reaches $1 million dollars, it will begin generating around $50,000 dollars in income per year. This money will be used to help purchase equipment, perform building renovations and offset hiring costs for doctors, dentists and mental health workers. “One of our big priorities is to grow the endowment each year,” says Raimo. This endowment is essential because there’s a large gap between revenue that comes in (via reimbursements) and what it actually costs to provide services. Saratoga Hospital has committed to covering the difference, which is estimated to be $1 million dollars per year, but to close that gap even further, fundraising events are held.
To aid in this process, all proceeds from Saratoga Hospital’s Summer Gala have been designated for the Community Health Center. “We can’t think of a better use of those funds because the Community Health Center is such a valuable resource to the community,” says Raimo. This coming year’s annual appeal has also been earmarked to help the facility. “We only mail to donors once per year and the donors appreciate that. They know that when they receive an appeal, it’s important,” says Raimo.
In addition, the CHC will receive fundraising dollars from Saratoga Hospital’s Employee Campaign and an upcoming Business Appeal. Raimo explains, “For a lot of employees of downtown businesses, this is an incredible resource. We all know that a healthy employee is a more productive employee.”
Saratoga Springs’s official motto is “Health, History, and Horses”, but “Wealth” might also come to mind when you think of our fine city. Unfortunately, the staff at the Community Health Center knows all too well that there are many underinsured residents living right next door. Many families face a choice between seeing the dentist or getting a flu shot and buying essentials like groceries. “The focus of the Community Health Center is to fill a gap in the community. So that people who are uninsured or underinsured have a place to go to get high quality medical, dental, and mental health services,” explains Raimo.
Receiving routine care at the Community Health Center ultimately means fewer Emergency Room visits, which is important because an ER visit costs, on average, twice as much as a primary care doctor’s appointment.
To help individuals get set up with routine care, the Saratoga Hospital Emergency Department works with the Community Health Center to provide a list of people who come in without insurance and a primary care provider. Each month about 30 of those individuals become established Community Health Center patients. In this case, the saying by Benjamin Franklin rings true: “An ounce of prevention is worth a pound of cure.”
“We really are committed to the health center and its success”, says Raimo. “If you go down and hear some of the stories – from an elderly person who needed dentures to kids who needed immunizations to start school – you’ll realize how the staff is helping people in this community and how grateful those people are.” Raimo explains, “That’s all we need to hear to continue doing what we need to do.”
And at 24 Hamilton Street, you’ll feel the personal touch. Rodriguez-Goodemote explains, “We’re not just a medical practice, we want to be a part of their life and help them navigate their stresses.”
The CHC’s comprehensive approach includes not only health care, but services such as a food pantry and clothing if needed. Raimo agrees, “The staff is so caring and amazing and they really take the time to get to know their patients and find out their needs.” For example, staff saw that many patients were struggling to come up with prescription co-pays, so the CHC recently established a patient Rx fund. Due to it’s popularity, the fund was almost depleted, but when this was mentioned at a Foundation Board meeting, members gave whatever they had in their own pockets and came up with nearly $1,000 on the spot. “That’s how important this is to us,” says Raimo.
With over 10,000 visits in its first year and numbers on the rise, staff and supporters of the Community Health Center are poised to make 2015 even healthier for area residents.
For more information, visit saratogahospital.org/locations-directions/saratoga-community-health-center
Saratoga Hospital Benefit Auction a Success
SARATOGA SPRINGS — More than 700 guests donned animal prints and vibrant colors of the rain forest for Saratoga Hospital’s 31st annual Benefit Auction on Wednesday. It was truly a jungle under the packed tent on the grounds of Saratoga Casino and Raceway.
Milton to be the Site of New Saratoga Hospital Facility
MILTON – Residents in the Town of Milton will no longer have to drive into Saratoga or Malta for primary medical care, with the opening of a new medical building this fall. The medical facility will be operated by Saratoga Hospital and will be located in the Town Center. A Boghosian Brothers project, the Milton Medical Office will be the first of its kind in the Milton area.