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Rome Health Here. Delivering the Best Care Out There.

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By Tami S. Scott

Rome Health is making positive and significant changes to local, community based healthcare. By investing in new technology and a comprehensive master facility plan, the hospital is prepared to deliver the best care “here” — in Rome, N.Y. – so local patients can stay local.

Now in the final phases of a years-long master facility plan, administrators will soon see the fruits of their labor come to life with the construction of a 30,000 square-foot, three-floor modernized addition that will replace the hospital’s current operating rooms and intensive care unit.

Its advancements in new technology, including the Da Vinci Xi surgical system, the 7D Image-guided surgical system for spine care, and EUS and ERCP equipment for GI purposes, benefit both surgeons and patients, particularly those with complex cases. And with its recent expansion of gastroenterology services, patient needs will be fully met without the hassle of long distance travel or months-long waiting periods.

“Our goal was to match the skill set of our physicians with the desire of our community to receive local healthcare here, and match that with the technology we have available to them to provide those services,” said Chief Medical Officer Cristian Andrade, MD.

A new surgical center and intensive care unit
The new Kaplan Center for Surgical Services (named in honor of philanthropists Charles and Florence Kaplan) will be transformed from its existing design to a contemporary, stateof- the-art surgical center with four new operating rooms, two new procedure rooms, and a pre- and post-op area that will be located directly next to the ORs — important for not only flow of care but also patient satisfaction, said 

Chief Operating Officer Ryan Thompson, MBA, FACHE. The front entrance, lobby and waiting room are also being
remade.

Construction will be completed in three phases. The addition for the ORs and ICU is under construction and will be open in mid-2025. In the second phase, the old ORs will be repurposed for pre-op and post-op space. The third phase creates staff support space and will be complete by mid-2026.

“When we make facility changes in our design, we really focus on making sure that we’re finding the balance first and foremost of how it’s going to impact the patient,” Thompson said. “Second, how it’s going to work for the teams that are providing care, including the physicians and advanced practice clinicians and nurses, and even the workflow of our environmental services staff. And then third, to make sure that staff has a space they can go to provide respite during the day, as they’re very busy providing care.”

The new nine-bed ICU considers all aspects of patient and care team needs. Among the highlights are larger individual rooms to accommodate not only the critical care team and necessary equipment but also family members so they too can participate in their loved one’s healing journey.

“We all know that family participation and loved ones’ care lends itself to better patient outcomes,” said Acute Care Director Kelly West, R.N., B.S.N. “And that’s very important to us.”

The rooms also boast specialty beds to reduce the risk of pressure wounds, specialty rooms for behavioral health population, private restrooms with accessibility features, an advanced ventilation system for infection control, more natural daylight to aid in healing, and charting located at pods adjacent to the bedside to allow for closer connection with the patient.

King + King Architects and Haynor Hoyt Corporation built a mockup of the ICU and the OR in the hospital garage so staff could experience what the rooms would look like and how large they would be. “We put the outlets on the walls where we wanted them, we put monitors on the walls where we would want them,” said Vicki Weiss, R.N., OR nurse manager. “Some of the small things that you wouldn’t think were important are so important to the staff.”

The $45.7 million capital project is being funded through a partnership of more than $29 million in public funding and private philanthropy, including a $26 million New York State Transformation Grant and $3 million in ARPA funds from the City of Rome. The Rome Health Foundation kicked off the public phase of the capital campaign in January with $14.2 million already raised. The goal is to raise $16.5 million.

“We’re about a million and a half dollars away from hitting that overall goal,” Thompson said. “It’s just tremendous support from the community to be able to hit that.”

Advanced technology, gastroenterology services

“The DaVinci Xi Surgical System was among the first new pieces of equipment that Rome Health acquired and was very well received by our medical staff colleagues,” said Chief Medical Officer Cristian Andrade, MD. The goal was to get staff trained and able to utilize the robot well before the new surgical center is open, and the plan “went seamlessly,” he said. “We had our first non-proctored surgery with robotic assistance performed on June 12 by our general surgeon, Dr. [Keneth] Hall,” — also a bariatric surgeon.

Since then, Rome Health has equipped other general surgeons and gynecologists to perform robotic assisted surgery. “We will likely be doing some urologic procedures in the near future as well,” Dr. Andrade added.

Dr. Hall explained the benefits of robotic-assisted surgeries as enhancing surgical precision, control, and efficiency. “This advanced system enables smaller incisions, leading to reduced pain, scarring, and faster recovery times. It also decreases the risk of complications and improves surgical outcomes,” he said. “The robot’s capabilities streamline surgeries, allowing for more efficient use of operating room time and potentially increasing patient throughput.”

General surgeon Dr. Samuel Molica, DO is hopeful that the advanced technology will prevent the more difficult minimally invasive procedures from being converted to open.

The same benefits and even more apply to the 7D Image-guided surgical system for spinal surgeries.

“The advantages we have received from using the 7D technology is that infection rates are minimal to non existent and patients who may have been at high risk now have the opportunity to receive the needed surgery due to the smaller incisions and how minimally invasive the procedure can be,” said Dr. Nicholas Qandah (aka Dr. Q), a leading back and spine surgeon in the CNY region.

Rome Health administrators also found a way to combat the regional shortage of gastroenterologists by establishing a GI practice this past spring at the Medical Center on the main campus of the hospital.

“When we got together as an administrative team to develop a physician development plan, it became very clear from a community needs assessment that there was a significant need for gastroenterology services to be provided here locally,” Dr. Andrade said. “If you look at that specific specialty, lots of times, patients here would have to be transferred sometimes two or three hours away to be able to get the level of care we’re going to be able to provide right here at home.”

Rome Health recruited two board certified gastroenterologists, Dr. Aamer Mirza, MD, who has been practicing for more than 24 years, and most recently Dr. W. Asher Wolf, MD. “They’ve been very well-received by the community. We’ve already seen the demand for their services skyrocket,” Dr. Andrade said. Dr. Wolf ’s advanced background includes providing patients with endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) services. Consequently, Rome Health invested in the equipment to perform these procedures.

“There’s only a handful of other gastroenterologists in the Central New York region that provide these procedures,” Dr. Andrade said. Additionally, with Dr. Wolf on board, Rome Health is now offering weekend appointments for colonoscopies, providing greater accessibility and convenience for patients.

Keeping it local

Rome Health decided long ago to set its sights on the needs and wants of its community — to have access to the best physicians with advanced technology — locally.

“When we decided to acquire these different technologies, first of all, the patient was at the center of it, really keeping in mind what the desire for the community has been, and [it] really has been to receive quality care right here at home,” Dr. Andrade said. Dr. Qandah drove it home: “Our top priority is to bring ideal health care to our region. That way we can deliver the care locally and patients can get better quicker in their own home, in their own
community.” 

Nursing Work Force Shortages

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By: Kathryn Ruscitto,
Advisor

I was recently asked to moderate a panel in NYC sponsored by the Mother Cabrini Health Foundation , on the shortage in the nursing workforce.

Leaders from a variety of settings discussed the challenges facing nursing and the opportunities to improve recruitment and retention.

The Center for Workforce Studies specifically detailed options to address recruitment ranging from scholarships, and tuition assistance to nursing residencies, and mentors. Among retentions strategies were nursing councils within programs like Magnet and Pathways to Excellence. Clearly the demand for nurses is increasing and the challenges facing nurses are also increasing.

The issue that struck me the most listening to this panel was the dramatic increase in workplace violence. Many public facing employees in our society have seen an increase in violence, health professionals are seeing that same increase. There are no easy answers, but there are many research projects that have looked at the issues and have detailed violence prevention programs and interventions. Public Health Services have identified the same process model to be used across all violence prevention in areas from domestic violence to health care.

Fig. 1: 10 Essential Public Health Services
Currently the focus in most health settings is on training for assessing and managing risks, leading to reporting and assigning resources for the most at risk patients. One of the clearest messages from the panel was on leaders placing a priority on training, and reporting.

It is also not just nurses facing these challenges, but all those who are part of the health care team. Violence prevention training must be part of all onboarding and communications across the team must be ongoing.

Resolving conflict avoids violence and is a skill to learn for all aspects of life. Take any training offered and look for resources on conflict resolution, violence prevention, and policies. Syracuse University offers unique training through PARCC, the Program for the Advancement of Colloboration and Conflict Resolution.   https://www.maxwell.syr. edu/research/program-for-the-advancement- research-on-conflict-collaboration

Health professionals need our advocacy and support in bringing attention to these challenges. While we all must focus on first preventing violence, when it occurs action needs to be taken to protect health professionals in all settings.

Resources:
Center for Workforce Studies
https://www.chwsny.org/

NIH
https://www.ncbi.nlm.nih.gov/pmc/articles/
PMC9536186/

Journal of Emergency Nursing
https://www.jenonline.org/article/S0099-
1767(23)00059-4/fulltext

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

5 Points Your Physician Employment Agreement Should Address Regarding Med Mal Coverage

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By: Jenn Negley

Physician employment agreement clauses regarding your medical malpractice coverage are complex issues that are often muddled at best, and some even create more questions than they would if they just didn’t deal with the important malpractice insurance issues. Confusion and ambiguous wording in contracts create lawsuits so fully understanding these five points will help immensely:

1. Who will be purchasing what coverage?

Most Physician employment agreements at least state if the employer or employed physician will be purchasing coverage. The issues go well beyond that, but most agreements only hit the broad-brush basics.

2. Retro coverage or not when joining a new practice?

Will retroactive coverage be purchased for the employed doctor’s possible previous exposure? If not, who will pay for the expensive “tail” coverage? If retroactive coverage is being brought into the new practice who will be paying the difference between the “mature” policy cost and a first-year claims-made policy cost? Tail coverage allows a physician to extend coverage after the cancellation of a claims made policy. With tail coverage, if a claim is filed that reflects the period of the expired policy, coverage is provided even though the policy is no longer in effect. An important portion of the employment agreement should address any professional liability insurance coverage that will be required, as well as which party will be responsible for acquiring and paying for the coverage. If the professional liability insurance is a “claims made” policy, then tail coverage needs to be addressed in the agreement as well in case of departure or termination.

3. What limits will be required to be purchased?

There are differing opinions on purchasing low or high liability limits so the physician employment agreement needs to address the limits issues, as well as situations in which the employed doctor might want higher limits than most in the group, which brings up if this will be allowed and, if so, who will pay for the increased costs of a higher limits policy.

4. Quality of insurance company:

To say the least, not all insurers are created equal and there are vastly different thoughts on the risks versus costs of purchasing coverage from a financially unstable insurer versus an A.M. Best toprated insurer.

5. Departing physician’s tail issues:

Will a tail purchase be required, or will it be acceptable to purchase continuing coverage, keeping the in-force retroactive coverage date for at least five years after leaving a group? Will the choice between those two depend upon termination with cause or not, and/or termination by which party? Since there is now a stand alone tail market, what quality of tail insurer is acceptable, and how long of a tail must be purchased, since even one year tails can be bought but do not begin to offer relief for the much longer liability risk window?

The physician employment  agreement should outline all these terms on whether the group or the individual physician is obligated to pay for and purchase these coverages. By clearly stating the expectations and requirements in the employment agreement there should be no question about what is expected surrounding the beginning, duration, and termination of the employment relationship. All parties in an employment agreement need to fully  educate themselves with a knowledgeable and experienced malpractice insurance expert to prevent any unrealized expectations or miscommunications about the key issues, and a misstep in this area can lead to coverage gaps or coverage issues which can lead to very costly legal actions.

Women In Healthcare Look For The Beacons: Building Hope Through Behavioral Health

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By Erin L.W. Zacholl

There is a special glimmer when you realize that you are in the presence of someone who didn’t necessarily find the right course in life but were simply placed on it. Perhaps by serendipity or fate, Stephanie Montgomery was led to a small path at an early age. She recognized its direction, worked hard, persevered over tough times and forged a mighty highway out of its humble start.

Stephanie is the Administrative Director of Behavioral Health at Syracuse Community Health. Her SCH career began almost 30 years ago when she served as the receptionist for the Counseling Addiction and Psychological Services (or CAPS) department of SCH. Every promotion she has earned since serving as receptionist was created for her. She has truly pioneered her own career while making opportunities for others to follow. “I firmly believe that all of us must stay focused and use what we have in front of us as an advantage, nota hurdle,” Stephanie speaks these words with a laser focus.

At an early age, she found herself the victim of domestic violence and used this experience as a building block, not a crushing boulder. “Syracuse Community Health was my safe place,” Stephanie recalls with accomplishment. “I used this period of my life to propel myself. I kept pulling myself up and that experience helps me with much of what we do in Behavioral Health.” Stephanie continued, “It’s not always easy, but we all must recognize our own strengths and stay committed. Keeping my word is so important; to the people I serve and to myself.”

Stephanie feels that is both her responsibility and honor to especially reach areas of our general population that are often misheard and misunderstood. “As a biracial woman, I understand what it’s like to feel connected to more than one place, but not necessarily feel grounded in either,” she speaks from the heart, “I am proud to help other biracial women, as well as others in our community who are most vulnerable. We all need to recognize our value and belonging, and SCH is such a wonderful platform for this purpose,” her words are spoken with a smile. “There is so much here to offer our community.”

Through her own journey at SCH, Stephanie attests that her years at SCH have seen, much change, yet much has also stayed the same. “While the stigma of mental health has alleviated over time, I would love to see it gone,” Stephanie reflects, “it’s still a roadblock.” When Stephanie speaks, her words are annunciated from such a place of solid experience, ,“When someone is diagnosed with cancer, there is no judgment when the patient needs help and treatment. Society needs to treat people facing addiction and mental illness the same as they would treat someone with a terminal disease.” She believes that the department title Behavioral Health helps integrate all the services the SCH offers while hopefully helping to eliminate the stigma associated with the “addiction” portion of CAPS. “The majority of addiction patients are navigating a deeper illness,” Stephanie says, “often, overdosing is a result of self-medicating for an underlying condition.” Through her decades at SCH, Stephanie has seen the, addiction crisis evolve from crack cocaine toward opioids. “It’s eye-opening when you look around,” she says, “mental health and the opioid addiction have exploded; waiting lists are long, but hope exists.”

Stephanie’s department at SCH offers a personalized approach to care and treatment. Their individualized method of care is respectful, educational and focuses on a person-centered journey. “We treat the whole person,” Stephanie explains the approach to SCH’s services. “It’s important to respect each person’s perspective by listening to them and by supporting  improvements in their mind, body and spiritual well-being.” She also stresses the importance of seeing someone in person. “Since COVID, there is such a shortage of mental health providers, social workers, marriage-family and crisis therapists.” Additionally, the pandemic found many providers with their own issues and unable to provide services to others. Since COVID, New York State has also started telehealth, services, to include mental health. While this helps broaden the possibilities for more people to seek help, Stephanie cautions that “many professionals went into private practice with the convenience of telehealth, even though providers really do need to see people in person (at least sometimes).”

The Behavioral Health Department at SCH is small and intimate, but large in the services offered and the accreditations of their team. “It’s important that our community understands all that is offered here,” Stephanie proudly states. “W are a unique behavioral health department with a team that specializes in Medication Assistance Treatment Services, Out-patient Addiction Services (inclusive of impaired driver assessments) as well as Individual and Family Therapy.” Stephanie says that she loves watching the transformation in people that are seeking help and pursuing help, “I was brought up here and to be able to work in such a place that is so patient focused and understanding about the populations we serve is a tremendous feeling.”

At SCH, Stephanie Montgomery makes every day intentional. “Did I do my best today?” she asks herself nightly. “I have gone through seasons of my careers at SCH and each one found me right where I needed to be,” reflecting on her years. “I feel so blessed to be part of this humbly wonderful team.” Stephanie is often asked how she balances her work and professional lives. In addition to her gratitude for the environment at SCH, she always replies, “My simple answer is Faith, Family and a good support system; no matter how large or small that system may be.”

Is Your Restrictive Covenant Still Enforceable?

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By: Sarah E. Steinmann

The Federal Trade Commission (“FTC”) made a big splash this spring when it published its Final Non-Compete Clause Rule (“Rule”), which bans most post-employment non-compete agreements between employers and workers.

The FTC issued the Rule under its authority to regulate “unfair restraints on trade and business” and intends for the Rule to open the door for new businesses, innovation, and increased wages for workers.

Until now, non-compete covenants have been governed by state law, with the scope and enforceability of such arrangements varying widely. The Rule—set to go into effect on September 4—will affect businesses nationwide and across industries, including those operating in the healthcare space.

Applicability
Most healthcare entities will be subject to the Rule, which applies to “all persons and private for profit business entities,” regardless of business structure. While non-profits are generally not subject to the Rule, the FTC will scrutinize non-profit corporations to determine “whether either the corporation or its members derive a profit.” If they do, the Rule will apply.

On the other hand, anyone who produces work for a business, including employees, independent contractors, interns, and even unpaid volunteers, is considered a “worker” protected under the Rule.

FTC Defines Non-Compete Clause
A non-compete agreement is a restrictive covenant that prevents a worker from working for or operating a business that is competitive with the employer after the worker ceases to work for the employer.

The Rule implements a broad definition of “non-compete clause” to include restrictions in employment agreements, workplace policies and even oral agreements between parties. Any term or condition of employment that “prohibits a worker from, penalizes a worker for, or functions to prevent a worker from” working for or operating a business after their employment with the employer ends is prohibited under the Rule.

The Rule also extends to other types of restrictive covenants such as non-disclosure and non solicitation agreements—if they have the same effect as a standard non-compete (i.e. if they prevent a worker from, or penalize a worker for, seeking or accepting work after their employment ends). Businesses that offer on-the-job training should be aware that training repayment agreements might be challenged under the Rule.

Exceptions
The Rule does not prohibit restrictions on workers during their employment, so a business can prevent workers from simultaneously working for their competitors. The Rule also allows noncompete restrictions between buyers and sellers of a business in connection with the sale of a business or an individual’s ownership interest.

Existing Covenants
The Rule is retroactive, so non  compete agreements made before September 4 between businesses and their workers will become unenforceable. 

One notable exception will allow businesses to enforce existing noncompetes against their senior executives. A “senior executive” is an employee who earns more than $151,164 per year, who is in a “policy-making position,” and who has “final authority” over decisions controlling a significant aspect of the business. For most physicians, the question of whether they are in a “policy making position” will be the most controversial in determining the enforceability of a restrictive covenant.

State Laws
Physicians and healthcare businesses may be familiar with existing state laws and regulations and shouldn’t assume they no longer apply. While the Rule supersedes existing state laws and regulations that conflict with it, states are free to regulate non, compete covenants outside the Rule’s scope.

Next Steps for Employers 

Employers will need to notify every worker subject to a non compete that it is no longer enforceable, so businesses should start identifying workers affected by the Rule. They should also start preparing the notices, which must be “on paper” and delivered personally or by mail, e mail, or text message. Businesses might also consider why they used noncompetes and how they might achieve their business aims within the bounds of the Rule.

Legal Challenges
Employers rushed to challenge the Rule in court, seeking injunctions to prevent it from going into effect. A federal judge in Texas issued a preliminary injunction temporarily halting implementation of the Rule and is expected to issue a final decision by August 30. In a separate case in Pennsylvania, the court rejected the employer’s request for an injunction. Businesses should keep an eye out for developments as the September 4 effective date approaches. Because of the pending litigation and the plethora of cases we expect to be filed in the coming months, ultimately, this is an issue that will probably reach the Supreme Court for a final determination. 

If you have questions about the enforceability of your restrictive covenants, it is crucial to act now to ensure your agreements are in full compliance with the FTC’s new Rule before the September 4 deadline. For questions, contact Lippes Mathias attorney Sarah E. Steinmann by phone at 315-477- 6232 or by email at ssteinmann@lippes.com.

Significant research for this piece was performed by Jennifer E. Forward, summer associate, Albany Law School (anticipated Class of 2025).

Cardiovascular Disease Research:One Phase Ahead of Alzheimer’s Studies?

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By: Robert C. Cupelo, MD Principal Investigator

For everyone involved in neurological disease research, the last two years have brought about major advances in our understanding of Alzheimer’s disease and related neurodegenerative disorders. Along with the discovery of new avenues for effective therapies, we now have, for the first time, proven disease modifying treatments. And as we acquire more options shown to be effective, we look forward to applying these tools and developing regimens not only to treat this disease, but also to prevent the very onset of its clinical manifestations.

But when it comes to the area of metabolic disorders and their role in causing cardiovascular disease, science is in an historical phase ahead. As someone who started his medical training in the late 1970s, I can attest to the lack of effective, convenient, and tolerable treatments for conditions like diabetes and hyperlipidemia at that time,relegating many patients to a life with relentless symptom progression, cardiac events and frequent essentially palliative surgical procedures. I can even remember a very respected and prominent cardiovascular surgeon who could predict with uncanny but somewhat sad accuracy when his successful bypass patients would be back in the OR requiring another procedure. With limited therapeutic options available, patients often endured a poor quality of life, many experiencing a feeling of helplessness, despite valiant efforts at lifestyle modification.

The release of lovastatin (Mevacor) in 1987 changed all that. The first statin to gain FDA approval, it was the first truly effective treatment for hypercholesterolemia. Actual statistical proof that it reduced cardiovascular events and surgeries would come a little later (it’s now required for approval of these medications), but we all knew from the start that this was a game changer. It could be said that it was, in effect, the first viable disease modifying medication for coronary artery disease. And in the years since, countless pharmaceutical advances have followed, treating not just elevated LDL cholesterol, but numerous other metabolic conditions which increased risk for cardiovascular disease, such as other dyslipidemia, type II diabetes, chronic renal disease, coagulation abnormalities, obesity, and acquired diseases of myocardial function.

We at Velocity Clinical Research Syracuse embrace the study of the prevention and treatment of metabolic and cardiovascular diseases with today’s therapeutic tools and ask, “How do we best help the further development of our current available medications, and how do we promote their best use both in primary (warding off the first event) and secondary (warding off subsequent events) prevention?” The dedicated and competent staff at our research site on Brittonfield Parkway have run and are actively running several studies in multiple, areas of metabolic disorders including two studies for hypertriglyceridemia, an oral PCSK9 inhibitor for patients with hypercholesterolemia at increased cardiovascular risk (currently in maintenance phase), a long-acting basal insulin dosed weekly, an oral GLP- 1 that is more effective and tolerable than currently available options, and several classes of injectable weight loss medications, assessing not only their efficacy with weight loss but also the metabolic consequences of the therapy.

As always, clinical research studies are fluid in nature, often starting and ending enrollment somewhat suddenly and unpredictably. So, if you have any interest in participating in this research, or would just like to know more about it, we encourage you to call us to learn of our latest developments. We can also keep you up to date on our ongoing efforts to study Alzheimer’s disease, another core focus at our site. Indeed, we look to a vision of the future when, just as we now have with metabolic disorders, we will have numerous and varied options available to people at risk of dementia and other neurodegenerative diseases.

At Velocity Syracuse, we encourage our Central New York medical community colleagues to keep us in mind as a dynamic and viable partner in your efforts to provide preventative care and treatment to your patients, including ones at elevated cardiovascular risk. And as always, we especially seek people from diverse backgrounds and those who are traditionally underserved, as they can potentially benefit in many ways from participation in clinical research. A culture of inclusion is especially vital to the accuracy and validity of our results.

Heart disease is still the number one cause of death for Americans, but our health care system has been making progress on this for quite a few years now. Let us at Velocity Clinical Research Syracuse help you and your patients keep that ball rolling.

A&M Graphics: Revolutionizing Visual Spaces in CNY and Beyond

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By Elizabeth Landry

In high school, Matthew Ferguson was deeply invested in art, taking every available class in Auburn, NY. Initially aiming to become an art teacher, his path shifted when he began working at a local sign shop. Ferguson’s experience in the sign shop later combined with a short career in sales and managing wireless company stores like Verizon, where he delved into technology during the dawn of the smartphone era. The result of Ferguson’s varying experience was a fused passion for art and technology, which, along with a knack for problem-solving and customer service, led him to where he is today: Creative Director and President of A&M Graphics, a company he helped found in 2009 and of which he has been the sole owner for the past four years. 

Located in Auburn, A&M Graphics has carved out a niche in what the team has dubbed “Premium Graphic Environments,” offering a full range of products and services from Vinyl Wall Murals and Wall Coverings to Dimensional Letters and Logos, ADA and Wayfinding Signage, Custom Displays and Exhibits, 3M DI-NOC Architectural Films, and 3M FASARA Window Films. On the other end of A&M Graphics’ business, the team has also proved themselves as the premier Vehicle Wrap and Fleet Graphics provider in the area. No matter what kind of service the team at A&M Graphics is providing, the central goal is always the same: to provide the highest quality of design, printing, fabrication, and installation as illustrated in their tagline: “design. create. deploy.”  This tagline, along with the company’s logo, was recently trademarked by Ferguson and is all fueled by passion, creativity, and strong relationships with fantastic clients. According to Ferguson, this has been true since the very beginning of the business, which will be celebrating 15 years this coming fall. 

“Since day one, we’ve forged a reputation for not just providing quality work but also continuing to set the bar for top levels of quality and service in what we do and what we offer. We’ve continued to build relationships based on these values, and that has really gotten us to where we are today,” said Ferguson. 

Crafting Impactful Visual Experiences

Many of the different mixed-media services A&M Graphics provides come together to form premium graphic environments that transform entire spaces, including office spaces and whole campuses, and significantly boost a brand’s visual communication. Ferguson explained how the creativity, expertise, and passion behind the team’s large-scale graphic installations play a large role in how the company sets itself apart from competitors. 

“We are so much more than just a sign shop or wrap shop,” Ferguson said. “We’ve really forged our own niche in the industry based on our passion for what we do with these premium graphic environments – centered around the creativity, time, and dedication poured into each custom project. Keeping the emphasis on creativity as part of our process and not just being a ‘feed the beast’ or ‘churn and burn’ kind of shop has always been our focus. We have definitely kept that credo the nucleus of our business.”  

Ferguson and his team recently completed several large-scale graphic installations for the Pall Corporation, a global leader in filtration solutions, at its Cortland and Long Island locations. The A&M Graphics team worked with the Pall Corporation to achieve a vibrant, high-impact space at both locations, which features a mixed-media timeline of the company’s history and legacy. Designed, printed, fabricated, and installed by Ferguson’s team, the projects took many hours of labor and weeks of creative, high-end graphic design work, ultimately achieving the Pall Corporation’s vision through the use of varying shapes and thicknesses of acrylics and the stand-out effect of the DryTac Polar Chrome material. 

Although the details and vision for custom graphic design projects can vary greatly from one client to the next, each premium graphic environment that A&M Graphics creates is intended to have a strong impact on those who enter the space. This aim remains true whether the space is intended to impress visiting clients or instill a sense of company culture with employees. Mike Durkin, Vice President of Client & Investor Relations for VIP Structures, which has been a client and partner of A&M Graphics in recent years, described how a similarly high-impact design with a very different strategy was achieved for a client in the healthcare industry.

“I toured the new Nappi Wellness Institute at SUNY Upstate Medical University, and in their MRI room, they have this panoramic image of the Adirondack mountains wrapping an entire wall that Matt and his team installed,” said Durkin. “Going to see a doctor and getting an MRI done can be nerve-wracking, but when you walk in the room and see this gorgeous image, I think it can really ease patients’ concerns – it gave me a sense of calm immediately. It’s such a better experience than walking into a room with a stale, blank white wall. A&M Graphics really listens and brings so much creativity into the solution to achieve the impact a client is hoping for. Their creativity, focus on what the client is trying to convey in the space, and delivery of a product that far surpasses expectations are what set Matt and his team apart from the rest.”

Upstate’s Nappi Wellness Institute is one of A&M Graphics’ marquee projects of the last few years. Led by project manager Todd LaFlamme, the team completed hundreds of wall murals, premium sign components, and art pieces throughout the five-story new construction in the heart of Syracuse. “SUNY Upstate and VIP Structures are two important relationships that we feel very fortunate to be able to service,” commented Ferguson. A&M Graphics also completed Wall Murals and Signage for VIP Structures’ new downtown home at “The Post.” 

Nationally Recognized for Excellence

Among A&M Graphics’ clientele are manufacturers, contractors, architects, healthcare organizations, and the higher education sector, and the team is often brought into larger organizations’ projects early during the formation of architectural plans to ensure direct involvement from the start and a smooth result. Having completed numerous projects over several years for Central New York-based organizations such as SUNY Upstate University Hospital and VIP Structures, A&M Graphics has also begun to receive interest from national and even global organizations due to Ferguson’s drive to achieve and maintain important quality standards. 

The company holds two certifications from 3M, which is considered the graphics industry leader and sets the highest bar of quality for graphic application businesses. Ferguson first earned A&M Graphics’ designation as a 3M Certified Graphics Company, which placed the company on 3M’s national registry, signifying that A&M Graphics is not only one of the best in the business but is fully insured and abides by certain business practices and a code of ethics. Later, Ferguson trained, tested, and received 3M’s Endorsed Architectural installer certification, which deems A&M Graphics a certified installer for 3M’s architectural line, including DI-NOC architectural finishes, glass finishes and window films. Both certifications were achieved at 3M’s global headquarters in St. Paul, Minnesota and they put A&M Graphics on the radar of national organizations that only look to 3M’s national registry for companies they can trust to provide top-quality, reliable graphics services. For Ferguson, pursuing these certifications was non-negotiable. 

“We’re nationally connected with industry peers and always keeping our finger on the pulse with the latest and greatest technologies, materials, and techniques. We’re constantly finding the best methods and products to bring back home to our clients, and being 3M Certified is a big part of that, so obtaining the certifications for our business was very important. We pursued and earned these certifications, and they really show that A&M Graphics is committed to being among the best in our industry,” Ferguson explained.

Ferguson has now started taking this a step further, recently participating in industry training demonstrations for different manufacturers in Boston and Chicago.  

People at the Heart of the Vision  

Another way A&M Graphics is naturally expanding beyond Central New York is through Ferguson’s involvement within his industry on a national level. Whether by attending trade shows or simply connecting with his peers around the country, Ferguson expressed a passion for bettering the graphic industry at large. 

“I’m very involved in my industry on a national level – not just for myself and my business, but as a way to advocate for our industry as a whole. I’m trying to help my peers both locally and nationwide by making sure we keep moving the goalposts as the industry expands and helping to grow it even further,” stated Ferguson. 

Building relationships with industry peers in different parts of the country mirrors Ferguson’s value of strong relationships with both clients and members of his team, who he calls the “DREA&M TEA&M.” For Ferguson, it’s those genuine relationships and pride in his team’s excellence that really drive his passion for the work he does every day. 

“At A&M Graphics, we’re all about relationships,” Ferguson emphasized. “Whether that’s our hometown relationships or the accounts we service nationwide. Everything is handled the same way – the right way – and we really enjoy the relationships we’ve forged and that we continue to forge. The relationships I’ve made with my amazing staff, who are more like family to me, are also what I enjoy the most about coming to work each day. They really are a dream team because they’re all professionals who have worked at a high level in the industry before we all came together and who work hard to produce spectacular outcomes that blow our clients’ expectations away.” 

Future Expansion and a New Location 

With great relationships to build on and new ones to be made, the future looks bright for A&M Graphics. The exciting next phase for the business will be bolstered by a brand-new facility being built in partnership with VIP Structures that is planned to be completed in the latter part of 2024. The new space will more than double A&M Graphics’ current square footage, which will allow the company to add additional team members as well as increase the amount of equipment in fabrication and installation areas. The facility will also sit on a plot that allows for future expansion. Ferguson stated that the new location will be an important next chapter for the company. 

“The new space is going to be really impressive, and it will be unlike anything currently in our area. I couldn’t be more excited about where the company is headed and about what the new space will allow us to do,” said Ferguson. 

Certainly, with a leader like Ferguson and a focus on providing high-value premium graphic environments for its clients, A&M Graphics will continue to find success in the future. As Durkin described Ferguson, “He’s a natural-born leader, and it’s clear that his team is all-in on delivering his vision for the company. With Matt and his team, there really is an art form to the design, the production, and the installation they provide. They really do care about the impact of the end product and not just mass-producing for the sake of closing a product order. That’s why I’m really excited to continue to work together and see what we can accomplish.” 

NONCOMPETE AGREEMENTS BANNED NATIONWIDE

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By: Monika Herrera, Sheats & Bailey, PLLC

FTC BAN

On April 23,2024, the Federal Trade Commission (“FTC”) issued its final ruling banning noncompete clauses across the United States. The FTC’s new rule comes into effect September 4, 2024. 

The FTC defines noncompete clauses as follows: a term or requirement in an employee contract that forbids, fines, or prevents a worker from (i) looking for or taking a job in the United States with another individual, where the job would start after the employment that contains the term or condition ends; or (ii) continuing to run a business in the U.S. following the conclusion of the job that contain the term or condition.       

Prior to this act noncompete clauses acted as a barrier to shield businesses from employees who might seek to exploit confidential information gained through their employment to start a competing business.  Noncompetes were common practice across many industries to protect their trade secrets and to keep a competitive advantage. The FTC’s new rule strips businesses of this protection.

The FTC’s ruling bans new noncompetes for all workers including senior executives and invalidates prior noncompetes for all workers, except senior executives. Existing noncompetes for senior executives remain enforced. The FTC defines senior executives as employees that earn at least $151,164 and are in policy making positions. Policy making position refers to a business’ president or chief executive officer or officer equivalent with final authority to make policy decisions over the enterprise such as restructuring, company expansion through mergers or acquisitions, and resource allocation.

In addition, noncompete agreements entered into by a person pursuant to a bona fide sale of a business entity are exempt from the ban by the FTC. According to the FTC, a bona fide sale is one in which the seller has a reasonable opportunity to negotiate the terms of the sale and is made between two independent parties at arm’s length. State law will control the noncompetes permitted by the bona fide sale exception.

IMPACT ON CONSTRUCTION BUSINESS

The construction industry relies on skilled talent and strong relationships. The FTC’s new rule is broad and applies to all employees and independent contractors.  Noncompete clauses have allowed contractors to protect their proprietary information and methods, things like bidding practices/formulas and project management techniques.

Contractors who relied on noncompete clauses to prevent workers from leaving the company and utilizing the information gained while working at the company must now find alternative ways to protect confidential information.

The ban on noncompetes could leave contractors vulnerable to the sharing of their valuable information regarding customers and business development strategies. To stay ahead of the curve companies should look into alternative strategies for protecting proprietary information. Intellectual property protections such as trade secrets are legal tools for protecting valuable information. In order to satisfy trade secret requirements businesses should consult with an attorney to enact the necessary measures.  

Although noncompete clauses are no longer valid there are other restrictive covenants that can be used.  A non-disclosure or non-solicitation agreement can still protect certain aspects of the business.  A non-disclosure agreement keeps workers from revealing confidential information learned through their employment to other companies, but it does not prevent them from quitting to work for a rival company or starting their own business with that knowledge in mind.  A non-solicitation agreement prohibits an employee from leaving the company and taking other employees or clients with them after their departure. Both NDA’s and non-solicitation agreements can lessen the harm caused by the FTC’s new rule.

Businesses that wish to safeguard themselves moving forward should consider adding these kinds of clauses to their employee contracts and handbooks.  Consult an attorney to guarantee compliance with the new rule and prevent such revisions from appearing as a noncompete.  

MOVING FORWARD

In order to be compliant with the ruling, employers must provide clear notice in writing to their employees that they are no longer bound by noncompetes by September 4, 2024, and should remove noncompete clauses from all employment documents. There is a lot of resistance from companies and business groups to the FTC’s authority to remove all active noncompete agreements from millions of employee contracts. There are currently two lawsuits pending, one of which is from the U.S. Chamber of Commerce to contest the enforceability of the new rule.

At this point in time businesses should monitor the progress surrounding the ruling and whether a court will delay its enforcement. In the meantime, employers should understand how this rule affects their businesses and seek protective measures.   

 

For more information or assistance contact Sheats & Bailey, PLLC, Tel: (315) 676-7314, www.TheConstructionLaw.com.

 The information provided in this article is not intended to serve as specific legal advice for any particular situation. Competent legal and experienced counsel should be consulted.

Prevailing Wage – What Do I Need to Know?

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Lori A. Beirman, Director of Audit Quality, Dannible & McKee, LLP

Micron Technologies is slated to build a semiconductor fabrication facility in Onondaga County. The project may receive, among other things, up to $5.5 billion in tax incentives from Albany’s “Green CHIPS” program. This program requires construction projects to comply with prevailing wage rules.

Prevailing wage laws are designed to level the playing field for local workers. These laws apply to public projects and require contractors to pay most of their workers a set minimum wage of no less than the local “prevailing wage” rate. This rate is often based on wages and benefits paid to union employees. By standardizing compensation rates across union and nonunion worksites, the higher standards and benefits obtained by unions through collective bargaining agreements are extended to a much larger base of workers.

For some background, federal construction projects are covered by the Davis-Bacon Act, which is a federal law that protects construction workers’ wages on government-funded projects. It covers all 50 states. In addition, 32 states have their own prevailing wage laws for state government-owned construction projects. The New York State Department of Labor (NYSDOL) is responsible for calculating the prevailing wage for state and local government projects, except for New York City, where the city comptroller publicizes prevailing wage rates. While the U.S. Labor Department determines prevailing wage by conducting periodic surveys of area employers, New York State does not conduct a wage census. Instead, the NYSDOL copies the terms and conditions of construction union contracts, for each trade and region. This difference is due to the assumption that at least 30% of the workers in every trade in every part of the state belong to a trade union. Because these “prevailing” wages are often based on union contracts, including union fringe benefits, they can equal or even exceed a worker’s hourly cash pay on private work. In other words, in addition to the basic hourly cash pay rate, prevailing wage schedules include supplements (fringe benefits) that vary based on the craft, trade or occupation. Prevailing wage supplements may be provided to workers in the form of a cash payment (wages), or through irrevocable contributions to a fund, plan or program, or any combination of the two. Deciding which method of payment for supplements to use can be complicated and should involve discussions with a financial professional.

To further support local workers and boost the local economy, lawmakers continue to work to broaden the definition of public work and expand the reach of the prevailing wage to more projects across the state. For example, since prevailing wages drive up costs, it may encourage contractors to have more work performed off-site. To counteract this issue, in 2017 and again in 2023, lawmakers worked to pass laws to apply prevailing wage rules to certain off-site fabrication of goods used on a public works job site. In February 2022, New York State passed a law relating to the payment of prevailing wage for work involving the delivery to and hauling of aggregate supply construction materials on a public works job. Additionally, state and federal lawmakers have proposed legislation to broaden the definition of public works projects to include those paid for in whole or in part out of public funds.

Due to these constant changes in the law, it is important for construction contractors in New York to stay up to date with the laws and their responsibilities, not just for their employees but also for the employees of their subcontractors. According to Section 198 (e) of the New York State labor laws, contractors are liable for all claims on unpaid wages, benefits and wage supplements for workers employed by their subcontractors.  Therefore, it is critical for contractors to perform due diligence on their subcontractors. Recordkeeping is critical to ensure compliance with prevailing wage laws in New York. Proper documentation of employee hours worked ensures contractors adhere to the law and assists in any possible investigations or audits conducted by the NYSDOL.

Prevailing wage laws support good wages and benefits, thereby helping to close racial, gender and geographical pay gaps, promote quality work and improve the value received for each taxpayer dollar. However, for employers, prevailing wage laws can be confusing and complex. The repercussions of noncompliance can be devastating to any business. Therefore, it is important for employers to have a clear understanding of prevailing wage laws and to know when to ask for assistance.

Lori A. Beirman is the director of audit quality at Dannible & McKee, LLP, a public accounting firm with offices in Syracuse, Auburn, Binghamton and Schenectady, NY, and Tampa, FL. She has over 23 years of experience in audit, reviews and compilations in a variety of industries, such as construction, manufacturing and professional service firms. For more information on this topic, you may contact Lori at (315) 472-9127 or visit online at www.dmcpas.com.

State of the Construction Industry

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Earl R. Hall, Executive Director, Syracuse Builders Exchange

 Considering the multi-year, $2.5 billion Route 81 project, and the highly anticipated start of Micron’s 20-year, $100 billion semi-conductor chip fabrication project in Clay, the media and elected officials have used the word “megaprojects”.   These unusual megaprojects garner great interest and typically lead to questions about the impact of these projects on society.  As a result, people have asked me about how such megaprojects impact the construction industry in central New York.

To begin with, it is important to understand that the construction ecosystem, although resilient, is fragile.  The tripartite balance that exists between project owners, contractors and labor has never experienced projects of this magnitude happening at once, so forecasting the impact on the industry may be difficult.  Making assumptions is what a good actuary does to assist in predicting the future, so I will make assumptions to provide better context.

Assumption #1 – Labor

The lack of labor continues to plague the industry, which in some cases may result in a contractor’s inability to complete a project on time.  Failure to complete projects on time may contractually lead to liquidated damages.  Delivering labor to Micron will certainly be a challenge as the regional industry today does not have such capacity; however, one can assume much of the labor for Micron will be imported from other regions of the United States.  As a result, I do anticipate the project will have the labor force necessary to achieve project delivery requirements, but certainly there will be labor challenges.  Moreover, regional contractors serving traditional clients, such as hospitals, universities, industrial and institutional facilities may not be materially impacted to the extent of not having available labor.

Assumption #2 – Project Schedules

Project owners’ delivery schedules are becoming increasingly aggressive, both in the public and private sectors.  Often the contractor’s ability to achieve the schedule is dependent upon a wide variety of items but having adequate labor and timely delivery of construction material, such as concrete, is essential to achieving schedule goals.  Although much of the labor on the megaprojects may come from out of state, one should assume meeting project owners’ future aggressive schedules may be more challenging due to the potential labor pressures associated with megaprojects.

Assumption #3 – Wage Growth

Anticipating future regional wage growth is paramount for construction contractors and project owners alike.  How will the megaprojects impact future wage growth?  Over the past two years, construction industry employees have enjoyed advantageous conditions leading to above average wage growth.  I expect this environment to continue, with wage adjustments far exceeding inflation.  Additionally, many employers are rewarding their best employees with additional compensation, benefits and other incentives to remain with their employer.

Forecasting future regional wage growth will be difficult as it remains unknown the incentives required to attract labor to Micron’s project.  While Micron’s 20-year project has a Project Labor Agreement which contains the unions’ wages and fringe benefit schedules, I anticipate such wage schedules will be the “minimum wage” requirement for this project.

“What does this all mean?”

The most asked question is, “How will these megaprojects impact other project owners?”  This question is most difficult to answer; however, one can assume:

  • Continued exceptional craftsmanship from labor.
  • Continued exceptional project management, execution and delivery from construction industry employers.
  • Renewed focus on the tripartite relationships.
  • Increased cost of labor and associated increased cost of construction project budgets.
  • Less compressed project delivery schedules.
  • Billions of dollars in new construction spending for new projects surrounding and supporting these megaprojects.
  • Continued labor shortages.
  • Enhanced Career and Technical Education programs in public schools.
  • Increased construction in the housing market.
  • A revitalization of the central New York region.

These two megaprojects, along with additional capital investments from both the public and private sectors, will directly fuel the incredible economic development central New York will experience over the next decade.  It will be essential that the construction industry, and society in general, take advantage of these opportunities and overcome any of the barriers associated with change.