Oneida Health Pursues Another 125 Years of Exceptional Care

By Becca Taurisano

From investments in facilities, technology, and medical staff to strategic partnerships, Oneida Heath is committed to providing the best quality outcomes and patient experience today and in the future.

THE EARLY YEARS

From the very beginning, Oneida Health’s mission has been driven by the community’s need for exceptional care, close to home. In 1894, a railroad accident in Oneida brought to light the need for immediate health care services. With a makeshift treatment room established at the Presbyterian Church to treat the railroad victims, the concept of delivering organized healthcare services in the community was born.

In 1899, Oneida Mayor, J.M. Goldstein donated a plot of land on Williams Street and Oneida Health opened the doors to its first hospital, a four-bed city-operated facility. After an expansion a few years later, it was clear more was needed and the first Broad Street Hospital was built in 1906, followed by a new 80-bed Board Street facility in 1938. 

Over the next 30 years, the Broad Street Hospital continued to expand to meet the needs of the community driving the need for a new site. In 1972, a 126-bed hospital opened its doors at 321 Genesee Street which serves as the hospital’s primary location today. Two years later, the Broad Street facility was converted into a skilled nursing facility, marking the beginning stages of Oneida Health’s healthcare system.

“Since 1899, the growth of Oneida Health has been a reflection of the needs of our community,” says Michael Kallet, Chair, Board of Trustees of Oneida Health. “From our humble beginnings to today, our organization continues to be driven to provide convenient access to the highest quality of care possible.”

TRANSFORMATION TO AN INTEGRATED HEALTH CARE SYSTEM

With the hospital location firmly established on the hill overlooking Genesee Street and a skilled nursing facility downtown, the city-owned and operated healthcare system in Oneida continued to deliver care for the next 20 years without much change. It wasn’t until the 1990s that Oneida Health started to expand its services beyond the hospital and skilled nursing
facility.

Throughout the 1990s and 2000s, Oneida Health saw tremendous growth in services offered with the expansion of outpatient locations. This transformed Oneida Health into an integrated healthcare system.

“To best care for your community, you need to invest in providing preventative care,” says Kallet. “As an organization, we recognized this as the next step to meet the needs of our community by supporting population health and preventing more intensive and costly care
down the road.”

Recognizing the need for primary and preventive care services, Oneida Health opened its first outpatient office in Camden in 1991 marking the beginning of what is now a six-location primary care network with 18 primary care providers. To support access to diagnostic services, Oneida Health expanded its lab and imaging services with the development of five outpatient lab draw locations and two outpatient imaging centers.

In addition to the expansion of primary care, Oneida Health recognized the need for increased access to specialty services close to home. “The need for increased access to specialty services in healthcare has grown with the advancement of medicine,” says Felissa Koernig, President and CEO of Oneida Health. “Developing and nurturing a network of preventative and specialty services is instrumental to improving care in our communities.”

This commitment has created an integrated healthcare network offering specialty services that include: Allergy; Breast Surgery; Cardiology; Convenient Care; Ear, Nose, and Throat; Gastroenterology; Neurology; Obstetrics and Gynecology; Oncology; Orthopedics; Podiatry;

 Pulmonology; Sleep; Vascular; and Wound Care.

A LEADER IN COMMUNITY HEALTHCARE:WORLD CLASS TECHNOLOGY

Along the way, Oneida Health has taken a strategic approach to providing convenient access to services with leading-edge technology. “As a rural healthcare organization, it is not enough to provide patients convenient access to healthcare services,” says Koernig. “Our mission is to provide patients with the best healthcare services, and to achieve this you need to pair
talented medical staff and the best technology.”

Oneida Health has had a history of investing in state-of the-art technology to support the diagnosis and treatment of its patients. In 2002, Oneida Health was the first hospital in Central New York (CNY) to introduce computeraided mammography. This was later followed by being among the first in CNY to invest in 3D mammography, the new gold standard in early breast cancer detection. With continued new investments in advanced imaging over the last decade which includes a 3-Tesla MRI and Advanced PET/CT, to name a few, Oneida Health has become a destination for imaging services.

From instituting robotic surgery in 2012 to providing TrueBeam radiotherapy, the most advanced linear accelerator and radiosurgery treatment system available, 

Oneida Health ensures providers have access to the best technology when it comes to treating patients. 

“It’s a common misconception that the best technology exists only in big cities,” says Kallet. “At Oneida Health, we have taken every step to ensure our talented Medical Staff has access to the best technology to treat their patients.”

 

STRATEGIC PARTNERSHIPS

For rural-based healthcare networks, the ability to develop highly specialized service lines can often be hindered by a lack of expertise and their ability to recruit Medical Specialists. Oneida Health has leveraged key strategic partnerships to help bridge the gap and bring
highly specialized care to Oneida.

In 2017, Oneida Health opened the William L. Griffin Medical Oncology Center followed by the Dorothy G. Griffin Radiation Oncology Center, both centers are members of the Roswell Park Care Network. The collaboration provides the Oneida region with quality cancer care that meets National Cancer Institute (NCI) guidelines, creating local access to some of the latest treatment options from a nationally ranked cancer center.

In response to an increase in diabetic patients with difficulty healing wounds, Oneida Health recently partnered with Restorix, an expert in wound care and hyperbaric medicine, to open the Wound Care Center in 2018. By developing this partnership, Oneida Health was able to bring in a high level of expertise in this specialized area to become operational in a very short time frame.

“Anytime we offer a service, we should be among the best in the area providing it, otherwise why would patients choose us,” says Koernig. “Strategic partnerships with Roswell Park, Restorix, and other healthcare systems have allowed us to leverage expertise in a collaborative effort to provide the highest quality of care on day one.”

NATIONALLY RECOGNIZED CARE

Oneida Health prides itself on exceptional care, always and has received numerous awards for high-quality care and patient experience for many years. Some of the most impressive recent highlights include:
The region’s only 5-star rated hospital by the Centers for Medicaid and Medicare (CMS) for quality care in 2021

Ranked in the top 2% of hospitals nationally for patient safety and patient experience by Healthgrades in 2019.

Women’s Choice Award for Best 100 Hospitals for Patient Experience four years in a row, 2020-2023.

A five-star recipient for Vaginal Delivery from Healthgrades for 5 years in a row (2015-2019)

“As an organization, we have a history of being committed to excellence,” says Koernig. “Awards at the national and state level are a testament to the talented Medical Staff we have at Oneida Health and their dedication to providing patients with the highest level of care at every visit.”

BUILT ON COMMUNITY SUPPORT

From a four-bed hospital to an integrated healthcare network, Oneida Health today includes a 101-bed acute care hospital, stateof-the-art robotic surgery center, 160 bed extended-care facility, multiple primary and urgent care offices, comprehensive lab and imaging services, outpatient and inpatient therapy, and a variety of specialty services providing care to approximately 29 communities with a population of over a 100,000 throughout Madison and Oneida counties.

The incredible growth and success the organization has seen over the last 125 years would not be possible without significant community support throughout its history.

Recent donations have helped support technology, expansions, and renovations of facilities like the William L. Griffin Medical Oncology Center, the Alice M. Gorman Imaging Center, the Dorothy G. Griffin Radiation Oncology Center, and the expansion of the Emergency Department and Operating Rooms including the Chapman Foundation main hospital entrance.

“So much of what we’ve achieved has been made possible 

by our generous donors,” says Kallet. “From the original land donation by the mayor to our most recent donations  by the Griffin Foundation for the expansion of oncology, these contributions to our mission have elevated our network to what it is today.”

Support from community groups has been essential as well, from the Oneida Health Foundation to individual volunteers and groups like the Oneida Health Auxiliary. Their combined efforts have provided valuable resources to Oneida Health’s success.

“Community-based organizations have provided their support throughout our 125 years because they believe in our vision,” says Koernig “From a single volunteer fulfilling hours of service to large financial gifts from area nonprofits, these generous acts have helped make our patient care exceptional. I extend our thanks to everyone in the community who has contributed so selflessly
over our organization’s history.”

THE NEXT 125 YEARS

As the future of healthcare changes, Oneida Health plans to stay agile to adapt to the ever-changing healthcare landscape.

“As an organization, we need to continue to look for opportunities to deliver care where it is needed and how patients want to receive it,” says Koernig. “Our ability to connect patients digitally with their providers and patient information is going to become more
essential as we move forward.”

While the method of delivering care may be changing, Oneida Health’s approach to patient care looks to remain consistent. “Our commitment to providing the highest quality of care and patient experience will continue to set us apart and remain an important reason why patients will choose us for years to come,” says Koernig.

The future of Oneida Health will continue to rest on its most important asset: its people. “As a healthcare organization, we will need to continue to recruit the highest level of talent while providing an environment where healthcare providers and professionals can thrive. 

Investing in our people will ensure we’re providing care for the next century and beyond,” adds Koernig.

The Evolution of Primary Care

BY KATHRYN RUSCITTO, ADVISOR

For many years we have lived with the concept that primary care is delivered by an office based physician who treats and coordinates all our care. The wisdom and experience primary care physicians have brought to this practice has been remarkable. Over the last several years environmental pressures have brought about an evolution in the Primary Care model leading to unique new access points for patients.

Covid added to an existing workforce shortage and many physicians faced burnout from growing demands. From 2005 to 2015 there was an 11% drop in primary care physicians. Recent tracking suggests that decline has continued.

The result is the evolution of a broader model of primary care access ranging from Urgent Care, Retail Clinics to Online Telemedicine consults, and Paramedicine Pilots. 

Heather Drake Bianchi, CEO of Drakos Dynamics, a provider of urgent care and family medicine in CNY underscores the importance of accessibility. In a recent interview she emphasized the value of being available when patients need care, outside traditional office hours, aligning with the shifting demands of today’s workforce and lifestyle.

Another essential change, is that many sub specialties are now seen as key or integral to the primary care provider. Integrated primary care considers the input from Pharmacy, Dental, Mental Health, Physical Therapy and Health coaching in an integrated record. These teams, often system based, believe primary care has to include a balanced view across all providers. The blending of all these perspectives across an integrated team allows for better delivery of care in a patient collaborative model.

Dr. Julie Colvin a busy Family Physician and Medical Director of Northeast Family Physicians at St. Joseph’s HHC states, “Healthcare has to change and evolve, and those options will also give patients and providers more flexibility, and will help the healthcare workforce shortage. We want to make sure that the quality of care in those extended fields is the same as traditional medical care.”

These new access points are exploding using technology, remote access to physicians and even algorithms that direct care based on AI analysis of patients answers to questions. 

In many ways these new access points are part of an Integrated Primary Care model. In order for that information to be readily available from any access point, it must be integrated across the medical record, or accessible to providers through the Regional Health Information Organization.

It is not unusual for me to find younger patients using these new access points and not having a primary care physician. For specialty practices I pose the question, have you adjusted your outreach approaches for patients based on these new access points?

The health care environment continues to evolve utilizing the opportunities from technology, and helping patients find the right care, at the right time, in the right setting.


Kruscitto 1/24
Krusct@gmail.com
Board member and advisor


Resources:
Primary Care in the US, a brief history
https://www.ncbi.nlm.nih.gov/books/
NBK571806/#:~:text=New%20models%20
of%20care%2C%20such,of%20quality%
2C%20and%20more%20formally

Primary Care: Past, Present and Future
https://www.medpagetoday.com/opinion/focusonpolicy/
103811

https://www.sjhsyr.org/find-a-service-or-specialty/
primary-care

https://www.drakosdynamics.com/


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

Enhancing Patient Care Through Clinical Research with Velocity

In the rapidly evolving landscape of healthcare staying at the forefront of medical advancements is crucial. Velocity Clinical Research, a global leader in conducting clinical trials with almost 100 sites worldwide, offers an 

avenue for healthcare professionals in the Central New York region to contribute to this evolution and significantly impact the future of patient care. By referring patients to clinical trials at Velocity Syracuse, you not only provide them with access to next-generation healthcare options but also participate in the advancement of medical knowledge and treatment.

Transforming Patient Engagement with Clinical Research
Velocity Syracuse is currently spearheading several clinical 

trials covering a wide range of medical conditions. Current studies include; cognitive decline, Alzheimer’s disease and agitation associated with it, non-alcoholic fatty liver disease, diabetes, secondary treatment of hypercholesterolemia, severe hypertriglyceridemia, gastroparesis, hepatic encephalopathy, obesity, and several vaccine trials. 

We are also participating in a unique clinical trial involving the evaluation of a new PET scan tracer to better identify brain changes in early Alzheimer’s disease. The study is looking for patients with a projected life expectancy of less than one year, with and without Alzheimer’s, who are willing to undergo a PET scan and donate their brain postmortem for comparison and evaluation.

A Step Towards Better Healthcare
Referring patients to clinical trials at Velocity is not just about accessing new treatment options, it is about being part of the larger community and movement toward the future of healthcare. It is also an opportunity to contribute to the advancement of medicine while simultaneously enhancing patient care and distinguishing your practice as one that is evidenced based and forward thinking.

These trials are more than just research studies; they are potential advanced treatment options for those patients with conditions not adequately addressed by existing therapies. Referring patients to clinical trials empowers and enables them to play a more active role in their healthcare journey.

Collaboration and Compensation
Participants in all studies receive compensation for their time and effort. Other advantages for individuals who participate in clinical trials include but are not limited to; access to medications irrespective of cost, transportation to/from our office if necessary, and additional medical testing that may not otherwise be available through the course of routine medical care.

We are committed to full collaboration and continuity of care with medical providers and the patients we share. We recognize the importance of sharing this information and the value of working together. We also make every effort to minimize time and work required to make a referral to us. Additionally, Velocity is striving to extend the potential benefits of participation in clinical research to everyone equitably. Historically, minority populations have been significantly underrepresented in research studies. We continue to make efforts to promote diversity in clinical research.

Stay Informed and Involved
We urge you to embrace this possibility to make a significant difference. Join Velocity in shaping the future of healthcare, one patient, one trial at a time.

To stay updated on the latest studies and how they align with your patients’ needs, you can easily reach out to us at Syracuse@VelocityClinical.com. Your proactive engagement ensures that you are always informed about the latest clinical research opportunities available
for your patients.

Abscope Environmental, Inc. Celebrates 35-Year Anniversary

by Becca Taurisano

Abscope Environmental, Inc. is a Canastota, New York-based, full-service remediation firm in its 35th year of business, thanks to a proud legacy started by founders John Romagnoli and his son, Jack. Beginning in 1989 as solely an asbestos abatement company, Abscope expanded into more comprehensive environmental remediation services in 1994 and fast tracked its growth in 2004 when Jack’s brother Jerry came on board. Planning for their succession, Jack and Jerry looked to their youngest brother, Bob Romagnoli, to take the reins. Bob became President of Abscope in 2019 and later, CEO, in 2020 as both brothers retired. While the company has experienced tremendous growth since its founding, Bob and his partners are now poised to expand into new geographical regions, offer new and innovative services, and most importantly, sustain the business for the next generation.

An Experienced Leadership Team

With more than 25 years of environmental consulting experience, Bob Romagnoli is an engineer by trade, but brought a vast array of leadership and operational skills to help Abscope redefine itself as a more state-of-the-art organization. During his career, Romagnoli led multi-million-dollar Superfund sediment remediation programs and developed turn-key environmental strategies for Fortune 100 companies, serving as Sr. Vice President at Arcadis and Managing Director at TIG Environmental.

Working closely with Romagnoli are three key long-time Abscope employees: Executive Vice President Rob Gray, Executive Vice President Robert Duffy, and General Manager, Steve Mitchell. All three have been with the company for decades and are part owners of the firm.

Rob Gray joined Abscope in 1995 when he started as an estimator. Over time his role grew into a managerial one and he currently serves as the Executive Vice President of the Environmental Remediation and Geotechnical Services division. Gray has extensive experience in Manufactured Gas Plant (MGP) remediation, hazardous waste remediation, stream sediment removal, In-Situ Stabilization (ISS), sheet pile installation, deep excavations, and site development projects.

Executive Vice President Robert Duffy and General Manager Steve Mitchell lead the Asbestos Abatement and Industrial Decontamination division. They oversee the removal, encapsulation, enclosure, transportation, and disposal of asbestos-containing materials, building demolition, and lead and mold remediation. Duffy has been part of the Abscope team since its inception in 1989 and has been crucial to its success and growth. He is responsible for estimating, proposal development, submittal generation, waste disposal coordination, and final report development, not to mention business development.

Mitchell has been with the company 30 years and is responsible for coordinating manpower across both divisions, a task that can be very challenging, especially in today’s environment. “Stevie’s attention to detail is second to none” says Romagnoli. “He’s the ultimate team player and always puts the company’s interests first.” 

Romagnoli said it took some time for the leadership team to learn how to best work together but have now struck the right balance. “These three guys have been here for decades and have significantly contributed to the success of this company,” said Romagnoli. “My role is to allow them to continue building on that success, while bringing a new perspective on operational and strategic matters.”

A Fresh Perspective

After joining Abscope, Romagnoli immediately identified several key areas for improvement, the most evident of which was in-house technology. While IT changes are never easy to implement, Romagnoli felt they were imperative to keeping Abscope at the forefront of the industry.

As an example, Abscope invested heavily in upgrading their take-off and estimating systems. The conversion to InSite and HeavyBid allowed for higher productivity and more accurate results. According to Romagnoli, the value was apparent from day one. “Our PMs have done a great job in assimilating to these new systems which in turn have allowed them to be much more productive. Given the complexity of the new platforms, we’ve only scratched the surface of their potential. I’m excited to see how much more we can extract and use to our benefit.”

Abscope also upgraded the GPS equipment on their “yellow iron” with the latest, most cutting-edge Trimble™ technology, including Trimble™ TSC7 v2s and R780 bases and rovers. The new equipment delivers the latest in field technology, optimizing efficiency and most importantly, accuracy. Abscope’s fleet is extensive, consisting of approximately 30 pieces of heavy equipment.

On the administration side, Abscope recently converted the invoice approval and payment process from paper-based to digital. “It is much more efficient for our PMs to digitally approve vendor invoices versus dealing with mounds and mounds of paper,” said Romagnoli. “The system has also minimized duplicate or erroneous payments.” Field Superintendents are also joining in Abscope’s IT revolution, now using tablet apps to track time, significantly reducing transcription errors within the accounting department.

New Horizons

From the types of projects, the size and scope of the work, and even the geographical location, much has changed at Abscope since its beginning in 1989. Most recently, there has been a surge of projects in the alternative energy space and Abscope has provided civil works for commercial-scale solar and wind projects. The work generally includes preparing the site for ultimate component installation by others and consists of earthwork, installation of storm water drainage, development of access roads, crane pads, and various other site features.

“Alternative energy has exploded for us, and it is not something that we necessarily expected,” said Romagnoli. “Smaller, more local opportunities have opened us up to much larger and broader opportunities nation-wide.” In fact, there has been so much growth, Abscope is considering the creation of a new division to execute the work.

Abscope’s job size and scope 

has changed too over the years. In the early years, jobs were $500,000 or less lasting up to a month, but now jobs range from $10 to $12 million lasting six months to a year. “The diversity of our projects shows how we have grown,” said Gray. “Today our projects are more complicated and the systems we have been installing are much more sophisticated.”

Geographically things are changing as well. Gray recalls in the early days, most of the work was within a two-to-three-hour radius, but not lately. Remediation projects are bringing Abscope’s crews to the Mid Atlantic, Midwest, Southeast, Southwest, and as far away as Puerto Rico. In 2022, they successfully completed a challenging six-month project in Dallas, TX with a world-renowned chemical manufacturer, where Abscope remediated asbestos contaminated soil on residential and small commercial properties. “We are now set up well to handle these larger, more complex projects,” said Romagnoli. “It is exciting to see such large and iconic companies/clients view us as a trusted partner.”

Thanks to the successful completion of the Dallas project, the very same Fortune 500 client selected Abscope for a large PCB soil remediation project in Puerto Rico in 2024. “We are grateful to them for giving us this unique opportunity to assist in such a highly visible and intricate project, especially in a geographic location that’s not necessarily familiar to us.” Abscope has invested a significant amount of time and money to make sure the project goes off without a hitch. “Ideally we’d love to leverage this opportunity to do other work (e.g., emergency response and disaster assistance) in Puerto Rico in future years, but for now, we need to keep our eye on the ball and ensure that this critical project is successful” said Romagnoli.

With Romagnoli’s experience 

in sediment removal, stream remediation, and shoreline stabilization, Abscope has been doing more work in those markets as well. “We most recently did a shoreline stabilization job in Lackawanna along Lake Erie,” said Gray. “With all the erosion from wind and waves, shoreline stabilization has been a big area of focus for us.” The addition of wetland and stream remediation is one example of how complex their current projects are due to the adherence to regulations with the Environmental Protection Agency (EPA) and the Department of Environmental Conservation (DEC) on the plantings, soils, and rocks required during the restoration process.

As work around the country continues to grow, Romagnoli and Gray are considering an expansion into new office locations. “We are looking to expand in the near future and discussing our growth plans for the Mid Atlantic area,” Gray said. With upcoming work in Puerto Rico, Romagnoli could see an office location in Florida as well to support the Southeast and Caribbean. “There is a lot of potential there, just a question of if and where,” he said.

Safety First

From environmental remediation to asbestos abatement, sediment dredging to shore stabilization, deep excavation to restoration, safety is Abscope’s number one priority. Duffy was instrumental in the creation of project-specific health and safety work plans for Abscope’s company-wide, behavior-based Health and Safety program. His daily interaction with clients, regulatory personnel, subcontractors, and project engineers as well as having managed or supervised over 3,500 asbestos abatement projects gives him a keen understanding of the safety issues facing field workers. “There are so many things that could go wrong on a job,” said Duffy. “We have to get ahead of it and make sure everyone is as safe as possible.”

On project sites, Abscope superintendents hold Toolbox Talks or safety meetings every morning to discuss the particulars of the job, what protective equipment is required, and what to do if something goes wrong. “Our guys in the field are very diligent when it comes to safety; they know there are no short cuts,” said Romagnoli.

The leadership team, Project Managers, and employees in the field also attend monthly safety calls to share stories about “good catches;” things on the job that could cause an injury. Good catches are recognized on the monthly safety calls and quarterly safety awards are given out to employees who are most focused on safety. “We rank health and safety here above everything else,” said Gray. “We take it very seriously.”

Investing in the Future

One of Romagnoli’s other priorities has been to bolster Abscope’s employee benefits and incentives. Romagnoli is focused not only on employee retention but attracting new talent as well. As an example, Romagnoli established a 401(k) program for the company back in 2020 to help employees help themselves. Abscope also provides a generous match. In addition, Romagnoli also set up a tuition reimbursement program that is meant to

encourage staff to continuously improve their skills. “We’re always looking to get better, but we want to make sure to take care of those that continue to make this company what it is,” he said.

Looking ahead to the future, Romagnoli would like to see the company grow to $25-30 million over the next five years. From acquisitions to new office locations, he is focused on building out systems and services to benefit the next generation. “My Dad would be bursting with pride seeing that the company has stayed in the family and become so much more than what he anticipated it to be,” he said. There is the potential for other family members to join the company at some point, but for now, Abscope is flourishing under current ownership. By honoring the past and continuing the proud legacy of the Romagnoli family into the future, Abscope is poised to be sustainable for generations to come.  

NYS MAKES SIGNIFICANT AMENDMENTS TO THE PROMPT PAYMENT ACT

Diana Plue, Esq. Sheats & Bailey, PLLC

On November 17, 2023, New York State amended sections of General Business Law Article 35E, known as the Prompt Payment Act, which applies to all private commercial construction projects having a value of $150,000.00 or more. This new legislation amends two sections of the Prompt Payment Act: General Business Law section 756-a and 756-c.

Section §756-a (2) of the Prompt Payment Act is amended to allow a contractor to submit a final invoice that includes retainage upon substantial completion of the contract, as defined or contemplated by the terms of the contract.  This is a notable departure from the prior version of the statute, where a Contractor had to wait to submit a final invoice until the contractor performed all its obligations under the contract.

The amendment to GBL § 756-c, limits the amount of retainage that can be withheld by an owner, contractor, or subcontractor on a private construction project. Under this new legislation, the maximum amount of retainage that can be withheld on private construction projects is five percent (5%).  In addition, contractors and subcontractors cannot withhold more retainage than the owner.  So, if the owner does not withhold the maximum 5% in retainage, then the contractor or subcontractor cannot withhold the maximum 5% retainage. Upon receipt of retainage, a contractor or subcontractor must release a proportionate amount of retainage to the relevant down the line subcontractor. Failure to release the retainage per GBL §756-c subjects the owner, contractor, or subcontractor to pay interest at the rate of 1% per month from the date retention was due and owing until paid.  

On their face these amendments dictate that the maximum amount of retainage withheld can only be 5% and that retainage can be billed before the project is fully complete. However, the opening of section 756-a states “except as otherwise provided in this article, the terms and conditions of a construction contract shall supersede the provisions of this article and govern the conduct of the parties thereto.”  Section 757 of the Prompt Payment Act provides only four instances where terms of a contract are void and therefore the parties conduct is fully governed by the Prompt Payment Act, and not the contract terms.  The amount of retainage withheld and the contracts definition of substantial completion are not one of the listed contract terms that are void.  As such, we think there are ways with carefully constructed contract provisions to still withhold 10%. 

Furthermore, the amendment to the GBL §756-a leave the definition of substantial completion to the contracting parties.  Thus, the definition needs to be carefully drafted and vetted by the parties as the definition will dictate when a final invoice can be submitted and thus when final payment received. 

For more information, contact Sheats & Bailey, PLLC; a law firm dedicated to serving the construction industry.  Tel: (315) 676-7314

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.

NYS WORKERS’ COMPENSATION – COVID-19 UPDATE

ANNETTE MALPICA, VICE PRESIDENT, DIRECTOR OF CLAIMS & LEGAL COUNSEL, LOVELL SAFETY MANAGEMENT CO, LLC

Is fear of contracting the COVID-19 virus a compensable mental injury under the Workers’ Compensation statute? On July 20, 2023, The Appellate Division-Third Department in three separate unanimous opinions decided the issue with a resounding “NO”.

Matters of Matthews, Brown, and Djanuzakov* involved claims filed against the New York City Transit Authority and its subsidiary by claimants who had public facing jobs.  The claimants, a train conductor, cleaner and bus driver filed mental stress claims alleging various psychological conditions as a result of being exposed to COVID-19 in the workplace. The claimants never contracted COVID prior to filing the claim however, they claimed exposure to other workers who tested positive and several coworkers and passengers who died of COVID-19 causing claimants to feel unsafe, depressed, and afraid to return to work.  In all three claims, the treating psychologists gave total disability, finding that the psychological symptoms made it impossible for the claimants to return to work. All three claims were disallowed by the Law Judge and the Workers’ Compensation Board.

In Matter of Brown, the claim was disallowed due to insufficient medical evidence to establish a causal nexus between the mental stress and claimant’s job duties. In Matters of Matthews and Djanuzakov, the Board disallowed the claims finding that the stress experienced by the claimant (train conductor and bus driver respectively) was the same as other similarly situated workers during the pandemic. The attorney representing all three claimants appealed to the Third Department.

The Court noted that “it is well settled that a mental injury arising from work-related stress is compensable” and the fact that the condition was pre-existing will not preclude the claim if the claimant’s employment exacerbated the condition as “to cause a disability which did not previously exist.” The claimant, however, must demonstrate that the stress that caused the injury was “greater than that which other similarly situated workers experienced in the normal work environment.” The Workers’ Compensation Board, as the fact finder, determines whether workplace stress is extraordinary based upon the evidence presented to it. In all three claims, the Third Department found that the Board’s reasoning was supported by the case law and affirmed its decisions.      

2017 and 2022 Legislation to Address Mental Stress Injuries

WCL Section 10 recognizes that certain stressful situations at work may trigger disabling mental injuries. In order for a mental injury to be compensable, the stress that caused it must be considered to be greater than the normal stress at work experienced by similarly situated workers. This evidentiary standard sets a high bar. In 2017, the legislature in recognition of the high standard for mental injury claims by police officers, firefighters, and emergency medical technicians created a carve out by removing the restriction that a mental stress claim had to be greater than the stress sustained by similar first responders.

During the 2022 legislative session, the Assembly and Senate passed a bill that would have extended the exception carve out for first responders to the entire labor force (A2020-A/S.6373-B). In addition, the bill if passed, would eliminate the requirement that the stress stemmed from a work emergency. The Governor vetoed the bill, noting the significant cost to the system, this however, did not stop the bill from being reintroduced during the 2023 session. In 2023, A.5745/S.6635 passed the Senate, but failed to pass the Assembly.       

For more information on workers’ compensation contact Lovell at 1-800-5-LOVELL or visit online www. Lovellsafety.com.

*Matter of Sheldon Matthews v. New York City Transit Authority, 218 AD3d 983 (2023)

Matter of Tracey Brown v. New York City Transit Authority, 218 AD3d 967 (2023)

Matter of Djanuzakov v. Manhattan & Bronx Surface Transit Operating Authority, 218 AD3d 980 (2023)

Insurance Renewals – Navigating the Hard Market

Actions that aid results

By: Brett Findlay, Vice President, Business Risk Specialist, OneGroup

The New York construction industry, and realistically the entire New York business landscape, is in the midst of an insurance hard market. The lack of insurance availability and the pricing volatility associated with it is leaving consumers in a difficult place when it comes to their insurance renewals. Although insurance options may be limited, it’s critical to know what or who those options are and when to approach them. Proactively managing your program can be an effective solution to unpredictable insurance renewals.

A hard insurance market is characterized by an increased demand for insurance coverage coupled with reduced supply. Underwriting guidelines from the carriers will become more stringent, policies issued by carriers will decrease, premiums are higher, and carriers are less willing to negotiate terms. The current market is hard and exhibits all of those tendencies. The question is, how do you proactively and effectively manage your program to counter the marketplace?

There are a couple simple strategies you can deploy to make this process more manageable and limit surprises and negative outcomes for your business.

Know where to look. A lack of options and higher prices are attributable to most coverage lines of insurance right now, including but not limited to property, commercial automobile liability, and umbrella liability. Identifying the key coverage lines of your program and asking your agent what the renewal is looking like early in the process is the first step. At that point, you should be gathering the data necessary for the carriers to quote those lines for you. Accurate data, provided in full 90+ days prior to the renewal date, will help your cause.

Be ahead of the renewal. By starting the renewal process early, 90+ days out, and by utilizing a broker who understands your business and the insurance marketplace, you’re putting yourself in a better position. It’s critical to select a broker that has availability to those necessary carriers. Ask the broker at that early stage what their marketing strategy is, what carriers they’ll be approaching and why.  Some of the carriers may need to visit your operations and meet with key team members in advance of providing alternatives. As they are interviewing you, this is a great time to ask them questions to see if a partnership would be a good fit for your operations and growth strategy. This is a key reason for why timing is so important. When you are discussing this process with your agent, if you’re not comfortable with their answers, it may be time to find a new one.

Know the landscape (and how to work within it). Much like the construction industry, insurance companies aren’t immune to staffing shortages either. Underwriters are going to work on accounts where they have all the data necessary to finish their process and in a timely manner. If you are not in front of them early, with what they need, the likelihood that you’ll be getting their best is drastically reduced.

It’s equally important that your agent is competent in representing your best attributes. The ability of that agent to forecast the costs and insurance availability with the proper insurance carrier should be a pre-requisite. Knowing how to communicate your businesses story is also key. You need someone who knows construction, knows your business, and knows the carriers and underwriters that are writing insurance competitively for your type of operations.

Relationships Matter. A broker’s relationship with their carriers is every bit as important as your relationship to your agent; there are two sides to the relationship. Having an agency that is well respected in the local insurance marketplace is critical to getting the best program in place at the most competitive cost. This becomes even more critical when the availability of options is limited. I firmly believe that instead of selecting multiple brokers to “quote” your insurance, it’s significantly more beneficial to interview brokers and select one to represent you. You’ll garner greater respect and attention to your business if the local underwriters know that you’re serious about your program and who represents it. If they get multiple submissions from different agents, and the data those agents submit is conflicting, the likelihood that you’ll get their best is also limited.

Typically, a hard market is not a fun process to go through. But you have the ability to proactively position your business to handle the situation. Talk to your agent, prepare yourself for the unexpected and the possibility of having to market your insurance, and get in front of the curve. Contractors, especially in today’s Upstate New York economic landscape, must be sharper than ever to increase or even maintain profit margins. Preparing yourself for a hard market and forecasting any potential dramatic increases in your insurance costs will put you in a better position to control those margins.

For more information on renewing your insurance, you may reach out to Brett Findlay at 315-280-6376 or by email at BFindlay@OneGroup.com.

Knowing Your Financing Options for Purchasing Construction Equipment

Joseph A. Hardick, CPA, CCIFP, Dannible & McKee, LLP

When purchasing new construction equipment, one of the most important factors to consider is the financing option that works best for your needs. Paying in cash may be the most convenient and cost-effective option as it eliminates the concerns of long-term debt, high interest rates and debt-to-equity ratios. However, most construction companies opt for financing due to the lack of available funds.

There are three options available for financing equipment: short-term rental, lease, and loan. For our purposes, we will focus on the latter two. Although renting is a good choice for specialized equipment that’s only needed for a short period, it can be more expensive than taking out a loan or leasing. Renting is a suitable option here because there is no long-term commitment and maintenance is covered by the rental company.

Most companies, however, require long-term equipment availability. This is where leasing and financing are best suited. Both options have their pros and cons, so the best financing option will depend on how the equipment is being used.

Purchasing With a Loan

Obtaining a loan is the most common type of financing when acquiring equipment. It was particularly popular when there were low interest rates and fast tax depreciation options. With the rising rates, it is important to assess this option. Nevertheless, loans still offer many benefits, such as:

  • It is the most cost-effective option in the long run.
  • There are no usage restrictions.
  • Payments can be customized to suit your needs.
  • The equipment can be sold or traded at any time.
  • Tax benefits such as Section 179 deduction or bonus depreciation are available.

Purchasing equipment with a loan also has some downsides, including:

  • High initial cost and high down payments.
  • Higher monthly interest and payment.
  • Equipment can become outdated, potentially affecting resale value.
  • A significant impact on cash flow.

Leasing Equipment

Leasing is another form of financing that has become increasingly popular recently. However, it’s important to note that the rising interest rates have also affected new leases. Recently, there have been significant changes in the rules involving leases, which could greatly impact your decision when acquiring new equipment. There are two types of leases: finance leases and operating leases, each with its own advantages and disadvantages.

A finance lease is similar to a loan, where it is a long-term commitment, and the equipment can be purchased at the end of the lease term. Several requirements must be met to qualify for a finance lease. The financial lease has the following characteristics:

  • Fixed payment plan based on the equipment’s useful life and fair market value.
  • Lower monthly interest and payment, but longer lease terms.
  • The equipment might have usage restrictions.
  • The option to buy at the end of the lease term, either at FMV or a predetermined price.
  • A long-term commitment, sometimes can be longer than a loan.

An operating lease is any other lease that doesn’t qualify as a financial lease. An operating lease is like a rental for an extended period, where the equipment must be returned without the option to purchase it at the end of the lease term. The operating lease has the following characteristics:

  • Flexible lease period.
  • Requires the equipment to be returned at the end of the lease term.
  • Does not impact the debt-to-equity ratio if it’s less than a year.
  • Offers access to newer models and technology.
  • Requires limited maintenance.
  • Last for a short term, usually three years, but can be modified.
  • Has higher monthly payments (flexibility comes at a cost!).

Summary

Making the right financial decision when purchasing equipment can greatly impact your profitability. The financial options available to you will depend on your specific situation, and there are many variables that need to be taken into consideration. However, if funds are readily available and the equipment is essential to your daily operations, paying in cash is the best option.

Contributing Author: Joseph A. Hardick, CPA, CCIFP, is a tax partner who has over 40 years of experience in all areas of individual and corporate income tax preparation and planning. Joe specializes in corporate tax and tax planning for manufacturing and construction companies.

State of Construction Industry

Earl R Hall, Executive Director – Syracuse Builders Exchange

By most measures, 2023 was a strong year for construction industry employers throughout upstate New York.  Measuring growth can be subjective, however, the increase in membership at the Syracuse Builders Exchange is one standard metric which is objective.  Membership increased to 970 at the end of 2023, with 42 new member employers joining during the year.  Today, the Syracuse Builders Exchange remains the largest construction industry Association in the state of New York.

Another metric used to measure growth is the total number of building projects for bid compared to 2022.  Building projects for bid increased 3.6% from 5,064 in 2022 to 5,244 in 2023.  The increase was driven by continued public investment in the medical, secondary and higher education markets, coupled with strong private capital investments in the industrial, multi-family residential, and commercial markets. 

Central New York is poised to continue sustained construction growth into 2024 with many regional project owners beginning work on such projects as:

  • Onondaga County STEAM School
  • MICRON
  • Turning Stone Expansion
  • Onondaga County Aquarium
  • Syracuse Inner Harbor Development

The continued optimism associated with regional economic development, coupled with increased construction bidding opportunities, is somewhat tampered by a potential recession, lack of adequate skilled labor, increased material costs and aggressive project schedules.  The construction industry is not immune from periodic challenges, but contractors have proven to be resilient over the past century as they continue to deliver finished projects to owners.

Labor will continue to be the most concerning matter going into 2024 as the lack of skilled craftsmen and craftswomen may impact contractors’ abilities to bid additional work and/or to complete tight schedules on time.  Although the building trades’ unions and non-signatory employers have been aggressively attempting to recruit, train, and retain construction workers, such efforts have not produced a labor pool large enough to accommodate the current projects scheduled to being in 2024.  There remains much optimism the abundance of work will attract skilled craftspeople from other geographies throughout the United States.

Labor wages continue to increase at rates upstate New York has rarely seen.  Wage increases vary by trade but have averaged close to 4% per year in the past two years, and in some cases higher.  Such wage increases have been driven by high inflation, huge demand for skilled labor and significant increased costs associated with food, gas, and clothing.   Labor costs and the availability of skilled labor will continue to be of concern throughout the year.

The anticipated economic development to hit central New York will be led by the construction industry.  Although many leaders in the secondary and higher education arenas are focused on careers inside these yet to be built new buildings and facilities, those project owners need to first build those facilities.  Most suburban school districts are a decade behind in developing career and technical education programs, in particular construction career pathways.  And while regional BOCES programs remain vital to the construction industry, those student seats are limited.  The need for a four-year construction curriculum is essential in developing the next generation skilled workforce contractors and project owners desperately needed.  The only way to meet the incredible economic development opportunities that await central New York is to have the skilled work force to build those projects.

These issues are not unique to upstate New York as such is prevailing throughout the country.  Although such headwinds are anticipated to continue in the short term, contractors and project owners alike remain resilient and will explore developing alternative methods to deliver a finished project. 

Auburn Community Hospital Health System:A Destination For Quality Care

By: Elizabeth Landry

Dr. James I. Syrett Chief Medical Officer, Dr. Daniel Alexander, Chief Administrative Officer & Chief of Orthopedics, Dr. Emily Brooks, Chief Nursing Officer Joshua Alexander, Chief Operating Officer, Stephen Graziano, MD, Division Chief of Upstate Cancer Center Adult Hematology/Oncology, Scott Berlucchi, President & CEO Christina Sherman, RN, Director of Cancer Services, Auburn Community Hospital, Erik Burch, Sr. VP Administration

It’s hard to imagine the growing Auburn Community Hospital (ACH) of today filed for bankruptcy just 16 years ago. Since 2007, bolstered by the belief brighter days were ahead and led by the expertise of CEO and President Scott Berlucchi, FACHE, LNHA, Auburn Community Hospital has experienced a financial and operational turnaround. Berlucchi is known for his specialty in managing and growing small rural hospitals and has a proven track record for turning around struggling healthcare systems, as evidenced most recently by his leadership of ACH.

Today, ACH is both a Safety Net and Sole Community Provider Hospital offering a myriad of medical services to its patients. The health care center also encompasses the top-rated Finger Lakes Center for Living skilled nursing facility, three urgent care centers in the surrounding communities, and Auburn Memorial Medical Services, a multi-specialty physician group. Exciting additional services that will soon be offered at ACH include the new Auburn Heart Institute, Comprehensive Cancer Care Center, and Auburn Concussion Clinic, as well as new initiatives focusing on orthopedic care and excellence in nursing.

Reflecting on this exciting phase of expansion, Berlucchi emphasized the hard work of the entire team at ACH.

“The Center will provide needed care for the local community that they would otherwise have to travel long distances for and will also increase employment”

“We are taking care of our business. We could not do this without strong support from our Board of Trustees, led by Anthony Franceschelli, and an exceptional management team that has worked hard to transform our healthcare system. Demand for ACH’s services, utilization and growth continues to increase as we bring acute, post-acute and preventive care to members of our community. What I am most proud of is according to a recent study by The University of Wisconsin Population Health Institute, Cayuga County has experienced remarkable year over year improvements in health outcomes vs. other NYS counties over the last 10 years despite numerous challenging health factors. That means as the only health system in the area we are making a difference in our community when it comes to health outcomes,” he said.

LIFE-SAVING CANCER CARE
A recent partnership with Upstate Medical Center has allowed ACH to bring highly advanced specialty outpatient treatments closer to home for its patients, with the new comprehensive Cancer Center planned to open in January of 2024. The addition of the Cancer Center to ACH is aimed at directly improving the health and well being of the hospital’s patient population, as data indicates that cancer is the leading cause of premature death in Cayuga County. Additionally, according to Truven Health Analytics, 80% of residents in the surrounding area must travel further than 25 miles to receive medical oncology services.

To help alleviate these concerning circumstances, the Cancer Center allows patients to take advantage of “one-stop shopping” for their medical treatments, since the Cancer Center  is connected to the main hospital. Combined with the partnership of excellent SUNY Upstate cancer physicians, this increased convenience for patients will provide for more efficient, cost effective, and quality care right in their own community. Dr. Komal Akhtar, Medical Director for the new Cancer Center, has extensive training in Internal Medicine, Hematology and Medical Oncology, and is a member of the American Society of Clinical Oncology. She expressed her excitement about the impact the new Cancer Center will have on the area served by ACH.

“The Center will provide needed care for the local community that they would otherwise have to travel long distances for and will also increase employment,” she said. “The partnership with SUNY Upstate Cancer will provide world class care and lives will be saved because of the care given locally. This is the hospital’s highest priority and a critical part of our long-term sustainability as the largest employer in the area.”

INVESTMENTS IN CARDIAC CARE
Alongside the addition of the Cancer Center, ACH is enhancing the level of cardiovascular care for its patients with the new Auburn Heart Institute. Located in a newly renovated wing on the third floor of ACH, this multimillion-dollar investment in cardiac care will be led by Dr. Ronald Kirshner, who was recently appointed as its chair and medical director. Dr. Kirshner recently served as the Chief of Cardiac Services and Cardiothoracic Surgery at Rochester Regional Health Sands Constellation Heart Institute for over 30 years, and his clinical interests and expertise include creating systems to drive healthcare efficiency and quality.

After Berlucchi had asked Dr. Kirshner to come to ACH and recommend improvements to its cardiac care offerings, Dr. Kirshner found that for those in Auburn and Cayuga County, the risk of dying from heart disease is significantly higher than other parts of the state. He thus identified the need for a comprehensive cardiac care center at ACH, and the idea for the Auburn Heart Institute was born. The Heart Institute will offer many cardiac care services, from diagnostic testing to a cardiac catheterization laboratory, and the longterm vision is to perform procedures and surgeries at the facility.

Dr. Kirshner stated that he’s looking forward to continuing to build a strong team at the Heart Institute. “I’m excited about the opportunity to develop a world‐class heart institute in close collaboration with my colleagues and this community. We’re going to start out with the highest quality and that will be our North Star. Our goal is to make the Auburn Heart Institute a healthcare destination for cardiac care in Upstate New York. I’m committed to recruiting world-class cardiologists and other cardiac professionals to join our multidisciplinary team,” he said.

ENHANCEMENTS IN ORTHOPEDICS, NURSING AND MORE
Exciting new developments at ACH are certainly not limited to cancer and cardiac care. In the realm of orthopedic care, Dr. Daniel Alexander joined Auburn Orthopedic Specialists (AOS) in October of 2022, and he has over 20 years of experience performing more than 20,000 surgeries. He is laser focused on continuing to build a “patient first” orthopedic practice at ACH. “The team at AOS has built a first-class orthopedic practice, and I look forward to helping them grow this practice. All the surgeons in the AOS practice are doing remarkable work, and I’m impressed with the investments Auburn Community Hospital leadership has made in new technology to allow this practice to grow and serve this community. I’m excited, too, about working with our  local physicians and those healthcare professionals who are doing remarkable work in our operating rooms and in the various service areas offered throughout our healthcare system,” he stated.

Another important addition to the team at ACH is Dr. James Syrett, who joined the hospital in May of 2023 as the Chief Medical Officer. Board certified in both Emergency Medicine and EMS Medicine, Dr. Syrett has become only the third physician within a 100 mile radius of Auburn to be certified by ImPACT Applications Inc., a leading provider of concussion management tools, which helps ensure healthcare providers have the necessary skills and knowledge to use the tools effectively. Utilizing his extensive experience in EMS and Emergency Medicine, as well as an interest in the emergency management of concussions. Dr Syrett will serve as the Medical Director of the new Auburn Concussion Clinic, which opened in October and is seeing patients next day when referred from other physicians. This gives patients immediate access to concussion specialists, which is unusual in this region.

The groundbreaking growth of service offerings at ACH, from orthopedics to cancer care, cardiac care, and emergency concussion management, is also bringing about excitement and a new vision for the hospital’s nursing staff. Led by Dr. Emily Brooks, DNP, RN, who joined the leadership team at ACH as the new Chief Nursing Officer in June of 2023, the nursing staff’s goal is to serve the surrounding community with the utmost compassion and highest quality of  evidence-based care.

“We’re creating a culture of nursing excellence at Auburn Community Hospital,” Dr. Brooks explained. “We’re creating the best place for nurses to work in a healthy work environment. This will create a nursing workforce committed to delivering the very best evidence-based care. For every patient that comes into our hospital, the goal is to be able to care for them here, in their community. As such, we have developed the very first Auburn Community Hospital Nursing Strategic Plan. The focus is quality, patient experience, excellence, and nursing performance.”

BUILDING ON CURRENT GROWTH FOR FUTURE SUCCESS
Certainly, the focus on providing highquality health care for patients right in their own community that Dr. Brooks emphasized is already having an immensely positive impact.

Looking to the future, Berlucchi has a vision for ACH to build on this success in the surrounding community and partner with other area hospitals to better serve patients throughout the wider region, as well.

“We want to work with the other central New York hospitals to become more of a regional health care hub that partners to provide care for the growing population, in particular the increased healthcare needs of employees and family members of Micron when that ramps up. I’m also very concerned about the lack of sufficient mental health care in our area and plan on working with NYS, Cayuga County Health Department, and the other hospitals to develop a comprehensive plan to  serve the needs of those suffering from mental health challenges and addiction,” said Berlucchi.

However, for Berlucchi and the rest of the team at ACH, there is no limit
to how far ACH’s reach will extend and how many patients’ lives will be positively affected by the quality care being offered. “What’s happening right here in Auburn is that we are working together with our community, regional partners and our State and Local governments to build the model for rural community hospitals,'” Berlucchi said. “We’ll take care of Auburn. We’ll take care of Cayuga County. But mark my words, you’ll see a region that is growing and we are going to see the whole region coming to Auburn for the level of care that we’re providing.”

“What’s happening right here in Auburn is that we are working together with our community, regional partners and our State and Local governments to build the model for rural community hospitals,’” Berlucchi said. “We’ll take care of Auburn. We’ll take care of Cayuga County. But mark my words, you’ll see a region that is growing and we are going to see the whole region coming to Auburn for the level of care that we’re providing.”