Category: 2026

Deep Expertise. Seeing the Bigger Picture. How OneGroup’s expanding surety capabilities bring insurance, risk management and specialized construction expertise together to help contractors protect what they’ve built and prepare for what’s next.

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By Tami S. Scott


In the vast, ever-changing construction industry, OneGroup offers companies of all sizes access to experts who understand the risks, demands, and opportunities that come with running a construction business. A leading independent provider of insurance, surety services, risk management, employee benefits and HR consulting, OneGroup provides tailored protection and business solutions for individuals and businesses.

“Contractors don’t need another insurance broker,” said Pierre Morrisseau, OneGroup CEO. “They need an adviser who understands [that] risk, insurance, financial strength and surety intersect with the way they actually run and grow their businesses. Much has changed in the contractor’s world, especially risk, but risk isn’t a silo. We look holistically at the business so it’s a relationship, not a vendor transaction as individual agencies have in the past.”

The Syracuse, New York-based firm launched in the late 1980s when two reputable family-owned insurance agencies joined to form Bailey & Haskell Associates Inc., bringing a combined century of experience serving clients. In 2000, another agency strengthened the firm further by expanding its regional reach. Thus, Bailey, Haskell & LaLonde (BHL) was born.

As clients’ needs evolved, so did BHL. The company expanded beyond insurance, offering employers employee benefits and human resources consulting through a new Benefit Consulting Group (BCG). By 2014, with multiple agencies now part of its core, the company brought them together under one culture and rebranded as OneGroup.

“Over the years, OneGroup has evolved from an insurance agency into a broader advisory partner because our clients’ needs have evolved,” said Morrisseau. “Our goal is to bring the right expertise to the table and, just as importantly, understand how those areas connect. For contractors, that means looking beyond the policy or the bond and understanding the business as a whole, so we can help them manage risk today and prepare for where they want to go tomorrow.”

Today, OneGroup employs over 250 people and serves clients from across the country and internationally. It prides itself on being “a mile wide and a mile deep,” offering contractors access to specialized areas of expertise while understanding how those areas intersect.

That philosophy is also behind OneGroup’s expansion of its surety capabilities with the addition of Chris and Kelly Shea to the team. With a combined 75 years of experience in surety bonding, commercial insurance and risk management, the Rochester-based team adds another layer of expertise for contractors, navigating the connection between risk, bonding capacity and growth. The goal is not simply to secure a bond when a project requires one, but to help contractors understand how their overall risk and financial picture can affect their ability to compete for new opportunities.

OneGroup works with contractors seeking their first bond as well as established firms looking to strengthen an existing program. The goal is not simply to issue a bond, but to help the contractor understand what a surety partner will evaluate and to build a credible case for capacity.

That breadth also extends to the insurance marketplace. As an independent broker, OneGroup works with more than 250 insurance carriers, giving its professionals the ability to evaluate multiple options and develop solutions tailored to each client’s needs.

A relationship, not a transaction

Personable, gracious, sincere, loyal — and deeply rooted in the construction industry. Those are the qualities clients repeatedly use when describing their experience with OneGroup.

Take Lovett Mechanical Inc., a commercial mechanical and plumbing contractor based in Syracuse. In 2010, it had four employees. Since then, it has grown to just under 40.

When asked about OneGroup and its customer service, Owner and President Thaddeus Lovett described it as “excellent.”

“Other companies we’ve dealt with seemed to have a revolving door of representatives. With OneGroup, Brett Findlay has been our main contact from day one, and the office staff who handle our day-to-day needs for both business insurance and employee benefits have stayed remarkably consistent,” he said. “That continuity makes everything run smoother.”

Since 2013, OneGroup has handled Lovett Mechanical’s corporate insurance, workers’ compensation and employee health benefits.

“From our very first conversation, Brett took the time to understand my business and showed a real interest in what we needed,” Lovett added. “That kind of attention isn’t something you find everywhere, and it made the decision to choose OneGroup easy.”

For Findlay, that kind of relationship is rooted in something more than insurance experience. It began with construction itself.

Findlay joined OneGroup in 2012 as a Commercial Insurance Account Executive. He now leads the construction unit as Senior Vice President, Construction Practice Leader. Before entering the insurance industry, he worked in construction for his father, a contractor.

In fact, Findlay was literally sitting in an excavator digging a hole when he encountered John Haskell, principal of Bailey, Haskell & LaLonde, the predecessor of OneGroup. Haskell recognized Findlay’s business acumen and asked to meet with him.

“He says, ‘Hey, I really want to grow construction out. It’s not an area we focus on a ton, but we do have business there.’ So I met with them,” Findlay recalled.

The conversation ultimately convinced Findlay to take a chance on the agency and its vision for construction. At the time, construction was about the agency’s eighth-largest practice area. Today, he said, it is the agency’s second- or third-largest.

A significant part of that growth, Findlay said, came from the agency’s willingness to invest in the construction unit before it had the clients or revenue to support it.

“Pierre gave us the means to build the infrastructure out for the unit before we had clients or revenue to do it,” Findlay said.

Findlay approached that development from the perspective of a contractor.

“What do I need?” he asked. “I need certs and ID cards quickly. I need super-responsive service. We need quick turnaround times. We need expertise with contracts.”

Those needs became the foundation for OneGroup’s construction service model.

“Our service model has been built upon understanding the very specific needs of a construction company,” Findlay said. “Everything we’ve done has basically been built around that premise: What can we do to better serve the client?”

But construction isn’t the only area in which OneGroup’s professionals bring firsthand industry experience to the table.

Megan Coville has more than 15 years of experience in safety and risk management. Her background in occupational therapy at The Arc of Ulster-Greene, a private nonprofit serving individuals with intellectual and developmental disabilities, eventually led her to OneGroup, where she began as a Risk Management Consultant and now serves as Vice President of Risk Management.

Initially, Coville’s primary responsibilities included consulting with New York Arc chapters to improve their safety and workers’ compensation programs. She also focused on safe patient-handling programs within health care organizations and coordinated the implementation of OneGroup’s EmploySmart: The Informed Hiring System with clients to improve their hiring processes.

“Many of us have worked in the industry. I worked for one of our clients,” she said, referring to her time at The Arc of Ulster-Greene. “We can think through being in the business, in the operations. What’s important to us? What is the political environment, the economic environment that a traditional insurance person may or may not be able to recognize just because they don’t have their feet in those work boots?”

That same service model extends to other departments.

Senior Human Resources Consultant Brittani O’Connell said her department’s entire existence is built around customer service — a reflection, she said, of OneGroup’s philosophy about the importance of serving its clients.

“My whole role is to support clients,” she said. “I’m here to help them understand the many changes that are happening in the regulatory space, the employment law space. I’m spending a lot of time just talking clients through these changes and helping them understand how it affects their business.”

That support also comes with an emphasis on responsiveness.

“Not only do you typically know who you’re talking to, but we’re really committed to turnaround time as well,” O’Connell said. “A lot of times, the questions that come my way tend to be critical, timely, time-sensitive. It’s not only the fact that they know who they’re talking to, but they know that they’re going to get an answer. We may have to spend some time researching it, but we’re going to turn that around as quickly as we possibly can.”

That responsiveness is an agency-wide standard. Findlay said that if an inquiry comes in before 4 p.m., the client receives a response that day.
“That doesn’t mean you have what you need or an answer before the end of day, but you have a response,” Findlay said. “You know somebody’s working on it.”

Sun Environmental Corp. specializes in environmental services, including industrial cleaning, remediation, waste management, abatement and spill response. The company employs more than 150 people and operates throughout New York State, with locations in Syracuse, Buffalo, Rochester and Albany, as well as in the Philadelphia and New Jersey region.

Having been a client for almost seven years, Sun’s President Matt Notaro can attest to OneGroup’s accessibility.

“OneGroup’s customer service is second to none,” Notaro said. “Their team is responsive and available whenever we need support — 24 hours a day, seven days a week, 365 days a year.”

The company utilizes OneGroup’s insurance, risk management and business solutions services and credits Findlay’s expertise and the team’s extensive understanding of its industry and unique needs for why it chose OneGroup.

“We established an immediate connection, and their team took a proactive, strategic approach to understanding our insurance requirements and helping manage our risks,” Notaro said. “Their commitment to customer service, combined with their experience and industry knowledge, has made them more than just a vendor, but a trusted partner for our business.”

New York’s New Work Rules: What Contractors Can’t Afford to Miss

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By: Rick Boyle, Esq. and Diana Plue, Esq. Sheats & Bailey, PLLC

Four employment law changes will affect your crews, payroll, and personnel policies in 2026. One change is already in effect, and three more take effect before year-end. Together, they will affect how contractors schedule crews, maintain personnel files, screen applicants, and structure employee repayment agreements. Reviewing these practices now can help prevent payroll disputes and costly compliance problems later.

Cancelled Shifts can cost you money

Construction schedules change quickly. Weather, delayed deliveries, and an unavailable work area can leave a crew with little or nothing to do. Under the Construction Reporting Pay Act, sending workers home—or canceling too late—can still trigger a payment obligation.
The Construction Reporting Act adds Labor Law §§ 196-e and 224-g and applies across both public-sector and private construction projects. Labor Law § 224-g applies to public work construction projects. Starting December 8, 2026, the Act requires employers to pay two hours of cancellation pay, at the prevailing wage rate including supplemental benefits, to any employee whose scheduled shift is canceled with less than 12 hours’ notice. It also requires at least four hours of reporting pay, or payment for the number of hours worked if greater than four, for any employee who reports for a shift and is sent home early. If the applicable prevailing wage schedule provides greater cancellation or reporting pay benefits, the employer must follow that schedule.

Under Labor Law §196-e, for private construction projects, employees reporting for work at the employer’s request triggers a minimum payment of four hours, or the regularly scheduled shift if shorter, at the employee’s promised hourly wage. Canceling a scheduled shift with less than 12 hours’ notice requires two hours of pay.

Since reporting pay and cancellation pay are considered wages, employees may bring an action for non-payment of wages if not properly paid. Therefore, contractors should designate who may cancel shifts and use written, time-stamped notices to document when workers were notified. Employers should make sure their payroll system distinguishes hours actually worked from reporting and cancellation payments, account for required supplements, and handle applicable certified-payroll reporting.

If an owner or another contractor gives late notice that work cannot proceed, your company may still owe its employees. So, contractors should update their contracts to address how cost for cancellation or reporting pay will be allocated.

Personnel files will become easier to access:

Effective November 8, 2026, New York Labor Law § 210-b will require New York employers to provide current and former employees access to, and one free copy of, their personnel records within five business days after receiving a written request. Employers must retain the following records, if prepared by or provided to the employer, for at least three years after employment ends:

• Name, address, date of birth, job title, and job description;
• Pay rate and other compensation paid to the employee;
Employment start date;
• Job application;
• Resume or other employment inquiry materials submitted to the employer;
• Performance evaluations, written warnings, disciplinary actions, and similar records;
• Employee waivers; and
• A copy of the employee’s notice of termination.

Employers must also notify an employee within 10 days after placing in the personnel file any disciplinary record or other document that could negatively affect the employee’s transfer, employment, promotion, or compensation opportunities. Employees may submit a written rebuttal, which must be included in the personnel file.

Employers that deny access or otherwise violate the law may face penalties from the Attorney General’s Office ranging from $500 to $2,500.

Employers should create protocols for responding to record requests and notifying employees when negative information is added to a personnel file.

Rethink Credit Checks before you hire
Credit Check Restrictions—Effective April 18, 2026:

NYS amended the NYS Fair Credit Reporting Act to prohibit an employer, except in limited circumstances, from requesting and using an individual’s credit history when making employment decisions. The restriction reaches hiring, compensation, and other terms and conditions of employment, including promotion and termination decisions.

An employer generally cannot avoid the restriction by asking the individual to supply a credit report directly or by obtaining it through a background screening company. Contractors should review employment applications, screening authorizations, and instructions to background screening vendors. Remove routine credit checks unless a specific exception applies and document the basis for any check that remains.

Review repayment clauses before investing in training:
Under the Trapped at Work Act employers may not require, as a condition of employment, that an employee or applicant execute an employment promissory note that requires an employee to pay the employer a sum of money for reimbursement of training expenses or nontransferable education expenses, if the employment relationship terminates before a stated period. The law includes exceptions, but those exceptions have conditions. Employers should review training reimbursement agreements and repayment provisions before the effective date. Whether a clause is permissible depends on what it covers and how it is structured, rather than its label.

Taken together, these changes make early compliance planning essential for New York contractors. Reviewing scheduling practices, personnel-file procedures, hiring screens, and repayment provisions now can help avoid wage claims, penalties, and project disruptions once the new rules take effect.

If you need further assistance or have additional questions, please contact Sheats & Bailey, PLLC. www.TheConstructionlaw.com; Tel. 315-676-7314.

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

Building Surety Confidence: Five Keys to a Stronger WIP Schedule

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Kaitlyn H. Axenfeld, CPA/CFF, CFE, Dannible & McKee, LLP

For many construction companies, bonding capacity is an important tool for supporting growth. Whether a contractor is pursuing larger projects, expanding into new markets or competing for public work, the surety needs confidence that the contractor understands its numbers.

Financial statements show where a company stands at a point in time, but the work in progress (WIP) schedule provides insight into how individual jobs are performing and the risk associated with work still underway. It helps sureties assess whether estimates are realistic, margins are changing, losses are being recognized in a timely manner and management is monitoring project performance.

A well-prepared WIP schedule can strengthen a contractor’s credibility and support bonding capacity. An inaccurate, inconsistent or difficult-to-explain schedule can quickly raise concerns.

From a generally accepted accounting principles (GAAP) perspective, the WIP schedule is more than an internal management report. For contractors recognizing revenue over time under ASC 606, Revenue from Contracts with Customers, it often supports the measurement of progress, estimated total contract costs, revenue recognized to date and related contract asset or liability balances. As a result, WIP estimates need to be current, supportable and consistent with the financial statements.

1. Accurate Cost-to-Complete Estimates
The foundation of a reliable WIP schedule is a realistic estimate of what it will cost to finish each job.

Problem jobs often begin with overly optimistic cost-to-complete estimates. Even relatively small forecasting errors can result in significant profit fade by project completion. Strong contractors regularly update forecasts, incorporate input from the field, monitor labor productivity and material costs, and reflect known problems as they emerge.

When jobs consistently finish near the gross profit projected during construction, it demonstrates strong estimating discipline and project oversight.

2. Timely Recognition of Job Losses
Few things undermine credibility with a surety faster than delaying recognition of an expected job loss. Sureties understand that not every project will perform as planned. The concern arises when significant losses appear suddenly after months of favorable reporting.

Under U.S. GAAP, when current estimates indicate that a contract will result in an overall loss, the expected loss is generally recognized in the period it is identified rather than deferred until project completion.

Contractors therefore need a disciplined process for identifying cost overruns, reassessing estimated costs and recognizing anticipated losses. Warning signs can include significant underbillings on troubled jobs, repeated profit fade, substantial year-end adjustments, and sudden write-downs. From a surety’s perspective, transparency builds trust. Surprises do not.

3. Consistency Between Financial Statements and WIP Reports
The WIP schedule should reconcile to the contractor’s financial statements. Job costs should agree with the general ledger, revenue should align with accounting records, retainage should be reconciled and contract asset and liability balances should be supported.

ASC 606 changed the terminology and presentation historically associated with underbillings and overbillings. Amounts previously described as costs and estimated earnings in excess of billings, or billings in excess of costs and estimated earnings, are commonly presented as contract assets or contract liabilities, depending on the facts and circumstances. This makes reconciliation among the WIP schedule, billing records, retainage and general ledger particularly important. 

4. Monitoring Profit Fade and Gain
Sureties pay close attention to changes in estimated gross profit. Some fluctuation is normal, but recurring profit fade may indicate estimating problems, weak project management or delays in identifying cost overruns.

Contractors should compare original estimated gross profit with current estimates and, actual results once a job is complete. Analyzing these trends can improve future bidding and demonstrate that management is actively evaluating project performance rather than simply reporting it.

5. Clean Underbilling and Overbilling Positions
Material underbillings often generate questions. Some result from normal timing differences, but significant or recurring balances may indicate unapproved change orders, collection issues, contract disputes or revenue recognized before it can be billed.

Overbillings can benefit cash flow, but unusually large balances may require explanation. Management should understand material underbilling and overbilling positions and be prepared to provide supporting documentation.

Building Surety Confidence
Contractors seeking to strengthen bonding capacity should make WIP reporting part of their regular project management process. Monthly reviews involving project managers and accounting personnel can keep forecasts current, while consistent cost-to-complete methodologies and detailed change-order tracking improve reliability.

Management should analyze profit fade, investigate significant variances and use completed-job results to improve future estimates. Periodic review by an outside accountant experienced with construction and surety expectations can provide additional perspective and help identify weaknesses in the reporting process.

Sureties do not expect every job to be perfect. They expect the information to be reliable and management to understand what the numbers are saying.

A timely, accurate and well-supported WIP schedule demonstrates financial discipline and operational control. That confidence can support greater bonding capacity, expanded access to project opportunities and stronger relationships with sureties, lenders and project owners.

For contractors, the WIP schedule should not be viewed simply as an accounting requirement. It is a valuable management tool for understanding project performance, identifying problems earlier and demonstrating the financial discipline necessary for long-term growth.

Kaitlyn H. Axenfeld, CPA/CFF, CFE, is an audit partner at Dannible & McKee, LLP, a certified public accounting firm. She has more than 13 years of experience providing audit, review, compilation and advisory services to a wide variety of clients with a focus on the construction industry. For more information on this topic, contact Kaitlyn at kaxenfeld@dmcpas.com or (315) 472-9127. Learn more at dmcpas.com.

The Never-Ending Decline in New York Workers’ Compensation Loss Costs

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Steve Bell, VP Underwriting & Sales, Lovell Safety

Just when you think New York workers’ compensation loss costs cannot go much lower, they do.

Effective October 1, 2026, New York has approved an average 21.9% reduction in workers’ compensation loss costs. This is the tenth consecutive year of statewide average loss cost decreases and another significant reduction in what has become a very long-term trend.
The obvious question is: What continues to drive loss costs down, and how long can it continue?

There is no single answer, but the biggest factor continues to be fewer claims. The Rating Board’s five-year analysis shows an annual claim frequency trend of -6.1%. Claim costs are still increasing, indemnity severity increased 1.9% annually and medical severity increased 3.0%, but claims are occurring less frequently.

At the same time, wages continue to increase. The Rating Board used expected annual wage growth of 4.3% in developing the new loss costs. Since workers’ compensation loss costs are generally applied to payroll, rising wages combined with declining claim frequency can substantially reduce the amount needed for every $100 of payroll.

The numbers behind this year’s filing make that pretty clear. Looking just at the latest two policy years of loss experience, the indicated change was only a 1.1% decrease. The much larger reduction comes from the projected relationship between claim frequency, claim severity and wage growth. Taken together, the Rating Board calculated a total trend factor of -23.2%.

This Has Been Going on for a Long Time

The 21.9% reduction gets your attention because of its size, but the bigger story is how long this has been going on. We have now had ten consecutive years of loss cost decreases.

It is also important to distinguish between loss cost and premium. An employer can receive a significant loss cost decrease without seeing the same percentage decrease in its actual premium. Payroll may be increasing, and experience modifications, classifications, CPAP, and other rating factors can all affect the final cost. Your carrier may also move you to another subsidiary with a higher loss cost multiplier. All these items impact your final cost, but if your workers’ compensation costs didn’t go down this year, you should be asking why.

Still, there is no question that the underlying cost of workers’ compensation in New York has come down significantly.

What We Have Seen in Our Safety Groups

What I find particularly interesting is what has happened in our safety groups during this same period. Our groups have absorbed the same continuing statewide loss cost decreases without increasing the loss cost multiplier to offset those decreases. At the same time, we have been able to increase average upfront discounts and continue returning favorable underwriting results to participating employers through dividends.

To date, more than $1.31 billion in dividends have been returned to participants in Lovell-managed safety groups.

I think that is an important part of the story because of how safety groups are structured. The groups are nonprofit in nature. Lovell manages them for a flat service fee. We do not receive a percentage of the underwriting profit. When a group performs well, the benefit of that favorable underwriting result remains with the group and can ultimately be returned to its participants through dividends.

Of course, dividends are never guaranteed, and results can vary from year to year and from group to group. But well-managed groups with disciplined underwriting, effective loss control and appropriate reserving can produce favorable underwriting results and consistent dividends over time. When that happens, the participating employers are the ones who ultimately benefit.

Lower Loss Costs Don’t Mean Safety Matters Less

There is also another side to all these loss cost reductions. Every time loss costs go down, there are fewer premium dollars available to pay claims and expenses. A 21.9% reduction is significant. It means underwriting, safety and claims management become more important, not less important.

You cannot continually take loss cost out of the system without also having the loss results to support it. That is why we continue to focus so heavily on underwriting, safety and accident prevention, claims oversight and getting injured employees back to work.

The same applies to the safety groups themselves. A group cannot depend on favorable statewide loss costs to produce good results. It still has to select the right risks, price right, prevent losses, manage claims, and maintain appropriate reserves. That discipline is what allows a group to continue performing even as the amount of premium being collected declines.

How Much Further Down Can Loss Costs Go?

That is probably the most interesting question now.

I certainly would not assume that reductions of this size can continue indefinitely. Claim frequency cannot decline forever, and there are still pressures moving in the other direction. For example, increases in maximum and minimum weekly benefits added approximately 2.4% to the Rating Board’s overall loss cost indication.

For now, though, the numbers continue to support lower loss costs.

The 21.9% reduction effective October 1, 2026, is the latest and largest chapter in what has been a remarkable 10-year period for New York workers’ compensation. From our perspective, what is just as interesting is what has happened alongside those decreases. Our safety groups have absorbed years of declining loss costs while average discounts and dividends have increased.

That tells me something important about the safety group model. When you combine lower underlying workers’ compensation costs with disciplined underwriting, strong safety and claims management, and a nonprofit structure where favorable underwriting results are returned to the participants, well-run safety groups can continue to be market leaders in both price and service, even in a market where loss costs just keep going down.

For more information on New York Workers’ Compensation Loss Costs, please reach out to Steve Bell, VP Underwriting & Sales, Lovell Safety at 212-709-8832, email SBell@LovellSafety.com or visit online at www.LovellSafety.com.

The Impact of the USA v Canada Tariff War on the NYS Construction Industry

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Earl R. Hall, Executive Director, Syracuse Builders Exchange

The continuing trade dispute between the United States and Canada is creating a significant level of uncertainty for the New York State construction industry. The issue is particularly important to New York because Canada is the state’s largest trading partner, and Canadian-sourced materials, such as lumber, steel, aluminum, plywood, cement, and other construction products, which are integrated into New York’s construction supply chains. Recent developments in September increased the potential for higher material costs, supply disruptions, project delays and greater financial risk for contractors and project owners.

New York’s construction industry is a major component of the state’s economy, employing more than 400,000 New Yorkers and contributing more than $66 billion annually. The state has previously identified steel, aluminum, and lumber as important construction material affected by tariffs and warned that higher material costs can result in fewer projects, delays, and increased project costs.

Impact on Construction Contractors

For contractors, the most immediate concern is price volatility. A contractor may develop a bid based on a supplier’s quoted price, only to discover that a tariff or retaliatory measure has increased the cost before the material is purchased. This creates substantial exposure, particularly on fixed-price contracts where the contractor has limited ability to recover unforeseen increases.

The problem extends beyond materials imported directly from Canada. A product manufactured in the United States may contain Canadian steel, aluminum, lumber, or other components. As a result, purchasing from an American supplier does not necessarily eliminate tariff exposure.

Contractors are therefore likely to place greater emphasis on early procurement, supplier commitments, escalation clauses, allowances, contingencies, and alternative sources of supply. Owners and contractors may also face more negotiations over responsibility for tariff-related increases after a contract has been awarded.

Impact on Material Costs

The construction materials most exposed to the dispute in New York include lumber and engineered wood products, steel, aluminum, copper, plywood, and cement. Existing tariffs on steel and aluminum can reach 50%, while additional tariffs imposed during 2026 have expanded the number of Canadian construction-related products potentially affected.

Canadian softwood lumber is particularly important because Canada has historically supplied a substantial majority of U.S. softwood lumber imports. New York contractors, homebuilders and remodelers therefore have exposure to changes in Canadian lumber pricing even when the supplier is located in the United States.

Impact on Construction Project Owners

For project owners, the principal consequence is increased uncertainty in establishing and maintaining project budgets. Public agencies, private developers, hospitals, universities, manufacturers, and commercial property owners may face higher costs between initial design, bidding, and construction.

Projects that were financially feasible under earlier material prices may require additional funding or redesign. Owners may also encounter longer procurement periods when contractors seek alternative suppliers or wait for pricing to stabilize.

For public projects, these issues can be particularly significant because funding is often established well before construction begins. A substantial increase in steel, aluminum, lumber, or other materials can create a gap between the original project budget and the contractor’s actual cost.

Contracting and Risk Management

The New York tariff environment reinforces the importance of carefully drafted construction contracts. Owners and contractors should consider clearly defining who bears the risk of newly imposed tariffs, establishing material escalation provisions, identifying notice requirements, and determining how changes in law will affect the contract price.

Contractors should also consider obtaining firm supplier quotations, identifying tariff exposure during estimating and purchasing critical materials earlier when economically justified. Owners can reduce uncertainty through early contractor involvement, design flexibility, and realistic contingencies.

Outlook for New York

The most significant issue may be uncertainty rather than any single tariff. New York contractors operate in a highly competitive market where bids are often prepared months before construction begins. Rapid changes in trade policy can make conventional estimating assumptions less reliable.
The U.S.–Canada tariff dispute therefore has the potential to increase construction costs, compress contractor margins, delay projects, and cause owners to postpone or modify planned investments.

For New York’s construction industry, the coming period will require greater attention to procurement, contractual risk allocation, material sourcing, and cost forecasting. Until trade policies become more predictable, both contractors and owners should assume that material pricing and availability can change materially between the time a project is estimated and the time construction is completed. Whoever bears the fiscal responsibility for such unexpected and unanticipated changes should be illustrated in a contract.

The U.S.–Canada tariff dispute represents a material risk to New York’s construction industry. Its effects will extend beyond the importer paying the tariff and can ultimately reach contractors, subcontractors, suppliers and most likely project owners through higher prices, reduced availability, and increased uncertainty. Effective risk management, early procurement, contractual protection, and realistic project contingencies will become increasingly important as New York’s construction industry navigates the evolving trade environment.

Note: Reviewed and amended with the assistance of Microsoft Word and Chat GPT

Caring for the Caregiver: How David’s Refuge Supports Families in Central New York

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By: Kate Houck, Chief Energy Officer/Executive Director

Airline safety briefings tell passengers to put on their own oxygen mask before helping anyone else. David’s Refuge uses that image to describe its mission: offering care to the caregiver. For parents raising children with significant medical or developmental needs, that advice is easy to agree with and nearly impossible to follow.

A Need That Is Easy to Overlook

One in every 26 American families is raising a child with a disability, and many of those parents provide round-the-clock care with little relief. Friends and family can pull away because they no longer know how to relate, and a child’s needs can dictate the family’s every move, leaving parents little say over how they spend their time. Self-care falls to the bottom of the list, and exhaustion follows.

David’s Refuge exists to interrupt that cycle. Its mission is to provide respite, resources and support to parents and guardians of children with special needs or life-threatening medical conditions, so they can be refreshed, restored and renewed in their role as caregivers.

The Heart of the Work

The organization’s signature offerings include an overnight weekend respite program, wellness programming and community events. During respite, caregiving couples receive a getaway at no cost, typically two nights at a Central New York bed-and-breakfast, made possible by donations from the community.  The weekends encourage social connection where several couples attend at once, allowing for parents to meet others walking a similar path. For families who often feel isolated, that connection can matter as much as the rest.

Because not every family can make a scheduled weekend work, David’s Refuge offers a reimbursement respite program allowing parents to plan their own one- or two-night break, on a weekday or weekend, pay up front, and apply for reimbursement afterward.

The wellness programming covers five areas (physical, emotional, spiritual, social and financial) and includes a monthly newsletter along with virtual and in-person offerings. David’s Refuge has also partnered with CNY Mental Health Counseling to support caregivers and their families with their mental health needs.

Community programming is hosted throughout the year, both virtual and in person, some for whole families and some for caregivers alone, and offers a private Facebook page where caregivers can connect. Each November, during National Caregiver Awareness Month, caregivers can find weekly wellness tips and education about caregiver burnout.

Growth and Recognition

David’s Refuge has grown considerably. What began in 2012 as a small start-up serving 43 parents a year has grown to support nearly 1000 families annually with extensive year-round programming.  The mission continues to draw wider notice and recognition.  In 2026, SUNY Upstate selected David’s Refuge as its Your Cause charity, which brings volunteer support and funding to expand support for caregivers and their children.

How to Help

Demand is high, and the organization relies on the community. It receives no state or government funding. Supporters can give monthly, volunteer, give through their business or attend one of many wonderful fundraising events.  Caregivers who need support, or anyone who knows one, can find the application and all event information at davidsrefuge.org. In a system that mostly focuses on the child, David’s Refuge reminds parents that they matter too, and that families and our community thrive when we do one simple thing- care for the caregiver.

Join us! Davidsrefuge.org

Upstate University Hospital Serving Patients with a Laser-Focused Commitment to Quality

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By Elizabeth Landry

As the only academic medical center in Central New York, and the region’s largest employer, Upstate Medical University is a pillar of the area’s healthcare resources as well as a key component of the community at large. Intertwined with the organization’s continued growth is its focus on pursuing quality as the best measure of how it serves its patients.

“Something that’s been made clear to all by our hospital CEO, Dr. Robert Corona, is that quality is the priority at Upstate. He emphasizes that quality is our brand, that it’s what we want to be known for, and we are laser-focused on that,” said Amy Tucker, MD, MHCM, Upstate’s Chief Medical Officer. “Our leadership team is investing in the resources required to drive quality and patient safety.”

Dr. Tucker explained that as a complex academic medical center, quality is part of the education as well. With learners including medical students, residents, fellows, graduate students, nursing students and other health professional trainees, quality-related priorities are embedded at every step of their education.

“It is an expectation that students participate in quality from the very first stages of their education and it is a major part of their curriculum. It is part of what they see on wards and in clinics, so in the development of these future health professionals quality becomes a part of the culture,” she said.

Utilizing Quality Ratings and Metrics

Along with quality leaders at Upstate, including Matthew Glidden, MD, Upstate’s Chief Quality Officer, and Harvir Gambhir, MD, Upstate’s Associate Chief Quality Officer, Dr. Tucker and the Upstate leadership team look to several quality rating entities to understand how Upstate performs within the wider healthcare landscape.

Dr. Glidden shared that Upstate looks to scorecards from three benchmarking entities: CMS (Centers for Medicare and Medicaid Services), Vizient, and the Leapfrog Hospital Safety Grade. While these organizations rate hospital quality in different ways – some use older data while others use newer data, and some release the ratings publicly while others do not – each generally looks at data including patient readmission rates, patient experience, safety, mortality rates, and timely and effective care.

“Our overall goal is to provide the highest-quality, evidence-based care in a safe manner that reduces potential harm to patients and provides care they value, along with the best experience possible,” said Dr. Glidden. “Until you benchmark yourself to other hospitals, you don’t really know how you’re performing.”

Upstate’s quality score from Vizient, the largest leading healthcare improvement organization in the country, is particularly useful because the hospital is compared with other comprehensive academic medical centers, rather than smaller hospitals. The ratings also are often related; for example, the Leapfrog score, which primarily focuses on patient safety, uses a lot of metrics from the CMS scorecard, Dr. Glidden explained.

When looking at the overall metrics, there are many data points that show how Upstate’s focus on quality has paid off to benefit patients. In recent years, Upstate achieved a 20.7% relative reduction in overall risk-adjusted mortality, meaning that fewer patients died than would be expected based on their sickness and medical complexity.

“In terms of safety, we’ve been able to drive a significant improvement in our outcomes measure over the last four or five years. The data suggests that Upstate saves more lives when compared to expected among our academic peer group” said Dr. Tucker. “When we look at our mortality rate, it’s considerably below the national benchmark and has been sustained over a long period of time. That’s something we’re very proud of.”

Dr. Glidden shared that patient safety has improved significantly at Upstate during this period of intensified leadership commitment. Also, over the last two years there are additional specifics: accidental punctures and lacerations were reduced to zero. Patient falls resulting in serious injury were reduced by 87.4%, and there was a 54.5% reduction in serious pressure injuries, which are also known as bedsores.

“Taken together, these results demonstrate meaningful progress in outcomes that matter most to patients,” said Dr. Glidden. These include surviving serious illness, avoiding preventable complications and infections, and recovering safely after surgery. “They reflect Upstate’s continued focus on improving care while serving patients who have significant illness and medical complexity.”

A Strategy for Success

The metric categories that rating organizations use to grade hospitals relate to the six pillars of healthcare quality Upstate embraces to aim for high scores: safety, timely, effective, efficient, equitable, and patient-centered care. A big part of how Upstate strives to achieve top-performing quality for patients is the concept of high reliability, which is underscored by Dr. Corona.

Originally used by the airline industry and the nuclear power industry — fields that are highly resilient to stresses on the organization and the imperative to continuously keep their customers satisfied — the five concepts of high reliability are: preoccupation with failure; commitment to resilience; sensitivity to operations; reluctance to simplify; and deference to expertise.

To put these concepts into action, Dr. Glidden uses the mnemonic of SOAP: Structure, Oversight, Accountability, and Processes. “When we have to clean something up, we look at questions like: How can we improve? What is the quality and operational structure? How do we maintain oversight of quality and operations? How do we hold people accountable, and what are our processes?” he said.

A strategic innovation that’s shown positive outcomes is the opening of the Care Connect Clinic across the street from University Hospital. The clinic allows patients to receive immediate walk-in care when they have an acute problem but don’t need to go to the emergency room.

“The clinic helps a timely flow of care and helps with access for patients, making it more convenient for them. It’s been a nice resource for the patients in our community and reduces the load on our ED,” said Dr. Tucker.

Another strategy Upstate has utilized to improve quality has been what Dr. Tucker termed the “clinical flash mob.” This strategy has increased immediate communication among care providers when there’s a difficult problem that requires input from experts across the organization.

“During a ‘clinical flash mob’ we get together over an emergency virtual meeting, discuss the problem together, and come up with an agreed-upon solution,” explained Dr. Tucker. “We’ve found this really helps with decision making and provides support for our clinicians.”

Staff on the Front Lines of Patient Care

When facing challenges and determining solutions, Dr. Glidden said leadership places great importance on listening to those who are caring for patients on hospital floors. Through a safety alert system, Upstate employees are empowered to report quality concerns and mistakes without a fear of retribution — an important part of the just culture and psychological safety found at Upstate, shared Dr. Glidden.

“It’s really the nurses, techs, managers—the ‘boots on the ground’ – who are telling us where we can improve. Upper-level departments process the information, but we always go back to the people on the front lines because they’re the ones that know how to solve the problem,” Dr. Glidden explained.

Beginning in November 2025, Upstate employees have come together to focus on quality through the Co-Elevate program. A series of monthly meetings that center on diverse topics, all related to quality, Co-Elevate brings senior leadership and frontline employees together to share their voices and help solve problems. The meetings include nurses, physicians, residents, fellows, pharmacists, environmental services workers, patient advocates and others.

“Co-Elevate is a link between the frontline workers who take care of patients and see quality concerns and the senior leadership,” said Dr. Gambhir. “We didn’t want another meeting to talk about quality metrics – we wanted a meeting to discuss the story behind what is happening and to work together to improve patient safety.”

Although the topics range widely, each one is always patient-centered, Dr. Gambhir said. All Upstate employees are invited to the meetings, which are held both in-person and virtually. Patient advocates and family advisors are also welcome as Co-Elevate panelists.

Despite being a relatively new program at Upstate, there are already tangible success outcomes. Dr. Gambhir highlighted new patient care huddles, an idea that came out of Co-Elevate meetings, in which all physicians and residents involved in a patient case will gather at the patient’s bedside together at the same time, helping to keep everyone on the same page. Another byproduct of the Co-Elevate program has been the implementation of Lean Six Sigma strategies in operating rooms for improved workflow efficiency. Overall, Dr. Gambhir said, Co-Elevate has helped create a more proactive culture at Upstate at all levels of the organization.

“We want to close the gap between how the work is imagined, and how the work is actually done,” stated Dr. Gambhir. “That’s where we’re heading. We want everyone to feel that we are all working together as a team.”

The Future of Quality at Upstate

Built upon guiding principles from leadership, it’s clear that Upstate’s focus on quality is steering the organization into the future. CEO Robert Corona, DO, MBA, continually presents quality as the “operating system” for the hospital, coordinating and connecting the functions of the entire enterprise. He also builds quality specifically into the strategic pillars he established when he first started as CEO: Quality, the Upstate Experience, Innovation and Sustainability and Growth.

“We can ask a quality question for each aspect of our strategy,” Dr. Corona added. “Are we delivering exceptional outcomes? Would we want this care for someone we love? Are we finding the best ways to operate? Are we building an organization that can fulfill its mission for generations? These are the questions that drive quality in every part of our system.”

Related to the strategic pillar of the Upstate Experience, the conversations are happening. “The goal is that we keep on speaking up, and we develop an interdisciplinary collaboration in a psychological safe space,” said Dr. Gambhir. “No matter if it’s a nurse or a resident who is on their first day at work, or a physician who’s been with us for ten years, we can talk freely in front of everyone. It is proactive culture, every day we try to improve, and things get better and better.”

Dr. Tucker also emphasized teamwork and open communication as some of Upstate’s priorities related to quality.

“We know when teams get together and focus on a common goal, and everyone’s helping one another, we see better outcomes,” said Dr. Tucker. “To increase the robustness of our communication pathways, we’ll be rolling out some new technology to make it even easier to connect with people in the moment.”

Looking toward the future, perhaps the most central goal for quality at Upstate is making sure patients are aware of the quality that’s available to them at the hospital.

“We really provide quality care here at Upstate. We want to provide the best care we can for the people here in Central New York, and it’s important to us that our public face reflects this, and people feel comfortable and secure when they come to us,” said Dr. Tucker. “We want that reassurance for patients. We want them to have the peace of mind that if they need care, Upstate is the place to come.”

 

Food is Medicine

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BY KATHRYN RUSCITTO, ADVISOR

The American Heart Association defines food is medicine as the provision of healthy food such as produce prescriptions, medically tailored groceries and medically tailored meals to treat, manage or prevent diet-related health conditions. We know that inner cities and rural communities often have poor access to stores or farmers markets, further complicating good food access when there is a health issue. In these circumstances we look to many community based organizations to fill those gaps.

Recently the increase in prices on all household goods has put a great deal of pressure on families and the elderly to adjust spending and for many that means cutting food expenses. USDA notes 14% of all households in the NYS as being food insecure. https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-us/interactive-charts-and-highlights

Our local library in Old Forge in the Adirondacks has a wall of food shelves at the entrance. Always open, it’s used anonymously by residents in need. Food pantries in churches and food banks also report seeing steady increases in demand. My concern is those individuals who are isolated or not connected to resources.

In doing research I had the opportunity to talk with Rachel Sherrow, Chief Operating Officer of Citymeals on Wheels. Citymeals located in NYC, serves over 22,000 residents each month. My interest was to understand new ways for people to access help, especially with frail elders. In addition I wanted to understand how “Food as Medicine,” projects were connecting with clinicians. Rachael shared,

“Questions about food insecurity and access to fresh produce should be a standard part of a physician’s intake with patients. The HFIAS (Household Food Insecurity Access Scale) can open avenues for referrals and resources for those who need better nutrition or accessibility and can be part of the solution to better health outcomes for so many, especially our most vulnerable populations.”

https://citymeals.org

Citymeals has developed unique monthly boxes of supplies to allow additional meal access besides a home delivered traditional meal. They have found ways to close food gaps based on individual needs.

For office practices consider two simple food related questions on intake forms as a way to assess any food issues. Follow up linking a patient with 211NY.org or area churches, food banks and meal programs helps bridge an initial response to connecting a patient in need to resources.

Across Upstate NY there are resources unique to each community, but all share common missions to make food accessible to those in need. Consider how assessing this issue fits within your practice.

Navigating Physician Noncompete Clauses What’s Changing in New York by Brigid M. Maloney and Kennedy A. Farr

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If you’re a physician, your employment agreement likely contains a noncompete clause, and the rules governing that clause may be changing. States across the country are limiting or banning physician noncompetes, and New York could be next.

WHERE NEW YORK STANDS TODAY

As of today, New York has no statute specifically governing physician noncompetes. As a result, courts generally apply a common-law test when disputes arise. Under BDO Seidman v. Hirshberg, 93 N.Y.2d 382 (1999), a restraint is reasonable only if it (1) is no greater than required to protect the employer’s legitimate interest, (2) does not impose undue hardship on the employee, and (3) is not injurious to the public. Violation of any one of these prongs renders the covenant invalid. Separately, the Reed, Roberts standard quoted in BDO requires the restriction to be reasonable in time and geographic area. New York courts have historically given employers somewhat more latitude when restricting competition among learned professionals, including physicians, within a confined area, but they still scrutinize the particular facts and circumstances. For physicians, the public-interest prong is especially important because restricting a physician can limit patients’ access to care. An overbroad covenant is not automatically void. A court may partially enforce it by narrowing the restriction if the employer acted in good faith, without overreaching or coercively using its bargaining power. But a court may strike it entirely where the employer overreached, such as imposing the covenant as a condition of hiring.

In Long Island Minimally Invasive Surgery, P.C. v. St. John’s Episcopal Hospital, 164 A.D.3d 575 (2d Dep’t 2018), the covenant barred the surgeon from performing any type of surgery for two years within 10 miles of any of the practice’s seven offices and affiliated hospitals, including locations where he had never worked. The court held that the restriction was geographically unreasonable because it effectively barred him from practicing surgery in the New York metropolitan area, which far exceeded what was necessary to protect the practice’s interests. The court declined to partially enforce the covenant because it was clearly overbroad, the practice required it as a condition of hiring from a superior bargaining position, and it refused to negotiate the restriction.

WHAT’S PENDING IN ALBANY

New York Senate Bill S4641 passed the Senate in June 2025 and, as of this writing, remains in the Assembly Labor Committee. It would ban noncompetes for physicians regardless of income while preserving an exception for the sale of a practice. Separate physician-specific bills (S9228/A10981) would also address repayment of bonuses and training costs when a physician leaves a hospital employer.

THE NATIONAL PICTURE

i. Arkansas, Massachusetts, New Hampshire, and Wyoming: Prohibit physician noncompetes.

ii. Virginia: Bans noncompetes for most licensed health care professionals as of July 1, 2026.

iii. Maryland: Prohibits noncompetes for health care practitioners earning under $350,000.

iv. Oregon: Voids most physician noncompetes with hospitals and management services organizations.

v. Florida: Moves in the opposite direction by making certain “covered” noncompetes fully enforceable if notice requirements are met.

PRACTICAL TAKEAWAYS

i. Check the length and radius. Limit restricted areas to offices where you actually work, not every location the employer operates.

ii. Watch for clawbacks. Some agreements require repayment of bonuses, relocation expenses, or training costs when a physician leaves—terms that can function as disguised noncompetes.

iii. Plan your exit if you sell a practice. Sale-of-business noncompetes are treated differently and are generally enforced more readily.

iv. Confirm which state’s law applies. If you practice near a state line, review the choice-of-law clause because it can affect your legal rights.

v. Get it reviewed. Because the law is changing quickly, have your agreement reviewed by a legal professional before signing or giving notice.

Please note that this article is for general informational purposes only, is not legal advice, and does not create an attorney-client relationship. Because each situation is unique, the information is general in nature and should not be considered a substitute for legal counsel. Readers should not take, or refrain from taking, any action based on the information in this article without first seeking legal advice from competent counsel.

Marching Toward One Million:Why Pain-Management Education Should Begin Before Surgery

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Each year, millions of Americans undergo surgery, and more than half receive an opioid prescription. Yet one of the most important parts of the surgical journey is often overlooked: how pain will be managed afterward. For years, opioids have played a prominent role in postsurgical pain management. Today, advances in medicine offer more ways to manage pain effectively while reducing unnecessary opioid exposure when appropriate. As these options continue to evolve, patients deserve to understand the choices available to them.

As an orthopedic surgeon, I’ve seen pain management practices evolve throughout my career. Early in my training, postsurgical recovery followed a largely uniform pattern: a patient had surgery, and an opioid prescription followed almost automatically. It was rarely presented as a choice; it was simply standard practice. Over time, that approach has become more nuanced, with greater emphasis on tailoring pain management plans to each patient’s needs. While every recovery is unique, the goal remains the same: helping patients recover comfortably, safely, and confidently. That’s why these conversations should begin long before surgery. When patients understand the full range of available options, including non-opioid therapies, they are better equipped to make informed decisions with their healthcare team.

Pain management remains one of the most overlooked parts of the surgical journey. Patients may spend weeks preparing for the procedure itself by researching providers, learning about the operation, arranging time away from work and figuring out support at home. Yet, the discussion of how their pain will be managed afterward is often condensed into a brief exchange shortly before discharge. This is not a failing of any individual provider; it reflects the time constraints clinicians face when communicating complex information. As a result, some patients may leave the hospital without fully understanding the options available to them.

A Mission Beyond the Operating Room

My passion for improving patient education around surgical recovery inspired me to launch March2AMillion, a nationwide initiative with a bold goal: helping one million patients recover from knee or hip replacement surgery with little to no opioids. Through work with hospitals, healthcare organizations, community events and patient advocacy groups across the country, the initiative raises awareness of today’s pain management options and encourages patients and providers to begin these conversations before surgery, not after.

The initiative grew out of a recurring pattern I saw in clinical practice. Patients would return for follow-up visits asking questions that should have been addressed before they entered the operating room. Could opioids have been avoided? Why were other pain-management options not discussed? By the time these questions arise, the opportunity to make a different choice has often already passed. March2AMillion is designed to shift that timeline so that these conversations happen during preoperative visits rather than after surgery.

One of the most common things I hear from patients is that they didn’t realize they had a choice. Many assume opioids are an expected part of recovery, often based on what they have heard from friends and family or experienced during a previous surgery. While opioids continue to play an important role in postsurgical care, today’s pain management landscape also includes non-opioid therapies that may be incorporated into individualized treatment plans when appropriate.

These options may include long-acting local anesthetics, regional nerve blocks, other non-opioid analgesics and multimodal approaches that address pain in different ways. When patients understand what is available, they can ask better questions, have more productive conversations with their providers and better understand what their recovery may look like.

Awareness Drives Better Decisions

Innovation alone isn’t enough if patients do not know their options. Education remains one of the most powerful tools we have. By encouraging patients to ask what pain management options are available, whether non-opioid therapies may be appropriate and what to expect during recovery, we can support a more informed and collaborative approach to care.

Even modest shifts in when these conversations happen can make a meaningful difference. When a patient enters a preoperative appointment having already considered a few key questions, the discussion with their surgical team becomes more substantive. It moves beyond a one-way delivery of instructions and becomes a genuine dialogue. In turn, the patient’s preferences, medical history, and any concerns about opioid use – whether rooted in past experiences, family history, or a desire to minimize exposure – are factored directly into the treatment plan. This kind of shared decision-making can help patients feel more informed and prepared as they head into surgery.

Through March2AMillion, I’ve had the privilege of meeting healthcare professionals and patients across the country who share the same goal: improving recovery through education, innovation, and personalized care. Whether I am speaking with providers about introducing non-opioid options earlier or with patients navigating their recovery, these conversations reinforce my belief that meaningful change begins with awareness. They also show that progress depends not only on new drugs, devices or protocols, but on earlier, and more open communication between patients and providers.

Thoughtful conversations about postsurgical pain management can also help patients understand the risks and potential side effects associated with opioids, including misuse, nausea and constipation. When patients and providers discuss the full range of available strategies, they can develop a plan that balances effective pain management with each patient’s needs and preferences. As non-opioid pain management continues to advance, we have an opportunity to redefine what patients expect from recovery. My hope is that every patient feels empowered to discuss their options before surgery and work with their healthcare provider on a pain management plan tailored to their individual needs. This is not about replacing one default with another; it is about replacing the notion of a default altogether with individualized plans built on open communication.

By continuing to educate, advocate, and encourage open dialogue, we can support efforts to reduce unnecessary opioid exposure while helping patients make informed decisions with their healthcare providers. One million conversations might seem ambitious, but each one begins the same way: with a patient asking what their options are and a provider taking the time to explore that with them. Learn more about my mission at March2Amillion.com.

This article is sponsored by Pacira BioSciences Inc. Dr. Andrew Wickline is a partner of Pacira BioSciences.

2026 Pacira Pharmaceuticals, Inc., a wholly owned subsidiary of Pacira BioSciences, Inc.

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