Health Care

The ribbon is cut and UR Medicine's new Batavia campus is ready to receive patients for care in a variety of specialties that officials say will save them a trip to Rochester.

"What I learned is that the patients won't get the care unless the health care providers come to them, at least in the beginning," said neurosurgeon Dr. Webster H. Pilcher during opening remarks.

The campus will serve patients from Genesee, Orleans, and Wyoming counties, and care will include adult and pediatric allergy/immunology, neurosurgery, oncology, otolaryngology and audiology, and urology, as well as providing primary care.

"Bringing specialty and primary care clinics under one roof allows for better care for our patients, as well as really helps us practice efficiently," said Kathleen Parrinello, COO of UR Medicine. "So there's a lot to be gained by having all of our clinicians together so that the people in this community can really appreciate the integrated Clinical Network at UR Medicine."

The new 24,455 square foot medical campus – located at 7995 Call Parkway – will centralize specialty clinics and primary care into one location, along with on-site lab services. 

UR Medicine Radiation Oncology will remain in its current Bank Street location.  Eric Wu, M.D., and the Batavia Ophthalmology practice are joining UR Medicine and will move to the Flaum Eye Institute’s location on Liberty Street on June 1, which will be expanded into space formerly occupied by primary care.

"We will continue our practice of staffing specialty clinics with providers who are either locally from here or are based consistently in Batavia in this community," Parrinello said. "Meaning that the people who receive care here will receive care from physicians, advanced practice providers, nurses, and staff who spend all of their work hours here."

“Almost 30 years ago, I started seeing patients out in Batavia and it has been an incredibly rewarding experience to serve the patients of that community,” Pilcher said. “It is often difficult for patients to negotiate a complex care system, especially if that means traveling to Rochester.  By bringing that care to them and simplifying the relationship between our patients and primary and specialized care, we can provide them with access to world-class care, right in their own community.”

Top photo: Ribbon cutting with Alexander K. Mandych, Dr. Webster H. Pilcher, Victoria Godwin Hines, COO and Vice President, Lily J. Snyder, faculty in the Department of Family Medicine.

Photos by Howard Owens

Check-out desks area for patients.

A nurse's workstation.

Lily Snyder in her office.

Joy Michaelides, assistant professor of clinical urology in a urology exam room.

Oncology center.

Press release:

The Genesee County Funding Corporation (GCFC), an affiliate of the Genesee County Economic Development Center (GCEDC), approved tax-exempt bonds to support projects by Rochester Regional Health (RRH) expanding healthcare services in Genesee County and throughout New York State at its April 28th board meeting.

The tax-exempt bonds approved by the GCFC support the construction of a 105,393 square-foot healthcare facility on Oak Orchard Road in the Town of Batavia and 56,147 square feet of related ground floor parking.

In Batavia, Rochester Regional Health will offer outpatient cardiac care, women’s health services, primary care, urgent care, outpatient surgical services, gastroenterology, outpatient radiology and other outpatient services.

The Batavia project is projected to create approximately 70 full-time equivalent jobs with an average salary of $110,000, and over 200 construction jobs.

In addition to new bonding, the project also includes improvements of machinery, equipment and other tangible personal property, the refunding or refinancing of all or a portion of the outstanding principal amounts of existing bonds, and the construction of a 96,189 square-foot healthcare facility in the town of Potsdam in St. Lawrence County.

The projects will generate over $172.6 million of economic benefits to Genesee County and other communities over 10 years, including $161.4 million of payroll for temporary and ongoing jobs, and $11.2 million of tax revenues.

Press release:

Yesterday we introduced the new Mobile Medical Unit (MMU) at the ribbon-cutting event at our Brockport location. The MMU will operate like a primary care site bringing healthcare to Monroe, Orleans, Wyoming, Steuben, and Genesee counties.

“The Mobile Medical Unit would not have been possible without the support of our Board of Directors and The John R. Oishei Foundation that gave us a grant to fund this state-of-the-art medical facility,” said Mary Ann Pettibon, CEO, Oak Orchard Health.  The John R. Oishei Foundation enhances the economic vitality and quality of life for the Buffalo Niagara region through grantmaking, leadership and network building. For more information about The John R. Oishei Foundation, visit www.oishei.org.”

“Oak Orchard Health will be working collaboratively with the County Health Departments, partnering agencies, the Head Start programs, and the homeless to bring the Mobile Medical Unit closer to those in need. This is all part of our mission. We will also serve farmworkers, as we always do, but with this new unit we will be able to provide access during the times and the places that are convenient for them,” said Mary Ann Pettibon, CEO, Oak Orchard Health.

Public Health Commissioner, Dr. Michael Mendoza also spoke at the event and said, “one thing this pandemic has taught us is that we haven’t done a good job meeting people where they are, where they live, and where they are comfortable. Our region suffers from a lack of primary care access -- doctors, nurses, behavioral health professionals, the gamut of healthcare professionals. This Mobile Medical Unit will help to bridge that gap. Without Federally Qualified Health Centers like Oak Orchard Health, many, many, people would be going without healthcare. This unit will provide more primary care to more people especially those who are underserved.”

The Mobile Medical Unit will also provide vision screenings, behavioral health services, COVID testing and vaccinations, other vaccinations, routine health screenings, chronic disease management, EKGs, and so much more.

Unless you are over 103 years old and remember the Spanish Flu worldwide outbreak of 1918, then the COVID virus is your first (and hopefully last) pandemic. Enduring all of the shortages, masking, social distancing, quarantining, and isolation for the past year and a half has caused me to think back to when I was a kid growing up in Batavia in the 1950s and 1960s.

What kind of health care did I receive? Who were my providers? What kind of medical problems did I experience? Did we have fears back then like there are now with COVID?

Doctor In The House
My first memory of a doctor is when I had appendicitis at age 5. We lived at 26 Thomas Avenue and our family physician , Doctor Mansueto, lived across the street at number 23. He regularly made house calls after office hours and my mother summoned him to see me.

I had a fever, was vomiting, and had severe lower right side belly pain – the class signs of an infected appendix. But when Dr. Mansueto began examining my abdomen I started giggling like he was tickling me. My mom was exasperated by my reaction until he touched the right spot and I let out a screech so loud that the customers at Olivers Candies probably heard me. It was off to St. Jerome's Hospital for me.

This was in 1952 and a year earlier a major renovation of St. Jerome's had been completed so they were all ready for me. I recall that the anesthesia that was used for my surgery was ether which causes a lot of nausea upon awakening. In between throwing up, all they would give me was ice chips to moisten my mouth. After several days' stay, I got to go home minus my appendix and plus the first of many scars.

Dr. Biagio Mansueto had gotten his degree from the University of Bologna in Italy and then served in the U.S. Army Medical Corps in Europe during WWII. In 1946 he began his medical practice as a family physician in Batavia with an office upstairs at 73 Main Street above what was Critic's Restaurant. He had a 35-year career and helped deliver over 2,000 babies before retiring to California in 1980. He passed away in 1995.

We had many occasions in our family to call on the services of Dr. Mansueto over the years. When I was about 7 or 8, I had a bad case of strep throat and he had me hospitalized for several days at St. Jerome's. Back then your own family doctor would visit the hospital and oversee your care. The only thing I can remember is that I was given some Hydrogen Peroxide to gargle with and for some reason the nurse left me alone to do that. I spilled it in my bed and lay uncomfortably in the wet sheets until someone discovered it.

A Bad Dime Was Had By Me
A more humorous incident that ended up at the doctor's house began in St. Mary's Church. While attending Sunday Mass my mother gave me a dime (talk about inflation) to put in the collection basket. Me being a goofy little boy, the dime ended up stuck in my nostril. After a couple of embarrassing minutes trying to extricate it (resulting in a lot of runny snot), mom dragged me (probably literally) out of there.

She got me in the car and proceeded to Mansueto's across the street from our house. Fortunately, the doctor was home and calmly removed the stuck coin with tweezers. He told my mother and me that he would be required to keep the coin as payment. This became a funny family tale in subsequent years, but I got my ears blistered (as my mom used to say) that day.

College Interruptus
Probably my last interaction with Doctor Mansueto was after my sophomore year of college in 1966. The whole school year I had been feeling off health-wise and had been losing weight. While working a summer job at Coca- Cola on East Main St. I developed a nagging cough. Eventually, the doctor suspected pneumonia and had me admitted to St. Jerome's for tests and observation.

I have 2 memories of that stay. First, one night the dinner that was served was a not very fresh plate of fruit. Nutrition-wise I guess that was okay ( if it didn't look like it had been left out for a couple of days), but not exactly what a 19-year-old would want. I think I had my mom go to Kustas Kandies on Main Street and get me a big cheeseburger.

Secondly, I know people seem older when you are that young, but there was one nurse who looked about 80. She was walking so slowly entering and leaving the room, with tongue only partially in cheek I asked the young man who was my roommate if he thought we should get out of bed and assist her.

As it turned out. I ended up at a specialist in Rochester and had to withdraw from St. John Fisher College to have surgery for a benign (thankfully ) tumor in my lung. That was definitely not a fun experience but did result in my spending an extra year getting a degree and delaying immersion into the real world of adulthood.

Take Your Best Shot

One other very clear memory I have from back then is how frightened my friends, classmates, and I were of polio. Of course, adults including our parents were concerned too. There had been a polio outbreak in 1939 resulting in school closings and some quarantining. Everyone knew someone in the community who had been paralyzed or crippled by it. In fact, the President during the 1930s and 1940s, Franklin D. Roosevelt, was debilitated by polio including needing leg braces and having to use a wheelchair.

But by far the things that scared us the most were the newspaper and magazine photos of kids in “Iron Lungs”. These were the precursors to ventilators and consisted of a large metal tank which the patient was placed into with only their head sticking out. The apparatus helped you to breathe easier and helped the lungs and diaphragm to regain their strength.

Most people only needed the iron lungs for several weeks, but somehow we kids got the impression that if you got polio you'd have to spend your whole life in there.

So, needless to say, when we and our parents learned of Doctor Jonas Salk's vaccine discovery that would keep us from those horrible contraptions we counted the days until we could get our shots. Sound familiar in 2021?

It was in the spring of 1955 when the vaccinations finally came. I was in the fourth grade at St. Mary's School and it was announced that doctors would be going to the schools and be assisted by nurses in doing the inoculations. Dr. Samuel Gerace came to our school and I recall him being very friendly and soft-spoken to make the nervous kids more at ease.

I don't remember which kid it was, but one of the boys was boasting about how easy it was going to be and no one should be a “scaredy-cat”. As he waited in line for his turn, he saw the needle go into a child's arm and fainted, going down like an electric pole in a hurricane. For the rest of the year, he was the one that got needled.

Later on in the 1960s, my younger brother was protected against polio by an oral vaccine developed by Doctor Albert Sabin. Instead of a shot, the medication was placed on a sugar cube and you just had to pop it in your mouth. No more fainting.

You Know The Drill
I would be remiss if I didn't mention my experiences with dental care. Our dentist was Doctor Lawrence Mulcahy whose office was in a big white building on the northeast corner of East Main and Ross Streets. I'm sure that he was a very capable dentist, but I would have rather eaten bugs than endure a session with him. I used to stress for days before my appointment.

I don't recall Doctor Mulcahy giving an injection (what most people call Novacaine but used to be Procaine and is now Lidocaine) to numb my mouth for fillings. Rather, he administered Nitrous Oxide, also known as laughing gas.

This is a chemical that apparently people have fun with at Grateful Dead concerts, but I can assure you that I wasn't doing any laughing in the dental chair. It made me feel a little lightheaded but did practically nothing for the pain. I'm pretty sure I yelled out in agony on several occasions.

I was so traumatized by my dental visits that I did not go to the dentist for many years. Eventually, when I finally did go, I had so many cavities that I had to have them taken care of in stages. Dental care was not as bad in the 1950s as in the Old West days when the barber doubled as the dentist. But, I'm sure happy that my appointments for dental care today are painless and anxiety-free.

A lot of folks who get on board the nostalgia train seem to think that everything was better back then. Admittedly, you were more likely to have a personal relationship with your family physician, especially in a small town and particularly when they sometimes came right to your home. But, advances in scientific discoveries ( for those of us who trust them) and medical technology have enabled us to have a longer and healthier life today.

More than 40 health care organizations along with 40 physicians from throughout Western New York have issued a statement calling on area residents to ignore social media misinformation about COVID-19 treatment and prevention and asking them to follow the recommendations of doctors and scientists. 

Among the organizations: Erie County Medical Center, Veterans Affairs, Kaleida Health, Horizon Health, Lake Plains Community Care, and Independent Health.  

Among the physicians signing the letter is Dr. Michael Merrill, former chief medical officer at UMMC and currently an executive with Independent Health. 

To view the document with the statement and a list of all the supporters of the statement, click here (pdf).

Statement:

These organizations and the individuals signing below say the following message is correct and reliable. Social media posts may be incorrect. Find reliable, science- based information sources, such as the CDC.

We are experiencing a high number of COVID-19 cases in the region. You should wear a mask in indoor public places, even if you are fully vaccinated. Please wear a mask in outdoor settings if it is crowded or you expect close contact with others.

Wearing a mask will protect you. It will protect people around you. And the more people who do it, the more we protect the community. This is similar to littering. If one person litters, no one notices the impact. If many people litter, it creates a problem for everyone.

The risks of the vaccine are far lower than the risks of COVID-19. Please get a vaccine. Even if you are healthy, it is best not to get the COVID-19 infection, because you can spread it to vulnerable people without knowing.

92% of recent COVID-19 deaths in Erie County are in people who are not fully vaccinated.
There is evidence that the COVID-19 vaccines are SAFE during pregnancy. Infection with the COVID-19 virus during pregnancy can cause poor outcomes for moms and newborns. One study showed if a mother gives birth while infected with COVID-19, they have a 5 times elevated risk of dying.

There is NO evidence that the COVID-19 vaccines affect fertility. However, the COVID-19 infection CAN affect future fertility. You are not protected by your racial, ethnic or age group. COVID-19 is not like influenza. It is 10 times more fatal.

Why get a COVID-19 vaccine if we still have to wear masks and practice social distancing? We must use every tool available to control the pandemic. Each tool contributes toward “flattening the curve” and reducing, for example, the number of critically ill patients.

Why should I get the vaccine when people who are vaccinated can still get COVID-19? The COVID-19 vaccines were designed to prevent serious infection, hospitalization, and death. All of the current US vaccines provide very strong protection against all of these outcomes, with protection against hospitalization and death greater than 90%. Most vaccinated people who do get COVID have either no symptoms or very mild symptoms and are much less likely to be hospitalized or die.

How do we know the vaccines are safe in the long term? In the history of vaccine research, most vaccine side effects appear within a few weeks and almost all appear within six months. We now have data for well beyond six months for people who have received the COVID-19 vaccines, and it continues to show they are extremely safe. More than 360 million doses have been given in the US. At no point were shortcuts taken or safety compromised.

Press release:

In support of Breastfeeding Month, today the USDA Food and Nutrition Service (FNS) held a virtual ceremony for its WIC Breastfeeding Award of Excellence winners in the Northeast Region, including seven in New York.

“USDA established the award program to recognize local WIC agencies that have provided exemplary breastfeeding promotion and support to WIC moms,” said Lizbeth Silbermann, Northeast Regional Administrator for USDA’s Food and Nutrition Service. "The intent is to provide models to help other WIC clinics strengthen their breastfeeding programs to increase breastfeeding initiation and duration rates nationwide.” 

A major goal of the WIC Program is to improve the health of babies and moms through breastfeeding; WIC serves about half of all babies born in the country and is uniquely positioned to help moms successfully breastfeed.

In New York the following WIC clinics received Gold awards: 

• Catholic Charities WIC of Buffalo, Buffalo
• Oak Orchard Health WIC, Batavia
• Ryan Health WIC Program, NYC
• Bedford Stuyvesant Family Health Center, Brooklyn
• Morris Heights Health Center WIC, Bronx
• SBH Health System, Bronx
• Northwell Health Staten Island University Hospital, Staten Island

“Peer counselors have a unique ability to relate to participants and play a key role in providing support beyond the office when parents need it most, especially throughout the pandemic,” said Corie Nadzan, WIC Director for New York State. “These awards highlight the dedicated efforts of WIC staff to empower families to meet their breastfeeding goals beginning prenatally, through delivery and beyond. Having worked in a local agency myself, I know this is no easy feat, and I am incredibly proud of these agencies for their outstanding services.”

The award is given at three levels of performance that build on one another: Gold, Premiere, and Elite. 

One hundred and one awards were handed out across the country throughout the month of August, including 16 awards presented today to clinics in Connecticut, Massachusetts, New Hampshire, New York and Vermont.

The Special Supplemental Nutrition Program for Women, Infants, and Children - better known as WIC - serves to safeguard the health of low-income pregnant, postpartum, and breastfeeding women, infants, and children up to age 5 who are at nutritional risk by providing nutritious foods to supplement diets, information on healthy eating including breastfeeding promotion and support, and referrals to health care. More information about WIC can be found at www.fns.usda.gov/WIC.

The U.S. Department of Agriculture (USDA) Food and Nutrition Service (FNS) leverages its 15 nutrition assistance programs to ensure that children, low-income individuals, and families have opportunities for a better future through equitable access to safe, healthy, and nutritious food while building a more resilient food system. Under the leadership of Secretary Tom Vilsack, FNS is fighting to end food and nutrition insecurity for all through programs such as SNAP, school meals, and WIC. FNS also provides science-based nutrition recommendations through the co-development of the Dietary Guidelines for Americans. To learn more, visitwww.fns.usda.gov. 

Press release:

The COVID-19 pandemic is shining a spotlight on the value of more complete medical records in assessing and assisting people who need care to become and remain healthy. Now, 300 regional Community Based Organization (CBOs) sites have connected to Rochester RHIO. 

For the first time, social services and behavioral health organizations have a more complete picture of health records, including recent hospitalizations, laboratory tests and imaging, and medications administered. The same holds true for long-term care facilities, who can contribute details about residents that can speed and improve treatment should they fall ill.

Even select non-HIPAA organizations utilize RHIO DIRECT messaging service, which enables secure point to point electronic communication between caregivers. During no other time in history has a holistic collection of health information been as vital to quality care as it is today.

CBOs work to improve the lives of residents in their geographic location, delivering services that address social determinants of health, including education, transportation, socioeconomic factors, employment status and access to healthy food and activities. With this collaboration, secure data sharing is building a more complete medical record for communities and the 1.5 million residents across the RHIO’s 14-county region. 

“We work to assure that all our population can lead healthy lives,” said Jill Eisenstein, CEO and president of Rochester RHIO. “Community Based Organizations interact with people in their everyday lives, and work to address the economic, educational and social factors that have a direct bearing on their health and well-being.

"By working in coordination with clinical providers, CBOs will be better equipped to provide their services, especially during our current public health emergency.”

CBOs connect to the RHIO Contribute service to achieve bi-directional exchange, meaning they can transmit and receive data that helps caregivers make better decisions and provide better guidance. In turn, other health organizations such as hospitals and specialists who also have permission to access the data can use it to help their assessments and recommendations.

Learn more by contacting Rochester RHIO at 877-865-7446 or info@grrhio.org.

The following community participants are located in Genesee County.

• ARC of Genesee, Orleans (NYSARC)
• Genesee County Office of the Aging
• Genesee County Mental Health
• Genesee County Public Health
• Mental Health Association of Genesee and Orleans Counties
• Lake Plains Community Care Network (Batavia)
• Le Roy Volunteer Ambulance Service
• UMMC Healthy Living Programs (Batavia)
• Western NY Independent Living (Batavia)

The full participant map is available here.

Press release:

Congressman Chris Collins (NY-27) introduced legislation which provides a financial solution for uninsured Americans seeking medical procedures by hospitals.

The Protect the Uninsured Act of 2019 would amend Title XI of the Social Security Act to require hospitals and critical access hospitals to offer the uninsured individual access to the lowest negotiated price for any service or procedure.

“Hospitals are supposed to take care of everyone, the uninsured are often saddled with debt far beyond what they can pay while others are receiving steep discounts for the same procedures,” Collins said. “People are putting their health at risk by avoiding important procedures due to inflated costs while hospitals are writing off uncollected debts as charity work."

Hospitals negotiate discounts with insurance companies to determine costs of procedures or services they are willing to accept. This negotiated discount is subtracted from an inflated total cost of a procedure or service, the individual then pays a copay while the insurance company covers the remaining expenses.

Under current law, an uninsured patient is forced to cover the full cost of the procedure with no discounts, leading to uninsured patients mounting debt or avoiding necessary care.

This legislation will provide financial relief to those who are uninsured by allowing the individual to receive the lowest discount negotiated with an insurance company for a procedure or service by a hospital.

According to data compiled by the Center for Disease Control, a federal agency, and compiled by USA Today, United Memorial Medical Center has one of the best rates of mothers avoiding serious complications during childbirth in New York and the nation.

UMMC's severe maternal morbidity (SMM) rate for births to all mothers is 0.09 percent, compared to 1.8 percent for New York and a 1.4-percent rate nationwide.

SMM includes unexpected outcomes of labor and delivery that result in significant short- or long-term consequences to a woman’s health, according to the CDC.

The rate for UMMC is based on 2,341 deliveries from 2014 through 2017.

Dr. Tara Gellasch, chief medical officer for UMMC, and a physician at Batavia's Women Care Center, said UMMC's rating reflects the hospital's commitment to quality care and the support of the Rochester Regional Health system.

"Due to a myriad of potential conditions that can increase risk, maternal mortality is a growing concern in New York State and throughout the country," Gellasch said. "At United Memorial Medical Center, our providers and staff are trained to identify patients at risk so we can work with our Rochester Regional Health experts in high-risk obstetrics to provide these patients with the prenatal care they need.

"Our team is proud that we have kept maternal mortality rates consistently low and, as we do in all areas of care, we continue to evaluate our work and find ways to raise the bar for the future."

The severe maternal morbidity rate "is a composite measure of things that can go wrong at the hospital before, during or after delivery – heart attacks, strokes, blood transfusions, hysterectomies and other perilous emergencies that can permanently harm or even kill a new mother," reported USA Today.

Because the SMM rate is especially a concern for black mothers, the newspaper also reported on the rate and deaths for black mothers at UMMC during the study period.

The rate of episiotomy, an incision made in the vagina to assist during difficult births but not recommended by most health care experts, is 1.2 percent at UMMC compared to 7.8 percent at hospitals in 13 other states. 

The cesarean rate at UMMC is 18.5 percent compared to a national rate, among hospitals that report the rate -- some do not disclose it -- is 19.9 percent.

Press release:

The Alzheimer’s Association® Western New York Chapter is offering a number of programs and services across Genesee County in August. These programs are free and open to the public.

Haxton Memorial Library at 3 North Pearl Street in Oakfield will host "Know the Ten Warning Signs: Early Detection Matters" at 4:30 p.m. on Aug. 29.

This program will focus on recognizing potential warning signs of memory problems because early diagnosis is critical to ensure that families can plan for the future together, take advantage of available resources and take part in social engagement programs where they can interact and connect with others facing similar challenges.

Additionally, the Chapter trains facilitators to lead several monthly caregiver support groups across the county, which allow caregivers to connect with others facing similar challenges and hear advice for overcoming them:

Batavia:

• 3^rd  Wednesday of every month at 7 p.m. – Richmond Memorial Library, 19 Ross St.
• 3^rd Thursday at 1 p.m. – Genesee County Office for the Aging, 12 Bank St.

Le Roy:

• 2^nd Monday at 2 p.m. – The Greens of Le Roy, 1 West Ave.

Telephone Support Group:

• 2^nd Wednesday from 12:10-12:55 p.m. – For more information, call the Genesee County Office for the Aging at (585) 343-1611

A community social program, or respite, is also available every month in Corfu. This program provides relief to those who care for individuals with Alzheimer’s disease or other dementia and offers them some time to refresh and recharge, while their loved one is engaged in social activities in a safe environment.

Indian Falls United Methodist Church at 7908 Allegany Road offers a respite service on the 3^rd Wednesday of every month. For more information, call Celinda McQuiston at (585) 762-9105.

To learn more about other Alzheimer’s Association programs and services, contact the WNY Chapter office at 1.800.272.3900.

Press release:

During the month of June, designated by the Alzheimer’s Association® as Alzheimer’s & Brain Awareness Month, you can take advantage of a free educational program being offered by the Association’s Western New York Chapter.

A diagnosis of Alzheimer’s disease makes planning for the future a very important task for families. Concerns about care planning and programs that can help offset costs mean that families need accurate information about legal and financial matters specific to the disease.

"Legal and Financial Planning for Alzheimer’s Disease" is an opportunity to learn about important legal and financial issues to consider, how to put plans in place and how to access legal and financial resources in the community.

The Alzheimer’s Association WNY Chapter is offering the program on Wednesday, June 13, at 4:30 p.m. in The Manor House at 427 E. Main St. in Batavia. A light meal will also be provided.

Topics to be discussed include:

• Making legal plans that fit individual and family needs;

• Legal documents and what they mean;

• How to find legal and financial assistance;

• Practical strategies for making a long-term plan of care;

• Government programs that can help pay for care;

The program is free and open to the public, but seating reservations are requested by calling 1-800-272-3900.

Yesterday, Rep. Chris Collins was quick to tout his support for legislation to change the nation's health care laws, but today, Collins was among a handful of Republican congressmen under fire after admitting they didn't read all of the language of the legislation before the rollcall vote.

"I will fully admit, Wolf, I did not," Collins told CNN's Wolf Blitzer. "But I can also assure you my staff did. We have to rely on our staff."  

According to CNN, Collins said he had several meetings with staff to discuss the plan, known as the "repeal and replace" answer to the Affordable Care Act that could change health insurance coverage for millions of Americans. He said he is "very comfortable that we have a solution to the disaster called 'Obamacare.' "

Collins reportedly went on to say, "You know, I have to rely on my staff, and I could probably tell you that I read every word, and I wouldn't be telling you the truth, nor would any other member. We rely on our staff, and we rely on our committees, and I'm comfortable that I understand this bill in its entirety, Wolf, without poring through every word."

Thousands of residents of the 27th Congressional District receive subsidized health insurance under the ACA, including more than 5,000 in Genesee County.

The legislation passed by the House yesterday, known as the American Health Care Act, would replace the subsidies, currently paid directly to health insurance companies, with tax credits that some critics say will not provide the same level of financial assistance for ever-more-expensive health insurance.

Jerry Zremski, bureau chief for the Buffalo News, picked up on the remarks by Collins and asked him about one specific provision of the bill, an amendment that would cost the State of New York $3 billion by ending a provision called "The Essential Plan," an optional program under the ACA offered only to New York and Minnesota. It provides low-cost health insurance to low- and middle-income residents who don't qualify for Medicaid. 

According to Zremski's report, Collins was unaware of the bill's elimination of the funding. He quotes Collins as saying, "No. But it doesn't surprise me for you to tell me that there were two states in the nation that were taking advantage of some other waiver program and New York was one of the two states."

Collins was traveling today and couldn't be reached for comment, but his local staff provided the following statement drafted by Micheal McAdams, press secretary in the D.C. office of the congressman:

“Once again the Buffalo News is twisting a Republican’s words to fit its out of touch, liberal narrative. Congressman Collins has been intimately involved in the creation of this legislation from its inception. Over the past four years, he has participated in hundreds of hours of health care hearings, spent many hours marking up this legislation including a 26 hour mark-up in March, and spent hundreds of hours hearing from countless organizations that have a stake in the the health care debate. As a member of the Health Subcommittee, he participated in writing the text of the American Health Care Act.

“Just like Congressman Elijah Cummings who also said he didn’t read every word of this legislation, Congressman Collins has a complete understanding of this bill. He understands the impact it would have on Western New Yorkers. To infer Congressman Collins doesn’t understand the disastrous impact Obamacare has had on our region and our nation is absolutely shameful. The bottom line is the American Health Care Act provides the health care solutions Western New Yorkers need to increase choice and lower costs, as well as providing real property tax relief to every taxpayer in his district. 

"Congressman Collins is proud to have played a substantial role in the legislation’s creation and passage.”

The dustup over reading the bill is just the latest bit of negative publicity Collins has gotten from the national media. He's also been scrutinized for a financial investment that gives the appearance of an overlap with his legislative activity.

From The Daily Beast:

The Republican congressman purchased $2.2 million worth of stock in Innate Immunotherapeutics as part of its initial public offering in late 2013, according to a previously unreported document Collins filed with Australia’s securities authority. The IPO prospectus said Innate would seek FDA approval of its drug to treat multiple sclerosis. More than a year later, Collins wrote into a bill language to expedite the FDA’s approval process for such drugs. Four months before the bill was signed into law, Collins again purchased stock in Innate, this time as much as $1 million, according to congressional financial disclosure records.

According to the story, Collins, who owns $22 million of the stock, has been criticized by ethics experts for the transactions.

We also sought comments from Collins on the controversy and received the following statement drafted by McAdams:

“Despite the continued partisan attacks insinuating otherwise, Congressman Collins has followed all ethical guidelines related to his personal finances during his time in the House and will continue to do so.
 
“Congressman Collins’ relationship with Innate Immunotherapeutics dates back more than 15 years. Secondary Progressive Multiple Sclerosis is one of the most debilitating diseases in the world and Congressman Collins saw its deadly impact first hand as it affected a close family member. As of now, it has no cure and no relief of symptoms. He is very proud of the progress the company has made over the years and hopeful it will develop a potentially life-saving treatment for the millions of individuals suffering from Secondary Progressive Multiple Sclerosis.”

Press release:

Congressman Chris Collins (NY-27) today released the following statement regarding the American Health Care Act.

“I am extremely disappointed with today’s result,” Congressman Collins said. “This bill, while not perfect, was a solution that would have ended the Obamacare nightmare that Western New Yorkers have had to endure for too long.

"By increasing competition and giving people the power to make their own choices with their own health care, the American Health Care Act would have been a drastic improvement over the healthcare system Obamacare has left us with.

“Despite today’s result, this process has provided the opportunity to push for reforms vital to Western New York, specifically my amendment to force Albany to end its unfunded mandate on New York’s counties once and for all.

"I will continue advocating for that critical measure going forward and will remain resolute in my commitment to the taxpayers in my district.”

It might be nice to think that some bit of magic could just make the county share of Medicaid expense disappear, but somebody has to pay one way or another, said Lt. Gov. Kathy Hochul during an interview with The Batavian yesterday about the Collins' Amendment to the GOP's health care coverage reform bill.

"It’s not a free gift," Hochul said. "You can’t say, 'oh, this is going to be great,' and have it work out. They have not thought through the ramifications for this."

Rep. Chris Collins convinced the House GOP leadership to allow his amendment to the American Health Care Act, ostensibly a replacement for the Affordable Health Care Act, pushed through Congress by the Obama Administration in 2010. The amendment affects only New York and blocks the state from taking county money to provide Medicaid coverage to residents.

County leaders have long complained that this unfunded mandate is crippling local budgets and forcing counties to cut other services.

"Year after year, Albany’s leadership relies on counties to foot the bill for New York State’s out-of-control Medicaid costs. Enough is enough," Collins said in a statement released when he announced the amendment. "This amendment will stop Albany from forcing its unfunded mandate down the throats of taxpayers, and help counties lower the property tax burden on hardworking families."

The cost shift won't lead to cuts in property taxes, Hochul predicted, but there would be other ramifications for New York's taxpayers. Those ramifications could include either the poor and middle-class families who rely on Medicaid having $2.3 billion in services cut or counties losing their share of sales tax collections.

"Here's what is going happen, and the counties need to be aware of this, there are going to be tough choices to compensate for the Collins' scam and one of them is to re-examine the assistance we give to counties now," Hochul said.

According to Hochul, when Medicaid was created, the condition set up by the state was that counties would pay for 25 percent of Medicaid coverage and to compensate counties for the cost, counties could keep a portion of sales tax revenue.

County Manager Jay Gsell isn't sure that is exactly the history of sales tax in New York and said he's researching it. The threat to take money away from the counties if the amendment goes through is in line with Gsell's prediction in a story we published yesterday about the amendment.

"The state is not going to go quietly into the night," Gsell said.

We had trouble getting in touch with Hochul or staff members before yesterday's story, so yesterday Hochul had her staff reach out to The Batavian to arrange an interview so she could address local residents directly about her concerns with the Collins' amendment.

"I want people to have a full perspective that if you take out the county’s share, there are still going to be consequences," Hochul said. "Either we cut services $2.3 billion or we raise taxes, and it just comes from another pocket in the State of New York to the tune of $2.3 billion."

Hochul has long positioned herself as an advocate for local communities, and she said she is, but it's also her job as lieutenant governor now to look out for all the people of New York and the Collins Amendment, she said, will be devastating for the state.

"The governor and I are very much aware of this cost on counties and that’s why the governor cut that share down to 13 percent and so now NY state counties are paying less per person than they did back in the year 2000," Hochul said. "In addition, we did two more things: we capped the escalation of these costs, so the state is picking up any increases in the Medicaid costs. That has been in place the last five years and the governor also in 2011 created the Medicaid redesign team to squeeze out saving out of this program; $34 billion has been saved overall, and a large part of that was savings for the counties."

There is some dispute over the history of how we got in a position where county taxpayers are helping to foot the bill for a program that is billed as a "state and federal" benefit for people who can't otherwise afford healthcare. New York is one of only 16 states that pass some of the cost onto county taxpayers and New York's county share is the highest in the nation.

"What they’re proposing is the unraveling of a deal that was put in place in the 1960s when, at the time, counties were picking up 44 percent of their residents' health care costs," Hochul said. "Then when Medicaid and Medicare were in enacted in 1965 there was the thought we could reduce that down for the counties to 25 percent and also allow them -- again, allow them -- to collect some sales tax to offset that cost."

Gsell's version includes 1960 with the Kerr-Mills Act, which created a program called Medical Assistance for the Aged. It gave states the ability to create a medical coverage program and decide on the criteria for eligibility. The Federal government provided matching funds to cover the costs. The act was a precursor to Medicaid.

The prior 1950s program, Gsell said, provided matching funds for state payment to medical providers on behalf of people on public assistance.

"Nowhere did I find that NYS counties were voluntary partners in these pre-Medicaid funding programs," Gsell said. "The Hochul quote about counties paying pre-Medicaid, pre-1965, 44 percent of elderly indigent care, which NYS reduced our 'burden' to 25 percent, maybe 'accurate' in regards to then cost sharing, but this 1965 to 2017 Medicaid program is not the same in terms of benefits, entitlement, number of recipients, with counties having no say in size, eligibility and an open-ended entitlement as back 52-plus years ago."

The Cuomo Administration has been in full attack mode the past few days over the Collins Amendment. Yesterday, The Batavian received at least a half-dozen press releases from the governor's office about the amendment, plus statements funneled through the governor's press release database from hospitals in the region attacking the amendment.

"The radical conservative ideology in Washington has declared war on New York with legislation that will devastate hospitals across the state and hurt New Yorkers," Cuomo is quoted as saying in one press release. "These massive cuts will cripple our hospitals and ravage the health care services on which New Yorkers rely."

The other bit of history that came out in news reports yesterday over the Medicaid spat is that Andrew Cuomo's father, Mario, when he was governor pushed for years for the state to pick up the county's share of the Medicaid tab.

Both Andrew Cuomo and Hochul have accused Collins of political pandering to try and secure more Upstate congressional votes for the AHCA, which is far from guaranteed passage. The reform, pushed as part of President Donald Trump's promise to repeal and replace Obamacare, would scuttle direct subsidies to people who purchase insurance through health care exchanges, as well as end the individual mandate to buy health insurance, and replace it with a refundable tax credit for all qualifying Americans.

Critics contend the bill would drive up the cost of health insurance while conservatives argue the bill doesn't actually repeal Obamacare.

A poll commissioned by The Economist shows strong opposition to the AHCA in several rural Upstate districts, including the NY-24 (33 percent support / 51 percent oppose), NY-23 (38/45), NY-22 (38/45), NY-21 (37/45), as examples.

In the NY-19, the district of John Faso, the cosponsor of the Collins' Amendment, 35 percent support and 48 percent oppose. The bill has a little stronger support in Collins' own district, the NY-27, with a split of 40/42.

"The reason that Representative Collins proposed this is to literally offer a bribe to on-the-fence Upstate Republicans who were starting to hear from constituents that decimating and destroying the Affordable Care Act, which benefits seven million New Yorkers now, is not something their constituents really want," Hochul said.

Cuomo has characterized the Collins Amendment as putting politics before people, and we asked Hochul about that statement, noting that really any decision about budgets, taxes, and spending is about people. For Genesee County, a cost savings of $9.4 million might not lead to much, or any, savings to taxpayers, but it could save critical programs.

This past year, the County Legislature went through a contentious budget debate that had some members of the Legislature even floating the idea of eliminating deputies from road patrols. The county will also likely be forced by the state to build a new jail in a few years, plus the county needs at least $15 million in road and bridge repairs. 

Meanwhile, New York's menu of Medicaid options is the most generous in the nation and the program leaves the perception of operating on an open checkbook. (Gsell provided this chart that shows county share of Medicaid expense across the nation and New York's is far and away the highest rate.)

"I disagree with your assessment that it’s an open checkbook," Hochul said. "The fact (is) that we shaved $34 billion off of it just in the last few years and the governor continues to have a Medicaid redesign team in place to make sure we’re cutting costs."

Hochul said if the ACA is repealed, it's just going to drive up costs for all New York taxpayers because the uninsured will be more likely to use emergency rooms for routine medical needs.

"They’re going to the ER and the cost is going to be dramatically higher," Hochul said. "Those costs are being picked up by taxpayers. People have to realize this is a united system and we’re going to continue as a state to cut those costs."

She said New York's costs are higher because we have a larger elderly, middle- and working-class population and our industrial past means we have higher rates of cancer. She recalled seeing as a child the pollution spewed by steel plants, for example, in Buffalo area.

"That is largely a way to explain why we have higher costs, not that we’re just throwing good money after bad," Hochul said. "We have a governor who is very tight-fisted with the state’s taxpayers' dollars. He’s very conscientious. That’s why we’ve cut middle-class taxes. We’ve cut business taxes. We continue to focus on creating jobs to put more money back into the local economy, more sales tax for the counties, more property tax revenue for house sales. It all works together. You can’t just pull out one piece of the puzzle and have that collapse and have the other part be picked up by everybody else."

She called the Collins' amendment a betrayal of the people of New York.

"The number one rule for doctors is 'first do no harm,' " Hochul said. "I think that should also apply to members of Congress. What Chris Collins is proposing will inflict harm and pain on the people of the State of New York and we have to get pressure on him to take this back and put it on the sidelines and realize this is a horrible mistake."

Late yesterday, Collins, who won the NY-27 seat from Hochul three years ago, put out a press release that characterized the Cuomo Administration's response to his proposed amendment as "a complete meltdown."

“Governor Cuomo and his sidekick are using doomsday predictions to scare everyday New Yorkers into allowing Albany to continue taxing them to death," Collins said. "It’s absolutely disgusting the governor would threaten the middle class with a tax increase while holding a $14 billion taxpayer-funded slush fund in his back pocket. As I have said before, if this Governor can’t find 1.5 percent to save in his budget, I am more than willing to find it for him.”

Insource Urgent Care is now Genesee Urgent Care, and there are other changes in store for the acute healthcare provider that opened in Batavia just last year.

For one, Melissa Marsocci is now the sole owner of the business, located Downtown at 35 Batavia City Centre. (Three other locations were sold earlier this year to urgent care groups in Philadelphia and Auburn.) And as head of the company, Marsocci has "really innovative plans."

"Batavia has always been 'the model' for the characteristics I've wanted," said the 30-year-old lifelong Genesee County resident.

One of those is the expansion of telemedicine. The center has a contract with Genesee Community College to augment its student health services. Marsocci donated desktop telemedicine equipment to the college to enable Genesee Urgent Care to see students as patients virtually, seven days a week.

They are planning to roll out a telemedicine system the week before Thanksgiving. If a student isn't feeling well, he or she could go to the telemedicine area, which would have a nurse on duty, and there a dialog could take place with Genesee Urgent Care about appropriate care.

Marsocci calls this the "hub-spoke model."

She sees it as having global applications.

"We are researching putting in a (telemedicine) clinic to help a Christian missionary in Haiti and the Dominican Republic to provide care for people," Marsocci said.

The company is making a big push into occupational medicine, too, and negotiations are under way with two orthopedic groups.

Genesee wants to partner with a psychiatrist for "telepsychiatry," and to sublease space to an oncology group to see patients on site.

A Downtown daycare center in the building wouldn't be a bad idea either.

"I would like to get support for other medical businesses in the building so we could offer (daycare) as a service to patients," Marsocci said.

Genesee has teamed up with another firm to craft a commonsense healthcare option that would "give employers a means of circumventing Obama Care." Because she wants to trademark the plan, which targets self-funded health plans, she is keeping pretty tight-lipped about it.

Awhile back, she said the company was briefly without a healthcare plan for its employees and the available options were a sorry lot.

"My premiums went up 20 percent," she said. "Employees who were used to paying $20 to $40 deductibles, were now paying for an office visit because of high-deductible plans."

The lawsuit with Health Now, the BlueShield BlueCross franchise for WNY, is settled and Genesee Urgent Care now takes their insurance.

As regards staffing, there's a new medical director. Dr. Tom Malinich has replaced Dr. Magdi Credi, but for the foreseeable future Credi will remain on staff and continue to be a valuable mentor. Dr. Henry Moscicki, DNP, is at the clinic once a week.

"He blends into the hybrid model we've always prided ourselves on," Marsocci said.

There are no other changes to speak of but the center is in hiring mode.

"We still promise to see patients within 15 minutes," Marsocci said. "We have no intention of replacing primary care doctors. But it is important that patients needing acute care be followed."

(The sign currently on the outside of the building in City Centre will soon be replaced. The job is out to bid locally.)