Wednesday, August 8, 2012

Making Sense of Health Care Reform for Your Nonprofit

NYCON's insurance subsidiary Council Services Plus (CS Plus) offers info, resources and direct insurance assistance to nonprofits across NYS. CS Plus only works with nonprofits, and has brought over $1 million in savings to nonprofit clients. Visit www.councilservicesplus.com for more info or e-mail.
Health Care Reform: Are You Prepared?
The United States Supreme Court largely upheld President Obama's health care law, the Affordable Care Act in a mixed decision. The court's ruling, seen as one of the most significant in decade, is a crucial milestone for the law, allowing almost all of its far-reaching changes to roll forward. The decision did significantly restrict one major portion of the law: the expansion of Medicaid, the government health-insurance program for low-income and sick people. The ruling gives states more flexibility not to expand their Medicaid programs, without paying the same financial penalties that the law called for.
The legislation for the Patient Protection and Affordable Care Act (PPACA) will impose significant new responsibilities on employers, some of which are already effective. While further guidance is expected on the application of these requirements, the following provides a summary and timeline of key provisions of the PPACA. As employers look ahead to the implementation of the PPACA, CS Plus will be providing additional updates to provide clients with compliance strategies in connection with various components of the new law.
Summary of the Affordable Care Act
The Affordable Care Act (umbrella term for the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010) was passed by Congress in March 2010 to overhaul the health care system, expand affordable coverage, change insurance rules and create an online marketplace (exchange) in each state for the individual and small group markets.

Most U.S. citizens and legal residents will be required to have health insurance in 2014. Those without coverage would pay a tax penalty based on household income to be phased-in starting in 2014. Federal subsidies will be available to assist those who cannot afford to purchase coverage.

Large employers (50 or more full-time employees) will be required to "pay or play" starting in 2014.

Qualifying small employers (no more than 25 employees) are eligible for a tax credit for offering coverage beginning in 2010. The tax credit increases in 2014 if employers buy from the exchange, and then phases out in 2016.

How Health Reform will Impact Businesses
The Patient Protection and Affordable Care Act (PPACA) impacts businesses in several ways - from the types of benefits offered under insurance plans, to the ways employers conduct their businesses. Some provisions are already in effect and more will be implemented over the next several years.

General Impacts on Employer-Provided Coverage
There are several mandates from the Patient Protection and Affordable Care Act (PPACA) already in effect. View the Timeline below for more information on timing of provisions.

Some of the key mandates are below.
Grandfathering - "Grandfathering" allowed some plans to be exempt from some Health Care Reform provisions.
Lifetime Limits and Annual Limits - Law prohibits imposing annual limits on Essential Health Benefits and any lifetime dollar limits.
Medical Loss Ratio (MLR) Reporting - A Medical Loss Ratio or MLR is the percentage of premium dollars insurers spend to provide covered medical services and improve the quality of health care for their members.
No Pre-Existing Conditions Exclusions - As of September 2010 there are no pre-existing exclusions for children under age 19. Beginning in 2014, this provision applies to everyone, including adults.
Patient-centered Outcomes Research Fee - The Patient-Centered Outcomes Research Tax, also known as the Comparative Effectiveness Research Fee, is a fee paid to the government to fund Patient-Centered Outcomes Research Institute (PCORI) research.
Preventive Services - The Patient Protection and Affordable Care Act of 2010 (PPACA) requires health plans to cover designated preventive services without any member cost sharing.
Summary of Benefits Coverage - The Departments of Health and Human Services, Labor and Treasury recently issued final regulations requiring health plans to provide a SBC and Uniform Glossary that clearly explain benefits and coverage within a standardized template with uniform language.
W-2 reporting - PPACA contains a requirement for employers to report the cost of health coverage under an employer sponsored group health plan on an employees W-2 form. The cost includes both the cost paid by the employer and contributions from the employee.
Women's Preventive Services - The Patient Protection and Affordable Care Act (PPACA) requires health plans to cover designated women's preventive services without cost sharing for the member. Cost-sharing includes deductibles, copayments and coinsurance. Some of the benefits and services outlined in the women's preventive guidelines are already included within the existing PPACA preventive services requirements.
Establishment of Health Insurance Exchanges
On April 12, 2012 Governor Andrew M. Cuomo issued an Executive Order to establish a statewide Health Exchange. State-established health insurance exchanges must begin to operate on January 1, 2014. The Exchanges are virtual marketplaces that allow individuals and eligible employers to purchase health insurance. Initially in 2014, only employers with up to100 employees can purchase insurance for their employees through the Exchange. Prior to 2016, states can limit the size to businesses with up to 50 employees. Beginning in 2017, states can allow employers with more than 100 employees to purchase health insurance for their employees through the Exchange.

How Does Health Care Reform Affect Small Businesses?
In addition to the key provisions outlined, it's important to know that small businesses already have an opportunity to qualify for:
Small business tax credits - In an effort to help small employers offer affordable coverage to their employees, the Patient Protection and Affordable Care Act provides for tax credits for qualified small employers. These credits began in 2010. The credits increase in 2014, but are only available for coverage purchased on an Exchange. The small group tax credit sunsets in 2016.

Timeline
It will take several years for changes to be enacted and regulations written. However it's important to begin to understand what will be happening in the near future versus long term changes.
HC Reform Timeline
To view a larger image of the timeline, CLICK HERE.



If you have any questions regarding this update, please contact Anthony DeCicco, Account Executive, Group Benefits at adecicco@councilservicesplus.com;
or by phone at (877) 501-4277, ext 123.

Wednesday, May 30, 2012

Idealware's Upcoming June Trainings: Social Media, Technology and More


June 2012

Idealware's Upcoming Online Training

Have you heard about "the Cloud" but don't know what it is? Or are you just not sure how it compares to traditional software? Idealware has you covered with TWO seminars this week. Tomorrow, Idealware and NTEN present the findings from their "2012 State of the Nonprofit Cloud" report in a free seminar, The State of the Nonprofit Cloud. On Thursday, delve deeper into online software and see how it stacks up with Comparing Google Apps to Outlook

Later this month, expand your tech knowledge with some Idealware crowd favorites. Learn how to monitor your website traffic with Google Analytics, AWStats and more in Introduction to Website Analytics, or learn the best practices of creating online surveys with the free Online Survey Tools and Techniques seminar.



TOMORROW: The State of the Nonprofit Cloud: Results of the Study
May 30, 2:00 pm - 3:00 pm Eastern. $0.00
Consultants and advertisements alike are urging nonprofits "to The Cloud," but how many have heeded the call? Are organizations actually using it? To answer these questions and more, NTEN and Idealware surveyed 780 nonprofits nationwide about how they used hosted software.
Read more or register > 

THIS WEEK: Comparing Google Apps With Outlook
May 31, 1:00 pm - 2:30 pm Eastern. $40.00
Google Apps provides a compelling set of features -- from email to calendars to a organizational portal to shared documents -- that gives Outlook a run for its money at a fraction of the  cost. We'll demo the main components of Google Apps, talk about administrating it as an organization, and show how it compares to Microsoft Outlook. This session is geared for those familiar with Outlook who want an introduction to Google Apps.
Read more or register > 

Choosing a Volunteer Management System
June 7, 1:00 pm - 2:30 pm Eastern. $40.00
How do you keep track of your volunteers? Do you still use pen and paper? Should you buy a new tool for tracking volunteers, or use one that you already have?
Read more or register > 

FREE: Online Survey Tools and Techniques
June 14, 1:00 pm - 2:00 pm Eastern. $0.00
We'll talk through the tools (and demo a few) that can help you create online surveys, from low cost options to more robust ones. We'll wind up with best practices on designing a solid and reputable online recruiting participants and analyzing the data.
Read more or register > 



Have you been asked to take a lot of online surveys and always thought you could make a better one? Learn how with the free seminar, Online Survey Tools and Techniques.



Branding Through Social Media
June 21, 1:00 pm - 2:30 pm Eastern. $40.00
In this session we will dive into the concept of branding through the lens of social media. Taking a detailed look at how you can create, refine and manage your brand message and personality through social media, this class will explore how what you say and how you say it impacts people's impressions of your organization.
Read more or register > 


Introduction to Website Analytics
June 28, 1:00 pm - 2:30 pm Eastern. $40.00
How many people visit your Web site? What are they doing there? Through demos of AWStats and Google Analytics, we’ll look at what analytics packages can tell you about your site.
Read more or register > 


Telling Your Story with Blogs, Photos, and Videos
July 12, 1:00 pm - 2:30 pm Eastern. $40.00
How do you convey the great work your organization is doing with blogs, photos and videos? These tools are powerful ways to share the difference you're making in the world.  We’ll cover the principles of good storytelling, look at examples and research about what’s working for nonprofits, and then discuss the tools that can help you put them online.
Read more or register > 

Tuesday, February 21, 2012

A.G. SCHNEIDERMAN ANNOUNCES BOLD PLAN TO REVITALIZE AND REFORM NEW YORK’S NONPROFIT SECTOR

Attorney General Announces Nonprofit Report: Recommendations Guided by the Leadership Committee for Nonprofit Revitalization

New York State Attorney General Schneiderman unveiled a new plan on Thursday to reform and revitalize New York's nonprofit sector.

Announced before an audience of nonprofit and business leaders, the plan includes legislation to eliminate outdated and costly burdens on nonprofits, strengthen oversight and accountability, and reaffirm his office's commitment to policing fraud and abuse.

Acknowledging that organizations throughout New York State face historic financial and strategic challenges, the Attorney General's plan also includes several new partnerships with the business and academic communities to enhance nonprofit governance.

"New York is the proud home of the world's most dynamic and vibrant nonprofit sector, but for too long, our state's regulatory framework has placed unnecessary burdens on these essential organizations. This plan will unlock the full potential of our nonprofit community, and improve the lives of the countless New Yorkers they serve every day," said Attorney General Schneiderman. "In these difficult economic times, it is more important than ever to make New York a hospitable environment so nonprofits can continue to carry out their vital work. At the same time, we must maintain the public's trust by ensuring that nonprofits are governed effectively, and with meaningful oversight."

"NYCON applauds the Attorney General for his leadership in putting forth a positive agenda for reform of state and nonprofit relations," said Doug Sauer, NYCON CEO. "In the spirit of cooperation and partnership, we are hopeful that the AG, Comptroller, Governor and Legislature can work together to further shape and support the recommendations."

In 2011, Attorney General Schneiderman convened a Leadership Committee for Nonprofit Revitalization with 32 nonprofit leaders, including NYCON CEO Doug Sauer, to recommend proposals that would reduce regulatory burdens on nonprofits, while strengthening governance and accountability.

Today's legislative and reform initiatives are responsive to the committee's recommendations.

They include:
The Nonprofit Revitalization Act, to be proposed by the Attorney General;
"New York on BOARD" and;
"Directors U" designed to improve nonprofit governance

More Details & Full Report
http://www.ag.ny.gov/media_center/2012/feb/feb16a_12.html

Sunday, February 19, 2012

Hospital affiliations increasing: Auburn and Rochester recent example

Recent article on hospital affiliations:

The Auburn hospital, rebranded last week as Auburn Community Hospital, announced Jan. 25 it will explore pairing with the Rochester General Health System "to further enhance its 120-year tradition of providing compassionate, quality acute and long-term care services."

It chose Rochester General over three other suitors: the University of Rochester Medical Center and St. Joseph's and Upstate University hospitals in Syracuse. Crouse Hospital, also in Syracuse, was asked to submit a proposal but did not.

ACH said in a statement that it chose to continue talks with Rochester General because of its "successful track record of collaboration with smaller standalone hospitals, its reputation for innovation, a sterling record of patient safety and a national reputation for quality."

Neither ACH nor Rochester General would elaborate on those criteria, but the decision to seek a partner is part of a statewide trend among hospitals small and large, rural and urban.

William Van Slyke, a spokesman for the nonprofit advocacy group Healthcare Association of New York State, said reductions in Medicaid and Medicare reimbursement rates have cut into hospitals' margins at the same time that stricter performance measures demand greater accountability and better patient results.

"Really what's happening is the whole health care system is transitioning from a fee-for-service model to a coordinated care management system, where you're paid by an insurance company to provide care for a person," he said. "Definitely the squeeze is on. Hospitals across the state are having to find new ways and build new relationships to provide care."

One common way forward has been collaborations, from clinical affiliations to full mergers and purchases. Those discussions have taken place in every corner of the state, from New York City and the Albany area to central and western New York, Van Slyke said.

Rochester General already has a partnership with Newark-Wayne Community Hospital, a 120-bed facility in Wayne County. It also spent two years working with Auburn's neurology unit to attain Stroke Center designation, something AMH achieved last August.

In Syracuse, Upstate took over Community General Hospital last July, combining to create the largest hospital in the region.

Upstate also made a strong pitch to partner with ACH. Its CEO, John McCabe, said the majority of Cayuga County patients who can't be treated at ACH end up at Upstate, including many visits for cardiology, orthopedics, trauma and cancer services.

Upstate's offer included financial help in adding specialists, clinics and infrastructure and paying for a study to decide what sort of health care presence Auburn needs, now and in the future.

The Syracuse hospital put forward five possible business models, ranging from "franchising" as an affiliate to a full purchase, McCabe said.

ACH would not comment on why it chose Rochester General over the other offers, but McCabe said he believed Upstate lost out because he would not promise that Auburn could retain a traditional hospital in the future.

"Clearly other people who responded to the (request for proposals) said you can always have a hospital in Auburn and here's $10 million for capital improvements," he said. "(I was unwilling) to make an absolute commitment that nothing would change in Auburn. I think that's unrealistic with what's going around."

Part of the difficulty for small, rural hospitals like ACH has been attracting doctors in the most profitable sub-specialty practices. Without those lucrative services, they often struggle to generate enough revenue to reinvest in their practice and facilities.

"More and more in New York, people will be asking, 'What's the right configuration of services? What should be regional and what should be left local?'" he said. "I think it may be difficult for (ACH) to still be a full-service, 100-bed hospital.

"That doesn't mean there can't be a medical campus that takes care of the needs of the people of Auburn to a certain level. ... Rather than saying, 'Will there be a building that's a hospital as we know it today?,' people should say, 'What services do we need?'"

A spokeswoman for the University of Rochester Medical Center said that hospital's proposal to ACH "did not offer a capital investment but maintained local ownership and control." St. Joseph's declined to comment.

Van Slyke, of the Healthcare Association of New York State, speaking about hospital affiliations in general but not Auburn in particular, said it's important to be transparent and communicate clearly, and not to be afraid to change.

"More and more providers and hospitals, if they continue to operate under the old model, they won't be able to sustain," he said. "It's very natural for communities to want to hold onto their facilities as they know them. But if there's a transparent discussion centered around meeting community needs under this new era of decreased reimbursement, that will lead to a solution. ... We need to figure out how those services - in-patient beds, OB-GYNs, cancer services, pediatrics - can be sustained in whatever model is the most efficient and most likely to succeed into the future."

ACH and Rochester General plan to provide an update on their discussions at the end of May.

Staff writer Justin Murphy can be reached at 282-2237 or justin.murphy@lee.net. Follow him on Twitter at

CitizenMurphy.


Read more: http://auburnpub.com/news/local/hospital-affiliations-becoming-common/article_fc387244-5aa9-11e1-b042-001871e3ce6c.html#ixzz1ms8xtmVa

Monday, February 6, 2012

NYCON CEO Doug Sauer Testifies at Public Hearing on Executive Compensation at Not-for-Profits

Public Hearing: To examine executive compensation at not-for-profit organizations receiving State funding and the actions needed to prevent State tax dollars from being wasted on excessive salaries
Senate Standing Committee on Investigations and Government Operations
Chair: Senator Carl L. Marcellino

NY Council of Nonprofits CEO Doug Sauer shares feedback and testimony on the Governor's Executive Order addressing Executive Compensation for Not-for-Profits. You can hear Doug's comments beginning at 49:30. Watch for more from NYCON shortly. Interested in joining the NYCON mailing list? Subscribe here.

Wednesday, January 4, 2012

Report: Upstate pays state less in taxes than it receives

Upstate New York pays the state less in taxes and other revenue than it receives back in state expenditures, according to a report from the Nelson A. Rockefeller Institute of Government at the University at Albany.

About 24 percent of taxes and revenues collected by New York state in 2010 came from the upstate region, according to the report, titled “Giving and Getting.” But upstate New York received about 35 percent of state spending.

The Rockefeller Institute classified upstate New York as including 48 counties that are not part of the Capital Region, New York City, or the five-county downstate suburbs linked to New York City.

The Capital Region — made up of Albany, Rensselaer, Saratoga, and Schenectady counties — also paid the state less than it received. It paid just below 4 percent of the state’s total taxes and receipts and received 7 percent of state spending.

Meanwhile, New York City and its downstate suburbs paid the state more than they received in expenditures.

New York City contributed more than 45 percent of all state taxes and revenues. It received about 40 percent of expenditures in return, according to the report.

Downstate suburbs in Nassau, Suffolk, Westchester, Rockland, and Putnam counties gave the state 24 percent or 27 percent of its taxes and revenues, depending on calculation methods used. Those areas took home around 18 percent of state funding, the Rockefeller Institute report found.

The report calculated receipts paid and expenditures received in each region using various methods — by place of residence and by place of work. Each method showed that upstate New York and the Capital Region received more than they paid, while New York City and its downstate suburbs paid more than they received.

Upstate New York would have lost between $8.1 billion and $9.3 billion if its share of state-funded expenditures matched the revenues it contributed, according to the Rockefeller Institute. The Capital Region would have lost about $2.7 billion.

New York City would have received an additional $4.1 billion to $6.1 billion in state funding if state expenditures matched revenues from the city, the report found. Downstate suburbs would have gained $4.6 billion to $7.9 billion.

The New York City–based Citizens Budget Commission, which describes itself as a nonprofit civic organization focused on changing the finances and services of New York City and New York state government, commissioned the report. It was supported by a grant from the New York Community Trust, a New York City–based community foundation with more than $1.9 billion in almost 2,000 individual charitable funds.

Thursday, December 15, 2011

1 in 2 Americans are now poor or low income

Squeezed by rising living costs, a record number of Americans — nearly 1 in 2 — have fallen into poverty or are scraping by on earnings that classify them as low income.

The latest census data depict a middle class that's shrinking as unemployment stays high and the government's safety net frays. The new numbers follow years of stagnating wages for the middle class that have hurt millions of workers and families.

"Safety net programs such as food stamps and tax credits kept poverty from rising even higher in 2010, but for many low-income families with work-related and medical expenses, they are considered too 'rich' to qualify," said Sheldon Danziger, a University of Michigan public policy professor who specializes in poverty.

"The reality is that prospects for the poor and the near poor are dismal," he said. "If Congress and the states make further cuts, we can expect the number of poor and low-income families to rise for the next several years."

•Study: 1 in 5 American children lives in poverty
Congressional Republicans and Democrats are sparring over legislation that would renew a Social Security payroll tax cut, part of a year-end political showdown over economic priorities that could also trim unemployment benefits, freeze federal pay and reduce entitlement spending.

Robert Rector, a senior research fellow at the conservative Heritage Foundation, questioned whether some people classified as poor or low-income actually suffer material hardship. He said that while safety-net programs have helped many Americans, they have gone too far, citing poor people who live in decent-size homes, drive cars and own wide-screen TVs.

With nearly 14 million Americans unemployed, a new child welfare study finds one in five children are living in poverty. Nearly one in three live in homes where no parent works full-time year-round. NBC's Chris Jansing reports.
"There's no doubt the recession has thrown a lot of people out of work and incomes have fallen," Rector said. "As we come out of recession, it will be important that these programs promote self-sufficiency rather than dependence and encourage people to look for work."

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Mayors in 29 cities say more than 1 in 4 people needing emergency food assistance did not receive it. Many middle-class Americans are dropping below the low-income threshold — roughly $45,000 for a family of four — because of pay cuts, a forced reduction of work hours or a spouse losing a job. Housing and child-care costs are consuming up to half of a family's income.

States in the South and West had the highest shares of low-income families, including Arizona, New Mexico and South Carolina, which have scaled back or eliminated aid programs for the needy. By raw numbers, such families were most numerous in California and Texas, each with more than 1 million.

The struggling Americans include Zenobia Bechtol, 18, in Austin, Texas, who earns minimum wage as a part-time pizza delivery driver. Bechtol and her 7-month-old baby were recently evicted from their bedbug-infested apartment after her boyfriend, an electrician, lost his job in the sluggish economy.

After an 18-month job search, Bechtol's boyfriend now works as a waiter and the family of three is temporarily living with her mother.

"We're paying my mom $200 a month for rent, and after diapers and formula and gas for work, we barely have enough money to spend," said Bechtol, a high school graduate who wants to go to college. "If it weren't for food stamps and other government money for families who need help, we wouldn't have been able to survive."

About 97.3 million Americans fall into a low-income category, commonly defined as those earning between 100 and 199 percent of the poverty level, based on a new supplemental measure by the Census Bureau that is designed to provide a fuller picture of poverty. Together with the 49.1 million who fall below the poverty line and are counted as poor, they number 146.4 million, or 48 percent of the U.S. population. That's up by 4 million from 2009, the earliest numbers for the newly developed poverty measure.

Read more here.