Today I am pleased to announce a first for RSSBinghamton–a guest viewpoint. And it’s from someone who is (cordially) taking me to task over my recent remarks about Medicaid. Long-term readers of this blog will know that I welcome dissenting opinions and views from my own.

Today’s guest viewpoint comes from Leigh Ann Scheider, Executive Assistant to Broome County Executive Barbara Fiala. In the article Medicaid is Bankrupting Broome County and All of New York State I encouraged Ms. Fiala to “show leadership” and “think outside the box.” Those comments prompted Leigh Ann to write me a detailed email about Ms. Fiala’s record to date in showing said leadership. She gently chided me that perhaps I did not share enough facts on the matter. I asked Leigh Ann for her permission to post her email in toto (nothing has been changed), and she agreed. And forthwith:

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By Leigh Ann Scheider

Dear Mr. Willis,

This morning I read your blog post on rssbinghamton.com titled “Medicaid is Bankrupting Broome County and All of New York State”.  While your points are valid and very astute, your continuous chant that Broome County Executive Barbara Fiala has not addressed the Medicaid burden is sorely incorrect. In fact, as an outspoken member of the New York State Association of Counties (NYSAC), Executive Fiala has continually called upon state leaders to address this state’s uncontrolled Medicaid costs.

What you seem to have avoided or did not take the time to research is the constant, persistent, identification of the Medicaid burden by Executive Fiala in almost all of her budget addresses. Before and even after the Medicaid cap went into effect, Executive Fiala has drawn attention to the ever increasing Medicaid costs, that as you noted, continue to balloon.

This burden does indeed put local governments and the state in a poor fiscal position. Prior to the Medicaid cap being instituted, counties were negotiating projected Medicaid figures as they would spreads between sports teams (let me be upfront in stating that comparison is purely my own opinion). Factually, it would be better described by any county Budget Director that had to go through the process using empirical data. While the cap has given local governments the ability to more soundly budget for such defined increases, costs continue to rise. As Executive Fiala has said publicly, “Broome County’s Medicaid problem is not fixed”.

In further contrast to your claim that Executive Fiala has not addressed the depicted elephant in the room, her advocacy has gone beyond calling for state leaders to take action. Under her leadership, the State awarded Broome County the ability to conduct an audit of nearly 35 million dollars worth of Medicaid claims. For the news release: Click here. This local action proves Broome County’s commitment to protecting taxpayer dollars and preventing fraudulent practices. More information will be released soon on a large settlement that will more than cover the costs of the audits.

I respect your interest and perception of the Medicaid problem. Provided with the information and public statements made by Executive Fiala, it is my hope you would consider including more factual information within your post. While your post draws attention to a very real problem, it would be more impactful if the information was factual regarding the actions taken by leaders within Broome County.

As with any freelance media, credibility always stirs criticism, however, that is not my intention. Below, I have included remarks from Executive Fiala where she has addressed the Medicaid burden that Broome County taxpayers are faced with. These remarks do not include transcriptions of her comments made to state leaders and or NYSAC. If you have any further questions or comments please feel free to contact me directly through the information provided below. I appreciate your time and willingness to correct information within the contents of your blog.

Best regards,
Leigh Ann Scheider

[County Executive Fiala's previous public comments]

2006 Budget Address

“Some might be wondering that now with the Medicaid Cap, why our taxes are not decreasing? What you have to understand is that the cap is just that. It only caps the amount Medicaid costs would have increased. Do not get me wrong, we are extremely grateful state leaders have finally tackled this tremendous burden that has rested on counties’ shoulders, far too long.

What the state has given us is a formula that allows for an orderly and predictable way to forecast Medicaid expenses instead of the skyrocketing costs we were forced to solely absorb in the past. While we do not know for sure what our Medicaid costs for 2006 will be until the final numbers are certified by New York State on June 30th of 2006, we anticipate our local share of these expenses to rise by $1.2 million dollars.

Medicaid is still the single largest item in the Broome County Budget comprising approximately 11% of the total budget. I will continue to pressure our state lawmakers to better manage Medicaid. Our state by far has the highest Medicaid expenses, including highest total amount, highest per recipient and highest per capita.”

2006 State of the County

“Medicaid is a concern but our Medicaid situation is in much better shape than it was a few years ago, thanks to the state Medicaid cap. But I feel it is important to note that even with the cap in place our costs increased by $1.7 million from 2004 to 2005 and they will continue to increase this year by approximately $1.2 million dollars.

The cap has been a tremendous help in planning for the future but everyone needs to remember this does not make our Medicaid problem disappear. It is still quite a drain on our local resources, comprising about 11 percent of our overall budget or about $34 million dollars a year.

That is why we need to work on continuing to reduce the Medicaid burden that exists for property taxpayers across New York State. This is not to say that those in need will be sacrificed or ignored. I absolutely do not believe that should happen.

However, the system and how it is administered by New York State is broken. It seems there is complete incompetence, fraud or both.

The New York Times reported last year that our Medicaid system which is quote-the most expensive and most generous in the nation-has been misspending billions as a result of fraud, waste and profiteering. This has got to be stopped.

I strongly advocate an aggressive approach to cracking down on fraud. That is why I sought to have Broome County become one of the first counties in New York State to join the Verify New York Program.

This program will enable counties like Broome to flag inefficiencies and billing irregularities. The demonstration project makes counties partners in the effort to detect, investigate and prosecute Medicaid provider fraud.

By participating in this project, we are not assuming there is fraud on the local level, however, if we do nothing, we will never know and I would rather take steps to protect the taxpayers’ dollars than simply hope there is not a problem.

This is not costing Broome County a dime and if any money is recovered as a result of fraud, we will share in those recovered funds.

I want to assure you that Broome County Security Department efforts, to investigate user fraud, will continue as well.”

2007 Budget Address

“In the 2002 resolution, lawmakers resolved that they would review the sales tax distribution formula, “…if within the next 5 years, New York State should assume the County share of Medicaid costs…”

Today I tell you that Broome County Government’s share of Medicaid stands at $33.7 million dollars and climbing. In my opinion, a nearly $34 million dollar Medicaid bill proves that the state has not “assumed the County share of Medicaid costs” and Medicaid remains a huge tax burden.”

2008 Budget Address

“Let me again reiterate, Broome county’s Medicaid problem is not fixed.”

“For anyone to say that the Medicaid is fixed is not only incorrect, it is irresponsible and a dangerous message to send to Albany.”

For full remarks visit: http://www.gobroomecounty.com/files/countyexec/pdfs/2008BudgetFinal.pdf

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Thank you Leigh Ann, for taking the time to write and bring to light Ms. Fiala’s efforts to contain Medicaid costs. As a taxpayer in Broome County, I appreciate her efforts. – Jim

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