Too Much Medicaid Messaging

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Medicaid, Medicaid, Medicaid.

How the cost of this program plays on the minds of local government leaders as they try to make ends meet.

You can’t turn around without seeing some county legislator or executive lament how the local share of this vastly growing social service program beats down their budget.

Look at Monroe County. You’ve seen the stories about how county leaders want to deal with a gap in the budget. Republicans want a sales tax increase. Democrats want to charge towns that use the sheriff’s department directly for the service. Behind it all – Medicaid.

And, boy, if the county doesn’t remind you about it – over and over again. That bad state government, says the county leader. They push that Medicaid cost on the counties and won’t control the spending. Albany allows that runaway freight train to run right over us.

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The Message with Sizzle

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The people who work in Albany will now be running from Albany to run for reelection.

Many from our region believe they are coming with good news in hand.

Assembly member Susan John proudly touts that she “delivers for Rochester.” She worked to get more state aid to the city and to the City School District.

Assemblyman Joe Morelle talks about how – as chairman of the  Assembly Committee on Tourism, Arts, and Sports Development, he’s “pleased that the Legislature approved $36 million for the multi-venue performing arts component of Rochester’s Renaissance Square project, as well as $5 million
for the construction of PAETEC Park, the new home of the Raging Rhino’s soccer

Senators Joe Robach, George Maziarz and Jim Alesi are thrilled to report that the budget has $15 million in aid to assist in the construction of a new student recreation center/multipurpose field house at SUNY Brockport.

Hey, even Governor George Pataki – the man who fumed about the veto overrides that kept in place a fatter state budget – is fine with taking credit for approving $26.5 million for school construction in Rochester.

Heck, you don’t get a guy like Pataki or, say, Assembly Speaker Sheldon Silver out to town on an announcement that Medicaid has been reformed. It’s much easier to announce a tangible item paid for by New York State aid (otherwise known as your money). Just a few years ago, for example, it was the announcement of the state aid for the Fast Ferry that brought Silver here.

And, by golly, it was an announcement of state aid that got Senate Majority Leader Joe Bruno to downtown Rochester in 2004.

I had a colleague who gave this advice when making any kind of presentation: Make sure it has sizzle.

To New York State lawmakers, it is the doling out of state money for projects and to local governments that “has the sizzle.” They believe this is what sells to the voter.

It put me in mind of something written by Jay Gallagher, the Albany Bureau chief for Gannett News Service. He posed a few questions in his column a few weeks back. Among them:

How can state lawmakers  hold down taxes by increasing spending well beyond inflation? How come we keep hearing that the state debt is huge, yet we still borrow more?

Aren’t these good questions to pose to state lawmakers when they start on the road to reelection? Don’t these have “sizzle?”


Playing the Press

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Scott McClellan stepped down from his job as press secretary to the Bush White House last week. The position as defined by McClellan seemed more like one of those blow-up, punching clowns we kids of the 1960s used to batter.

Jay Rosen, the New York University journalism professor and author of the excellent PressThink blog, saw the McClellan years as a watershed for the press relationship with an administration.

You should read it. But in short… he said the years of spinning the media are over. Instead, we now see the Bush administration engaged in a kind of press nullification. McClellan, famous for saying nothing and repeating talking points over and over, devalued the press by not dealing with it. There is some truth to this. And it’s not one that civic-minded folks should be happy to see.

This got me to thinking about other administrations – and how they deal with the press. There have been some differences.

Currently in the Rochester area we have two people heading up administrations who have an ease with the press. County Executive Maggie Brooks was, in fact, a television reporter in a former life. Her polish and poise in front of inquisitors has so far served her well. A test of her press savvy is on deck, however. She has proposed a sales tax increase and a potentially thorny trade-off of sales tax money for Medicaid expenses. We’ll see how she does (in fact, I’ll get a chance at lobbing a few questions her way on Friday when she visits the WXXI studios for Need to Know).

The new mayor, Bob Duffy, also has an ease with the press. The former police chief has dealt with camera and microphones and pads shoved underneath his rather large frame. He gives you a kind of “aw-shucks” demeanor and speaks in a rather soothing tone. He hasn’t had any real tests during his first few months. We’ll see how he wears when a crisis comes his way.

The communications folks for both Brooks and Duffy are basically letting their bosses do the message-giving. They aren’t shielding him. And, as far as I can tell, the spinning is subtle. It’s there but not divorced from the chief administrator. It comes straight from the person holding the office.

That wasn’t always the case with a former chief administrator around these parts – County Executive Jack Doyle. This was a man who didn’t appear to like being questioned. It wasn’t the content of the question that bothered him – instead it was the idea of a question being posed at all. His top communications guy for most of those years, a former Democrat and Chronicle reporter named John Riley, played a much stronger role in directly spinning reporters. This was an administration that didn’t enjoy a palsy-walsy relationship with reporters. And for the most part, they liked it that way.

Former Mayor Bill Johnson seemed to act as his own press person. He took questions head on. And when he didn’t like how he was being covered, he’d let you know. My guess is that people who work in government communications would have cringed at how Johnson would engage the press.

Then there is the current occupant of the governor’s mansion – George Pataki. Most of what I know about him comes from others who dealt with that administration on a direct basis. But all reporters in the state have engaged Pataki and his press people, especially during election years.

Pataki’s predecessor, Mario Cuomo, seemed much like Bill Johnson. He would engage the press. He would also demean the reporter if he thought the question was based on a shaky premise. An intimidator, but at least accessible.

I dare anyone to call Pataki accessible. The first person a reporter thinks of when it comes to Pataki is Zenia Mucha, a tough-as-nails advisor who kept guard on Pataki. It became the hallmark of the Pataki administration ( here’s a great piece that describes the difference by the Albany Times Union’s Jim Odato. As Odato put it, press conferences were rare, news came via press releases. On the campaign trail it was no different. Local reporters would put questions to Pataki and either you’d get a non-response or no response. I can remember during the 1998 campaign a number of us in Rochester got to Pataki after an election event at Strong Memorial Hospital. We wanted to ask about a topic he didn’t want to deal with (I couldn’t tell you what it was now if I tried). Pataki simply shut down and walked briskly to his car… even as reporters continued buzzing around him trying in vein to get an answer

I remember that day for the way it felt – like we were an annoyance. And how it may have appeared to onlookers – like we were a pack of dogs. This sounds a lot like what you might have seen on a daily basis in the White House Press Room with McClellan behind the podium.

Rosen may be right – that McClellan ushered in a new era of press relations in Washington. But I think an earlier practitioner of this press nullification could be found in Albany.

A Buffalo Stampede

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So who owns the Buffalo Bills?

The answer is Ralph Wilson. But one would get the feeling that this was a government-run entity with recent events.

As you no doubt have heard, Wilson says that the new NFL collective bargaining agreement jeopardizes the financial survival of the Bills and other small market football teams. Wilson now appears to be willing to consider moving the franchise, something he previously said he would never do. And it’s because of the sharing arrangement. So bad is the situation, said Wilson, that he needs help.

He needs political help. And what does he get?

A Buffalo stampede that would do Willis McGahee proud. Rep. Tom Reynolds wrote a letter that took up Wilson’s cause and sent it to 94 other congressional representatives. Rep. Brian Higgins wants a congressional hearing about the Bills plight. State Sen George Maziarz put a petition on his website… a petition directed to "Commissioner Tagliabue" (as in Paul Tagliabue). A petition that talks about the hardworking western New Yorkers who will "roll up our sleeves" to keep the Bills in town. "I support the Buffalo Bills," the petition ends. Erie County Executive Joel Giambra weighs in.  Gubernatorial candidate Bill Weld says that he will go "helmet to helmet" to make sure that we don’t get "sacked" by a Bills departure. U.S. Sen. Chuck Schumer does a press conference with Wilson. Then he has a pow-wow with Paul Tagliabue.

How quickly the elected officials line up. And how tough they talk. They will fight to keep an NFL franchise from leaving the area. After all we in upstate New York couldn’t possibly survive the loss of an NFL franchise. Sure there are other problems –  the struggles of upstate cities to pay for services… the inability to attract jobs upstate… the crushing taxes and government spending burdens for local governments and taxpayers… the performance of schools. But come on, this is the Buffalo Bills.

Sure… some would argue that the elected officials are simply jumping on a bandwagon that might get easy press attention and give them easy praise from the electorate. They might say that it’s far simpler to back the Bills than, say, put effort into Medicaid reform or workers compensation changes.

Why with that kind of reaction from the public officials, you would think that this was a publicly-owned football team. But it’s not. It’s Ralph Wilson’s team.

Wilson tells the press that he doesn’t want public money for a new stadium – or to make up what he says are going to be revenue shortfalls. That’s good. Because the last time a threat of moving was voiced by the privately-owned Buffalo Bills… the state coughed up $96 million improve the county-owned stadium that bears his name.

The claim of losses by the Bills is just that – a claim. It’s not like the team cracks open the books for public scrutiny. They aren’t publicly-owned. Not that they aren’t in a tough position (as Leo Roth of the Democrat and Chronicle points out nicely in his piece

This whole thing winds up being quite a statement about what it is that we value. If this were a manufacturing firm – it would not get nearly this kind of attention from the public… it would not receive these kinds of public displays by elected officials. And a few years back… the last time the team complained about its survival in Western New York… the state gave it millions to refurbish the stadium in Orchard Park. You don’t see that every day either.

The investment isn’t just lung power from fans on a fall Sunday. It appears to be tax money… and the time of our regional and statewide lawmakers.

But remember who owns the team – and who would gain from any sales of the team in the end.

Musings on a Sales Tax Hike: Duffy’s Sales Tax Advantage

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Rochester Mayor Bob Duffy has taken his first turn at commenting on the sales tax hike proposal by County Executive Maggie Brooks. And he basically gave it a pan.

Duffy said that raising taxes would be his last resort… implying that the county and Brooks haven’t met the threshold for hitting the "last resort."

This is interesting coming from a man who about a month or so ago went to Albany and pleaded for his "fair share" of money from New York State in the form of aid. He used a per-capita calculation to show that Rochester gets less in direct state aid than Buffalo, Yonkers and Syracuse… the other big cities outside of the Big Apple. As if he wasn’t asking for more taxes – state taxes.

But it gets you to thinking about this as well… Rochester gets far more in "aid" from the sales tax than those other cities. Just check out page 14 of State Comptroller Alan Hevesi’s report on sales taxes in New York State. Look at what cities got from the sales tax in 2004:
Buffalo: $60.7 million
Yonkers: $53.8 million
Syracuse: $49.3 million
Rochester: $86.5 million

Now, I’m not sure what population measure the city used to derive their per capita comparison when it comes to state aid… (although it showed Rochester getting less than the other cities). But let’s use the census number for population and the above sales tax take:
Buffalo: $207
Yonkers: $275
Syracuse: $335
Rochester: $394

Why I would expect Buffalo’s Mayor Byron Brown to be storming the state capitol asking for parity any day now. After all, it is the state legislature that enacted the sharing arrangement for sales tax in Monroe County. And sales taxes on the local level must be approved by state lawmakers.

We all know why this is the case – because (as the Hevesi report showed again) Monroe County’s sharing arrangement is, by far, the most generous to county municipalities.

We should note that Duffy complains about the Brooks plan even as it provides more in sales tax money down the line. Interesting. And you might want to clip this and save the numbers above. Should the city want to negotiate with the Brooks administration – and want more… we all should refer to the figures.

Musings on a Sales Tax Hike: What’s With the Doomsday Cuts?

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The dire choices presented by Brooks had she opted to cut services. She told the assembled in the County Office Building last Thursday that to cut the programs necessary to balance the books would have been… well, draconian. She talked about ending the road patrol service. She talked about closing the zoo… closing the parks. (Check here for her complete list – it’s on page 3)

This is as if she couldn’t scale back on some or all of these programs. Why end them? Why give us the all or nothing scenario? That is, of course, about making a point using drastic means.

Brooks told us that her administration has done all it could to make cuts. The question is… does the electorate really believe this?

Musings on a Sales Tax Hike: Brooks Hatred for Taxes

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It was interesting to watch County Executive Maggie Brooks try and maintain her image as a conservative on taxes while calling for this increase. At one point during the question and answer session – she said something even more amusing – that she hated taxes… hated them. As if she hated all taxes.

Going over the top is a tried and true method of getting the basic point home (which was that she hates increasing taxes). And maybe her line was a subtle misstatement. But it makes you laugh just the same – this notion of "hating taxes."

Government doesn’t exist but for the raising of taxes. Of course, taxation is a relative way for the collective being served to pay for services that they benefit from. Hating all taxes would mean hating the funds that pay for garbage collection, sewer pipe repairs, the cop on the beat or the program that pays for Aunt Jenny to get long term nursing care.

That’s not to say that government shouldn’t grapple with how much it’s collecting and how much it’s spending. And, frankly, in New York State… that argument about the basic work of government and how much it should collect to pay for it has long stalled out. That gets me to my next thought…

Musings on a Sales Tax Hike: The Intercept Prod

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The sales tax intercept that we’ve been writing about in this space has been tabbed by County Executive Maggie Brooks. She called it a gift from Albany, the way that state government has given county governments a solution to the Medicaid cost crunch.

The other way to view this is that the intercept may be the way to get state government to finally look at the Medicaid cost.

State lawmakers have found it easy to expand Medicaid because a) it means getting more federal aid from the match that the feds pay in Medicaid and b) because the local counties share the cost. No direct pain, no need to change. Maybe the state will finally look at cost cutting for Medicaid if they take more of it on.

Wouldn’t that be a novel approach by government – cost cutting.

More From Tom Suozzi

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If you caught WXXI’s Need to Know program on April 14 at 9 p.m. you saw part of our interview with Tom Suozzi, the outsider running for the Democratic nomination, and current Nassau County Executive.

If you want to hear more from Suozzi click right here for a continuation of our conversation with the man who wants to challenge Eliot Spitzer for the Democratic nomination.

During the talk, Suozzi shoves Medicaid fraud in his rival’s face. "Eliot Spitzer has not made a priority of going after Medicaid fraud," he said in WXXI’s studios.

Suozzi again pushed his plan for finding $5 billion in savings from the state budget. Part of that plan goes right at unions in the state – cutting the workforce by 10 percent. You can see the results of one Suozzi squabble with a union here. You should also click here to see how Suozzi blames the clash with the Nassau PBA partly on Spitzer.

Suozzi also says state spending is a problem but won’t freeze it. And listen for when he talks about
alienating top leaders in Albany.

Accepting the Gift

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The Maggie Brooks budget solution has just a hint of Joel Giambra and Erie County, doesn’t it?

That sales tax hike comes as a last resort, said Brooks during her Thursday announcement. It’s the only way to cover up the $102 million county budget gap, she said.

So you must recall that in late 2004, Erie County Executive Joel Giambra proposed a penny hike in the sales tax as a way to close up Erie County’s budget hole. (This space in its former home called it "The Ghost of Erie County"). That initial sales tax increase was rejected. But in January 2006, Erie County leaders and the state finally bought into a 3/4 quarters of a penny hike. That’s what Brooks proposes to add on to Monroe County’s sales tax.

Of course, timing is everything.

When Giambra made his call, he came armed with a doomsday budget scenario – give me a sales tax hike or you get massive cuts. They call it the red-green budget debate. This sparked quite a backlash.

And he didn’t have "the gift."

That’s what Brooks called the Albany-created swap known as the sales tax intercept. The program where counties can give away some of their sales tax money in exchange for giving away the requirement to pay into Medicaid. She hardly sounded like a kid at Christmas when this idea for accepting the trade was first announced n March, remember?. But, coupled with the sales tax hike that will make the city, the towns, villages and school districts whole, the intercept is a box wrapped with a bow.

No such present for Giambra back then. Just loads of criticism.

Much of that criticism centered around the fact that when Giambra first came into office, the Erie County Executive slashed property taxes by some 30 percent.

But here’s an interesting thing. Monroe County also cut property taxes in the mid to late 1990s and into the early years of 2000. At least if you take it from the view that County Executive Brooks now holds.

Brooks’ predecessor often said he froze the property tax. But Jack Doyle meant the total amount of property taxes collected. Brooks has changed that definition. She, too, says she holds the line on taxes. But she means the property tax rate. This may sound esoteric. But it’s important.

Using the Brooks method of viewing the property tax, Doyle actually cut taxes by roughly 8 percent from the time he took over to the time he left. Now that reduction isn’t the same size as Giambra’s. But it’s interesting how a definition of how to measure property tax growth can, well, alleviate criticism.

I mean, imagine if Democrats started going after Brooks and Doyle for cutting property taxes and digging some of that fiscal hole themselves.

And it is interesting to note the Democratic proposal to combat the shortfall. The centerpiece is charging back use of the sheriff’s road patrol to towns that use it. Some municipalities have their own police department and so don’t use the sheriff patrols. But they pay for the service.

But that’s a painful approach. Town budgets would surely suffer. Just as the sales tax intercept proposal alone would have been painful to municipalities who share in the tax proceeds.

Hiking that sales tax, however, appears to be a pain reliever. At least for Brooks and her predicament.

Giambra laid out the pain relieving formula of sales tax hikes back in 2004 when he gave his budget choices… the tax hike or the doomsday budget. 

Perhaps when it comes to these situations, it’s all in the timing and the presentation, I suppose.

But something tells me we’re still in for the same kind of battle Erie County residents saw a few years ago.