NNY Business August 2013

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Y usIness // ANNUAL HEALTH CARE ISSUE

AUGUST 2013 Volume 3 No. 9

nnybizmag.com

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Busin ess Sc ene, Biz Te ch Busin , Small ess, N NY Snaps hot.

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THE INTERVIEW

FDRHPO Director Denise K. Young p. 54

INVESTING IN CARE $2.95

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>> Inside AUGUST 2013

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COVER STORY |

20 BUIDLING BETTER CARE North country hospitals have embraced the latest technology to meet health care needs. |

SMALL BIZ STARTUP

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19 PENNING AN IDENTITY Mike’s Pig Pen, the former Harby’s Hots, boasts a similar menu, but adds character. |

HEALTH CARE |

30 THE ACA AND YOU What the Affordable Care Act means for businesses and individuals. 34 A ‘GRAYING’ AREA The region works to meet the demands of aging residents. 37 CARRYING THE TORCH Guilfoyle Ambulance has strengthened in the wake of its matriarch’s death.

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FEATURES |

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ECONOMY |

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REAL ESTATE |

44 QUALITY REIGNS Painfull Acres Amish furniture has a reputation for unrivaled craftsmanship. 44 Q2 SALES TAX Collections post gains in St. Lawrence, Lewis counties, but drop in Jefferson.

26 ROBOTICS’ REACH Samaritan’s $2.5m DaVinci robot system has radically increased surgical precision.

38 A NATIVE VISION Dr. Toby Cosgrove of the Cleveland Clinic advocates consolidation and prevention.

49 SALES SHOW STRENGTH Second-quarter home sales remain strong, but have lost momentum over 2012.

28 ER UPGRADES Investments in its ER are paying off to improve patient wait times, care at Samaritan.

42 A SPORTY SURGEON Dr. Peter Van Eenenaam has found his niche treating athletes at all levels of play.

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BUSINESS HISTORY |

60 A CASINO IN NAME ONLY Clayton Casino, razed in ’08, was once a popular club. August 2013 | NNY Business

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INTERVIEW

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ON THE COVER

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42 TOGETHER FOR CHANGE Denise K. Young, director of the Fort Drum Regional Health Planning Organization, sees value in using data to analyze trends and leverage resources to improve health care. |

COLUMNS

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58 ECONOMICALLY SPEAKING 59 BUSINESS LAW 60 COMMERCE CORNER |

DEPARTMENTS

12 13 14 16 19

61 AGRI-BUSINESS 62 BUSINESS TECH BYTES 63 SMALL BUSINESS SUCCESS

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EDITOR’S NOTE PEOPLE ON THE MOVE ECONOMIC SNAPSHOT BUSINESS BRIEFCASE SMALL BIZ STARTUP

48 64 66 74 76

REAL ESTATE ROUNDUP CALENDAR BUSINESS SCENE BUSINESS HISTORY WHAT’S HAPPENING HERE?

For this month’s cover shot, photographer Amanda Morrison went behind the scenes in Samaritan Medical Center’s robotics surgical suite to capture the hospital’s $2 million da Vinci robotic surgery system, which surgeons began using in November. Amanda used a Nikon D700 with a 17mm lens, 500 ISO, f/2.8.

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CONTRIBUTORS

BusIness www.nnybizmag.com

Chairman of the Board John B. Johnson Jr.

Brian Bund is assistant vice president for the New York Business Development Corp. He writes about various alternative financing options for businesses. (p. 58)

Larry Covell is a professor of business at SUNY Jefferson and an attorney. He discusses the pros and cons of forming a limited liability partnership. (p. 59)

Lynn Pietroski is president and CEO of the Greater WatertownNorth Country Chamber of Commerce. She provides guidance on giving effective oral presentations. (p. 60)

Publishers

John B. Johnson Harold B. Johnson II

Magazine Editor

Kenneth J. Eysaman

Magazine Staff Writer Leah Buletti

Advertising Directors Karen K. Romeo Tammy S. Beaudin

Jay Matteson is the agricultural coordinator for the Jefferson County Industrial Development Corp. He discusses the obstacles farms face in providing health insurance. (p. 61)

Jill Van Hoesen is chief information officer for Johnson Newspapers and a 25-year IT veteran. She writes about the use of web portals and mobile apps in patient care. (p. 62)

Michelle Collins is an advisor for the state Small Business Development Center at SUNY Canton. She discusses some of the benefits of the ACA for small businesses. (p. 63)

Magazine Advertising Manager Matthew Costantino

Circulation Director Mary Sawyer

Photography

Norm Johnston, Justin Sorensen, Jason Hunter, Melanie Kimbler-Lago, Amanda Morrison

Ad Graphics, Design

Rick Gaskin, Brian Mitchell, Heather O’Driscoll, Scott Smith, Todd Soules Lance M. Evans is executive officer for the Jefferson-Lewis and St. Lawrence County Board of Realtors. He writes about the health benefits of home ownership. (p. 48)

Rebecca Madden is a Johnson Newspapers staff writer. In this month’s cover story, she discusses the various technology in use by north country hospitals. (p. 20)

Norah Machia is a veteran Watertown Daily Times reporter. She writes about Dr. Peter Van Eenenaam’s innovative Watertown orthopedic practice. (p. 42)

MARKETPLACE Advanced Business Systems ....... 67 AmeriCU Credit Union ..................... 4 Ameriprise/ Ken Piarulli ................ 29 Bach & Company ......................... 51 Bay Brokerage ............................... 31 Bayview Shores Realty ................. 50 Beardsley Design .......................... 76 The Blue Heron .............................. 73 Jeff-Lewis BOCES ..................... 23, 27 Bolton’s Pharmacy ........................ 13 C & M Auto ..................................... 12 Canton-Potsdam Hospital ............ 11 Carthage Area Hospital ........... 9, 22 Dr. Vincent Cesario, DDS .............. 79 Children’s Home of Jefferson County ........................... 45 CITEC Manufacturing .................... 56 Clayton Dental Office ................... 39 Coleman’s Corner ........................ 73 The Computer Guys ...................... 62 Credo Community Center ........... 16 D Laux Properties .......................... 50 Dano’s Pizzeria .............................. 73 Development Authority of NC....... 60 Fairfield Inn & Suites ...................... 80 Fairgrounds Inn .............................. 73 Foy Agency ................................... 45 Fuccillo Automotive ...................... 12

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Lori Gervera Real Estate ............... 50 Guilfoyle Ambulance ..................... 6 Haylor, Freyer & Coon .................. 33 High Tower Advisors ...................... 25 Hilton Garden Inn .......................... 73 Howard Orthotics .......................... 58 Innovative Physical Therapy ........ 59 Ives Hill Retirement ........................ 18 Jefferson County IDA .................... 75 J Fins Restaurant ............................ 73 KIMCO Steel Sales .......................... 2 LaClair Family Dental .................... 57 Lofink Ford ...................................... 66 LTI .................................................... 37 Macars ........................................... 18 Marra’s Home Care ...................... 68 Marceau Paving .......................... 51 Massey’s Furniture Barn ................ 49 Meade Optical .............................. 43 MediSpa at Center for Sight ......... 71 Richard J. Meagher ...................... 17 Moe’s Southwest Grill .................... 73 MRVO Stations............................... 51 NNY Community Foundation ....... 40 North Country Urgent Care .......... 70 O’Brien’s Restaurant ...................... 73 Painfull Acres ................................. 17 Phinney’s Automotive ................... 12

NNY Business | August 2013

Dr. Dale S. Porter ............................ 46 River Hospital ................................. 39 Samaritan Medical Center ............ 3 SeaComm Federal CU ................. 47 Shred Con ...................................... 63 Sideline Promotions ...................... 12 Slack Chemical ............................. 61 Stafford Piller .................................. 52 SUNY Potsdam ............................... 17 Syracuse Orthopedics .................. 35 The Scrub Hub ............................... 36 Three C Limousine ........................ 78 Thousand Islands Realty ............... 50 Tilted Kilt ......................................... 73 Dr. Paul Vanier ................................ 32 Waite Motor Sports ........................ 72 Waite Toyota .................................. 69 Walmart Pharmacy ....................... 53 Walmart Vision Center .................. 57 Washington Summit .... 29, 36, 40, 41 Watertown Chamber .............. 45, 52 Watertown Dental ....................... 5, 8 Watertown Local Development Corp. ...................... 48 Watertown Savings Bank .............. 24 Wells Communications ................ 75 WRVO Stations ............................... 51 WWTI TV 50...................................... 77

NNY Business (ISSN 2159-6115), is published monthly by Northern New York Newspaper Corp., 260 Washington St., Watertown, NY 13601, a Johnson Newspaper Corp. company. © 2010-2013. All material submitted to NNY Business becomes property of Northern New York Newspaper Corp., publishers of the Watertown Daily Times, and will not be returned.

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12 issues are $15 a year and 24 issues are $25 a year. Call 315-782-1000 to subscribe.

Submissions Send all editorial correspondence to keysaman@wdt.net Advertising For advertising rates and information in Jefferson and Lewis counties, email mcostantino@wdt.net, or call 315-661-2305 In St. Lawrence County, e-mail tbeaudin@ogd.com, or call 315-661-2512 Printed with pride in U.S.A. at Vanguard Printing LLC, Ithaca, N.Y., a Forest Stewardship Certified facility. Please recycle this magazine.


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EDITOR’S NOTE his month we are proud to deliver our largest issue to date. At 80 pages, you might want to put some coffee on because you’re in for a longlasting treat. In this, our annual health care issue, you’ll find stories about issues that impact nearly all who live and work in the north country. From staff writer Rebecca Madden’s look at what Northern New York hospitals are doing to improve care and her report on Samaritan Medical Center’s new robotic surgery system, to staff writer Leah Buletti’s examination of federal health care reform, I offer you one simple guarantee: you will learn something new about business in the north country before you close the cover on this issue. As always, feel free to drop me a note with your feedback to keysaman@wdt.net. I look forward to hearing from you. 20 QUESTIONS — We are pleased bring you a conversation with a remarkable woman whose own drive to public service is matched only by her grit and determination to improve our region’s health care system. Denise Young, executive director of the Fort Drum Regional Health Planning Organization, has served with the agency nearly since its inception. She was the agency’s first fulltime staff member and now leads a cadre of professionals who are driven to improve the quality of life for all who call the north country home. Our interview with Denise begins on page 54. BUSINESS SCENE — This month’s Scene section, which begins on page 66, features 59 faces from more than three-dozen north country businesses and organizations. On July 18, we joined the Greater WatertownNorth Country Chamber of Commerce for its July Business After Hours at Ives Hill Retirement Community. On July 24, magazine staff writer Leah Buletti visited the Greater

(315) 661-2399 or 1 (800) 724-1012

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NNY Business | August 2013

Watertown-North Country Chamber of Commerce Farm & Craft Market along Watertown’s Washington Street. The next day, we joined the Greater Watertown Jaycees for its 2013 EMERGE NNY Summit at Best Western Carriage House Inn & Conference Center. Congratulations to Cortel Improvement for delivering a great series of presentations to some fine young north country leaders. On July 28, we crossed the bridge to Wellesley Island for the River Hospital Foundation Annual Festive Evening. Our hat’s off to those who helped plan and Ken Eysaman organize the traditional river event at the Thousand Islands Club Restaurant. Since its inception in 2003, the foundation’s Festive Evening has raised nearly $1 million. On July 30, our friend and CarthageLowville Editor Jeremiah Papineau joined the Carthage Area Chamber of Commerce for Business After Hours at the Pleasant Night Inn in West Carthage. Congratulations to the Patel family for its recent purchase of the hotel. Finally, on Aug. 1, we joined Credo Community Center for the Treatment of Addictions as it celebrated 40 incredible years of service in the north country. Were it not for the perseverance, strength and love so generously shared by Credo co-founders the Rev. Ray Wertman and Edie Marsala, many would not be living well today. Thank you and congratulations once again on 40 years of service. Yours in business,


PEOPLE ON THE MOVE Vigliotti joins staff at Clayton Dental Office

Dr. Stephan Vigliotti has joined the staff at the 1000 Islands Center of Dental Technology at Clayton Dental Office, Dr. Scott LaClair recently announced. A 2011 graduate of the University at Buffalo School of Dental Medicine with a minor in endodontics, Dr. Vigliotti Vigliotti remained in the Buffalo area for completion of his residency, followed by a year in private practice in Orchard Park in Erie County. Dr. Vigliotti and his wife, Caitlin, grew up in the area, graduating in 2003 from General Brown and Thousand Islands high schools respectively. “The return of Stephan to the Thousand Islands with his family is fantastic; it is so hard to get young professionals to settle in Northern New York,” Dr. LaClair said. “Having Stephan and Caity back is exciting, but having him return to work with me is a great honor.” Dr. Vigliotti has begun work in Clayton. He lives in Clayton with his wife and son, Michael.

Firm adds three new employees

Barton & Loguidice, PC, has expanded its Watertown office with the addition of three new employees. Steven J. Olmstead has rejoined the firm in the Watertown office as a senior project engineer in the water-wastewater group. Mr. Olmstead was employed with B&L at the firm’s main office in Syracuse prior to his relocation to Lewis County in 2005. He returns to B&L with over 20 years of experience. Since 2005 he has worked throughout the north country in engineering and construction and since 2009 he has managed a small consulting firm that provides design and construction management services for water, wastewater, site planning and residential and commercial buildings. Mr. Olmstead is a graduate of Clarkson University and SUNY Cortland. Jeffrey E. Robinson has transferred to the Watertown office from the Syracuse office. He is relocating from Liverpool back to his home town of LaFargeville and is an engineer in the firm’s facilities group. Lucas J. Tabolt has joined the firm as an

engineer in the water/wastewater group. A resident of Liverpool, Mr. Tabolt graduated from Clarkson University and will split his time between the Watertown and Syracuse offices.

Honored as financial executive of year

Dale Corsa, chief financial officer at the Antique Boat Museum, was recently named a 2013 Financial Executive of the Year honoree by BizEventz, in conjunction with the Central New York Business Journal. Ms. Corsa joined the museum in 2008 as an accountant before later Corsa being named CFO. She previously worked for the Thousand Islands Bridge Authority. Since being named CFO, Ms. Corsa has played a fundamental role in the growth and progress of the ABM in areas such as project planning, ensuring positive yearend results, renegotiations and institutional budgeting. BizEventz and the Central New York Business Journal recognized Ms. Corsa and 14 other honorees from throughout the Central New York region in June at the SRC Arena in Syracuse.

Bernier, Carr announces summer intern class

Eight students from six colleges and universities across New York state are participating in the 2013 Bernier, Carr & Associates summer intern program. The interns are assisting in design and construction management of municipal, healthcare and K-12 school projects. The interns are: Dylan T. Morrow, a senior at Clarkson University and a mechanical engineering major; Scott E. Green Jr., a sophomore at Clarkson University and a mechanical engineering major; Ryan R. Eagles, a senior at Clarkson University and a civil engineering major; Payge E. Lehman, a senior at SUNY Cortland a physical education major; Robert J. Ingerson, a graduate of Jefferson Community College now enrolled at SUNY Brockport and a physical education major; Michael C. Patterson, a senior at the University at Buffalo and a civil engineering

Please see People, page 18

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ECON SNAPSHOT

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Economic indicators Average per-gallon milk price paid to N.Y. dairy farmers June 2013 $1.83 May 2013 $1.73 June 2012 $1.51

21.2%

(Percent gains and losses are over 12 months)

Vehicles crossing the Thousand Islands, OgdensburgPrescott and Seaway International (Massena) bridges

Source: NYS Department of Agriculture

461,633 in June 2013 443,233 in May 2013 474,032 in June 2012

Average NNY price for gallon of regular unleaded gas

Source: T.I. Bridge Authority, Ogdensburg Bridge & Port Authority, Seaway International Bridge Corp.

June 2013 $3.66 May 2013 $3.66 June 2012 $3.66

U.S.-Canadian dollar exchange rate (Canadian dollars per U.S. dollar)

Average NNY price for gallon of home heating oil

$1.05 on June 22, 2013 $1.04 on May 22, 2013 $1.03 on June 23, 2012

June 2013 $3.62 May 2013 $3.70 June 2012 $3.69

1.9%

2.6%

2.0%

Source: Federal Reserve Bank of N.Y.

Average NNY price for gallon of residential propane

Nonagriculture jobs in the Jefferson-Lewis-St. Lawrence counties area, not including military positions*

June 2013 $2.82 May 2013 $2.91 June 2012 $3.09

90,900 in June 2013 91,100 in May 2013 91,000 in June 2012

8.7%

1.1%

Source: NYS Energy Research and Development Authority

Source: NYS Department of Labor

Jefferson-Lewis Board of Realtors single-family home sales

St. Lawrence Board of Realtors single-family home sales

118, median price $155,000 in June 2013 75, median price $141,000 in May 2013 110, median price $124,750 in June 2012

54, median price $89,200 in June 2013 51, median price $73,000 in May 2013 56, median price $88,800 in June 2012

7.3% Sales

24.2% Price

Source: Jefferson-Lewis Board of Realtors Inc.

3.6% Sales

0.45% Price

Source: St. Lawrence Board of Realtors Inc.

NNY unemployment rates* Jefferson County

June ’13 May ’13 June ’12

8.8% 9.0% 9.4%

St. Lawrence County June ’13 May ’13

9.6% 9.2%

June ’12

10.8%

Lewis County June ’13

9.0%

May ’13

9.3%

June ’12

9.5%

Source: New York State Department of Labor (Not seasonally adjusted. Latest available data reported.) * Latest available data reported due to annual data updates at the New York State Department of Labor. Note: Due to updates in some “Econ. Snapshot” categories, numbers may differ from previously published prior month and year figures.

NNY Business | August 2013


NNY

Economic indicators New automobiles (cars and trucks) registered in Jefferson County Cars 551 in June 2013 526 in May 2013 437 in June 2012

26.1%

Trucks 167 in June 2013 122 in May 2013 101 in June 2012

65.3%

Source: Jefferson County Clerk’s Office

Passengers at Watertown International Airport

Open welfare cases in Jefferson, Lewis and St. Lawrence counties

3,303 inbound and outbound in June 2013 3,350 inbound and outbound in May 2013 2,765 inbound and outbound in June 2012

2,007 in June 2013 2,054 in May 2013 1,899 in June 2012

5.7%

19.5% Source: Jefferson County Board of Legislators

DBA (doing business under an assumed name) certificates filed at the Jefferson County Clerk’s office June 26 to July 31, 2013. For a complete list of DBAs filed in past months, visit us at WWW.NNYBIZMAG.COM.

JULY 31: D J Joe, 217 E. Main St., Brownville, Adam Joseph Shields, 217 E. Main St., PO Box 782, Brownville. JULY 30: Troy’s Trash and Junk Removal, 24467 White Road, Watertown, Troy M. Kaiser, 24467 White Road, Watertown. State Street Wines & Liquors, 804 State St., Watertown, Mark J. Bonner, 261 Franklin St., Watertown, and Vina Aileen Bonner, 261 Franklin St., Watertown. JULY 29: NNY Massage, 156 Clinton St.,Watertown, Melissa Sue Jordal, 28150 State Route 12, Watertown. JULY 26: Evident Truths, 22455 Apt. 12 Colonial Manor, Watertown, Avery L. Carman, 22455 Apt. D12 Colonial Manor, Watertown. JULY 25: Haynas Workshop, P 10730 A, Fort Drum, Hyang Mi Winkempleck, 504 Adelaide St., Carthage. Lee Nails, 21182 Salmon Run Mall, Watertown, Jimmy Nguyen, 851 Coffeen St., Watertown. Iron Paws Auto Repair, 34499 state Route 63, Deferiet, Troy M. Filiatrault, 34499 state Route 63, PO Box 64, Deferiet. The Rat Pack Shack, 34499 state Route 3, Deferiet, Gladys M. Palladino, 40 Wilna Ave., PO Box 184, Deferiet. JULY 24: CK Construction, 173 Maple St., Black River, Kim Martin Stone, 173 Maple St., Black River. Percision Painting & Drywall, 411 Main St., Theresa, Jeremy Reynolds, 411 Main St., Theresa, and Nick Forbes, 1757 State Highway 58, Edwards. JULY 23: Daniel T. Kelly Services, 814 Sherman St., Watertown, Daniel T. Kelley, 814 Sherman St., Watertown. Sand Bay Cattle Company, 36394 state Route 12E, Clayton, Raymond J. Healy Jr., 36394 state Route 12E, Clayton. JULY 22: Lyle’s Lamps & Clocks, Wellesley Hotel, Thousand Island Park, Allen A. Lyle, 42924 St. Lawrence Ave., Thousand Island Park. Ninjas Against Animal Cruelty, 604 Pine St., Watertown, Julie Bush, 604 Pine St., Watertown, and Jennifer Hartz, 215 Haley St., Watertown. Country Girl Cleaners, 7029 Hogsback Road, Harrisville, Barbara Jean Trahan, 7029 Hogsback Road, Harrisville. JULY 19: S&L Tree and Stump, 780 W Main St., Watertown, Lorrie A. McFarland, 23319 Road 1008, Dexter. JULY 18: Tru Ax Construction, 36275 Amend Road, LaFargeville, Jordan W. Smith, 36275 Amend Road, LaFargeville and Brooke Haukaas, 34854 Snell Road, Theresa. Upstate Towing and Recovery, 413 Factory St., Watertown, Ricky E. Frazier, 23960 White Road, Watertown. JULY 17: Renegades Automotive & Towing, 24619 Gonseth Road Apt. 2, Calcium, Lisa Marie Harding and Shaun M. Howland, 24619 Gonseth Road, Apt. 2, Calcium.

JULY 15: Orleans County Cutters Hair and Tanning Salon, 36331 state Route 180, LaFargeville, Kendra Cole, 36331 state Route 180, LaFargeville. JULY 11: Limerick Photography, 43618 state Route 3, Natural Bridge, Jennifer R. Limerick, 43618 state Route 3, Natural Bridge. Sew Darlin, 16791 County Route 76, Adams Center, Linda L. Elliott, 16791 County Route 76, Adams Center. JULY 10: BGC Squeky Clean, 31727 U.S. Route 11, Philadelphia, Nancy Junn, 31727 U.S. Route 11, Philadelphia. Booth Builders, 19219 Route 3, Watertown, Christopher Booth, 19219 Route 3, Watertown. Scents & Sentiments, 35033 Eddy Road, 24 Indian River Estates, Theresa, Janelle Jo Longton, 35033 Eddy Road, 24 Indian River Estates, Theresa. Nickles Trash Service, 35065 Countryman Road, Theresa, Michelle Nickles and Troy Nickles, 35065 Countryman Road, Theresa. JULY 9: AES Contracting, 26142 Allen Drive, Watertown, Anthony E. Secreti, 26142 Allen Drive, Watertown. JULY 8: Sy Creative Eye Photography of Northern NY, 254 N. Hamilton St., Watertown, Steven Mark Gebo, 254 N. Hamilton St., Watertown. Behind the Lens: Photography by Kelly, 29641 County Route 50, Black River, Kelly Lynn Robertson, 29641 County Route 50, Black River. JULY 5: Katrina Thomas, 324 Gale St., Watertown, Katrina S. Thomas, 324 Gale St., Watertown. JULY 3: Woodward Contracting, 621 Mundy St., Watertown, Steven R. Woodward, 621 Mundy St., Watertown. JULY 2: Lotus Yoga, 244 Clinton St., Watertown, Michele Deeney, 244 Clinton St., Watertown. Thousand Islands Dance Studio, 43 James St., Alexandria Bay, Marjorie A. Ely, 47189 County Route 1, P.O. Box 24, Redwood. JULY 1: Christian M. Photography, 109 Mechanic St., Antwerp, Christian Matthew Grabowski, 109 Mechanic St., Antwerp. Alyce Hattie Bea, 840 Edwards St., Carthage, Alexis L. Kadleck, 840 Edwards St., Carthage. JUNE 26: Belle Bearth, 23304 Fernwood Drive, Black River, Michelle R. Kluczinske, 23304 Fernwood Drive, Black River. Black Minds Promotion – B. M. P., 218 Stuart St., Watertown. Jamie L. Navarra, 218 Stuart St., Watertown. Jake Colins Designs, 10503 Wright St., Adams, Jacob Widrick, 10503 Wright St., Adams. Linda’s Specialty Breads & Muffins, 109 Church St., Alexandria Bay, Linda M. Musacchio, 109 Church St., Alexandria Bay.

TRANSACTIONS

DBAs

Source: Social Service Depts. of Jefferson, Lewis and St. Lawrence counties

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BUSINESS BRIEFCASE Lori Gervera partners with Keller Williams

Lori Gervera Real Estate, Watertown, has partnered with Keller Williams Realty, International, which has about 700 offices and more than 80,000 associates worldwide. Ms. Gervera said in a statement that the franchise partnership will give her team the opportunity “to better serve their customers and clients with the latest in cutting edge technology and specialized services new to the area.” The real estate company has been in business in Watertown since 1993 and has four licensed real estate salespeople in addition to Ms. Gervera.

ing time is also expected to be expedited because the laser makes a self-healing wound unlike that made with the blade used in traditional cataract surgery. “We are excited to be the first cataract practice in central and Northern New York to offer this procedure, even before any practice in Syracuse,” said Dr. Noaman Sanni, an ophthalmologist at the practice. “I feel this is the future of cataract surgery, where we combine the computerized femtosecond laser and traditional cataract surgery to give our patients the best results.” Visit www.centerforsightnny.com to learn more.

St. in Potsdam, celebrated its re-opening July 10 after closing last July for repairs following a windstorm that tore off the restaurant’s roof. State Sen. Joseph A. Griffo, R-Rome, visited the restaurant to mark the occasion. Owner Sam Spagnolo operated Sergi’s out of a smaller temporary location at 38 Market St. during the year of repairs, which included gutting and rebuilding the interior in addition to replacing the roof. The menu and décor, however, remain the same. The adjacent banquet hall is expected to open this month as it needed a few more weeks of repairs than the restaurant.

Knotty Pine restaurant Children’s Home to hold foster parenting Center for Sight pioneers celebrates re-opening The Knotty Pine restaurant in Thendainformation session cataract surgery tech ra opened for the season on June 21 un Center for Sight, Watertown, early this month added the first computerized femtosecond laser for cataract surgery in Central and Northern New York, a device expected to radically improve the procedure’s precision and success. The LenSx Laser allows a computer to make a fully customized map of the patient’s eye, which forms the basis of a unique treatment plan. Previously, all cataract surgery patients received the same lens implant and procedure with hand-held instruments. The laser also makes cataract surgery less traumatic to the eye, eliminates complications caused by patients who may move or flinch during the procedure and allows the surgeon to correct astigmatism with the laser while removing the cataract. Patients are not expected to need glasses or contacts following cataract surgery with the LenSx procedure and heal-

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NNY Business | August 2013

der the new management of Kristen and Travis Fata, who moved to Old Forge from the Binghamton area. The restaurant, which serves American cuisine, celebrated a grand re-opening and ribbon cutting on July 5. Mr. Fata is serving as the restaurant’s new bartender and operations manager, while Mrs. Fata is the business manager and hostess. Combined, the couple has more than 30 years of experience in the hospitality industry. The Knotty Pine, located one mile south of downtown Old Forge on Route 28, is open from 4 to 10 p.m. Monday through Saturday. Visit www.theknottypine.com or call 369-6859 to learn more.

Potsdam Italian eatery re-opens after storm

Sergi’s Italian Restaurant, at 10 Market

The Children’s Home of Jefferson County will hold an information session about foster parenting at 6 p.m. Tuesday, Aug. 27, in its Campus Dining Hall, 1704 State St., Watertown. Anyone interested in learning more about becoming a foster parent or learning about the agency’s various types of foster care is welcome to attend. Foster care program staff will be available to answer questions. Light hors d’ouevres will be served. A 10-week training class starts Tuesday, Sept. 10 for those who decide to begin the process to become a foster parent. Contact Kelly Sanford, foster care recruitment and training coordinator, 788-7430, ext. 3128, or ksandord@nnychild renshome.com to learn more.

Revitalizing Philadelphia A project under way in Philadelphia


BUSINESS BRIEFCASE aims to encourage more businesses to open in the area by transforming a walking bridge across a small island on the Indian River from the village downtown to the Kent Lane Park and Philadelphia Primary School area alongside Route 11. Trees will come down so businesses will be visible when looking through to Main Street on Route 11, said Matthew J. Montroy, mayor since 2009. After four years of planning, the village is putting final touches on a $459,083 project to build Gateway Island Park. Mid-way across the bridge will be a 568-square-foot, semicircular deck with benches. Lighting will be installed and aluminum railings will replace a chainlink fence. Bronze signs will greet people, who will be able to lock their bicycles at either end of the walkway. The newly landscaped island itself will not be accessible for public safety reasons, although it will showcase a large statue and flagpole. Steps from the bridge onto the island as shown in architectural renderings will be for workers only. The project hatched by village planners in 2009 was made possible by a $351,000 grant from the state Office of Parks, Recreation and Historic Preservation. The village will be responsible for matching 25 percent, or $87,750, of that grant. The remaining $108,083 of the cost will come from the village revitalization fund, which contains about $1 million. That money was acquired over the years from the sale of the village’s hydroelectric plant on Gardner Road, which is now owned by Fortis U.S. EnergyCorp., Newfoundland. Mr. Montroy said the blueprint for the project is being finalized by Bernier, Carr & Associates, Watertown. It is expected to get final approval soon from the state parks office, which would enable construction work to be put out to bid this fall. Workers are expected to break

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ground on the project in the spring. The large statue to be exhibited on the island will be paid for as an additional cost by the village, Mr. Montroy said, because the revitalization committee hasn’t selected a statue and is still taking suggestions from residents. The statue could feature Frenchman Jacques Le Ray de Chaumont, a historical figure who in 1802 sold land to the Quakers that became the village of Philadelphia in 1804. Gateway Island Park is just one of a litany of improvements outlined in the downtown revitalization plan completed by the village in 2011, Mr. Montroy said. Other projects include starting a walking trail along the Indian River, rehabilitating downtown buildings and facades, installing new lighting on Main Street and updating zoning laws to make them business-friendly. The latter goal has been worked on every month over the past year by members of the village zoning committee. This fall, the village plans to demolish two old buildings at 59 and 61 Main St. that it owns across from its office at 56 Main St., Mr. Montroy said. Demolishing those buildings will clear space to build a two-story building there in 2014 that will become its new office. The current office, which will be vacated under the plan, then could be sold to a business interested in moving downtown. Three businesses are on Main Street: Sylvia’s Antiques, Nature’s Warehouse and Upstate National Bank.

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PEOPLE ON THE MOVE PEOPLE, from page 13 major; Trevor T. Lehman, a freshman at SUNY College of Environmental Science and Forestry and a wildlife science major; and Alayna N. Arthur, a senior at the Rochester Institute of Technology and a civil engineering major.

Joins Thousand Islands Winery marketing team

Alekzandra Huttemann-Kall has been hired as a marketing director at Thousand

Islands Winery, Alexandria Bay. As marketing director, Ms. HuttemannKall is responsible for the overall operations of the marketing and advertising departments. She will help the winery expand its marketing strategies and design all promotional materials. Ms. Huttemann-Kall earned a bachelor’s degree in marketing with a concentration in international business from SUNY Oswego and the University of Barcelona.

JCC honors retirees, recognizes excellence

Jefferson Community College recently observed the retirement of nine faculty and staff — two newly appointed emeriti — and honored those for milestone years of service to the college. The Spirit of Jefferson Award, bestowed to a campus team that exemplifies cooperative effort and achieves exemplary results, was presented to the Library Learning Center. The LLC has helped foster a more collaborative learning model by providing access to tutors and a study area for individuals and as groups. It was selected from among 13 nominations. Retirees are: Mary Lou Bertrand, who joined JCC in 1984 as a business instructor. She retires this month with the rank of full professor after 29 years. Carolyn C. Clarke came to JCC in 1989 after answering an advertisement for an anatomy and physiology instructor. She retired in May from the post of associate professor of biology after 24 years. Frank P. Florence was teaching on a temporary basis at Syracuse University when he learned of an opening at JCC for a geology instructor. He joined the faculty in 1995 retires from the rank of full professor of geology after 18 years.

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Elizabeth Ann Durant joined the New York State Small Business Development Center in 1991 as a part-time business counselor. She retired from the position of assistant director in December after 18 years. Marie A. Hess first joined JCC in 1975 when she was hired to fill in for a member of the nursing faculty on sabbatical. Thirty-eight later, she retired in December with the rank of professor of nursing, achieved in 1991, and as the program coordinator for the U.S. Department of Labor Grant. Bruce J. Lobaito joined the institutional technology department at JCC in 1992, bringing the department count to two. He retired in March after 21 years. Mark D. Strader joined JCC in 1990 as a maintenance mechanic the facilities department. He was promoted to senior building maintenance mechanic in 2008 and retires this summer after 23 years. Karen R. Webb became the first human resources professional on staff when she joined JCC in 2005. She retired in December after seven years. Shirley A. Weikel will retire after seven years with the college. She joined the nursing faculty at JCC as an assistant professor in 2010, responsible for the classroom and clinical instruction of senior nursing students. Retirees receiving emeriti status are: Richard C. Howland, trustee emeritus, retired from the JCC Board of Trustees after nine years. His term included roles as chairman, vice chairman and member of the budget and planning and personnel committees. Richard F. Young, professor emeritus, retried from JCC after having worked at the college for 41½ years at nearly all levels of the institution and in multiple capacities.


S M A L L B I Z S TA R T U P BUSINESS

Mike’s Pig Pen THE INITIAL IDEA He might not be a

veteran businessman, but Michael A. Cornell knows that even running a storied establishment like the former Harby’s Hots takes innovation—something to make it stand out from the crowd of fast food joints. So in May, when Mr. Cornell bought Harby’s Hots, which the late Kenneth J. “Harby” Harblin Jr. ran for 27 years until his daughter Susan A. Dandrow took over six years ago, he bought a ceramic, pink pig while in Florida that perches over the door. On the same trip, he bought a 1940s Amishmade, antique John Deere tractor. Mr. Cornell churns homemade ice cream in the tractor, which has two churns and a large belt and sits on the newly remodeled porch of what is now Mike’s Pig Pen. “I’m trying to keep it going as it was,” Mr. Cornell said on the third morning after opening in his immaculate, brand new kitchen. “But I knew we needed something different. We had to have a theme, an identity. We’re building ourself around the pig end.” That’s not to say Mike’s Pig Pen is a barbecue joint. Mr. Cornell is keeping the menu roughly comparable to Harby’s Hots—hamburgers, cheeseburgers, hotdogs, sausage, chili. He has added hand-cut fries, bowls of vanilla, chocolate and strawberry ice cream and ice cream floats, and plans to add fish and steak sandwiches by the end of the summer. Hamburgers are $4.95, cheeseburgers $5.25, Hoffman hot dogs $3.25, Hoffman Coneys $3.25, sweet sausage $4.50, handcut french fries $3.00, toppings (chili, cheese, peppers and onions) an additional $0.50, soups (cheddar broccoli and chili) $3.50, ice cream $3.00, ice cream floats $5.00 and coffee $0.75.

TARGET CLIENTELE With reasonable

prices, quick service and close proximity to car dealerships and businesses on Route 11, “the lunch crowd” forms the backbone of the clientele, Mr. Cornell said. In its day, Harby’s Hots was known as a place for local gossip with a loyal following dubbed the “coffee club” who spent long hours at the lunch counter trading jokes and unwinding from the stress of daily life. Despite his ambitions of attracting a much broader clientele—”we want to try to get everybody,” he says—it’s important to Mr. Cornell to continue Harby’s legacy. His father, Ronald A., was a longtime friend of the legendary Mr. Harblin, known as Harby, who was said to have had an almost tangible passion for the diner and its regulars, always willing to lend a hand or an ear, ready with a joke and fiercely loyal to his principles and family. Mr. Cornell frequented the hangout as

JUSTIN SORENSEN | NNY BUSINESS

“I knew we needed something different. We had to have a theme, an identity. We’re building ourself around the pig end.”

— Mike A. Cornell, Mike’s Pig Pen

well, so his ties to the hub for local gossip and long conversations over coffee run deep. “The old timers still come every morning at 10 a.m. for their coffee to hang out and shoot the breeze,” Mr. Cornell said. “The coffee club still comes.” In May, Mrs. Dandrow told the Watertown Daily Times that leaving felt “bittersweet,” although she had discussed selling the eatery with her father before his passing and it “felt like the right time.” “Half of these guys here leave to Florida for the winter, and I cry every time they do because they’re like surrogate fathers,” Mrs. Dandrow said of the coffee club. Mr. Cornell also plans to hold special events this summer to draw in a broader crowd, such as biker nights and gatherings of car and motorcycle enthusiasts on Saturdays. The extensive renovations, which took eight weeks instead of the anticipated three and include a new ceiling, floor, bathroom, deck with outdoor seating and parking lot, have also brought in more people, Mr. Cornell said. He invested about $300,000 in the building. “People are coming in that wouldn’t have come in before,” he said.

THE JOURNEY Mr. Cornell, who lives in

Constantia, worked in heavy equipment for Syracuse Utilities for 22 years, work that he said was beginning to take a toll on his knees and body. “This became available on a whim and I said ‘here’s the opportunity’ and took it,” Mr. Cornell said of the decision.

Prior to his work for Syracuse Utilities, Mr. Cornell ran a detailing shop in Cicero for three years, experience that he said made the transition to running a diner seem feasible. Still, he described the process as challenging. “You have to get all the ducks in a row,” he said. “They’re getting in line now though.” In part because of how many people he knows in the area and Harby’s reputation and established clientele, Mr. Cornell said he is optimistic that he’ll have no problem making back his investment. “It’s going to work,” he said.

IN FIVE YEARS “I hope to have another one,” Mr. Cornell says. For now though, he’s considering hiring additional employees—he currently has two—so that he could churn the ice cream while customers watch. As the only chef currently, he has to primarily churn the ice cream at night. When he does churn it during operating hours, though, “it gets people’s attention.” “It gets a crowd every time I start it,” he said. He believes he has reason to be optimistic: On his Monday, July 8 opening, he sold all the food he had made. On Tuesday, he prepared more and sold out of that too. “It’s going exceptionally well,” he said Wednesday morning as he started making the coffee and readying for the faithful club’s arrival.

— Leah Buletti and Ted Booker

WHERE Watertown | FOUNDED 2013 | WEB www.mikespigpen.com

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Dr. Alejandro R. Rodriguez, seated, a urologist and chief of robotics and minimally invasive surgery at Samaritan Medical Center, directs staff in a simulated procedure in the hospital’s new robotic surgical suite. AMANDA MORRISON | NNY BUSINESS

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COVER STORY

BUILDING A

BETTER HEALTH CARE SYSTEM FOR NORTHERN NEW YORK’S HOSPITALS, INVESTMENTS IN TECHNOLOGY, SERVICES KEY TO IMPROVING PATIENT CARE AS QUESTIONS LOOM ON IMPACT OF FEDERAL REFORMS

W

hether it’s with money or time, north country hospitals continue to remain invested in the health care of Jefferson, Lewis and St. Lawrence counties’ residents. As some hospitals comb through their capital budgets to purchase new or upgraded equipment, others have turned to strategic planning as a means of investing in its future. Both options become

BY REBECCA MADDEN | NNY BUSINESS

equally important as the health care industry continues to face low insurance reimbursement rates and other fiscal challenges. Here is a look at some recent investments north country hospitals have made: RIVER HOSPITAL, ALEXANDRIA BAY A portable ultrasound machine for the emergency room, a digital mammography machine and an updated stationary ultrasound machine, totaling about $400,000,

will allow staff to perform a wide range of exams with precision, according to hospital staff. Earlier this year, the hospital celebrated the success of the opening of its River Community Wellness Program, which offers 10 active-duty soldiers an opportunity to participate in an intensive outpatient mental health program. Geared toward helping those military members with post-traumatic stress disorder, the program may receive a second cohort of 10 August 2013 | NNY Business

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COVER STORY later this year. River Hospital spent $400,000 to start the program, but services are reimbursed by Tricare, the insurance company that serves activeduty soldiers.

CARTHAGE AREA HOSPITAL, CARTHAGE

Once plagued by deep debt, the hospital went from being owed more than $21 million from former patients in 2011, to being on a path toward financial stability a year later. Now, Carthage Area Hospital has a clean balance sheet and is able to invest in its future. The hospital recently celebrated the opening of its sleep lab, which is being operated in conjunction with Fransiscan Cos. The hospital also recently invested about $2 million in the purchase of a new computed tomography (CT) scan, magnetic resonance imaging equipment and its service contracts. Through a partnership with Upstate University Hospital, Syracuse, the hospital will soon provide telemedicine services for stroke victims. Carthage Area Hospital also recently opened up a 60-bed assisted-living

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facility, Meadowbrook Terrace, on Cole Road, Town of Champion.

SAMARITAN MEDICAL CENTER, WATERTOWN

On the tail end of its $61 million expansion and renovation project, which added a parking garage, patient pavilion, connector between the hospital and Samaritan Keep Home, and renovated old hospital space, Samaritan Medical Center has also celebrated the spring opening of its $64 million 288bed assisted-living and skilled-nursing facility. Samaritan Summit Village is a multi-level, 230,000-square-foot complex at 22691 Summit Drive, just off Washington Street. The 2012-13 operating year continues to be one of celebration for the hospital, as it purchased a $2 million da Vinci robotics system to assist certain specialty physicians in some surgical cases and operations. The investment doesn’t stop there, according to Krista A. Kittle, Samaritan spokeswoman. Not only did the hospital open a primary care clinic in Sackets Harbor, but it also recently wrapped up a five-year

strategic plan. Ms. Kittle said part of that focused on purchasing equipment, but the next strategic plan will include a focus on introducing and expanding relationships and collaborations. “The federal mandate is really what’s driving this,” she said. “It’s ‘Do we really need the same equipment in every hospital, or are there opportunities to collaborate?’ Redundancy is what causes expenses to go up. Hospitals are certainly going to benefit from collaboration.”

LEWIS COUNTY GENERAL HOSPITAL, LOWVILLE

As the Lowville hospital considers a critical-access designation, which may increase Medicaid and Medicare revenues, it also has started a $1.7 million, 7,200-square-foot addition to accommodate an eight-station outpatient dialysis center. Once construction is complete, it will be turned over to Davita, Inc., which will finish the project and operate the center under a 10-year lease agreement. The project is expected to be complete and open in March or April 2014.


COVER STORY CANTON-POTSDAM HOSPITAL, POTSDAM Aside from having an agreement to

manage Edward John Noble Hospital, Gouverneur, Canton-Potsdam Hospital, too, has been busy with several projects. The Canton-Potsdam Hospital is moving forward with a $5.5 million expansion of its medical office complex at 49 Lawrence Ave., Potsdam. The hospital extension will house 10 primary care physicians and an urgent care center.

MASSENA MEMORIAL HOSPITAL, MASSENA

The hospital will invest about $1.26 million in a new CT scanner package, equipped with scanner, work station, power injector and facility modifications. The annual cost to operate it will be $147,313. The purchase didn’t come without controversy, however, as the hospital faces difficult financial times. Over the next 10 years, administrators have said they expect to lose $15 million in reimbursements. While open to collaborations, Massena Memorial will now investigate converting into a private, not-for-profit facility.

CLAXTON-HEPBURN HOSPITAL, OGDENSBURG

The Ogdensburg hospital will spend over $5.6 million on an upgraded cancer treatment center and new CT scan. The $1.46 million CT scan will take better images, with lower doses of radiation, according to spokeswoman Laura C. Shea. That cost includes the machine and modifications to the radiology department. Meanwhile, the hospital will spend $4.2 million on a new linear accelerator, which is used for radiation treatment. Mrs. Shea said the hospital’s full-time medical physicist takes the CT scan and writes a treatment plan so the linear accelerator knows what part of the body to target. “Our cancer center is one of our flagship services,” she said. “We’ve constantly invested in it because we see the need. Last year, we opened a breast health center. We want people to stay as close to home as possible.”

CLIFTON-FINE HOSPITAL, STAR LAKE Recent strategic planning efforts

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COVER STORY have led to a partnership with Samaritan Medical Center. As hospitals face financial uncertainty, more are collaborating to cut costs and share ideas. In other efforts to reduce costs to ensure the hospital is here in the future, the Star Lake hospital also recently became nonprofit, rather than a municipal public benefit corporation.

E.J. NOBLE HOSPITAL, GOUVERNEUR Although its future was uncertain

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in late September when its laboratory was shut down by the state Department of Health, the Gouverneur hospital is slowly bouncing back. Since January, the hospital has been managed by CantonPotsdam Hospital, and has gone through rigorous planning to figure out how it can remain open and viable. All of its satellite clinics were reviewed, and while two were closed, the lab was restored and became functional again. In the spring, the state Department of Health

offered the hospital a $2 million loan to help with the restructuring process. The hospital’s investment of time in planning for its future has resulted in renovation plans for a federally subsidized primary care clinic, and the re-opening of its operating room with upgrades to its heating, ventilation and air conditioning system. n REBECCA MADDEN is a Johnson Newspapers staff writer. Contact her at rmadden@ wdt.net or 661-2375.


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H E A LT H C A R E

Dr. Alejandro R. Rodriguez, chief of robotics and minimally invasive surgery at Samaritan Medical Center, with the da Vinci robotic surgery system. Dr. Rodriguez is a urologist who helped rebuild the medical center’s urology program. AMANDA MORRISON | NNY BUSINESS

Robotics aids in precision Samaritan surgeons complete 100 cases since November

By REBECCA MADDEN

R NNY Business

obotics-assisted surgery is all about improving physician precision, which, in turn, improves surgical outcomes for patients, officials at Samaritan Medical Center say. Urologist Alejandro R. Rodriguez said that since robotics-assisted surgery has spread to urban and rural communities, more hospitals and surgeons are using robotics for surgery. With an increase in cases often comes an increase in risks if physicians have not had adequate training and experience with the multi-million dollar equipment. “It’s not robotics that causes complications,” he said. “It’s a surgeon who operates the robot.” Of the 100 cases Samaritan surgeons have completed since the arrival of its $2 million da Vinci system in November; Dr. Rodriguez said there have been no

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complications. Samaritan wants to keep it that way, he said, and is ensuring that will remain the case because of the hospital’s in-depth training. Physicians who would like to become educated on using robotics-assisted surgery must have experience in laparoscopic surgery, and go through a series of lessons in a dry lab, simulator, wet lab working on animals, online seminars, and successfully complete two robotics-assisted surgeries under a proctor. A majority of that training, except the latter, is done at an outside training facility, Dr. Rodriguez said. The training regimen is less aggressive if surgeons come to Samaritan with experience maintaining several-dozen robotics-assisted cases annually. The system is made up of a control console linked by computer to the device’s four arms, one for optics and three others that move surgical instruments. A surgeon inserts access ports into the abdomen or chest through one or more small incisions. The operating room team views the proce-

dure on high-definition monitors as the physician’s fingers manipulate the delicate control arms at the control console, movements that are transmitted to the robot arms to maneuver surgical instruments inside the patient’s body. The surgeon performs procedures while sitting at a console and puts his or her head into a vision camera to obtain a three-dimensional image. The da Vinci system, which was named OSCAR, for Outstanding Surgical Care with Advanced Robotics, has been used in urology, gynecology and general surgery. Dr. Rodriguez, Samaritan’s chief of robotics and minimally invasive surgery, said Samaritan does not push robotics on any surgeon. It is a physician’s choice to pursue performing surgery with assistance of a robot. “Our target is to have 150 cases in one year,” Dr. Rodriguez said. Robotics-assisted surgery may also be used for operation on chest organs and ear, nose and throat issues, but no specialty


H E A LT H C A R E

Doctors have to be realistic of their capabilities in doing this. — Dr. Alejandro R. Rodriguez, Samaritan Medical Center chief of robotics and minimally invasive surgery.

physician at Samaritan is currently trained to use the da Vinci system. Dr. Rodriguez said while robotics offers less pain and bleeding in some cases, that type of surgery does not mean other surgical methods of open and laparoscopic are less important. He said the first step of surgery is a person selecting a physician, and then he or she will discuss options with the patient. “Doctors have to be realistic of their capabilities in doing this,” Dr. Rodriguez said. Some Samaritan physicians who are trained with the da Vinci system include Drs. Rodriguez; Robert O. Kimball, general surgeon; Walter Dodard, Kenya Cain and M. Kathryn Buchanan, obstetriciangynecologists; and Nanci L. Hawkins, gynecologist. “Samaritan has the possibility of being a hospital with cutting-edge technology, and probably more surgeons with robotics training would like to come here,” Dr. Rodriguez said. The da Vinci system at Samaritan is the only one of its kind in the north country. Since health care technology continues to advance, Dr. Rodriguez said he knows there will be additions, changes and improvements to OSCAR. Currently there are a couple ports of entry, but he hopes Samaritan is able to evolve into utilizing just one port of entry into a patient. He said there are also stapler, vessel sealers and other tools that may be used robotically. Samaritan spokeswoman Krista A. Kittle said the advances in technology that are available right here in the community “certainly boosts the community’s reception of the care locally.” “What was once a small rural hospital is now advanced in robotics that only used to be in large, urban medical centers,” she said. n REBECCA MADDEN is a Johnson Newspapers staff writer. Contact her at rmadden@ wdt.net or 661-2375.

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H E A LT H C A R E

NORM JOHNSTON | NNY BUSINESS

Samaritan Medical Center Emergency Department Drs. Maja L. Lundborg-Gray, left, and Dr. Sarah A. Delaney-Rowland in the hospital. For the past 18 months, the par has worked with staff and a consultant to streamline the department and cut patient waiting times.

Overhaul cuts wait times

SMC docs retool emergency department, boost patient care By KEN EYSAMAN

F Editor

or the better part of two years, Samaritan Medical Center Emergency Department Drs. Maja L. Lundborg-Gray and Sarah A. Delaney-Rowland have been watching the clock and it appears to be paying off. After an exhaustive 18-month top-tobottom overhaul of Samaritan’s Emergency Department, patients who come in the door seeking care are now averaging wait times of just 19 minutes to see a provider — a 72 percent decrease over the previous 68-minute average wait. “The ultimate goal was to decrease wait times and continue to deliver great care,” Dr. Lundborg-Gray said. “We are seeing some wonderful results it its infancy.” Dr. Lundborg-Gray is president of North Country Emergency Medical Consultants and serves as medical director

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of Samaritan’s Emergency Department, while practice partner and Watertown native Dr. Delaney-Rowland is department chairman. For months, the pair has worked with Dr. Emilio S. Belaval, a board-certified emergency physician who practices emergency medicine in Providence, R.I. Dr. Belaval is also senior vice president of Emergency Excellence, a consulting group that works with health care organizations to improve emergency departments and clinical outcomes. “Using a traditional model of trial and error, we look at how we run the department and make sure patient care is improved in the process by eliminating idle time,” Dr. Belaval said. “By streamlining the process, we see very little idle time, which allows us to cycle patients more efficiently and protect the beds from being erroneously filled.” In many emergency departments,

patients are given a bed before it is necessary, which, Dr. Belaval said, “clogs the system of care.” In a streamlined department, if a patient doesn’t need a bed, they won’t stay in bed, which increases bed capacity for the more critical patients. “Eliminating that idle time for patients means that they’re going to get the physician care and treatment they need and go home,” he said. How the emergency department interfaces with the lab and X-ray department and other teams was also analyzed for potential efficiencies. “A change in the entire process was necessary to improve,” Dr. LundborgGray said. “This was an institutional effort that involved all departments on all floors — from the bottom up.” In a typical day, Samaritan’s emergency department averages 150 patient visits with its busiest time from 9 a.m. to 1 a.m., which, save for trauma cases or


H E A LT H C A R E mass casualty incidents, leaves only eight hours of “down time” when emergency department staff can catch up on nonpatient-related tasks such as paperwork and administrative chores. For the team working to overhaul the department, it meant keeping up with patient demands and cases while searching for new and innovative ways to make lasting changes. “Sacrificing care was never an option,” Dr. Delaney-Rowland said. “It’s about how we get a patient through efficiently.” Overhauling the emergency department first meant a thorough assessment of existing procedures and practices. Once the department’s team understood how it was delivering services, each step was analyzed for potential improvements and streamlining. From patient registration to triage to intake and vitals, the doctors examined each step, every process and all procedures. Dr. Belaval and his group helped Samaritan write standing operating procedures, or SOPs, for routine occurrences, such as a surge in patients arriving at the emergency department. “Dealing with a surge in writing means that everyone knows their role before it takes place,” he said. Nationally, emergency department wait times continue to increase, which critics maintain is a drain on patient care and, if ignored, ultimately costs the health care system money. Samaritan’s push to improve patient wait times in its emergency department has been on the board for some time. “This discussion came out of our strategic plan back in 2005 when we started the facility expansion that included a new emergency department,” said Krista Kittle, Samaritan spokeswoman. “This is really our response to the community’s call for improvement.” While the initial results are positive, the focus within the emergency department has now turned to making minor adjustments, maintaining gains and continuously working to improve care and patient satisfaction. “We needed to challenge the management part of patient care,” Dr. LundborgGray said. “We’re not working in an assembly line. It took a year to het here by upending and redoing the entire system, now we are evaluating our results and seeking ways to still improve.” n KEN EYSAMAN is editor for NNY Business. Contact him at keysaman@wdt.net or 661-2399.

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H E A LT H C A R E

Understanding reform

Plenty of resources to navigate federal care act By LEAH BULETTI

A NNY Business

lthough the employer mandate portion of sweeping federal health care reform, the Affordable Care Act, was earlier this summer pushed until 2015 for businesses with 50 or more full-time employees, small businesses and individuals in the region can begin shopping for policies in their respective health care exchanges beginning Oct. 1 for plans that take effect Jan. 1. Individual premiums are expected to be about 50 percent lower in New York state before tax credits that could make the cost even less for many individuals, per a July announcement of the exchange by Gov. Andrew M. Cuomo. Rates for the small business exchange — the Small Business Health Options Program or SHOP — have yet to be announced but are also expected to be more affordable.

WHAT THE ACA MEANS FOR FIRMS WITH 50 OR FEWER EMPLOYEES

Businesses with 50 or fewer full-time employees will not face penalties if they don’t offer health insurance. Either by shopping for a policy in the SHOP and receiving a tax credit or by ceasing to offer a plan and providing money for employees to buy a health plan in the individual exchange, many insurance agents and analysts believe small businesses will be able to save substantially. Rep. William L. Owens, D-Plattsburgh, believes “the outcome is likely to be good in terms of rates and premiums” for both individuals and small businesses because the exchanges will lead to an increased number of plans which will generate competition. “The critical piece here is that there will be more competition in the plan marketplace, which will drive down premium costs,” Mr. Owens said. “When it’s clear that premiums have been driven down, that will drive down rates.” This effect is likely to be particularly pronounced in the north country, he said. “Increased competition and more variation in the type of plan being offered could be very beneficial to us,” Mr. Owens said. “More plans will have an interest in being in our area.”

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JUSTIN SORENSEN | NNY BUSINESS

Eric Sharlow, left, and Steve Foy are among several insurance firms that are helping small businesses and individuals navigate changes created by sweeping federal health care reform.

Statewide, about 80 percent of small businesses are expected to be eligible for tax credits if they decide to provide health insurance. Mr. Owens said he doesn’t believe that number will be substantially different in the north country — perhaps 82 percent compared to 78 percent in New York City. He also believes that navigating exchanges will be easier for individuals and small businesses than choosing a plan, particularly since more can be done online. Through a grant from New York Citybased nonprofit Community Service Society, the Greater Watertown-North Country Chamber of Commerce is providing free help to businesses and individuals navigating the exchanges. The chamber, which was awarded the 18-month grant in March, started counseling businesses at the beginning of April. Katrina Kapustay, small business assistance program specialist at the chamber, has already made 11 presentations to businesses and counseled 70 business owners, employees and individuals. The service can help small businesses navigate tax credits, Healthy New York, Medicaid, Medicare,

public coverage options, commercial coverage options, the state’s new prior approval law, how to choose a broker and other small group products. “I’m here to walk them through it to be as successful as they can be,” Ms. Kapustay said. Ms. Kapustay said the SHOP will likely make finding a plan easier for small businesses because of the ease of going online to shop for policies and because different methods of billing under the SHOP will save employers time and money. “It’s going to be of great value to people because of all the unknowns,” Lynn M. Pietroski, president and CEO of the chamber, said of the grant. “We can do group or individual sessions. If we don’t know the answers, we have the resources to at least get the answer that’s popular at that time.” Stephen C. Foy Inc., Watertown, is advising small businesses to take a slightly different tack: consider dropping the group plan and essentially provide money for employees to buy their own plan in the individual exchange so they can take advantage of the


H E A LT H C A R E The SHOP/ How it works n Employers can select among plans offered by a specific carrier, select specific plans offered by multiple carriers, select a tier of coverage or allow employees to select an exchangequalified plan. n Employers can contribute an uncapped percentage (55 percent of the premium), a capped percentage (55 percent of the premium, up to $300) or pay a defined dollar amount ($300/month). n Rates in the SHOP are expected to be available by the end of the summer.

larger individual tax credit. Agency President Stephen C. Foy and Benefit Consultant Eric S. Sharlow are advising small businesses to consider why they offer health insurance. Many do so to attract and retain quality employees or to ensure that the owner has coverage, but a survey his agency conducted found that as many as 80 percent of small businesses do so because they feel an obligation; if they don’t, their employees won’t have access to an affordable plan because of the high cost of individual plans in New York. “With the ACA, companies need to think about if they really need to keep their plan,” Mr. Foy said. “The obligation part is probably gone. Now there’s an opportunity for anybody on the street to go in and buy a plan in the exchange.” Not only is the obligation gone, but in some ways the employer would be doing their employees a disservice by continuing to have a health plan because the individual won’t be able to take advantage of the tax credit, Mr. Foy said. Since small businesses won’t be penalized if they don’t provide health insurance, these businesses need to ask if they want to continue to have a health plan and why, he said. Mr. Sharlow added that it’s important to note that the plans available in the exchange are not “state-sponsored plans” or some version of Medicaid, as many people perceive. “They’re the same plans their employers have now,” he said. Mr. Foy worked to develop the Freedom Plan with Kent Utsey, president of Chicagobased American Health Resources. The Freedom Plan allows small businesses to enable employees to buy insurance independently in the exchange. Mr. Foy is marketing it locally, statewide and nationally. He said small businesses could save up to 50 percent of what they now pay for a health plan and that all small businesses should consider the option “regardless of how much” they now pay. He believes this option is particularly

attractive for north country businesses because the majority of individuals are likely to be eligible for substantial tax credits in the individual exchange, which he said “could be significantly greater than those for the employer.” Businesses with 50 or more employers could also consider the Freedom Plan as a way to save money for a year until the employer mandate goes into effect, he said. Under SHOP, small businesses will still have to contend with rate increases, while individual plan rate increases are expected to be absorbed by the tax credit in the indi-

vidual exchange, Mr. Sharlow said. Although the Freedom Plan requires the manpower to assess employees’ household incomes, Mr. Foy said companies would likely need a navigator even if they were offering a group plan. He plans to partner with navigators in the region to advocate the Freedom Plan. An analysis of a construction company with 33 employees Mr. Foy conducted found that nearly all of the employees were eligible for subsidies that brought their premiums to zero and that the company could cut its health care costs by

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H E A LT H C A R E The ACA small business tax credit / How it works n To be eligible, you must cover at least 50 percent of the cost of single (not family) health care coverage for each of your employees. n You must also have fewer than 25 full-time equivalent employees, who must earn average wages of less than $50,000 a year. Two halftime workers count as one full-time worker, so if you have more than 25 employees, you could still be eligible for the tax credit. n The maximum tax credit is 35 percent and 25 percent for small tax-exempt employers like charities. An enhanced version of the tax credit — 50 percent and 35 percent, respectively — is slated take effect Jan. 1. n The tax credit is calculated on a sliding scale. If you have more than 10 full-time equivalent employees or if the average wage is more than $25,000, the less credit you will receive. n If you are a small business employer who did not owe tax during the year, you can carry the credit back or forward to other tax years. n Eligible businesses can still claim a business expense deduction for the premiums in excess of the credit since premium payments are more than the total credit. n The credit is refundable, so if you have no taxable income you may be eligible to receive the credit as a refund as long as it does not exceed your income tax withholding and Medicare tax liability. n If you did not claim the credit on your tax return this year, you can still file an amended return if you qualify for the credit. n Examples of how the credit applies in various circumstances and the form to calculate it can be found on the IRS website, www.irs.gov. Source: www.irs.gov

roughly 44 percent. While considering this option, all businesses should do two things to make sure they are compliant with ACA regulations, Mr. Foy said: notify employees of the exchange by Oct. 1 and ensure that they have no more than a 90-day waiting period to enroll employees in benefits.

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WHAT THE ACA MEANS FOR FIRMS WITH 50 OR MORE EMPLOYEES

The Obama administration in early July announced that requirements for businesses with 50 or more employees to provide health insurance would be delayed until 2015, citing businesses’ need for more time to comply with this portion of the law. Nationwide, about 96 percent of businesses in this category already offer health insurance. Businesses of this size that do not offer health insurance or those that do not offer health insurance that meets certain requirements will face a penalty, which will not be levied until 2015. Businesses with more than 200 employees will be required to automatically enroll employees. To avoid the penalty, the health insurance must not require the employee to contribute more than 9.5 percent of their household income and cover at least 60 percent of covered health care expenses. A penalty is levied based on the number of full-time employees, or $2,000 per full-time employee minus the first 30. Only full-time employees, calculated as 30 hours per week, are used to determine the penalty, but for the purpose of classifying a business as small or large (under or over 50 employees), 120 hours of part-time labor per month equals one full-time equivalent employee. Essentially, two part-time employees equate to one full-time employee. Lindsey H. Hazelton, an attorney at Hancock Estabrook, Syracuse, said that companies should begin assessing their workforce to ensure they have a clear system in place to count full- and part-time employees so they know which side of the law they fall on. “Even if the law changes, or the definition of full-time changes, companies are still going to need that data to see where the company fits,” Ms. Hazelton said. Ms. Hazelton anticipates further guide-

lines on the definitions of full-time, as most employers do not consider 30 hours fulltime, she said. She’s seen some businesses moving employees above or below the 30-hour threshold to avoid ambiguity, but said it’s too early to tell if cutting employee hours — an initial concern of critics of the ACA — will be widespread when the mandate takes effect. “I think it takes some pressure off,” Ms. Hazelton said of the delay. “Some businesses who had started making changes and told employees they could only work 25 hours for the rest of the year have now scaled back.” Still, she does not recommend that companies move away from 30 hours because of speculation that this threshold will change as it gets closer to when the law is implemented. “Right now we’re telling employers not to make any drastic changes,” she said. “It was a pretty cryptic announcement. We’ve been telling companies to wait and hopefully we’re given some clarity.” The announcement of the delay, made July 2 on the Treasury Department’s website, stated that rules on reporting employers’ policies and other guidance for insurers, self-insuring employers and other parties that provide health coverage would be made later this summer. Ms. Hazelton said requirements on quality and affordability may also change, as the affordability test is based on household income, data most employers don’t have access to. Businesses with 50 or more employees still need to provide employees with a notice about their policy and the availability of the individual exchange by Oct. 1, regardless of what type of coverage they offer. The notice, which can be accessed on the Department of Labor website, must inform employees about the marketplaces


H E A LT H C A R E and exchanges and inform them that if they get insurance through the marketplace, they might lose the employer contribution to a health benefit plan. “I think the Republicans will continue to fight for repeal, but I don’t see it going away,” she said. “As long as the individual mandate is in place, I think there will be an employer piece.” Mr. Owens said he also believes that the mandate will take effect and will not be buried by the political wrangling that has marred many other developments since the ACA was signed into law in March 2010. “[The delay] gives the opportunity for the plan to be better implemented,” he said. “This is not, in my view, going to have a dramatic impact on employees in companies with over 50 employees.” He added that he doesn’t think the employer mandate will have as much impact as other pieces of the law. The percentage of companies with 50 or more employees that do not offer health insurance is about 0.2 percent. “I think companies are going to get a lot more questions,” Ms. Hazelton said of the impact of the mandate. “Employees who weren’t concerned or didn’t have it are going to ask. It becomes a job retention issue — people are going to be more focused on finding jobs that provide health insurance as an employee benefit.”

WHAT THE ACA MEANS FOR INDIVIDUALS

The North Country Prenatal/Perinatal Council was awarded one of 50 state In-Person Assistor/Navigator grants in mid-July. It will transition this month from providing facilitated health enrollment and community health advocacy to helping individuals in Jefferson and Lewis counties navigate the New York Health Benefit

Exchange, which opens to individuals Oct. 1 via www.healthcare.gov. AIDS Community Resources, which subcontracted with CSS, will provide similar services in all three counties. “We’ll actually go online with them, go shopping through the exchange, to match their needs with whatever level plan they need,” said Donna Hynes, insurance programs coordinator at the council. The council anticipates that all of its current enrollers and community health advocates will be trained as navigators by the Oct. 1 opening. Ms. Hynes said council staff will be better positioned than many other organizations in the state because since 2000 they have been enrolling people in programs like Medicaid, Child Health Plus and Family Health Plus. Her four navigators will travel to various clinics, hospitals and local agencies in Jefferson and Lewis counties to educate people on their options. It will also have a fifth full-time navigator in the North Country Children’s Clinic, which was awarded a separate federal grant for inperson assistance, 30 percent of which will be targeted to the homeless population. “The key is to see people in their own communities as much as possible to increase their comfort level,” Ms. Hynes said. “Our job is to eliminate the barriers for them to apply.” Statewide, about 90,000 are expected to become newly eligible for Medicaid under the state’s expansion of that program. Another 1.1 million are eligible for Medicaid but not enrolled. Eligibility for Family Health Plus will also be expanded. Many people who didn’t take advantage of Family Health Plus in the past because it is a Medicaid program will be more willing to take advantage of it through the exchange, Ms. Hynes anticipates.

“I think there will be people coming on board who were reluctant to do so before,” she said. The most affordable individual policy now available in Jefferson County is $1,100 a month. Premiums for mid-level plans in the exchanges are expected to be around $300 to $500, of which most individuals will likely only pay a fraction because of “generous subsidies” for individuals with incomes up to 400 percent of the federal poverty line, Ms. Hynes said. Statewide, about 700,000 are expected to be eligible for subsides in the exchange. Single, childless couples earning just enough to have not been eligible for a subsidy will also be a population significantly impacted by the exchange, according to Ms. Hynes. A couple earning $1,500 a month can’t receive either Family Health Plus or Medicaid, but will probably be fully subsidized under the exchanges. The state is getting rid of the single childless couple category, meaning that households of two qualify regardless of the composition. Couples in their early 60s who are too young for Medicare but who have medical needs and have been going without insurance are “going to be one of the most impacted groups of people,” Ms. Hynes said. Of the four tiers of plans, Ms. Hynes said that subsidies will pay up to a mid-level plan; if an individual wants a higher-level plan, they can absorb that cost. Ms. Hynes advised individuals to use this period to ask questions. “It’s not as overwhelming as people may think,” she said. “We can walk them through the changes in a way they will understand, and we’ll be certified to do so.” n LEAH BULETTI is a staff writer for NNY magazines. Contact her at 661-2381 or lbuletti @wdt.net.

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H E A LT H C A R E

Joseph Millard, director at Meadowbrook Terrace in Carthage, sits in the common area. The assisted living facility is one of three in Jefferson County that has opened in the past 18 months.

JUSTIN SORENSEN | NNY BUSINESS

The ‘whole gamut’ of care Assisted living facilities meet growing demand

By LEAH BULETTI

W NNY Business

ith the nation’s population aging and health care costs ballooning, Jefferson County is by several indicators poised to meet demand for long-term care after two new assisted living centers opened within months of each other this year and Samaritan looks to soon expand its adult day-care program to adapt to the trend of adults staying at home longer. “I’m very satisfied with where we are,” said Anthony E. Joseph, Samaritan Health System director of long-term care. The Census Bureau estimates that about 34,400 people ages 65 or older were living in the tri-county area in 2012, making up 11.5 percent of the population of Jefferson County, 12.5 percent of St. Lawrence County’s population and 15.8 percent of Lewis County’s population. “We’re offering two levels of care in a very unique facility,” Mr. Joseph said of Samaritan Summit Village, the county’s

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second assisted living facility, which opened its doors in early April. “It’s a very residential facility, it’s a facility of the future. It’s a beautiful place that doesn’t look anything like a nursing home.” Of Summit Village’s 168 skilled nursing beds, 126 have been opened so far. Of those, 97 percent are full, Mr. Joseph said. Samaritan is still training certified nursing assistants and will open the remainder of the beds once training is complete, likely in September, he said. Of the 120 assisted living beds at Summit Village, of which 20 are enhanced assisted living not covered by Medicaid, 80 have been opened and there is a waiting list of 12 adults. Medicaid covers 80 of the assisted living beds. Mr. Joseph said training for assisted living staff will likely be completed earlier than that for the skilled nursing beds, at which time the remaining 40 will open. He described filling the $64 million facility at 22691 Summit Drive off Washington Street as a “continuous process.” It took about two months to reach its present occupancy, aided in part by residents who came from Samaritan Keep Home and the now

closed Jefferson County-owned adult home Whispering Pines. In April, 25 adults from Samaritan Keep Home and 46 from Whispering Pines moved into Summit Village. “We haven’t had a problem filling it,” Mr. Joseph said. “I think we could use even more than what we’ve got,” said Steven P. Duffany, a Watertown-based insurance agent who specializes in Medicare and has been working with the senior population since 1980. “You’re never going to have the facilities empty because you’re going to have such an influx with people living longer and a higher incidence of dementia, Alzheimer’s, frailty, diabetes.” In addition to the assisted living facility, Samaritan plans to expand its continuum of care with the addition of a social model of the adult day health care program it has offered to up to 29 adults per day for nearly two decades. That service targets adults who would be eligible for nursing home care but can stay in the home setting. The social model will serve adults who have social needs rather than medical needs—a hearing, psyche or mobility problem, or difficulty


H E A LT H C A R E preparing meals at home and social isolation — but who are not in wheelchairs and who don’t need other physical attention. “The social model is something that we think was needed in Jefferson County,” Mr. Joseph said. With advances in technology, such as telemedicine that is making specialist services more accessible to many people particularly in rural areas, and improved disease treatment, “people are coming in later in life and for shorter periods of time,” Mr. Joseph said. While 30 years ago the average stay in a nursing home was about 42 months, today it’s about 18 months, he said. With the addition of social day care, Jefferson County now offers the “whole gamut of services” so adults can stay in their homes for as long as is healthily possible and then “move through the system.” “We’re trying to give people choices and be able to react to whatever their choices are,” Mr. Joseph said. Louise J. Haraczka, deputy director of the Jefferson County Office for the Aging, has also observed the trend of adults remaining in their homes for longer periods, citing the fact that adults in their 90s have recently been seeking the office’s in-home nutritional services.

The office, which offers services such as financial counseling, nutrition, transportation and home delivered meals, has been “keeping up pretty well” with demand, Director Peter J. Fazio said. “We’re fortunate that with the addition of the assisted living facilities, we have a wider range of services in Jefferson County,” he said, adding that “it seems like we have what we need now.” Over the past three months, the office has acquired a waiting list for two of its services: non-medical home care for individuals ages 60 and older who need basic assistance with housekeeping or personal care and the personal emergency response system, a 24-hour emergency help line. Ms. Haraczka said it’s too early to tell if this if a definitive trend or merely the type of periodic uptick the office sees for its other services. Though the office provides services that help people remain in their homes for as long as is safely possible, Mr. Fazio said he thinks that as the population ages and stays healthy longer, demand for senior living facilities and in-home care will also increase. Ms. Haraczka said that she thinks adults in Northern New York tend to be fairly independent even into later years, possibly because seniors in rural areas are often more

connected to their families. “As the baby boomer generation continues to age, we certainly have the services we need right now, but I can definitely see an increased need in the future,” Ms. Haraczka said. The Lodge at Ives Hill, which opened an enriched living facility with 18 units — 10 studios and eight one-bedrooms — in late February 2012, has so far had little problem filling its beds. The Lodge accepts long-term care insurance but not Medicaid or Medicare. Donna S. MacPherson, executive director of Ives Hill Retirement Community, said about eight of the current 17 residents pay with long-term care insurance. Studios cost $4,300 per month and one-bedroom apartments cost $5,500. Medicare and Medicaid can be used for enriched assisted living facilities, the lowest level on the continuum of adult care, as well as assisted living, but facilities that do so must obtain approval from the state and compensate for fewer state dollars for those residents by charging private payers more. “We wanted to keep costs within what we thought the private payers could pay,” Ms. MacPherson said. Although the federal Affordable Care Act early on abandoned attempts to reform

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H E A LT H C A R E long-term care insurance, Ms. MacPherson said she anticipates little impact from that or other parts of the ACA as “many [residents] don’t have long-term care insurance as it is.” The Lodge, which cost more than $3.4 million, will be full as of one more studio, although it could have up to 24 residents because some rooms can accommodate two people. Mrs. MacPherson said it seemed to take longer than originally anticipated to fill the Lodge, in part because six initial residents who moved in had to soon after move to facilities that provided a higher level of care. “If they had stayed, we would have been filled much sooner, but that’s the nature of the business — when people start to need help getting out of bed and ambulating, they need to move to a nursing home or assisted living facility,” she said. “Since I’ve been here we’ve been filling beds.” The Lodge’s proximity to Ives Hill Retirement Community, which grew with the addition of five Elmore Lane duplex homes in September 2011, has been beneficial. If an adult living in the retirement community needs extra help, the family can pay for a caregiver to come in from the community, “just as they would in their own home,” Mrs. MacPherson said. “Once it gets to the point that a lot of hours are being covered, we start to encourage them to go across the street,” Mrs. MacPherson said. The relationship is also beneficial because residents at the Lodge can attend social events on the retirement community’s extensive calendar. Mrs. MacPherson said as baby boomers age out there will likely be the most growth in assisted living facilities, which are often attractive to people because of the stigma of nursing homes. Ives’ long-term plan involves building two additional enriched housing facilities, one similar to the Lodge and one memory care unit for dementia patients, likely within the next five to 10 years, Mrs. MacPherson said. “The Lodge is an example of how we need to serve the increasing ranks of the senior population that is remaining pretty healthy,” she said. “The Lodge has been very beneficial to the community. It opened up our eyes to the fact that a great number of residents can be very independent with the right type of support.” But at Meadowbrook Terrace, Jefferson County’s first assisted living facility in Champion, occupancy has been notably

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H E A LT H C A R E

Guilfoyle Ambulance gains strength Eldest son steps into CEO post after death of mother in June By LEAH BULETTI

Bruce G. Wright, left, is the new president and CEO of Guilfoyle Ambulance Service, shown at the facility with his brothers Toby, center, a paramedic, and Travis, an EMT. Their mother, former president Charmaine G. Wright, died in June.

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t may have lost its “matriarch” in June — a woman so in tune with her community that she slept with a police scanner by her bedside and so dedicated to her company that her employees called her ‘Mom’ — but familyrun Guilfoyle Ambulance Service hasn’t lost sight of its mission to serve the community. “If anything, we’ve strengthened since my mother passed away,” Bruce G. Wright, 30, one of Charmaine G. Wright’s three sons, said in an interview earlier this month. Mr. Wright, who graduated from Watertown High School in 2000 and from Utica College in 2005 with a degree in health studies and management, took over his mother’s role as CEO and president in June. He continues to work closely with his two brothers, Toby and Travis, also Guilfoyle employees. Travis, the youngest of the three, is an EMT and will begin training as a paramedic this fall, while Toby is more a “boots-to-the-ground type of person” who enjoys the operations side and had an interest in emergency medicine since childhood when a heart condition prohibited him from playing sports, Bruce Wright said. “He lives and breathes this, as many in this line of work do,” Mr. Wright said of Toby. Mrs. Wright joined Guilfoyle in 1971 when a partner in the company invited her to accompany him on a run to Syracuse. She was “an EMS pioneer,” Charles F. Brenon III, director of Jefferson County Emergency Medical Services told the Watertown Daily Times in June after her funeral.

JUSTIN SORENSEN | NNY BUSINESS

“Charmaine is a loss not just to Guilfoyle but to the whole county,” he said. “Her loss is a blow to the whole system.” Mrs. Wright’s late husband, Bruce M., ran the company from 1973 until his sudden death in 1993. At the time, EMS was a very new profession. “It didn’t start developing its science and real out coming until the 1960s,” Mr. Wright said. “My father took over just as it was starting to become what it is today.” Coupled with growth in Jefferson County and federal grants to serve Fort Drum, Guilfoyle has consistently expanded its services over the years, which it looks to continue through a focus on community outreach and preventative medicine in the wake of Mrs. Wright’s passing. Guilfoyle, which holds a state certificate of need to serve the county, including the Town of Watertown, has 120 employees and 26 vehicles, including 14

ambulances and six wheelchair vans. “We see the sky as the limit,” Mr. Wright said. “We want to show the community that we’ve been here since 1907 and that we are a part of this community. We want to make sure we’re meeting health care needs and a productive member of our area.” Community paramedicine, which essentially extends the role of emergency room doctors to treat and release patients on the spot if they call an ambulance—is an oftdebated program that is still in the works but which could prevent many unnecessary hospital rides, Mr. Wright said. Meanwhile, with health care costs skyrocketing, Guilfoyle plans to join the growing movement of preventative medicine through programs like hosting blood pressure clinics at apartment complexes and teaching public

Please see Guilfoyle, page 46

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H E A LT H C A R E

Prevention, efficiency critical

Noted doctor: Physician assistants will have greater role in care By LEAH BULETTI

W NNY Business

ith health care costs ballooning and anxiety about the Affordable Care Act mounting, hospitals should focus on more effective care delivery and campaigns that target smoking and obesity. That was the message that Dr. Delos M. “Toby” Cosgrove III, Watertown native and president and CEO of the Cleveland Clinic, gave last month to a packed Clayton Opera House during an interview with Dr. Robert F. Asbury, a physician in Rochester who served with Dr. Cosgrove during a residency at Massachusetts General Hospital. The Cleveland Clinic is a $6.2 billion health care system consistently ranked as one of the four best nationwide. Under the leadership of Dr. Cosgrove, who joined the clinic in 1975 and became chairman of the department of thoracic and cardiovascular surgery in 1989, the clinic’s cardiology program was ranked first nationwide for 10 consecutive years. Dr. Cosgrove has performed more than 22,000 operations, filed 30 patents and published nearly 450 journal articles. He attributes some of his success and interest in patient care to being an undiagnosed dyslexic until the age of 34, an experience which taught him persistence and a different way of looking at problems, as dyslexics tend to be more creative thinkers. But it did cause him to have an “absolutely horrible academic career” and nearly fail his first year of undergraduate work at Williams College. “I just thought I was dumb,” he said. “But I think dyslexia was a huge advantage. I never would have gotten through college if not for plain plugging.” Serving as a surgeon in the U.S. Air Force and as chief of the U.S. Air Force Casualty Staging Flight in Vietnam taught him the importance of hospital transportation systems and the value of physician assistants. He was in charge of a 100-bed hospital treating 75 to 100 patients per day with only one other doctor, 11 nurses and “uncounted” assistants. This system “allowed everyone to practice at their level of ability and it worked

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JUSTIN SORENSEN | NNY BUSINESS

Dr. Delos M. “Toby” Cosgrove, left, president and CEO of the Cleveland Clinic, speaks about health care innovation and reform during a discussion with Dr. Robert F. Asbury last month at the Clayton Opera House.

terrifically,” Dr. Cosgrove said. “We’re going to see a major change in Hospitals in the Cleveland Clinic’s syswho gives care and where it happens,” he tem, which includes more than 75 northern said. Ohio outpatient locations, are similarly spe- Small disruptions to the system, like cialized based on what he called a “FedEx those happening now with the rise of pharfor patients” that moves them around to macies doing more primary care, are the the right places. The main Cleveland Clinic catalyst to future innovations, he said. treats a The U.S. higher level health care of illness system isn’t than any currently an facility in integrated the country; model; it one-third of lacks a way to Dr. Delos M. “Toby” Cosgrove, Watertown move people its beds are native and Cleveland Clinic president and CEO through a intensive care. cycle of care Reliance on physician assistants will be between home, hospitals, outpatient clinics and rehabs. Implementing a better delivery key in hospitals nationwide, Dr. Cosgrove system and reducing the burden of disease said, when the Affordable Care Act exacare the two ways to reduce costs that erbates a physician shortage expected to have escalated to 18 percent of the counreach 98,000, half in primary care, in the try’s gross domestic product, the largest next 10 years. At the Cleveland Clinic, with percentage of any country in the world, Dr. 80 physician assistants and 12 surgeons in cardiac surgery, physicians can focus solely Cosgrove said. on their role and not tasks such as changing Initiatives to tackle both of these issues at the Cleveland Clinic include group visits dressings, thus improving the quality of of patients with the same disease, fewer care, he said.

There’s no question it had to change. The current system is unsustainable from a cost standpoint. —


H E A LT H C A R E unnecessary lab tests, yearly contracts and reviews of physicians to determine salary, less wasteful use of surgery tools and improved same-day access to physians. Hospitals also need to look at consolidating services like finances, information technology and purchasing, he said. In the past year, there have been 170 hospital mergers; 60 percent of hospitals nationwide are now part of a system, he said. “What you’re going to see is hospitals all over the country coming together in one large group,” he said. To reduce the burden of disease, the Cleveland Clinic stopped hiring smokers, removed all fried food from the cafeteria and placed a premium on exercise. As a result, staff members’ weight has decreased by 400,000 pounds collectively and the percentage of people who smoke in the clinic’s county has declined from 28 percent to 15 percent over five years. Though he said he initially received criticism for his smoking initiative from those who thought it was overstepping the bounds of an employer, today 6,000 businesses nationwide ban smoking. “You can make a difference,” Dr. Cosgrove said. He said he is disappointed that the ACA includes few provisions for such initiatives to keep people healthy, given that smoking, obesity and lack of exercise drive 70 percent of chronic disease and 70 percent of health care costs. But Dr. Cosgrove said it’s too early to determine the impact of the federal healthcare overhaul. “I guarantee it will be different,” he said, calling the changes a different way of administering health care. “I don’t think immediately the cost will go down. But there’s no question it had to change. The current system is unsustainable from a cost standpoint.” The Cleveland Clinic has teamed up with Community Health Systems—the second largest for-profit health care provider in the country. Dr. Cosgrove said the partnership makes sense because CHS is trying to create an efficient model, and his clinic’s focus on driving quality through transparency must be efficient to be the successful value-based health care model of the future. “We hope the hybrid helps us to both become more efficient and help spread our model of care,” he said. In response to a question from the audi-

ence about his work with autism, Dr. Cosgrove said that he is “deeply concerned” about higher incidences of both autism and Alzheimer’s disease. One in 88 live births today is an autistic child, he said, alarming considering he knew few autistic children growing up. The number of people over the age of 65 with Alzheimer’s is expected to increase by 40 percent over the next 12 years, to 7.1 million, according to the nonprofit Alzheimer’s Assocation. But he said he has reason for cautious optimism, as the two areas of innovation that have seen huge progress and have

widespread implications for the future are neurological diseases and genomics. With an enhanced ability to understand and image the brain, treatment for these neurological diseases, as well as for diseases like Epilepsy and Parkinson’s, can greatly improve. “There’s enormous potential to understand how the body works and how effective drugs are,” he said of advances in genomics. n LEAH BULETTI is a staff writer for NNY magazines. Contact her at 661-2381 or lbuletti @wdt.net.

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H E A LT H C A R E

Caring for the competitive spirit

Orthopedic surgeon treats athletes at all levels of play By NORAH MACHIA

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he number of sports injuries suffered by north country athletes has increased in recent years, but it’s “a reflection of what’s happening everywhere as youngsters become more competitive at an earlier age,” said Dr. Peter Van Eenenaam, director of sports medicine at North County Orthopaedic Group. “We are seeing an increasing number of knee and shoulder injuries than in past years,” Dr. Van Eenenaam said. Dr. Van Eenenaam is an orthopedic surgeon who is familiar with sports injuries at all levels of competition. A graduate of the Harvard Orthopedic Surgery Residency Program, Dr. Van Eenenaam received orthopedic training at Massachusetts General Hospital in Boston and advanced sports medicine training at the Steadman Hawkins Clinic in Vail, Colo. During his time in Colorado, Dr. Van Eenenaam was part of a team of physicians who performed surgery on Joe Montana, the Hall of Fame quarterback for the San Francisco 49ers and Kansas City Chiefs who played in numerous Super Bowl games. “That was very memorable,” said Dr. Van Eenenaam, who was completing a fellowship in orthopedic surgery at the time he joined the team of physicians treating the famous pro football player. Dr. Van Eenenaam and Dr. Michael Wainberg, also a physician with North Country Orthopaedic Group, were chosen from a pool of 700 applicants to provide medical care to athletes competing in the Winter Olympic Games in Salt Lake City in 2002. They were selected by the Salt Lake Olympic Organizing Committee after extensive screenings of their medical backgrounds, reference and security checks. The two physicians were assigned to treat athletes at the Olympic Sports Medicine Clinic. Since 1996, Dr. Van Eenenaam has also provided medical care to members of the U.S. Women’s Alpine Ski Team during their World Cup competitions in Sweden, Germany, and Austria. Dr. Van Eenenaam was selected by the U.S. Ski and Snowboard Association, the sanctioning federation for Olympic-eligible athletes in skiing and snowboarding, to cover the elite-level camps and competitions.

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Above, Dr. Peter Van Eenenaam with legendary retired New York Yankees pitcher Tommy John. Dr. Van Eenenaam met up with Mr. John for a physical therapy consult a few months ago while the former big leaguer was visiting friends in Watertown. Right, Olympic skier Julia Mancuso celebrates with Dr. Peter Van Eenenaam after she won the Super G races at the 2007 World Cup in Cortina, Italy. SPECIAL TO NNY BUSINESS

In recent years, Dr. Van Eenenaam has worked as a consulting physician for the Lake Placid Iron Man Triathlon. “We’re seeing older athletes working to stay fit and, in some cases, to compete,” he said. “That can bring people in here with overuse injuries or stress fractures. We’re seeing a lot more of that type of injury in this age group.” One type of injury that has increased over the years in younger athletes is

Anterior Cruciate Ligament injury, a knee injury that is more common among teenage girls, he said. “It’s almost an epidemic,” Dr. Van Eenenaam said. “It occurs eight times more often in females than males.” Nobody seems to have pinpointed the exact reason why it’s more common in females, but it probably has to do with the “mechanics and anatomy of females, the difference in their quad and hamstring


H E A LT H C A R E structure, and certain hormones which can weaken ligaments,” he said. That type of injury typically requires surgery and rehabilitation, he said. While it’s seen in athletes who play basketball, volleyball and lacrosse, it seems most common among soccer players, Dr. Van Eenenaam said. Many members of the U.S. Women’s Alpine Ski team, however, had scars on their knees from prior ACL surgeries, he noted. Concussions have also been increasing among young athletes, and that has “shifted our understanding of how serious we need to take head injuries,” Dr. Van Eenenaam said. “Everyone seems more aware, about the seriousness of head injuries — including the coaches and the parents,” he said. Damage to a ligament in the elbow is seen more often among college and professional baseball players. The surgery to treat it was nicknamed “Tommy John Surgery” after the retired famous major league pitcher. The surgery involves replacing a damaged ligament in the elbow with a tendon from elsewhere in the body. Although the incidence of this type of injury seems to be slowly increasing among high school athletes, it’s still primarily found among college and professional players, Dr. Van Eenenaam said. It doesn’t appear to be a big issue in the north county yet, but cases are starting to increase nationwide as youth become more competitive in the sport of baseball, he said. Ironically, Dr. Van Eenenaam met with Tommy John several months ago when he was visiting the Watertown area and requested a physical therapy consult. The retired pitcher has friends in the Watertown area who referred him to Dr. Van Eenenaam. “He was a great guy, very friendly,” Dr. Van Eenenaam said. Although Dr. Van Eenenaam has treated some well-known sports figures during his career, it was his desire to raise a family and practice medicine in his hometown that brought him back to Watertown more than 15 years ago. At that time, he joined his father, Dr. David Van Eenenaam, and several other physicians at the North Country Orthopaedic Group, 1571 Washington St. “I’ve always like the area,” said Dr. Van Eenenaam, a 1979 graduate of Watertown High School who was also a ski racer in his youth. “I really liked the idea of practicing with my Dad [Dr. David Van Eenenaam].” Dr. Van Eenenaam has helped to develop the sports medicine program at the North Country Orthopaedic group, which offers coordinated care for injured athletes, from

initial treatment to surgery and physical therapy if needed. “It’s a uniform treatment program with set protocols” on treating sports injuries, said Dr. Van Eenenaam, who serves as the director of sports medicine at the practice. While it remains a controversial issue as to how much is too much competition for young athletes, “the great majority of people we treat can continue to play sports successfully,” he said. Dr. Van Eenenaam and his wife, Dacia, have two children, Sarah, a student at SUNY Geneseo, and David, a student at Watertown High School. He also volunteers his time to attend home football games at Watertown High School and offers his services if needed, a tradition of his father that he has continued. “Both Dr. Van Eenenaam and his father have worked our sidelines and been a great resource to the district for more than 25 years,” said Michael A. Lennox, director of health, physical education and athletics for Watertown City School District. “They have a wealth of knowledge and have really provided a safety net for the kids and coaches on both teams,” he added. Dr. Van Eenenaam has also been present

at his children’s sporting events in the district for the past several years, and has made himself available to other parents who have questions about sports injuries and prevention, Mr. Lennox said. “He’s all about the kids,” Mr. Lennox said. “He volunteers his time for the district.” While individual coaches work with their players on injury prevention, the Watertown City School District also employs a full-time fitness center director, Eric Kendrew, who designs individual work-outs for athletes looking to stay in top condition during their off seasons. “He shows them specific exercises that are particular for their sport,” said Mr. Lennox. “He also incorporates a nutrition piece. The kids really utilize his advice.” A strong physical conditioning program can help to prevent sports-related injuries, Mr. Lennox said. Mr. Kendrew can help any student develop a fitness or conditioning program, regardless of whether the student plays on a sports team, Mr. Lennox said. n NORAH MACHIA is a freelance writer who lives in Watertown. She is a 20-year veteran journalist and former Watertown Daily Times reporter. Contact her at norahmachia@gmail.com.

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SMALL BUSINESS

Louis and Mary Dufresne, owners of Painfull Acres Amish Furniture, Adams Center. The retired dairy farmers have been dealing Amish furniture from Ohio for the past 10 years. NORM JOHNSTON | NNY BUSINESS

A PASSION FOR QUALITY

Painfull Acres nurtures unique bond with Amish craftsmen By LEAH BULETTI

W NNY Business

hen Louis Dufresne drives into Amish country in Berlin, Ohio, 450 miles from Painfull Acres, the Adams Center furniture store he runs with his wife, Mary, “you’re in 2013, and then all of a sudden you’re in 1850.” None of the 75 Amish furniture makers from whom Mr. Dufresne buys use electricity to make their highly respected, premier quality furniture, but rather compressed air run by a diesel engine. About one third are so conservative that they cannot use cameras; instead of catalogs, the furniture they sell is depicted in hand-drawn sketches by hired artists in binders that line a huge shelf behind the counter of the Painfull Acres showroom. The majority do not use cell phones, so the Dufresnes, who have been running the business for 10 years, mail in order forms and wait for the maker to call from a phone booth in their village. Before the Dufresnes found themselves navigating this insular, somewhat foreign world, though, they worked in a very different business: dairy farming. Painfull Acres operated as a dairy farm for nearly 50 years, passed down from Mr.

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Dufresne’s father in 1980. Throughout the 1980s, the Dufresnes traveled to Ohio about twice a year to attend horse auctions for their children’s 4-H competitions. On one trip, Mr. Dufresne saw a truck of Amish furniture from Pennsylvania. “I said to Mary, ‘we’re going to start selling Amish furniture,’” Mr. Dufresne recalled. Even though farming was becoming too much for the couple as they struggled to find workers, their children left home and Mrs. Dufresne suffered a heart attack, the idea didn’t go over well, initially. “That ruined that vacation,” Mr. Dufresne said with a laugh. But during the same trip, the Dufresnes met a couple from Illinois staying in their hotel who sold Amish furniture. They agreed to introduce the Dufresnes to the Amish. “You can’t just walk in,” Mrs. Dufresne said, even though very few Amish have their own wholesale or retail furniture operations. As lifelong farmers, though, the Dufresnes had a way in. “Being a farmer they really took a liking to him, which opened the door for us,” Mrs. Dufresne said of her husband, adding that he was able to “sit and visit and discuss farming” with the Amish.

“They’re very closed people. If you’re not one of them, you’re not one of them.” Familiarity with the area also helped the Dufresnes develop a network of makers. Many of the Amish don’t have signs or advertise their craft at all, Mr. Dufresne said. “It’s hard to even describe how much they don’t want their world invaded, but once you get amongst them, they’re just like you and I,” Mrs. Dufresne said. Furniture in Painfull Acres’ showroom, the main part of which was the farm’s calf barn and still has the high-ceilings and rustic feel Mrs. Dufresne wanted to preserve, includes wood bed frames (the showroom has four), wine servers, bar stools and TV hutches. Prices vary greatly—tables start at $575, while a brown maple wine server in the show room costs $1,700. The most expensive item currently in stock is a two-tone brown maple hutch, for $3,300. “Smaller does not necessarily mean cheaper,” Mr. Dufresne said. “You can buy it for a fraction of the cost, but you’ll have to spend the money again.” Oak, while “very good, strong wood,” is the least expensive. Wood choices include brown maple, elm, cherry, rustic quartersawn oak, hard maple, hickory, worm


SMALL BUSINESS maple and exotic woods, which come in 60 varieties. Painfull Acres recently added outdoor furniture, including rocking chairs, made from plastic milk jugs. About 75 percent of furniture orders are custom in some form, meaning that buyers can choose attributes like stain, wood, handles, knobs and measurements based around a basic concept found on the floor or in a catalog. Only about 5 percent of orders are “total custom,” meaning the buyer dictates everything about the piece. “We tell people they’re looking at strictly quality when they come in,” Mr. Dufresne said of the opportunities to customize. Amish furniture is not a style, it’s a builder; the Amish will build anything from traditional to modern to Shaker, he added. “If your pockets are deep enough, you can get anything,” he said. The Dufresnes travel to Ohio once a month to pick up orders, which take eight to 10 weeks to complete, using a 36-foot trailer and stopping at 20 to 25 different makers over a 20-mile radius per trip. For orders outside the eastern seaboard, they arrange for shipping from Ohio. The store’s primary clientele is tourists, in large part because of its proximity to Interstate 81, so business peaks in the summer months and around Christmas,

Mrs. Dufresne said. Many people who stop in on a whim are surprised at the quality; “they expect to see Adirondack chairs,” she said. To cater to the tourist crowd that might just be dropping in to look, Painfull Acres sells a wide array of smaller items like jewelry, bowls, quilts, hats, scarves, soap and cards — nearly all hand-made by local artists — that Mrs. Dufresne said make up a large part of the store’s sales. Repeat customers form the basis of Painfull Acre’s business; the Dufresnes keep a paper file on every customer who buys a piece of furniture at the store, so that when they return they can choose a subsequent piece that fits the design. “If we didn’t have repeat customers, we wouldn’t be in business,” Mr. Dufresne said. “Some people fill their houses up.” Two years ago, Painfull Acres had a customer who wanted to furnish a house on an island in the Thousand Islands. He bought two-thirds of the store’s furniture, loading it onto a barge. “It left us almost naked because everything has to be built,” Mrs. Dufresne said. “He wanted it all.” Mr. Dufresne said the fact that the furniture is American-made is a big selling point. “People want to buy American-made

and they want to buy quality,” he said. Pulaski resident Ruthann Walker, a self-described lifelong antique and interior design hobbyist, has been a customer at Painfull Acres since 2010, when she happened to see a sign for the store on I-81. She frequently spends hours in the showroom on weekends. Since her first visit, she has purchased four cherry bar stools, a TV stand/buffet that she uses in her bedroom as a dresser, three maple and elm pie safes and a butcher block

Please see Painfull Acres, page 72

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GUILFOYLE, from page 37 health education classes. Such initiatives not only connect Guilfoyle to the community and possibly prevent unnecessary emergency room trips, but enable employees to do what they love, Mr. Wright said. “People only see ambulances when they call 911, they rarely see our people,” he said. “But generally people do this job because they’re people people. They’d rather be out there talking to people and caring for them as opposed to filing paperwork or doing other things like that.” He likened these initiatives, which can be as simple as educating the population on how to properly install car seats and exercise daily, to the fact that fire prevention is a part of firefighting services. “Prevention and finding a way to make society healthier is absolutely in the future for us,” Mr. Wright said. “As far as what we do and where we go, that remains to be seen.” That direction seems to be forward in a year of challenges and changes for the company. On Jan. 4, Guilfoyle moved from a cramped headquarters on Jewell Drive that it occupied for 40 years to a spacious and remodeled building on Faichney Drive. Half of the building is the Bruce M. Wright Memorial Conference Center, a 13,000-square-foot building that can be used for everything from CPR classes to organizational meetings to baby showers, Mr. Wright said, calling the space “very affordable and accessible.” He said he is pleased with how renting the space has gone so far and called it an “adjustment” rather than a challenge to implement a new system of placing ambulances around the county to maximize call response times. And, as evidence that the company is upholding Mrs. Wright’s legacy, Mr. Wright described how the Friday after his family buried his mother, the company was able to get enough people and vehicles together to take second place in the annual Jefferson County Agriculture Promotion Board Dairy Festival parade. “My mother would’ve been extremely proud,” he said. “And it makes me extremely proud and confident in what our people can do.” Additional reporting by Johnson Newspapers staff writer Daniel Flatley. n LEAH BULETTI is a staff writer for NNY magazines. Contact her at 661-2381 or lbuletti @wdt.net.

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REGION

Sales tax revenues split in Q2

Jefferson County sees dip; St. Lawrence, Lewis climb By DANIEL FLATLEY and MARTHA ELLEN

S

NNY Business

ales tax collections were up for Lewis and St. Lawrence counties in the second quarter of 2013, while Jefferson County experienced a significant dip in

revenue. Down by nearly 2 percent compared with the same period last year, Jefferson County is projecting a budget shortfall of $538,226 to $817,328 by year’s end, according to Scott A. Gray, chairman of the Board of Legislators’ Finance and Rules Committee. “We would have to gain tremendous ground in order to have any increase and we would consider ourselves fortunate if we even make budget this year,” Mr. Gray said in an email to legislators. The quarter started out well enough, with $2.5 million collected in April, 6 percent more than last year, and $2.7 million collected in May, 12 percent more than 2012. But the county collected only $3,151,020 in sales tax revenue in June, a startling 20.72 percent less than in 2012. For 2013 thus far, the county has collected $15,992,996 — 1.94 percent less than last year. In November, the county halved a proposed 4.4 increase in its tax levy — the amount to be raised by taxes — in part by increasing the prediction of how much money the county would take in from sales tax in 2013. Now that calculus apparently has changed.

Second quarter tri-county sales tax revenues Year

Jefferson % Change

St. Lawrence % Change

Lewis

2013 2012

$15.9m $16.2m

$11.1m $10.5m

$2.72m $2.51m

—1.94 n/a

“Last year might have been an anomaly,” Mr. Gray said. “We have to recalibrate ourselves for budgeting purposes. It’s

It’s a sign we’re rebounding from the 2008 recession. — Karen M. St. Hilaire, St. Lawrence County administrator going to be even more difficult to hold the line on property tax for the upcoming budget cycle. Sales tax as a source of increasing revenue is not workable.” There was a ray of light, however, as Mr. Gray pointed out that although the county is experiencing a dip in sales tax revenue this year, it still is collecting more than it had in all years before 2012. The numbers told a different story in St. Lawrence County, where total quarterly receipts showed an increase of 3.22 percent, or $337,785.71, over the same period last year. For the year so far, the county showed a gain of 2.55 percent, or

+2.55 n/a

% Change +4.55 n/a

$525,444.24, over last year. “Excellent,” County Administrator Karen M. St. Hilaire said. “We are delighted to see sales tax is up, because it means increased economic activity in St. Lawrence County. Whenever there’s an increase in sales tax, it’s a good sign.” Ms. St. Hilaire said she thought the increase could be attributed to increased visits to the county by Canadians and others and is a general sign of improving business activity. “It’s a sign we’re rebounding from the 2008 recession,” she said. At $21,117,863.20 collected in 2013 so far — which the county shares with towns, villages and the city of Ogdensburg — the amount of sales tax the county will receive is about half of the $21,050,000 it budgeted for the year. “We’re about $50,000 up, which is always good,” Ms. St. Hilaire said. “I’m very happy with that.” In Lewis County, quarterly receipts showed an increase of 3.38 percent, or $84,853.51, over the same period last year. For the year so far, the county showed a gain of 4.55 percent, or $217,436.54, over last year.

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R E A L E S TAT E R O U N D U P

Report: Homeowners healthier

A

report about homeownership recently caught my eye. Canada’s national housing agency, the Canada Mortgage and Housing Corp., partnered with Habitat for Humanity to see how the lives of Habitat families changed after they purchased and moved into their homes. As you may know, Habitat helps lowto moderate-income families buy a home. Part of the purchase includes about 300 to 500 hours of “sweat equity” by the families. The houses have affordable, interestfree loans with monthly payments based on the cost of materials and the land. The study asked Habitat families across Canada how their lives changed after moving into their homes. The responses were very positive with 89 percent saying their family lives improved and 86 percent saying they are happier. Of the families who had school age children, most said the children’s confidence, behavior, grades and enjoyment of school had increased. In addition, the children were more likely to participate in extracurricular activities and volunteer. Another significant finding was that about 75 percent of the families reported that their health improved. They reported fewer illnesses caused by colds, flu, allergies, asthma symptoms and stress. Thirtyone percent said they visited the doctor less frequently and about a quarter said they took fewer sick days from work. This may be because many of the homeowners had moved from rentals that were not well-heated and had other issues such as mold and humidity. The new homes were much better insulated and drier. Financially, 58 percent said they were better off even though most said their over-

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all housing costs had increased. About half felt more in control of their finances and almost twothirds cited the benefits of building equity. Not surprisingly, the biggest disadvantage, Lance Evans cited by a little over a quarter of the participants, was the responsibility of doing maintenance on their home. The Canadian study mirrors studies cited in “Social Benefits of Homeownership and Stable Housing” published by the National Association of Realtors. The report uses a number of studies and articles that correlate homeownership to various aspects of family life. One corollary is school achievement. Authors of the various studies and articles reached several different conclusions as to why teens of homeowners stay in school longer and have a lower pregnancy rate. A 1997 article by Richard K. Green and Michelle J. White published in the Journal of Urban Economics, concludes that by buying and maintaining a home, parents become more financially savvy and pass that knowledge onto their children. Meanwhile, a study by the New York Federal Reserve Bank found that, as well as improving the education outcomes for children, homeownership also promotes neighborhood stability, which further enhanced the positive education outcome. This was reinforced by a study that focused on low-income neighborhoods and showed

a positive correlation between the rate of homeownership and high school graduation. Finally, Joseph Harkness and Sandra Newman, writing in the Journal of Housing Research, found that for children who grow up in families with incomes less than 150 percent of the federal poverty line, homeownership raises educational attainment, earnings and welfare independence in young adulthood. In addition to education, homeownership increases civic involvement. The NAR report points out that homeowners have a much greater financial stake in their neighborhoods than renters. This translates into greater political involvement and, since owners tend to remain in their homes longer, greater neighborhood stability. Additionally, because there are financial gains due to appreciation in the value of their home, owners tend to spend more time and money maintaining their residence, which contributes to the overall quality of the surrounding community. The NAR publication concludes: “There is evidence from numerous studies that attest to the benefits [of homeownership] accruing to many segments of society. Homeownership boosts the educational performance of children, induces higher participation in civic and volunteering activity, improves health care outcomes, lowers crime rates and lessens welfare dependency.” I think it’s easy to see that owning a home is good for your children’s education, your neighborhood and municipality and your health and happiness. n LANCE M. EVANS is the executive officer of the Jefferson-Lewis Board of Realtors and the St. Lawrence County Board of Realtors. He has lived in the north country since 1985. Contact him at levans@nnymls.com. His column appears monthly.


R E A L E S TAT E

Q2 home market a mixed bag

Sales lose last year’s momentum through first half of 2013 By TED BOOKER

First six months of home real estate sales

ome sales through the second quarter of 2013 in Jefferson County have lost momentum when compared with the first half of last year, according to data from the Jefferson-Lewis Board of Realtors. While sales in Jefferson County are still strong, they’ve dipped slightly through the first six months of the year after what Lance M. Evans, executive officer of the board, described as a “terrific year” for Realtors in Jefferson, Lewis and St. Lawrence counties in 2012. A total of 36 fewer homes, or 10 percent, were sold in Jefferson County compared with the same period last year, a decrease from 405 to 369 units. Comparing the second quarter by itself — April through June — 37 fewer homes, or 18 percent, were sold compared with last year, a decrease from 239 to 202 homes. The median price of homes climbed by $14,000, or 2 percent, from last year, from $142,500 to $156,500. Realtors in Lewis County sold 64 homes through the second quarter, the same number as last year. Four fewer homes, or 11 percent, were sold from April through June this year, a decrease from 38 to 34 homes. The median price of homes increased by $8,000, or 7 percent, from last year through the second quarter, from $108,000 to $116,000. In St. Lawrence County, six fewer homes, or 3 percent, were sold this year, a decrease from 234 to 228. From April through June, 13 fewer homes, or 9 percent, were sold, a drop from 141 to 128 homes. The median price of homes through the second quarter decreased by $1,300, or 2 percent, from $76,300 to $75,000. The makeup of the housing market in the region outside Fort Drum has changed this year, Mr. Evans said, due to the handful of large apartment complexes built to serve the military population. An increasing number of military families could be deciding to rent units, rather than buy houses. But while the 369 Jefferson County home sales through six months are down from last year, that figure still

2013 2012 2011

H NNY Business

JEFFERSON COUNTY Sales 369 405 319 Median price $156,500 $142,500 $136,000 LEWIS COUNTY Sales 64 64 46 Median price $116,000 $108,000 $97,000 ST. LAWRENCE COUNTY Sales 228 234 234 Median price $75,000 $76,300 $69,900 Source: Jefferson-Lewis Board of Realtors, St. Lawrence County Board of Realtors

tops 2011’s mark of 339 homes. “I don’t expect sales to be as great as last year at the moment, but it’s going to be a good year,” Mr. Evans said. “You now have the brand new apartment properties coming up for families, and some people may decide to rent rather than buy. In some cases, soldiers may come back from overseas and rent units because they’re going to be here only a year and don’t want to plant roots.” Sales in St. Lawrence County, which aren’t impacted as much by trends at Fort Drum, have stayed in the same range over the past five years, Mr. Evans said. “They’ve been down for the past couple of years, but only slightly,” he said. “One of the blessings that St. Lawrence County has is that sales don’t drop as much as they can in Jefferson County, but they also don’t reap as much benefit when the economy jumps.”

Deployments at Fort Drum may be another factor impacting housing sales this year. Of the 17,852 soldiers assigned at Fort Drum, a total of 5,152 are overseas, according to a report published July 15 by the Army’s Installation Management Command. A total of 11,194 soldiers have families, and 7,331 of them live off post. The report also gauges the number of rental units sold within 20 miles of Fort Drum. Some 2,700 rental units have been added to the market since 2006, data show, and there are about 1,100 rental units under construction. A total of 40 units were added to the market in 2012. Based on seven major housing projects under construction, a total of 600 units are projected to open in 2013, 300 in 2014 and 200 in 2015. n TED BOOKER is a Johnson Newspapers staff writer. Contact him at tbooker@wdt.net or 661-2371.

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R E A L E S TAT E / J E F F E R S O N C O . The following property sales were recorded in the Jefferson County clerk’s office in July 2013:

On the Web

JULY 3: Town of Alexandria: 54.5 acres, Route 12, DEC Properties Inc., Syracuse, sold to Robert J. Reddick, Gouverneur $1,000,000

n Visit us at WWW.NNYBIZMAG.COM for current real estate sales from Jefferson, Lewis and St. Lawrence counties, updated weekly. Click on ‘Data Center’ to access transactions.

n City of Watertown: 0.178 acre, Holcomb Street, Melissa E. Rodriguez, Enterprise, Ala., sold to Kaitlin S. Robbins and Jacob W. Backus, both of Watertown $126,000

136, Kristina M. Sampson, Theresa, sold to Michael L. Russell and Desirea Lea Russell, Dryden $246,000

n Village of Chaumont: 0.46 acre, Hart access road, Donald A. Knight and Shirley D. Knight, Chaumont, sold to Anthony W. Kasco Jr. and Sarah G. Kasco, Watertown $171,000 n Town of Hounsfield: 0.26 acre, near division line between towns of Henderson and Hounsfield, Betty L. Pieklik, Alachua, Fla.; Robert C. Milliman, Baldwinsville; and Nancy Lee Henry, Cleveland, Tenn., sold to Donald J. Krick and Monica Evans, both of Marcellus $100,000 n City of Watertown: 668 Cooper St., Ora P. Ball Jr., Watertown, sold to Megan Corbett-Hanson, Watertown $110,000 n Town of Watertown: 1.48 acres, 16688 U.S. Route 11, Donald Terpstra, successor trustee, Pauline A. Shelter Living Trust, Watertown, sold to Jake M. Bell and Danielle M. Bell, Mexico $207,000

n Village of Clayton: 0.25 acre, 535 James St., Donald E. Wilsey and D. Christine Wilsey, Bethlehem, Pa., sold to Christopher D. Frank, Clayton $135,000 n Town of Clayton: Five parcels, 50.25 acres, 28.25 acres, 63.66 acres, 50.50 acres, 10 acres, no addresses given, Thomas G. McMullen, Jordan, sold to Erik Swenson, Cape Vincent $60,000 n City of Watertown: 0.138 acre, Gotham Street (foreclosure) Todd J. Doldo, Watertown, referee, Thomas T. Harris and Annette M. Harris, sold to Northern Federal Credit Union, Watertown $123,000

90, David C. Johnson, Mannsville, sold to Linda M. Landers, Mannsville $25,000 n Village of West Carthage: High Street, Edith Martin, Carthage, sold to Gary Johnson, Carthage $50,000 n Town of Alexandria: Eight parcels, 0.3, acre, 0.3 acre, 0.1 acre, no acreage given for the rest, all on Wellesley Island, Vincent J. Chiaramonte and Joan C. Chiaramonte, Sanibel, Fla., sold to Eric R.L. Davies and Anita J. Davies, Kingston, Ontario, Canada $435,000 n Town of Lyme: 0.4 acre, 6541 Failing Shores Lane, James P. McMullen and Eileen A. McMullen, Spencerport, sold to Jeffry J. Gardner and Christine M. Gardner, Rochester $95,000 n City of Watertown: 0.22 acre, 1339 Richards Drive, Andrew S. Converse, Watertown, sold to Michael W. Higgins and Sharyl M. Higgins, Sackets Harbor $220,000 JULY 2: Village of Alexandria Bay: 0.45 acre, Route 12, and Church Street, ALM Holding Co. LLC, Alexandria Bay, sold to Daniel L. Davis Jr., Fishers Landing $320,000

n Village of Sackets Harbor: No acreage of address given, County of Jefferson, Watertown, sold to Thomas Johnson and Therese Johnson, Sackets Harbor $93,000

n City of Watertown: Lynde Street, Troy G. Marquez, Fort Benning, Ga., sold to Robert A. Rocca and Meredith S. Rocca, Hayward, Calif. $85,000

n Village of Carthage: Fulton Street, Jova Cabrera, Rayville, La., sold to Teri S. Tyner, Great Bend $90,000

n City of Watertown: 0.269 acre, Holcomb Street, Nathan A. Holloway and Kathryn C. Holloway, Watertown, sold to Anthony M. Netto and Jillian J. Netto, Watertown $238,000

n Town of Cape Vincent: 5.95 acres, Bedford Corners Road, Richard J. Henderson, Taberg, sold to Victor Chenard and Joanne Chenard, Embrun, Ontario $33,000

n Town of Theresa: 2.19 acres, County Route

n Town of Ellisburg: 10.096 acres, County Route

n Town of Adams: 1.972 acres, Caird Road,

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R E A L E S TAT E / J E F F E R S O N C O . Laurie B. Fitzsimmons, executor, will of Thor B. Cooper, late of Adams, sold to Kathy L. Woolf, Calcium $80,000 n City of Watertown: Two parcels, 436 Lincoln St., Mary S. Yott and Randy A. Yott, Watertown, sold to Laura M. Yott and Thomas M. Yott, Watertown $35,000 n Town of Cape Vincent: 0.74 acre, County Route 6, James V. Benvenuto Jr., Potsdam, and Jack Benvenuto, Rochester, sold to Mari L. Cecil and Cynthia Brenon, both of Watertown $176,000 n Village of Clayton: 0.4 acre, Washington Island, Edward E. Brown, Watertown; Helen R. Brown Duffy, Clayton; Kurt F. Brown, Mohawk;

and Jay M. Brown, Clayton, sold to Edwin N. Urf Jr. and Laticia M. Urf, Watertown $425,000 n Town of Lyme: No acreage or address given, County of Jefferson, Watertown, sold to Christopher G. Gilbert, Theresa $39,000 n Town of Worth: No acreage or address given, County of Jefferson, Watertown, sold to Richard Rapholz, Adams $56,000 n Village of West Carthage: 0.312 acre, 25 N. Main St., James H. Zehr, executor, will of Ronald C. Zehr, late of Lowville, sold to Ronald J. Johnson, Carthage $73,500 n City of Watertown: 0.203 acre, Iroquois Av-

Please see Real estate, page 57

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R E A L E S TAT E / S T. L AW R E N C E C O . The following property sales were recorded in the St. Lawrence County clerk’s office in the month of June 2013: JUNE 27: Town of Hammond: Unknown acres, in Kearney Tract, Jeffrey Ross (executor), Shirley M. Ross, Punta Gorda, Fla., sold to John D. and Virginia A. Vercillo, Cicero $63,000 n Town of Fowler: Unknown acres, bounded by Route 58, Daniel P. and Daniel R. Fetcie, Baldwinsville, sold to Cory V. Young, Hammond $85,000 n Town of Madrid: Parcel 1) 98 9/100 acres more or less, Parcel 2) 20.22 acres more or less, Parcel 3) 40 acres more or less, all parcels bounded by Cunningham Road, William and Marcia Tiernan, Waddington, sold to Jordan M. Bennett, Madrid $173,971.16 n Town of Brasher: 2 3/4 acres more or less, in Lot 1 and Lot 2 of Township 17, Raymond P. and Susan A. Martin, Brasher Falls, sold to William S. Todd, Norfolk $92,000 n Town of Parishville: 2.11 acres more or less, bounded by County Route 58, Darlene M. Snell, Colton, sold to Chantal Rainville and John Lawrence, Potsdam $156,000 n Village of Massena: Unknown acres, in Lot 31 of Block 49, Steven Gilson and Gregory Gilson (co-executors), Betty Ann Gilson, no address given, sold to William and Laurie Bero, Massena $34,950 n City of Ogdensburg: 0.13 of an acre more or less, in Lot 12 of Block 106, Kit W. Smith, Og-

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densburg, sold to Nicholas J. Finley and Michele J. O’Gorman, Slingerlands $29,000

Jackson J. Woika, Rose $75,000

JUNE 26: Town of Colton: 22.61 acres more or less, bounded by Irish Settlement Road, William LaPierre, Colton, sold to LaPierre Management LLC, Colton $75,000

n Town of Fowler: Parcel 1) 10 acres more or less, Parcel 2) 3 acres more or less, Parcel 3) 1/2 acres more or less, all Parcels bounded by Turnpike, Webb Dimon and Nellie S. Dimon, Gouverneur, sold to Roger S. House, Dexter $85,000

n Town of Colton: 1.07 acres more or less, in Section 14, bounded by Route 56, Mark A. and Lynn Martin, Colton, sold to Hugh W. and Peggy S. Horton, Colton $88,322

n Village of Gouverneur: Unknown acres, bounded by Main Street and William Street, Linda Boak and Aaron Lambert, Canton, sold to Nicolo and Francesca Ciambra, Gouverneur $55,000

n Town of Lisbon: Parcel 1) 10.01 acres more or less, Parcel 2) 1 acre more or less, Parcel 3) 28.702 acres more or less, all Parcels bounded by Pray Road, Robin L. Moore, Grantham, N.H., sold to Mark D. and Holly L. Shellenberger, Ogdensburg $235,500

n Village of Massena: Unknown acres, in Lot 23 of Block 1, bounded by Woodlawn Avenue, North Country Savings Bank, Canton, sold to Sean M. LaPlante, Norwood $38,000

n Town of Oswegatchie: Unknown acres, in Lot 4, Michael J. Legacy and Cheryl O’Brien, Ogdensburg, sold to Eric C. and Melinda A. Miller, Ogdensburg $277,000 JUNE 25: Village of Massena: Unknown acres, in Lot 3 of Block 42, Bernard A. Tyo Jr. and Nancy L. Tyo, Massena, Ronald G. and Debra A. St. Amand, Milton, Vt., sold to Ronald Daggett, Massena $28,000 n City of Ogdensburg: Unknown acres, in Lot 1 of Block 38, Richard L. Wagner, Ogdensburg, sold to Cynthia M. Ackerman, Lyons Falls $70,000 n Town of Russell: Parcel 1) 81.18 acres more or less, Parcel 2) Unknown acres, in Section 8, bounded by Crackerbox Road, Joyce E. Austin, Harrisville, sold to Douglas R. Harradine and

n City of Ogdensburg: Unknown acres, in Lot 170 and Lot 171 of Block 383, Alberta M. Scott, Ogdensburg, sold to Nadine M. Irvine, Ogdensburg $56,000 n Town of Fowler: 7.22 acres more or less, bounded by New York State Route 812, Robin L. Boyer, Gouverneur and Donald C. Boyer, Las Vegas, Nev., sold to Ryan Shampine, no address given $195,500 n Town of Potsdam: Unknown acres, bounded by State Route 56, Durward L. Thomas, Potsdam, sold to Jeffrey Pignona, Potsdam $86,000

$1,998,243 County real estate sales recorded over 3-day period, June 25-27, 2013


R E A L E S TAT E / L E W I S C O . The Lewis County Real Property Tax Service recorded the following property sales in May and June 2013: JUNE 21: Town of Diana: 7104 Deermouse Lane, Brainard Blundon sold to Michael Zicari $120,000 n Town of Martinsburg: 6663 B Arthur Road, Charity S. O’Dell sold to Jeffrey A. Davis $300,000 JUNE 20: Town of Denmark: 9379 state Route 12, Ronald J. Sheldon sold to Terry N. Groff $52,300 n Town of West Turin: Buneo Road (unspecified number), Robin T. Hoskins sold to Scott E. York $175,000 JUNE 19: Village of Croghan: 6504 Lefevre St., Robert J. Smith sold to Jeffrey L. Spencer $45,000 n Town of Diana: 6745 Old State Road, Harry J. Cross sold to Jeremiah O. Boaz $163,500 JUNE 13: Village of Croghan: Second Road (unspecified number), Karl A. Roggie sold to Norbert D. Farney $73,000 n Town of New Bremen: 9122 Briot Road, Vincent Briot sold to Dean F. Briot $50,000 JUNE 11: Town of Martinsburg: 6117 Blue St., Darren T. Pominville sold to Wicked Wench Saloon, Inc. $60,000 JUNE 10: Town of Greig: 5588 Shore Road, Barbara F. Monroe sold to Richard A. Cohen $165,000

JUNE 7: Town of Diana: 14505 Diana Way, Daniel Zurenda sold to Alan E. Deyo $45,000 JUNE 6: Town of West Turin: 5986 Swackhammer Road, Patricia N. Arms sold to Robert A. McCune $132,000 JUNE 5: Village of Lowville: 7663 State St., Elizabeth Czerwinski sold to Chris E. Buckingham $125,000 n Town of West Turin: 3329 Harris Road, Jeffrey M. Shafer sold to Christopher D. Skipper $270,000 MAY 31: Town of Pinckney: 672 County Route 194, Richard Lucas sold to John R. Olmstead $50,000 May 30: Village of Lowville: 7691 Lanpher St., Ruth M. Taylor sold to Joellen L. Myers $85,200 MAY 29: Village of Port Leyden: 7130 North St., Lawrence Seeloff sold to Melissa A. Parks $64,000 n Village of Lyons Falls: 4021 Markham St., Audrey J. Ward sold to Kyle Logan $70,000 MAY 25: Town of Denmark: State Route 26 (unspecified number), Duwayne R. Maurer sold to Ronald L. Clark $112,000 n Town of Greig: 8107 Sand Pond Road, Edward J. Knapp sold to Donald T. Schmitt $156,000 MAY 24: Town of Greig: 5612 Long Point Road, David G. Clarke sold to Timothy S. Fox $175,000 n Town of Watson: 8816 Davis Road, Mary R. Earl sold to The Ruhlman Trust B Dated 1990 $189,000

MAY 22: Town of Croghan: 9930 state Route 812, Charles R. Hancock sold to John U. Farney $110,000 n Village of Lowville: 5369 Summit Ave., Kenneth J. McAuliffe sold to Christopher A. Costella $265,000 MAY 21: Town of Denmark: 10951 state Route 26, Robert Johnson sold to Andrew D. Jennings $65,000 n Village of Croghan: 6898 Shady Ave., Lorri B. Zehr sold to Anne E. Boliver $116,000 n Town of Watson: 6742 River Road, Daniel J. Morak sold to Household Finance Realty Corp. $144,974 n Town of Greig: 6640-6660 Partridgeville Road, Andrew Schor sold to Trailside Ranch LLC $430,000 MAY 20: Village of Lyons Falls: 4144 Cherry St., William J. Dolan sold to Carl S. Ward, Jr. $73,750 MAY 17: Town of Croghan: 10812 state Route 126, Carol Noftsier sold to Han Van Der Veeken $103,000 n Town of Croghan: 10268 state Route 126, Carol Noftsier sold to Han Van Der Veeken $103,000

$4,087,724 County real estate sales recorded over 36-day period, May 17-June 21, 2013

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20 QUESTIONS

Targeting

D

enise K. Young brought a varied background and keen interest in the power of data to the Fort Drum Regional Health Planning Organization, which tackles an array of health care issues in the tri-county area, when she joined it in 2007. She believes leaders from all of the region’s health care providers need to come together in order to create a healthy community. Her organization facilitates these conversations between military and civilian health care leaders and leverages resources to tackle the problems identified.

1

NNYB: How long have you been with the Fort Drum Regional Health Planning Organization? YOUNG: I’ve been with this organization since they have had staff. It actually started in 2005, but I was hired in 2007. When they were first incorporated in 2005 they were just a board of directors who came together around the idea of bringing medical command from Fort Drum together with all the people working in health care in the community, so we could plan for the growth of Fort Drum when the Third Brigade was coming. We were also charged with looking at the health care system, finding out where the gaps were and then looking at the strengths and weaknesses of the unique model of integrated care here in the Fort Drum region and how it might be used by the army in a greater role in the future.

2

NNYB: In less than a decade your organization has transformed itself from being a board of directors with no budget to being a nonprofit with an annual budget of $2.5 million. What has that journey been like? YOUNG: It’s been exciting. It’s really rewarding to be part of moving things forward to where they need to be to help serve the community. This is a community

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gaps in the region’s

health

JUSTIN SORENSEN | NNY BUSINESS

n Fort Drum Regional Health Planning director sees value in data analysis

that really wasn’t prepared to meet all of the community’s needs in 2007. Health care is transforming, especially how it’s going to be paid for in the future. So when we look back to 2007 to where we are today in terms of making sure that this region is positioned to move forward, what we really need is to maintain a strong health care system. Maintenance is what we need to be talking about, with respect to our hospitals, physicians, health care workforce and technology. The gaps in health care here are what you would expect to see in any rural area — workforce, technology, behavioral health resources. Our mission as an organization is to analyze the health care system, identify the gaps and go out and leverage resources to fill them.

3

NNYB: Is that a process of constant re-evaluation? YOUNG: Yes. We look at how we support the hospitals, how we support the physicians and how we make sure as many resources as possible are coming to the north country health care system. That’s not always done in rural areas. This area is lucky to have a central entity doing that for the region as a whole. Individual hospitals and individual physicians really have to be thinking about daily functions and how to treat patients that come in each day. But we serve the role of asking how to serve the population going forward. With the changes caused by the Affordable Care Act, we have to look at how we measure how we’re doing taking care of people, which you can’t do if you don’t have the technology infrastructure in

your practices. We’ve worked very hard to secure various grants and to put in electronic medical records in all of the physician practices. We’ve been able to work with the hospitals and connect everyone through a health information exchange, which positions us to do the things we need to do in the future like create data registries so physicians can look at how they take care of their whole panel of patients.

4

NNYB: When you talk about maintenance, it’s way more than brick and mortar infrastructure right? It’s the human infrastructure? YOUNG: Yes. The best and the brightest minds that are coming out today and practicing expect that technology to be there when they get to an institution. The other piece of building our human workforce is our partnership with Jefferson Community College to leverage outside educational institutions to provide higher education here. Upstate Medical, which has brought its nurse practitioner and respiratory therapy programs here, has also been a huge partner of ours. We’ll soon have both bachelor and master’s degree programs in social work. It’s pretty incredible that we can have local people educated here and able to provide a health care workforce for the future. Those nurse practitioners will be our primary health care providers in the future. The county recognizes that this is an economic development issue and supports us in that effort. We help pipeline people into health care jobs because they are living-wage, secure jobs. The idea is to retain our hospitals and our health care access here, which means the jobs will stay here.


20 QUESTIONS

5

NNYB: How much is your organization’s focus on the regional community, not just the military community? YOUNG: From the beginning the focus has been regionwide. We are one community here at Fort Drum so when we improve health care for soldiers and families, we improve health care for the civilian community. If we’re talking about bringing everyone to the table around behavioral health, the Chief of Behavioral Health from Fort Drum sits at that table. But so does the Director of Behavioral Health for Carthage Area Hospital and for Samaritan Medical Center. We bring military and civilian together all at one table.

6

NNYB: From your perspective, what does it take to build a health community? YOUNG: Absolutely the most important thing is that we work together—the hospitals, public health, community and behavioral health providers. The Centers for Medicare & Medicaid Services has identified a triple aim for health care: to improve population health, to improve the patient’s experience with care and to reduce the cost of care. We can’t figure out how to do that if we’re not sitting at the table together. It starts with a few people having the passion to come together.

7

NNYB: Was there ever a plan that the post would have its own hospital or was it always the plan that it would be integrated with the community? YOUNG: The idea of community integration was there when Fort Drum started—801 housing was in the community, the schools were in the community. It made sense to have hospital bed capacity in the community. And it does work. I think the army has seen the way Fort Drum has grown into the community as being good for soldiers. For a light infantry division like Fort Drum, it makes sense.

8 9

NNYB: How many staff do you have? YOUNG: We have 18 today, but we may add another seven. We also have many partners. It’s not just leveraging resources for what we do, it’s leveraging resources for our partner organizations. NNYB: If you could fix one thing about our system, what would it be? YOUNG: I would bring behavioral health services and physical health services together. We need to move into a future where we’re treating the whole person and not trying to treat people in sections. As a region, we have increased the number of tri-care behavioral health care providers by 70 since I’ve been here. We continue to see growth in behavioral health services. I believe how we take care of our behavioral health is the same as how we take care of our physical health and if we’re not doing that then the whole community feels the ripple impact.

10

NNYB: Your agency was recently awarded a $225,000 grant from the state Office of Rural Health to focus on a web-based quality of life system. What will that enable you to do? YOUNG: It’s about how we measure taking care of the population going forward and making those measurements easily accessible to the public. We have the ability to constantly see how we’re doing. With ongoing data, we can identify regional problems.

11

NNYB: How important is getting people engaged in their own health to what you’re doing? YOUNG: It’s very important. We’ve been conscious

JUSTIN SORENSEN | NNY BUSINESS

Denise K. Young, Executive Director of Fort Drum Regional Health Planning Organization, in her Washington Street office. Mrs. Young has been with the organization since 2007 when it first had staff. of that for a long time because of our involvement with electronic medical records. Many of our physicians have portals where patients can go. We’ve found that if patients can go to their portal outside of their physician’s practice and are taught how, they go there. With an aging population, we have a lot of folks who are taking care of baby boomer parents. If your parent can give you access to their portal, you can help them with their medication. We can become a society that’s better able to take care of our population if we’re better able to access data about it. We also have a couple of initiatives around empowering individuals to then act on the information. The whole idea of payment reform is paying physicians to keep people healthy, not paying them to take care of patients when they’re sick.

12

NNYB: What would that treatment model look like? YOUNG: It’s making sure people go in for a tune-up and making sure that they see a primary care doctor. We have great primary care doctors here who are really engaged and passionate. They practice here because they want to, not because they’re getting rich here. Changes in health care create a greater workload for those physicians, but also let them do what they want to do. Electronic records allow physicians to monitor patients in addition to a yearly physical. Turning around prevention is a hard steer and it’s a pretty big turn from what health care financing has been for so long. We have to reduce inpatient admissions and unnecessary emergency department visits. A lot of people use the ED as their primary care through no fault of their own but because they don’t have access to primary care. As we reduce those visits though, we reduce revenue to hospitals. Hospitals have infrastructure. We have to figure out how to reduce hospitals’ overhead costs while maintaining the hospital for when we need it.

13

NNYB: Is your service area defined by the footprint of the post? YOUNG: Our region was somewhat defined by referral patterns. We have the 40-mile radius around the post which is our health service area. Our region is all of Jefferson, Lewis and southern St. Lawrence counties. In St. Lawrence, Claxton-Hepburn Medical Center, Clifton-Fine Hospital and E.J. Noble Hospital are on our board. North of Canton-Potsdam Hos-

The Denise K. Young file AGE: 55 JOB: Executive Director, Fort Drum Regional Health Planning Organization FAMILY: Husband, Daniel; son, Robert, 30; daughter, Christine, 28. HOMETOWN: Cogenhagen EDUCATION: Bachelor’s degree from Empire State University in Occupational Safety and Health, master’s degree in healthcare administration from University of Phoenix. EXPERIENCE: Started out in Cottage Inn, Copenhagen, when mom owned it, then Safety Director of paper mill in Carthage, went on to become Health Planner with Jefferson County Public Health, Director of Center for Community Studies at JCC, then joined Fort Drum Regional Health Planning Organization in 2007. LAST BOOK READ: Chesapeake by James Michener pital, the referral patterns tend to go north toward Burlington, Vt., so it makes sense that this group of hospitals is working together.

14

NNYB: What is your organization doing with telemedicine? YOUNG: We’ve been working in it a while, beginning with getting fiber in place with all the providers. We’ve got a Rural Health care pilot project that is a huge fiber network that extends from hospitals in Albany and Utica. We have another network north of us called the Action Network that goes all the way around the horn to Burlington. There’s a cross connect that connects the two. North Country Health care Providers is doing a study on what to do with the fiber. The fiber network has huge potential for health care and telemedicine. We’re also doing some small pilot programs because we have to figure out how this is going to be paid for. Many states pay for telemedi

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20 QUESTIONS cine just like they pay for other health care, but New York does not.

15

NNYB: What is the patient experience like with telemedicine? YOUNG: There have been a lot of studies and patients report being as satisfied, if not more satisfied, with the care. The patient doesn’t have to go sit in an office and wait forever or drive to Syracuse. There’s a wide range of telemedicine. With skin legions, for example, you don’t necessarily need to have a doctor looking at you, you just need to be able to get a picture. You don’t have to go into an office and have it done. It’s called store and forward. We have a grant in for doing ophthalmology for diabetic patients in primary care practices. One of the gaps we found

in practices was that the ophthalmology exam wasn’t being done. If the doctor could have telemedical equipment in his office and do the digital retinopothy exam there and send the pictures directly to the ophthalmologist, patients could get it done without even leaving the primary care office. Since these things are not being reimbursed, we have to figure out how to pay for everything we do. We’re doing pilot projects with Excellus right now to do psychiatry from a primary care practice. You hear me say primary care practice a lot because that really is where people go. We’re trying to tear down barriers to care.

16

NNYB: Are the primary care doctors on board with this? YOUNG: We’re doing pilots right now so we’re

just starting. We have one successful pilot and the patients are pleased. It’s access to care that they wouldn’t otherwise have and that they don’t have to drive to. Under the seven hospital North Country Initiative, we have some pretty sophisticated medical devices coming to emergency departments so doctors could present cases to specialists somewhere else. If doctors can send you virtually, they wouldn’t have to send you physically unless you really need to go. River Hospital right now has that equipment set up. Their partial hospitalization program for soldier’s mental health is using the equipment to provide psychiatric care to soldiers off site.

17

NNYB: You were a tremendous advocate for Air Medical. How is that going now? YOUNG: When MASH was phased out, it left this community with no Air Medical. Air Medical could come up from Syracuse but the reality is that we had ambulances sitting and waiting for Aid Medical to come. The ambulance would often get there before the helicopter ever could. With Aid Medical support, the time factor and the quality of care you get on the ride are both crucial. The Air Medical providers have highly trained flight nurses, some with very sophisticated equipment. And then the sticker shock — the $40,000 helicopter ride. People have to remember we don’t have a lot, but we have to have them staffed, ready and equipped every minute we need them. So we have to take the number of rides we get, split it by the number of dollars and make it feasible for them to be here. Also, insurance pays. We had the $40,000 price tag and it ended up costing the guy $20. The key is if you need that service — if it’s your child, your mother or your spouse — you don’t care. I’m happy they’re here and I hope we can keep them here.

18

NNYB: How did you get involved in this type of work? YOUNG: I’m very interested in health care and I’m also a data geek. I really have a strong belief that we need to use facts and information to make decisions. We all live in our own little corners and in our corners this is the way it is so we think this is the way it is everywhere. But we can’t make decisions based on our beliefs. We need to make data-based decisions. We analyze the health care system and we go out and leverage resources. The other thing I always say is that everything I ever really needed to know, I learned tending bar. You learn to talk to people. You learn that all people are the same inside and out. You learn people get along.

19

NNYB: What’s the best business advice you’ve ever followed? YOUNG: Jim Cadd, the manager of James River Paper Mill (Carthage) when it was going under, told me that it’s not about how good you are, it’s about how good you help the people who work for you to become. That’s what success is about. You need to hire people who are smarter than you and who are better than you. Your goal needs to be to make everyone else better than you are. As an organization, we strive to grow everybody to the point where they will be better than I will ever be individually.

20

NNYB: If you could have dinner with one person living or dead who would it be? YOUNG: I would love to have dinner with my mom. I would love to have a discussion about how she kept a hotel and restaurant running for 25 years. She’s been gone since 1998, but you never stop missing your mom. — Interview by Ken Eysaman. Edited for length and clarity.

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REAL ESTATE, from page 51 enue West, Amy DiFabion, Watertown, sold to Elizabeth L. Clark, Watertown $145,000 n Village of Dexter: 1.47 acres, Dexter Acres Subdivision, Converse Construction Don Inc., Watertown, sold to Brian Moore and Tricia Moore, Dexter $315,000 JULY 1: Town of Pamelia: 1.06 acres, Route 37, Michael Huber and Casey L. Huber, Watertown, sold to Michael Becker, Watertown $275,000 n Town of Clayton: Two parcels, 17.10 acres, 2.72 acres, Hart Road, Christina Lorraine Buxton, LaFargeville, sold to John S. Humphrey and Karen Humphrey, Watertown $130,000 n Town of Henderson: Two parcels, Lasher Road, George D. Mathias and Marilyn B. Mathias, Upperco, Md., sold to John F. Peebles and Karen A. Peebles, Adams $270,000 n Town of Ellisburg: No acreage or address given, County of Jefferson, Watertown, sold to Bernard Thomas, Mannsville $25,500 n Town of Henderson: 5.531 acres, Harbor View Road, Mark Leonard and Linda Stoddard Leonard, Henderson, sold to Brian Ward and Julie A. Ward, Adams $45,000 n Town of Wilna: No acreage or address given, County of Jefferson, Watertown, sold to Michael Hoppel, Lowville $28,000 n City of Watertown: 0.30 acre, Bugbee Drive, Michael T. Becker, Watertown, sold to Paul J. DiFabion III and Amy J.H. DiFabion, Watertown $220,000 n Village of Dexter: 1.54 acres, Grant Street, Converse Construction Don Inc., Watertown, sold to Jerry C. Heath and Nicole M. Modinger, both of Dexter $324,000 n Town of Rutland: Two parcels, 0.69 acre, 1.582 acres, County Route 162, Herby W. Waite and Shelly A. Waite, Watertown, sold to Howard V. Madsen II, Fort Drum $175,000 n Town of LeRay: 103.70 acres, U.S. Route 11, NBT Bank N.A., successor by merger to Alliance Bank, Norwich, sold to LeRay Route 11 LLC, Pittsford $550,000 n City of Watertown: 123-125 E. Main St., Linda L. Eveleigh and Larry W. Knight, both of Watertown, sold to Donna L. Gressler and Gary L. Gressler, Watertown $75,000 n Village of Clayton: 0.22 acre, 324 Webb St., Guy T. Mannix and Catherine A. Mannix, Clayton, sold to Nicholas J. Fusillo and Janet A. Fusillo, Liverpool $27,000 n Town of Pamelia: 0.13 acre, 9885 Aspen St., Beacon Deerfield LLC, Faytteville, sold to John Kubeika and Julianne Kubeika, Waynesville, Mo. $236,000 n Village of West Carthage: Two parcels, Madison Street, Carthage Federal Savings and Loan Association, Carthage, sold to William R. Leeder, Natural Bridge $94,000

$7,781,000 County real estate sales recorded over a 3-day period, July 1-3, 2013

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E C O N O M I C A L LY S P E A K I N G

A good tool to grow your business

I

t’s no secret that all businesses need funding. Business owners go through a variety of avenues to obtain funding and can often be met with frustration and rejection. Through personal conversations with a number of business owners, professional peers and friends, I hear over and over again that “there is no money to borrow” and that “lending institutions are not lending.” Despite these frustrations and concerns, options are available for financial assistance. The lending environment is actually becoming increasingly competitive because institutions do have capital to lend. In today’s environment, lenders are looking for creative and beneficial ways to provide loans to businesses. The old banking adage that “cash is king” still rings true today as businesses fight to hold onto their own capital. Businesses can never have too much cash and banks want to work with businesses that have cash. With the Small Business Administration’s 504 program, businesses can access capital on favorable terms as well as help preserve some of their own cash. The SBA program is available for businesses looking to acquire fixed assets. Eligible projects include purchase or construction of owner-occupied commercial real estate, equipment, furnishings and related soft costs. This program is beneficial because it allows existing businesses to put as little as 10 percent equity into a project, compared with traditional lending that would typically require 20 percent or more. A typical financing structure for a 504 project would include a 50 percent

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first mortgage held by the bank and up to a 40 percent second mortgage held by the SBA (not to exceed $5.5 million). While the low down payment requirement is a key component Brian Bund of the 504, another benefit is that the SBA’s second mortgage is a fixed rate, typically below market, for the duration of the loan, either 10 or 20 years. Current interest rates are 3.61 percent for 10 years and 4.53 percent for 20 years. The added security of fixing an interest rate allows a business to help predict their future debt payments much more accurately. To access the SBA 504 program, a local bank or credit union would engage with one of 260 Certified Development Companies that has authorization for the program. The CDC would then lead you through the process of determining SBA eligibility as well as a loan structure. We in New York are fortunate to have one of the largest CDCs in the United States to process 504 loans, Empire State CDC, Brian Bund (315) 453-8196. If eligible, the CDC will work with you to complete a package for SBA approval. During this process, financial information would be collected for the business and its owners, standard SBA forms would be filled out and other necessary documentation collected to meet SBA requirements.

Approvals take no longer than a typical bank application. The 504 program provides tangible benefits to the lending institution and the business owner. Through this program, the bank reduces its risk, therefore increasing the likelihood of approval. And, by injecting less cash than typically required into the project, a business is able to hold onto its cash to help fulfill future working capital needs. Through favorable repayment terms, less required equity and greater likelihood of obtaining approval from a lender, the 504 program is a beneficial tool that business owners should be aware of when looking to acquire real estate or equipment for their business needs. A FINANCING SUCCESS STORY Founded in 1990, Hi-Lite Markings is a second-generation, full-service airport striping operation based in Adams Center. In 2007, the company determined that an expansion was necessary given its projected growth. During the planning phase, expansion of the Adams Center location was deemed unfeasible. The company decided to expand its service shop in Watertown from 5,100 square feet to 14,700 square feet. This project was funded through the use of the 504 program accessed through Empire State CDC. The expansion of the Watertown facility proved to be essential and the firm was able to double its sales over five years. n BRIAN BUND is assistant vice president for the New York Business Development Corp. in Syracuse. Contact him at (315) 453-8196 or bbund@nybdc.com.


B U S I N E S S L AW

LLPs a good choice for some entities

I

n past columns, I have written about limited liability companies and closed corporations. In each instance, it was assumed that the owner or owners were actively involved in the operation of the business. There is, however, a business entity in which a person is considered an owner of the business but takes no part in the active operation of it. This type of business entity is called a Limited Liability Partnership. A LLP is required by law to have a twoclass ownership style. One class of ownership is the general partners who manage the day-to-day activities of the business. Another class of owner is the limited partners who invest in the partnership but are forbidden by statute from actually participating in any management activities. Essentially, a LLP has two classes of ownership: one class of ownership is the managers of the business, while the other class is the investors in the business. Like any business entity, LLPs have advantages and disadvantages. One advantage is that a person may be an owner of a business without the risk of unlimited personal liability should the entity be sued. In this case, the general partners who manage the business are exposed to that risk. Limited partners may have the same rights to profits as the general partners, depending on the LLP agreement. Limited partners may sell their interests, even at a profit, but this action must be permitted by the LLP agreement. One of the disadvantages of LLPs is defining the relationship of the two classes of ownership. A sophisticated LLP agree-

ment is used to accomplish this. The agreement must establish such things as profit and loss ratios, when and if a partner may withdraw and the terms of the admission of a new partner Larry Covell or valuation of a partnership interest. There is a cost of formalities in the creation of the entity. If LLP interests are offered to the general public, certain state or federal laws must be

six successive weeks. The Jefferson County clerk’s office has information on the approved newspapers for filing legal notices. The publication must contain the name and address of the limited partnership, the names and addresses of the general and limited partners and the duration of time that it will conduct business. Once the publication requirement has been fulfilled, a proof of publication affidavit must be sent to the Secretary of State’s Office. A limited partnership agreement is the third requirement. The agreement identifies the general and limited partners and their obligations and rights in the partnership; discusses policies for admissions of new partners and management authority of the general partners; and even provides an indemnity clause for the general partners. Although LLPs can be used in many small businesses, they are frequently used in the real estate rental business. The general partners usually manage the rental business while the limited partners invest the capital to build or purchase the rental property. A LLP is a complicated business entity and is designed for someone who is considering investing in a business but does not wish to manage its day-to-day affairs. As a general partner, it is an excellent business entity if you lack sufficient financing for your business and know of investors who wish to enter into business with you but do not intend on any day-today management.

One advantage is that a person may be an owner of a business, but does not have the risk of unlimited personal liability should the entity be sued. complied with, which drives up the cost of creation and operation. Certain formalities must be followed to create a LLP. The partnership must file a “Certificate of Limited Partnership” with the New York Secretary of State’s Office. The certificate requires the LLP have a name that is unique from all other limited partnerships in New York and that the business name contain the words “Limited Partnership” or “LP.” Additionally, the certificate must appoint the New York Secretary of State for the service of process. Along with filing the certificate, a legal notice must be filed in two local newspapers, once a week in each newspaper, for

n LARRY COVELL is a professor of business at Jefferson Community College and an attorney. Contact him at lcovell@sunyjefferson.edu. His column appears every other month in NNY Business.

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COMMERCE CORNER

Delivery, focus key to presentations

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here is truth in believing in what you want to be heard. Have you ever given a presentation, either to a small or large audience or even one-on-one and realize people appear to be looking through you, nodding off or getting fidgety? It happens to all of us, but there are several ways to enhance the delivery of your message to ensure your audience remains engaged. Many believe that, like leading, presenting and public speaking is a gift an individual is born with. This is not true. Some individuals are more comfortable speaking in front of others, but with time, as well as gaining more skills and knowledge, most can increase their level of confidence in giving a sales pitch to a room full of individuals waiting to hear what you have to say. Regardless of the field, the ability to present information clearly, efficiently and effectively is a key skill and a requirement of most jobs. Preparation begins long before the actual presentation or meeting. Wheather you are giving an elevator speech, speaking to a large audience or talking with one person, research will assist in delivering a clear, concise message by giving you a strong understanding of what you will be presenting. Reserach enables you to streamline the key points of the presentation, ensuring the information is accurate and all the points of the presentation are executed. There are several methods of effec-

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tive dleivery. Remember to assess who your audience is and how they will best receive the message. Relevance is key — if your message is not relevant to your Lynn Pietroski audience, the delivery method is irrelevant. Your delivery method, topic and audience should all play an integral role in how you share the message. Enticing individuals to hear your

How you say it is as important as what you are saying. message can begin with the introduction — short and strong. Although it is important to introduce yourself, chances are the audience, regardless of size, has some background and an idea of the general purpose of your presentation. As much as you want the audience to know who you are and your purpose, it’s equally important to know who your audience is to avoid sharing a message that may not be well received. Keep your audience informed by providing a brief overview of your presentation and timeline. People can often get distracted wondering when the presentation will be over and what the point of it

is. Begin your presentation with an eyeopening fact, statistic or other surprising insight. Avoid starting with “I want to talk about” or encouraging people to follow along with a PowerPoint. Have that available for them, but deliver the message yourself rather than relying on a PowerPoint. Always stick to the point of your presentation and its purpose. Many individuals veer away from the purpose of their presentation, begin to ramble and even provide more opinion than facts, which can lead to an unhappy audience and unnecessary use of jargon. Similar to writing, following your introduction, the main content of your presentation should provide your audience with the necessary information to make informed decisions or entice them to ask questions. The conclusion of a presentation should highlight the points of the content delivered, but use different words and encourage questions and comments. There are several resources available to individuals who are required or have a desire to give a presentation, speak in public or interact with various size groups. These resources can include a simple Internet search, a public speaking class or other leadership training. How you say it is as important as what you are saying. n LYNN PIETROSKI is president and CEO of the Greater Watertown-North Country Chamber of Commerce. Contact her at ceo@watertownny. com. Her column appears monthly.


AGRI-BUSINESS

Cost, turnover obstacles for coverage

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s with many small businesses, farms face tough choices when deciding on health care coverage for farm operators and employees. Agricultural is a high risk industry. A recent accident in July on a dairy farm in the Town of Rodman and a mishap on a farm last spring in the Town of Hounsfield show how quickly injuries can occur, especially given that farm workers are around large pieces of equipment and unpredictable large animals, and in environments where problems happen quickly and without advance warning. An analysis published in Agricultural Economics in Jan. 2012 documented annual health care expenditures of selfemployed farm households in the U.S. The analysis determined that farm households with no health insurance spend the least, an average of less than $4,000 per year. Farm households where the spouse or farm operator are also employed off the farm and receive health insurance through their outside employer spend slightly more, an average of about $5,000 per year. The highest expenditures tend to occur at farm households where either the farm provides the insurance coverage or insurance is obtained through a private insurance company. In these cases, average annual expenditures are $7,500 and $10,000 respectively. Although most farmers are self-employed, the share of farm operator household members who have no insurance equals that of the overall population of the U.S. —16 percent. Farm employers are not currently

required to carry health insurance for farm operators or employees. In most cases, farms are required to carry Worker’s Compensation insurance for Jay Matteson employees and a disability benefit if workers are disabled as a result of their job. Disability insurance is also often provided through the Worker’s Compensation insurance coverage. Health insurance coverage varies widely on Jefferson County farms. Through an informal phone survey of several dairy farms, it varied from no coverage to full coverage for operators and employees. Farm operators cited two problems to providing health insurance: high cost and high employee turnover. Smaller farms tended to not have coverage or have it through a spouse or farm operator who obtained coverage through other off-farm employment. With the average age of farm operators increasing, those who needed health insurance used federal and state health insurance programs. The cost of obtaining health insurance was prohibitive in many cases without the options provided by outside employment.Larger farms tended to offer more options. In some cases, farms indicated the farm operators and upper management ob-

tained health insurance through a private plan. If employees advanced to management positions, they were offered health insurance. However, high turnover rates caused farms to not offer health insurance to entry-level employees. In most of these instances, the farm operator indicated that if an injury occurred on the farm, the employees’ injuries were paid for by the farm out of pocket, regardless of the employees’ length of employment. Other larger farms that could afford private insurance plans offered health insurance to all employees after the workers completed a probationary period of working on the farm. Many have high deductibles to reduce the cost to the employer. One farm interviewed said they provided a health insurance stipend of $5,000 per year for employees. The farm said the employees seemed happy with this policy and that many of the workers had spouses who received health care benefits from off-farm employment; the stipend helped the employee meet deductibles and costs not covered by the spouse’s insurance. All of the farms interviewed said they are nervous about the new federal mandates. Many feel they may not be impacted because of their number of employees, but all said they are concerned that the new mandates will have a negative financial impact. n JAY M. MATTESON is agricultural coordinator for the Jefferson County Industrial Development Agency. He is a lifelong Northern New York resident who lives in Lorraine. Contact him at coordinator@comefarmwithus.com. His column appears monthly.

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BUSINESS TECH BYTES

Apps, e-portals improve patient care

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oes anyone remember a doctor making a house call complete with the famous black bag? Does your health care provider still have shelves and shelves of the color-coded manila folders? I personally haven’t been to a doctor, dentist or even an urgent care office that is not only taking appointments, but now conducting most patient care via laptops or iPads. During my latest visit to the Women to Women Samaritan Family Health Center, I was introduced to and enrolled in MySamaritanHealth.com. All I needed to provide was an email address and within minutes I had a login, temporary password and the website www.MySamaritanHealth.com up on my Android. As a matter of fact, I also got to check my email and send some text messages, but wait times are for another time and column. The MySamaritanHealth.com website as well as the Healow app are using software from eClinicalWorks, a leader in ambulatory clinic technology solutions boasting a customer base of more than 80,000 physicians and 472,000 other assorted medical professionals in all 50 states. The eClinicalWorks website has the largest cloud network in the medical industry with approximately one in five Americans’ health data stored in some version of the eClinicalWorks suite of software. At the Samaritan Family Health Cen-

ters, your experience begins with the care management tool, eClinicalMessenger. Two days before my scheduled appointment, a phone call and voice message reminded me of Jill Van Hoesen my appointment, followed by a text message with the date, time and phone number in case of the need to “change or cancel your appt.” On a desktop or laptop, you can

easy to navigate. Use the code HDGGA to eliminate the need to search for the Samaritan Family Health Centers in Watertown. Once you link your patient portal account, enter your username and password, the same one you use for MySamaritanHealth.com. You will then be prompted to assign a four-digit code to lock the Healow app and secure any linked patient portal accounts. You even have the option to add a photo to further personalize your Healow experience. The mail icon will take you to the same inbox you are accessing from MySamaritanHealth.com. The calendar icon displays appointments going back two years, while the “Pill” will provide you with a repository to track your prescriptions or request a refill. The chemistry beaker provides a list of your test results and the clipboard is chock full of your personal information, from your date of birth and address, to your height, weight and vital signs from your last exam. The Web-based patient portal at MySamaritanHealth.com and the Healow mobile app are both fast, intuitive and simple to use. If you would like access to this innovative health care option, contact your Samaritan Family Health Center office. You are only about five minutes from an online connection to your health care provider.

The Web-based patient portal at MySamaritanHealth.com and the Healow mobile app are fast, intuitive and easy to use.

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navigate to the eClinicalWorks Patient Portal on MySamaritanHealth.com. This website provides a whole new way to actively manage your health care and your relationship with your health care providers. You can view your medical records, request an appointment or refill your prescription. You also have access to an email function enabling you to send secure emails to your health care provider on non-emergency matters with an expectation of a response within 24 hours. Be sure to download the Healow app, available on both iOS and Android devices, which is very well designed and

n JILL VAN HOESEN is chief information officer for Johnson Newspapers and a 25-year IT veteran. Contact her at jvanhoesen@wdt.net. Her column appears monthly.


SMALL BUSINESS SUCCESS

Tax credits among benefits of ACA

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he Affordable Care Act has created a lot of discussion in the small business community, and with good reason. Many small business owners are apprehensive about how the act will impact their bottom line and whether they will be able to meet its requirements. There is still much that is unknown about the act; the recent announcement postponing the mandate for businesses with more than 50 employees has added to the confusion. The basic premise of the ACA is widely known: starting in 2014 everyone must have health insurance coverage and that insurance must meet a minimum standard of quality. What isn’t always understood is how this will impact small business owners. Although the mandate for some businesses has been pushed to 2015, this doesn’t necessarily mean they won’t be impacted by the act this coming year. Likewise, businesses with fewer than 50 employees who aren’t required to provide coverage may still be impacted by the act. With individuals required to have insurance beginning in 2014, small businesses that do not offer coverage may find that they are competing to attract or keep employees against businesses that do. Individuals have a strong incentive to have coverage. Those who are uninsured for more than three months in a year must pay a tax penalty of $95 per person in 2014. In 2015, that penalty increases to

$325 and in 2016 to $695. In 2015, small businesses with 50 or more employees will be required to offer health insurance Michelle Collins that meets standards for affordability and minimum value or face a penalty. The penalty will not be paid on a tax return, but will result in an IRS notice to the employer of a potential liability, to which the employer will have the opportunity to respond before payment is demanded. Although the ACA’s requirements seem arduous, it has benefits designed to help small businesses absorb the costs of providing coverage. Employer tax credits went into effect back in 2010 and are still in effect. The act provides for a credit of up to 35 percent of the employer’s share of the insurance premium cost. In 2014, that credit increases to 50 percent for coverage that is provided by one of the state-operated health insurance exchange programs. All that is required for an employer to take advantage of this credit is to have fewer than 25 full-time employees and average annual wages less than $50,000 and to pay at least 50 percent of the insurance premium for employees’ coverage. It is estimated that 81 percent of small

businesses in the state are eligible for this credit but many have not taken advantage of it. Employers who missed out on the credit in previous years may be able to amend previous tax returns and take advantage of it. Consultation with an accountant is strongly recommended to help determine eligibility for credits. Another tool that will help both individuals and employers comply with the ACA are health insurance exchanges that provide “one stop shopping” for comparing and selecting health insurance. New York will open the Small Business Health Options exchange for businesses with fewer than 50 employees and the Health Benefit Exchange for individuals and sole proprietors in October. Small businesses are going to need help sorting out their options under the ACA. In addition to accountants, a state grant has funded navigators to help businesses understand and comply. The navigators will be part of agencies with established relationships with employers, employees, consumers and the self-employed. They will educate the public on the act and will also distribute information about enrollment and tax credits. Small businesses should watch for more information on where to find a navigator. n MICHELLE COLLINS is a certified busi-

ness advisor with the New York State Small Business Development Center at SUNY Canton. Contact her at collinsm@canton.edu. Her column appears bi-monthly in NNY Business.

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COMMUNITY / BUSINESS CALENDAR

ALEXANDRIA BAY TUESDAY, AUG. 13

n Encore Entrepreneur: Marketing Your Small Business, 1 to 3 p.m., Mascherry Library. Workshop led by Sarah O’Connell, Small Business Development Center advisor, will cover marketing, market research, customer service, advertising, targeting, e-marketing and more. Part of Jefferson Community College’s Growth and Personal Enrichment Series. Cost: $15. Advance registration required: JCC Continuing Education Division, 786-2438.

SATURDAY, AUG. 17

n Thousand Islands Bridge 75th Anniversary Public Open House, 10 a.m. to 4 p.m., bridge property near toll plaza on U.S. mainland. To commemorate the bridge’s 75th year, there will be presentations on the bridge’s construction, entertainment by Brockville Pipers and Drums, the 10th Mountain Division Band and the color guard from 2nd Brigade Combat Team, a vintage auto show, a screening of a documentary on the building of the bridge, children’s games and refreshments. Admission is free. Information: www.tibridge.com.

ADAMS TUESDAY, AUG. 15

n Free community concert, 6:30 p.m., Village Green. The 10th Mountain Brass Quintet will perform. Sponsored by Adam Revitalization Committee.

BOONVILLE SATURDAY, AUG. 10

n Guided Mountain Biking Trip, 12 p.m., Great Lot Sportsman’s Club, Osceola Road. Follow a guide or use a map to explore miles of dirt trails on your own. Refreshments will be provided at the clubhouse following the ride, which is free and open to all ages. Information, registration: 378-7592.

CAPE VINCENT SATURDAY, AUG. 10

n Tennis Tournament, Celeste Letendre Memorial Recreation Park, men’s single senior doubles on Friday, Aug. 16; men’s 45 and over singles, men’s open doubles, men’s 45 and over doubles, men’s super senior doubles (65 plus), women’s open singles, women’s open doubles, women’s 55 and over doubles and mixed doubles on Saturday and Sunday. Cost: Singles, $10; doubles, $12. Seedings will be available Wednesday, Aug. 14. Registration: www.capevincent.org. Information: Jerry LeTendre, 654-2512.

CARTHAGE WEDNESDAY, AUG. 14

n Memory Lane Classic Car, Truck and Motorcycle Cruise-in, 6 to 8 p.m., Turning Point Park, behind Jreck Subs and Rite Aid parking lot. Food, prizes, music and 50-50 raffle. Proceeds to benefit scholarship fund. Sponsored by Carthage American Legion Post 789. Information: www. carthageamericanlegion.org.

TUESDAY, AUG. 13

n Roast Pork Dinner, 4 p.m. takeout, 4:30 p.m. serving, Grange Hall, Champion. Sponsored by Champion Grange 18. Cost: $9; children 12 and younger, $5. Information: 773-5133.

MONDAY, AUG. 19 TO FRIDAY, AUG. 23

n Summer Rocket Camp, 9 a.m. to 12 p.m., Don-

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ald F. Getman Memorial Park. Hands-on program for children ages 10 and older. Learn to design, build, test and fly your own model rocket. Registration fee: $145. Registration required: www. edgeonscience.com.

ABM. Information: www.abm.org or 686-4104.

CHAUMONT

n Tuggers 7th Annual Tug Hill 500, 9 a.m. to 12 p.m., Tuggers Bar and Grill, 544 state Route 177. ATV ride with nine different stops, food, games, music and more. Registration Friday, Aug. 23 from 6 to 9 p.m. at Tuggers. Information andreservations for RV sites, tent sites or cabins: Tuggers, 688-2627.

SATURDAY, AUG. 10

n 20th Annual Craft Fair, Food & Bake Sale, 9 a.m., Lyme Free Library, 12165 Route 12E. To reserve a 10-by-10-foot vendor space for $10, call 649-5454. Information: www.lymefreeli brary.org.

SUNDAY, AUG. 11

n Gourmet Breakfast, 9 to 11 a.m., Crescent Yacht Club. Breakfast will benefit the Lyme Community Foundation. Cost: $15; $7.50, children ages five to 12; free for children five and younger. Reservations required by Thursday, Aug. 8: Barb Peck, 649-2236.

MONDAY, AUG. 19 TO THURSDAY, AUG. 22

n Jr. Journalists 101 (ages 9-12), 1 to 3 p.m., Lyme Free Library. Children ages 9 to 12 can learn the basics of journalism and create their own newsletter to share with friends and family in this workshop led by Andrea Pedrick and sponsored by Jefferson Community College. Registration fee: $30. Information: www.sunyjefferson. edu or 786-2438.

CLAYTON FRIDAY, AUG. 9 TO SUNDAY, AUG. 11

n 49th Annual Antique Show & Sale, Wine & Cheese Preview 6 to 9 p.m. Friday at Thousand Islands Arts Center; antique show 10 a.m. to 5 p.m. Saturday; 10 a.m. to 4 p.m. Sunday, Cerow Recreation Park Arena. Show will feature more than 80 antique dealers selling furniture, jewelry, glassware, china, books and more. Children 12 and younger, free. Information: TI Arts Center, 686-4123.

COPENHAGEN WEDNESDAY, AUG. 14

DEXTER WEDNESDAY, AUG. 14

n Paul Buell Combo, 6:30 p.m., Dexter Village Green. Sponsored by the Dexter Historical Society. During ice cream and cake social. Bring a lawn chair. In the event of rain, the concert will be held in Village Hall. More information: 639-6260.

FORT DRUM THURSDAY, AUG. 8

n Fort Drum Career Fair, 10 a.m. to 2 p.m., Fort Drum Commons, 4350 Euphrates River Valley Road. Career fair sponsored by Fort Drum Army Career & Alumni Program. Information: 772-3434. List of participants: www.facebook.com/DrumACAP.

GOUVERNEUR SATURDAY, AUG. 24

n 20th Annual Antiques in Park, 10 a.m. to 3 p.m., Village park. Sponsored by E.J. Noble Hospital Auxillary. Vendor space: $30 for 15-by-15foot space. Contact: Carrie Porter, 286-4838 or carrielona@hotmail.com.

LAFARGEVILLE SATURDAY, AUG. 17

n History boat tour, leaves dock at 5:30 and returns at 8 p.m. Informative sunset tour around Grindstone and Canadian islands led by local historian Norman Wagner. Cost: $25 per person. Information: www.timuseum.org or 686-5794.

n Rivergate to Zenda Bike Trek with TILT, 10 a.m., Rivergate Trail LaFargeville Trailhead. Thousand Islands Land Trust Trustee Elaine Tack will lead a ride to TILT’s Zenda Farm Preserve in Clayton and share the history of Rivergate as a rails-to-trails project. Lunch will be provided by Subway of Clayton. Return transportation will be available for riders. Free for TILT supporters. Information, registration: 6865345 or www.tilandtrust.org.

SATURDAY, AUG. 17

LOWVILLE

WEDNESDAY, AUG. 14

n Diving presentation, 1 to 3 p.m., Thousand Islands Museum, 312 James St. Local divers Skip Couch and Dennis McCarthy will discuss the Clayton shipwrecks and present the new displays. Free admission. Information: www.timuseum.org or 686-5794.

SATURDAY, AUG. 17 TO SUNDAY, AUG. 18

n 36th Annual Rotary Gun and Sportsman Show, 9 a.m. Saturday to 5 p.m. Sunday, Cerow Recreation Park Arena. Sale of new, used and antique firearms; sporting goods, black powder firearms and supplies; fishing tackle; decoys; military surplus; firearm parts and supplies. Information: Tom Neely, 4824596 or captntom048@gmail.com.

FRIDAY, AUG. 23

n Movie Under the Stars, 8:30 p.m., Antique Boat Museum. The second of the Movies Under the Stars series nights will be Pirates of the Caribbean: The Curse of the Black Pearl starring Johnny Depp. Admission: Advance sale at the museum, $5; night of the show, $10. Ticket sales benefit the

SATURDAY, AUG. 17 n Pancake breakfast, 8 to 10 a.m., Lewis CountyHistorical Society, 7552 S. State St.. Sponsored by Lowville Chapter of Masonic Lodge, Order of the Eastern Star. Includes sausage, home fries, scrambled eggs, orange juice and coffee. Event will also be held Saturday, Sept. 14 and Saturday, Oct. 12. Cost: $7.

MEXICO SATURDAY, AUG. 17

n Afternoon Tea at Casey’s Cottage, 3 p.m., Mexico Point Park. Afternoon tea and treats will be served. Admission: Adults, $10; Children five and younger, $5. Reservations required: 963-7657.

OGDENSBURG SATURDAY, AUG. 10 TO SUNDAY, AUG. 11

n North Country Wine, Beer & Food Festival;


OLD FORGE TUESDAY, AUG. 27 TO SUNDAY, AUG. 31

n Annual Library Book & Bake Sale, Tuesday to Saturday 11 a.m. to 8 p.m., Saturday 11 a.m. to 3 p.m., Old Forge Library. Hardcovers are $1 each or five for $4 and paperbacks are $.50 each or five for $2. Saturday, Aug. 31 is bag day ($3). Information: 369-6008 or www.OldForgeLibrary.org.

PAUL SMITHS SUNDAY, AUG. 18

n Mushroom Walk, Paul Smith’s College Visitor Interpretive Center, 8023 State Route 30, 10 a.m. to 12:30 p.m. Mushroom expert Susan Hopkins will lead a guided walk discussing and identifying poisonous and edible species of mushrooms. The walk will be held rain or shine. Books and reference materials will be provided in the picnic pavilion for use after the walk. Admission: $10, Friends of the VIC; $20, non-members. Information: www.adirondackvic.org.

SANDY CREEK SATURDAY, AUG. 10 TO SUNDAY, AUG. 11

n South Jeff Mega Blast 2013, Oswego County Fairgrounds, grounds open at 8 a.m. Live music, food, camping and prizes, including a 2013 Ford 4x4 Raptor, 2013 Camaro 2LT, 2013 Cadillac, 2013 Jeep, camper, motorcycles, Polaris Razor, hunting rifles and more than $30,000 in cash. Proceeds benefit the South Jefferson Rescue Squad building fund. Cost: $100, each ticketholder permitted to bring one guest for an additional $20. Information: www.southjeff megablast.com.

SACKETS HARBOR

tion with the BASSMASTER Elite Series fishing tournament, the St. Lawrence Showdown. Free admission. Information: St. Lawrence County Chamber of Commerce, 386-4000.

Club. Admission: Rider, $20; Passenger, $10. Information: Laurie Mansil, 783-5661.

WATERTOWN

n PAWS for Reading, 12 to 2 p.m., Flower Memorial Library, 229 Washington St. Sign up for a 15-minute spot to read with Layla, a therapy dog. Open to children ages 5 and older. Registration required: 785-7705.

SATURDAY, AUG. 10

n Brew at the Zoo, 5:30 to 9 p.m., Thompson Park. Sample more than 65 different beers from New York state breweries and food from more than a dozen north country restaurants. Live music will be provided by Benjamin Sacci Plante, Satchmo Pops and Fox Richardson. Cost: Individual (21 plus), $30; military, $25; group of six, $150. Tickets, information: www.nyszoo.com.

SATURDAY, AUG. 10

n Tennis Tournament, Celeste Letendre Memorial Recreation Park, men’s single senior doubles on Friday, Aug. 16; men’s 45 and over singles, men’s open doubles, men’s 45 and over doubles, men’s super senior doubles (65 plus), women’s open singles, women’s open doubles, women’s 55 and over doubles and mixed doubles on Saturday and Sunday. Cost: Singles, $10; doubles, $12. Seedings will be available the evening of Wednesday, Aug. 14. Registration: www.capevincent.org. Information: Jerry LeTendre, 654-2512.

MONDAY, AUG. 12 TO FRIDAY, AUG. 16

n 3-C’s: Creepy, Crawly, Critters; 9 a.m. to 12 p.m.; Jefferson Community College. Entomology for kids (ages nine and above) workshop led by Joelle DeCillis will provide a hands-on science experience. Transportation to an offsite location to collect critters for study will be provided on Wednesday, Thursday and Friday. Registration fee: $199. Information, registration: www.suny jefferson.edu or 786-2438.

WEDNESDAY, AUG. 14

n Google Super Searcher, Jefferson Community College, 5:30 to 7:30 p.m. Workshop led by Carleen Huxley will cover Google Search, Google Scholar, Google Books, Google Images, Google Maps, Google Links and more. registration fee: $30. Information, registration: www. sunyjefferson.edu or 786-2438.

THURSDAY, AUG. 15

n Chicken BBQ, 12 to 4 p.m., Sackets Harbor American Legion, 209 Ambrose St., Cost: $8. Information: 646-3530.

n August Business After Hours, 5 to 7 p.m., Fairfield Inn & Suites, 250 Commerce Park Drive. An evening of networking, prizes and food. Admission: $8, members registered in advance; $10, non-registered members; $12, non-members. Registration: www.watertownnny.com or 788-3369.

SATURDAY, AUG. 10

FRIDAY, AUG. 16

SATURDAY, AUG. 10

n Classic Car & Motorcycle Show, 10 a.m. to 3 p.m., Sackets Harbor Visitor Center lawn. Information: Tom Spencer, 783-7022.

FRIDAY, AUG. 16

n Steak at the Bar, 5 to 7 p.m., Sackets Harbor American Legion, 209 Ambrose St., Cost: $12. Information: 646-3530.

WADDINGTON FRIDAY, AUG. 9 TO SUNDAY, AUG. 11

n Tastes and Talents of the North Country Vendor Show; 11 a.m. to 8 p.m. Friday, 10 a.m. to 8 p.m. Saturday, 11 a.m. to 5 p.m. Sunday; Whitaker Park. Family festival and consumer expo highlighting the local community’s artisan, food, craft, wine, brewery and entertainment businesses and organizations in conjunc-

n Girls Day Out!, 9 a.m. to 12 p.m., Jefferson Community College. Girls ages eight and older are invited to enjoy snacks and crafts while learning about American Girl Doll Carolina Abbott. Bring your American Girl Doll or other special doll or stuffed animal. Led by instructor Heather Miner. Registration fee: $45. Information, registration: www.sunyjefferson.edu or 786-2438.

FRIDAY, AUG. 16

n Tranquil Thunder LLC Third Annual Unmet Needs Run for the North Country; 9:30 a.m. registration, 11 a.m. start; North Country Children’s Clinic, 238 Arsenal St., finish at Eagles Club, Washington Street. Approximately 85-mile ride to benefit Unmet Needs, which helps individuals afford medications. Music will be provided by Paparazzi Scandal and food provided by Texas Roadhouse. Benefit and raffle at 1 p.m. at Eagles

SUNDAY, AUG. 18 TO MONDAY, AUG. 19

WEDNESDAY, AUG. 21

n Google Drive, 5:30 to 7:30 p.m., Jefferson Community College. Learn how to create a Google Drive account, upload and organize content, share documents and other useful tips. Led by instructor Carleen Huxley. Fee: $30. Information, registration: www.sunyjefferson.edu or 786-2438.

WEDNESDAY, AUG. 21

n Church and State Relations in the United States, 5 to 8 p.m., Jefferson Community College. Discussion is part of The Monticello Project with Molly Reilly. Registration fee: $45. Information and full schedule of talks on American politics and government: www.sunyjefferson.edu.

SUNDAY, SEPT. 1

n 1812 Challenge and 1/2 Marathon, race starts at 7 a.m. near Immaculate Heart Central School, Watertown, and finishes at the Historic 1812 Battlefield Site, Sackets Harbor. Races aim to commemorate the anniversary of the battle, promote distance running and honor the region’s military presence. Runners can pick up race packets at an expo from 11 a.m. to 4 p.m. Saturday on Main Street in Sackets Harbor featuring entertainment and vendors. The 18.12 mile course will be open for four hours. The 1/2 Marathon course will be open for three and a half hours. The race will be capped at 812 runners. All participants will receive a medal and a longsleeved dri-fit t-shirt. There will also be $1,1812 in prize money. More information, registration: www.1812challenge.com.

SUNDAY, SEPT. 8

n Mulligans for Kids 9th Annual Golf Tournament, 9 a.m. registration, 9:30 a.m. shot-gun start, Willowbrook Golf Club. Proceeds benefit The Resolution Center of Jefferson and Lewis counties, which funds Youth Court, Court Appointed Special Advocates and mediation programs for youth and families. Sponsored by the Resolution Center of Jefferson and Lewis Counties and the Sackets Boathouse Restaurant & Bar. Cost: $60 per person, includes green fee, golf cart, lunch on the turn, on-course contests, awards and sandwich buffet. Sponsorship and information: 785-0333 or www.resolutioncenter.net.

COMMUNITY / BUSINESS CALENDAR

11 a.m. to 6 p.m. Saturday, 12 to 5 p.m. Sunday; Lockwood Arena, 141 N. Water St. Sample wines, craft beers and specialty foods from the north country, including New York cheese, maple and honey products, olive oils, vinegars, spices, baked goods, coffees, organic vegetables and more. Admission: $5, free wine glass with Price Chopper AdvantEdge Card. Information: www. ogdensburgny.com or 393-3620.

WOODVILLE SUNDAY, AUG. 11

n Poetry potluck party, 4 to 6 p.m., 6253 Allard Road. Bring a poem, finger food and beverage to share. Event will be held outside and will be rescheduled for the following Sunday in the event of rain. Free admission. RSVP to Judith and Andre de Zanger: 846-5516.

 GOT A BUSINESS EVENT or calendar item? Email nnybusiness@wdt.net. Deadline is the 10th of each month for the following month’s issue. Visit us on Facebook at www. facebook.com/NNYBusiness or www.nnybizmag.com for events calendar updates. August 2013 | NNY Business

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BUSINESS SCENE GWNC Chamber of Commerce Business After Hours at Ives Hill

Karen Clark, director, USO-Fort Drum and Col. Carl A. Alex, deputy commander, support, 10th Mountain Division.

KEN EYSAMAN PHOTOS | NNY BUSINESS

From left, Wilson Tinney, resident, Ives Hill Retirement Community, and David Clark, General Dynamics, Fort Drum. Ives Hill Retirement Community hosted the July Greater Watertown-North Country Chamber of Commerce Business After Hours on July 18.

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From left, Donna MacPherson, executive director, Ives Hill Retirement Community, and Kristin Stockwell, O’Brien’s Restaurant & Bar, Clayton.

KEN EYSAMAN PHOTOS | NNY BUSINESS

From left, Dr. Ludwig E. Khoury, Allergy Care PLLC, Watertown, Cyril Mouaikel, RBC Wealth Management, , Watertown, Lt. Col. W. Scott Weaver, Communications and Outreach, 10th Mountain Division, and Kenneth R. Piarulli, Ameriprise Financial.


BUSINESS SCENE GWNC Chamber of Commerce Farm & Craft Market, Washington St., Watertown

Loren and Chris Bush, Bush Gardens, Carthage.

from left, Bondeana LaMont, and Jessica Gentry, LaMont’s Food Fair, Glenfield.

LEAH BULETTI PHOTOS | NNY BUSINESS

LEAH BULETTI PHOTOS | NNY BUSINESS

From left, Steve and Diane Rutigliano and Jim McCauley, Old Fashion Kettle Corn, Three Mile Bay. The Greater Watertown-North Country Chamber of Commerce Farm and Craft Market is held Wednesdays from 6:30 a.m. to 3 p.m. at the Dulles State Office Building on State Street through Oct. 2.

From left, Mindy Tyo and Robin Hannon, owner, Timmy Crack Corn, Rodman.

n LIKE NNY BUSINESS ON FACEBOOK

at www.facebook .com/nny business or scan this QR Code with your smartphone for links to exclusive content, daily updates and sneak peeks of coming issues.

August 2013 | NNY Business

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BUSINESS SCENE 2013 EMERGE NNY Summit at Best Western Carriage House Inn & Conference Center

From left, Janelle Bossuot, Samaritan Medical Center, Melanie Rafferty president, Cortel Improvement, and Jayne White, Samaritan Medical Center.

KEN EYSAMAN PHOTOS | NNY BUSINESS

From left, Joanna Fassett, Watertown Urban Mission, Stacey Finley and Destiny Walker, both of Children’s Home of Jefferson County. The Greater Watertown Jaycees presented 2013 EMERGE NNY on July 25 at the Best Western Carriage House Inn & Conference Center. About 100 professionals from across the north country attended the one-day professinal devleopment summit.

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From left, Jeannie Forrester, Samaritan Medical Center, Megan Fulton, American Red Cross, and Amy Rawson, Planned Parenthood of NCNY.

KEN EYSAMAN PHOTOS | NNY BUSINESS

From left, Jim Lewis, Watertown Vending, Kraig Everand, WPBS-TV, Watertown, Holly Boname, Cornell Cooperative Extension of Jefferson County, and Leslie DiStefano, Samaritan Medical Center.


BUSINESS SCENE River Hospital Foundation Festive Evening at the Thousand Islands Club

From left, Debi Provenzano, Baldwinsville and Pam Frisch, Fayetteville.

Irene Carman and husband, Tom, president and CEO, Samaritan Medical Center.

KEN EYSAMAN PHOTOS | NNY BUSINESS

From left, Rick Tague, Wellesley Island, Ben Moore III, River Hospital CEO, Dr. Troy Johnson, chief medical officer, River Hospital. River Hospital Foundation held its 11th Annual Festive Evening on July 28 at the Thousand Islands Club Restaurant. Since 2003, the summer event has raised nearly $1 million to benefit the foundation.

KEN EYSAMAN PHOTOS | NNY BUSINESS

Logan Hollinger and Andrew Garlock, both of Alexandria Bay.

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BUSINESS SCENE Carthage Area Chamber of Commerce Business After Hours at Pleasant Night Inn

Johnna and Kent Burto, Lube Express and Hunt Real Estate.

JEREMIAH PAPINEAU PHOTOS | NNY BUSINESS

Adil Ameer, Carthage Area Hospital, wife, Shaheen, and Sandip Patel, Pleasant Night Inn, West Carthage. Pleasant Night Inn hosted the July Carthage Area Chamber of Commerce Business After Hours on July 30.

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Teri Ellis, Carthage Federal Savings & Loan, and Justin Carroll, Northern Credit Union.

JEREMIAH PAPINEAU PHOTOS | NNY BUSINESS

From left, Stephenie Clemons and Amy McEathron, IMEC of Carthage.


BUSINESS SCENE CREDO Community Center 40th Anniversary Celebration at Hilton Garden Inn

Crystal Wilson and husband, John, Credo Community Center.

From left, Ruth Duffany, Dexter, and Jennifer and Bill Kinne, Watertown.

KEN EYSAMAN PHOTOS | NNY BUSINESS

James P. Scordo, executive director, Credo Community Center, and wife, Karen. Credo Community Center for the Treatment of Addictions celebrated its 40th anniversary on Aug. 1 at the Hilton Garden Inn, Watertown.

KEN EYSAMAN PHOTOS | NNY BUSINESS

Credo co-founders Rev. Ray Wertman and Edie Marsala.

August 2013 | NNY Business

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PAINFULL ACRES, from page 45 top to fit atop an antique dresser—all of which she has customized. She’s in the process of custom designing 13 different oval end tables for her four children and nine grandchildren. The tables are a foot wide and 25-inches long, with two Queen Anne drop leaves. All will match but have their own unique aspects, as Mrs. Walker is designing them with the child’s house in mind; her four children will receive tables made from exotic wood, the first time that Painfull Acres has ever had an order with exotic wood. Mrs. Walker said she envisions these tables as “heirlooms” that will last at least 50 years; she plans to ask a local artist to engrave plaques with her name as the designer and the name of the builder for the underside of each table. After years of weekends spent antiquing as far away as Indiana and Maine, Mrs. Walker has devoted her passion and eye for design to her offspring’s houses. “I don’t need anything anymore,” she

ASSISTED LIVING, from page 36 lower than anticipated since its late February opening. The 42,000-square foot facility, which was built by Carthage Area Hospital and cost about $9.5 million, has four dozen 322-square-foot studio apartments and 12 one bedroom, 433-square-foot apartments. Only 14 of its 60 beds are filled. “We’re growing continually, we don’t have a large number of patients right now,” Joseph W. Millard, administrator of the facility, said. “This level of care was lacking in the area — you have home and nursing home and nothing in between. People go through different stages as they progress and most of the time you don’t want to go right to a nursing home directly.” He said the facility was anticipating filling up slightly faster, but he believes it will be

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said. “That’s why I’m doing it for my kids.” The quality and craftsmanship of Amish furniture is “equal to what true antiques are.” “The way it’s put together—there’s no comparison,” she said, adding that it’s rare to see in today’s furniture the precision in different wood combinations that characterizes much Amish furniture. “I go for quality, I don’t talk about price,” she said when asked how much she was paying for the customized tables. “The quality is worth the price and the price is fantastic.” Given the costs associated with the trips to Ohio and the fact that the Amish are “very shrewd businessmen,” selling Amish furniture is not something “you’re going to get rich doing,” Mr. Dufresne said. But that doesn’t mean he doesn’t enjoy it, despite the store’s incongruous name, which was the name of the dairy farm that Mrs. Dufresne said they kept because the Amish liked its uniqueness. “People always say that it must be a culture shock to go from milking cows to

this,” Mr. Dufresne said, trailing off with a touch of sadness. “I do miss farming. Cows were fun. But I’ve met so many nice and interesting people … friends … doing this.” On a recent Saturday afternoon, at least seven couples and families were browsing Painfull Acre’s showroom or the tworoom barn on the property filled with overflow furniture from the showroom. Many were there for the first time, having stopped in on a whim. Ryan Koolovitz, of Fort Drum, said he and his girlfriend, “saw the sign and drove in.” He described it as a “nice little store” and said he would definitely consider buying a piece of furniture but is waiting to complete his last move with the army before making such a purchase. A Michigan native, Mr. Koolovitz said he had heard of Amish furniture before. “I’m familiar with the Amish reputation for quality,” he said.

full within a year. Opening at the same time as Summit Village made recruitment more difficult given the small population base from which to draw. “People are out there, but you have to wait until they’re ready to join us,” Mr. Millard said. Financial constraints have also played a role. Meadowbrook has 12 self-pay beds and 48 Medicaid beds, a quota set by the state. Seven residents pay the $145 per day fee privately, Mr. Millard said. Mr. Millard doesn’t think filling that number of private pay spots will pose a challenge. When full, Mr. Millard said Meadowbrook will expand from its present 16 employees to 40. Educating the community on assisted living is also key to attracting residents.

“I think there’s a big misunderstanding about who can qualify,” Mr. Millard said. But with people staying longer in the assisted living level of care — sometimes as long as five to 10 years — just as they are staying longer at home, Mr. Millard is optimistic not only about Meadowbrook’s ability to fill its beds, but to expand. Several open acres on the 10-acre property could be used to build an enhanced assisted living facility or start an adult day care program, he said. Nonetheless, “it’s nice to grow small— you learn the process as you’re growing,” he said. “We could grow with the residents.”

n LEAH BULETTI is a staff writer for NNY magazines. Contact her at 661-2381 or lbuletti @wdt.net.

n LEAH BULETTI is a staff writer for NNY magazines. Contact her at 661-2381 or lbuletti @wdt.net.


B

N N Y

To advertise on our lunch menu page, contact your account executive or contact NNY Magazine Advertising Manager Matt Costantino, (315) 661-2305 mcostantino@wdt.net

August 2013 | NNY Business

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BUSINESS HISTORY

Above, the Thousand Islands Museum held a last dance at the fomer Clayton Casino in June 2007. Right, the building, once a vibrant nightclub, was demolished in May 2008 to serve as a parking lot for the Hotel St. Laurents, which never came to fruition. WATERTOWN DAILY TIMES ARCHIVES

The day the music died

n Clayton Casino: No gambling, just a place for good fun, dancing By LEAH BULETTI

T

NNY Business

outed as the “biggest nightclub between Montreal and Chicago,” by Clayton resident Marilyn Hutchinson in a 2008 Watertown Daily Times article, the Clayton Casino hosted numerous popular musicians, including Timmy and Jimmy Dorsey, Glenn Miller and Paul Whiteman, in its heyday in the 1930s. It was “seven-days-a-week live

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entertainment,” Ms. Hutchinson said. The popular nightclub, which was never a gambling sight, only enjoyed six to seven years of business before closing permanently in 1942 as traffic declined during World War II. The building, which was demolished in May 2008 with the idea that it would serve as a parking lot for a hotel that never came to fruition, originally housed Clayton Ship & Boat Building Corp., which manufactured 110-foot-long submarine chasers during World War I. It later became Frye

and Denny Boatworks. In 1934, just after the 21st Amendment ended 13 years of Prohibition, Stewart and Mary Ormsby, of Belleville, and Westman LaLonde purchased the building and transformed it into the casino. Why call it a casino though? “I guess that’s what they called a nightclub back then,” Linda L. Schleher, executive director of the Thousand Islands Museum, said in the Times article, adding that the club attracted “big bands very popular at the time.”


The 800-person nightclub boasted an 80-by-100-foot oak dance floor. Eager party-goers could get beer for just 10 cents a glass, a hamburger for 20 cents, a club sandwich for 50 cents and ice cream for 15 cents. Admission was 40 cents. The casino went through several different owners after it closed its doors, becoming a six-lane bowling alley on the right-hand extension and a wax paper factory on the left-hand side in the 1950s, then becoming a marina and boat storage facility in the 1960s. Most recently prior to its demolition, the casino housed Remar Shipyards after Dr. Salvatore “Sam” Rivoli, Rochester, and son Peter S. purchased it in 2006. Before it was demolished, the Thousand Islands Museum held a last dance inside its once vibrant walls in 2007. Marlene R. Ennis, a Rutland native who attended events at the casino, called the dances “great fun” in a 2007 Times article. “Coming from the country, it was quite a delight for me,” she told the Times. Clayton Historian Norman H. Wagner, also remembered the casino as a place pulsating with celebratory spirit, even though he wasn’t old enough to participate in the festivities himself. “This place was all lit up and music was coming out,” he told the Times of his memories of walking past the casino with his father. The Rivolis, Spencerport, intended to use the site as a parking lot for a 58-room hotel, the Hotel St. Laurents, which was to replace the Islander Marina building. But that deal died and Watertown Savings Bank started foreclosure proceedings on the marina properties in June 2010. The Rivolis had taken out mortgages totaling about $1.7 million and owed the bank about $1.07 million. The bank was the lone bidder for the two parcels at 500 and 510 Theresa St. at a public auction in Nov. 2010 and later sold them to owner of adjacent French Bay Marina Jeremy B. Kellogg, who currently owns the Clayton Casino site where Islander Marina is today located. n BUSINESS HISTORY IS A monthly feature from the archives of the Watertown Daily Times. Visit www.watertowndailytimes. com to access digital archives since 1988, or stop by the Times, 260 Washington St., Watertown to research materials in our library that date back to the 1800s.

August 2013 | NNY Business

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W H AT ’ S H A P P E N I N G H E R E ? NICE N EASY GROCERY SHOPPES WHAT: Nice N Easy Grocery Shoppes convenience store with 16-dispenser fuel canopy and drive-through window. WHERE: Former Bomax site on Route 12F, outer Coffeen Street at Salmon Run Mall Road across from Jefferson County Industrial Park. OWNER: Valentine Stores Inc. Brothers Edward J. and John P. Valentine, who own about a dozen in the region, including one just a mile down the road at 19853 Route 12F in the town of Hounsfield. In March, the brothers told town officials that they hoped to target mall traffic, Canadian shoppers and Interstate 81 travelers. SIZE: 5,808-square-feet ARCHITECTURE & DESIGN: GYMO Architecture, Engineering & Land Surveying, Watertown. REAL ESTATE: Zircon Development LLC, a development company associated with Valentine Stores Inc., purchased a 0.459 acre property for $1,050,000 from Prime LLC and a 1.29 acre property for $350,000 from Toped Management Services Inc., both owned by Alexandria Bay developer P.J. Simao, for the development of the convenience store and gas station. The property is part of the former site of Bomax Inc., a manufacturer of small motors, which

KEN EYSAMAN | NNY BUSINESS

Site preparation continues at the corner of Route 12F and Salmon Run Mall Road in the Town of Watertown late last month. Nearly 1.75 acres of the 12-acre former Bomax site will house a Nice N Easy store. closed operations in 2004. COMPLETION: Several months, though no opening date has been announced. Site preparation began July 8. LOCAL JOBS: More than a dozen construc-

tion nies and jobs

jobs; several local contracting compafor construction. Nearly a dozen fullpart-time hourly and store management once operational.

HOURS: 24 hours a day, seven days a week.

NEXT MONTH

I

n our September cover story we examine the state of the radio industry in Northern New York as the battle for the airwaves heats up between a few favorites on the dial and relative newcomers scrapping to capture market share. Also coming next month: n ARE YOU A SQUARE?: Mobile app technology that enables businesses to accept credit or debit card payments on the go from a smartphone or tablet are catching on with north country businesses from farmers market and craft vendors to brick and mortar stores. n 20 QUESTIONS: With Ken Carmon, Bay Brokerage president and CEO. n PLUS: Small Business Startup, NNY Snapshot, Economically Speaking, Commerce Corner, Business Law, Business Tech Bytes, Small Business Success, Real Estate, Agri-Business, Business History and Business Scene. n VISIT US ONLINE at www.nnybizmag.com. Follow us on Twitter for daily updates at @ NNYBusinessMag, like us on Facebook at www.facebook.com/nnybusiness, and view eEditions at www.issuu.com/NNYBusiness.

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