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Albany County Comptroller Mike Conners

Q: What are your responsibilities as Comptroller? "Under Charter, the County Comptroller is the chief financial officer of the county. There are three basic areas: the accounting office so that you run the county's financial books; the audit process where we audit the claims for payment and the county borrowing. On the administrative side, it's help with all the administrative services provided to our office and other county departments. I'm a financial historian, so I get people information on what's happening financially. And I'm an 'umpire'-call the balls and strikes on whether we can or cannot do something. I've been working here for a over nine years."

Albany County Comptroller Mike Conners

Q: What’s the 5-10 year outlook for Albany County?

“For all counties the biggest problem is unfunded mandates. The largest is Medicaid. The growth on Medicaid spending in six years has doubled. Over a 12-year period we went from $18 mil to over $70 mil this coming year. The Medicaid portion is in excess of what our total property tax levy is for the county. Given the demands NY state lays at the counties’ feet, we are in a very dire straits on that kind of increased spending we have no control over. Programs are implemented where benefits are given away. We have no input into those benefits or into the eligibility-We just get the bill. We also have to deliver the services for the state and federal government-We’re the place the ‘rubber meets the road’. Financially, the county does face real difficulties-It has in the last several years. Because of that, we have had a deficit budget in 8 of the last 9 budgets. We’ve spent over $30 million in surplus providing services that were not being reimbursed by the state. Most notably, the biggest loss that we’ve had besides Medicaid, is the nursing home. Albany County provided nursing home funding-almost $40 mil in the last 3 years.”

Q: How does Medicaid affect the county budget?

“NY State is unusual in that it has a contract with the federal government-it’s one of two states that does this. They share 50% for any Medicaid services, then charge the counties for roughly half of that. So when someone on welfare receives benefits through Medicaid, and the bill is $100, the federal government pays $50, the state government pays $25, and the county pays $25. So, the county actually pays a share of the health costs. The state sends us a bill every week, and we wire transfer our share to the state. This problem at the state level-spend a dollar to put 25 cents up-has created a spending anomaly, a tremendous increase in spending. The result is problems at the county level.”

Q: What is more typical with most states?

“With the other 48 states, the state pays the entire share of the Medicaid portion. What also makes NY different is if you take the next two largest states in spending for Medicaid-California and Texas-NY spends more than they do combined. NY spends about 2.5 times the national average on Medicaid. My objection, in addition to this huge spending difference, is we don’t have a better outcome either. There really is a need for Medicaid reform.”

Q: What can be done about the Medicaid issue?

“I think they are not able to do it at the state level, and what I’d like to see happen is some experimentation at the local level. I’ve proposed for the ability for local governments to work through the state to seek demonstration grant projects or waivers from the Health and Human Services, from the federal level, to look at a way to do this. One way is to insure the Medicaid population, along with two side programs-to insure those people on Medicaid-so you’d have the insurance transferring the risk. You’d have the cost containment being done by the carriers, but you’d also have better coordination of services, and more work with those spending the most dollars. Some chronic diseases are tremendously expensive for us-Anything related to diabetes (we’ve waived heart diabetes), and with kidney disease. Another large expenditure is respiratory illness, asthma especially. With more intensive case management, you can have a better delivery of services and have a better outcome. Over the long haul you’re going to have healthier lifestyles and a better outcome health-wise, which would save the federal, state, and county money.”

Q: Is this the Opt Out program you advocate?

“It’s not an ‘Opt Out’. No, this is a program where you are eligible to put up innovative programming to provide better services to have a better outcome. That’s a good way to do that.

In addition, what I’ve advocated for (the ‘opt out’ asked about) is a side fund for those kinds of events not covered. The average taxpayer does not realize Medicaid has much better coverage than you can actually buy with health insurance. It covers what isn’t usually covered. One is long-term care. You need to have a pool of money to provide for those claims not covered. As you know, I’ve talked about advocating for whatever choice the recipient might make, but that carrier would then, in addition to insuring us for those insurable items, would manage the claim and deliver the care, coordinate that delivered care, and we pay them through a third party administrator. And the third part of that which I think is the most innovative and important is a ‘diversion’ program. People are looking to stay home longer, to avoid being forced into nursing homes. We can spend money to do that. I’ve advocated to take some of our retirees who are in financial difficulty, and welfare recipients, and run them through a training program-work them out of the nursing home on an outreach program where we actually visit all the medically frail and elderly in the county, and coordinate service delivery to people who weren’t getting them. Those people who have family and contacts, who have a network of people to care for them, are less likely to wind up forced into a nursing home. For every month you keep somebody home, you save the system around $7,000.”

Q: What is the county’s influence on schools?

Schools are run at the city level. The county does not do any school financing. Our role in education is for handicapped children, age 0-5, and also for our share of junior college tuition bills. School funding is primarily through local property taxes and state aid. A small component of that is federal, but in the Albany City school system it’s a very small percentage. You’d be better off talking to the school district about that.”

Q: How closely do you work with the State Comptroller, Alan Hevesi?

“We have a good relationship, and we help them with a number of things. If we have concerns about county procedures they are there to help us as well. Each county runs its own operation. Depending on the size of the county, there are different levels of sophistication to deal with the issues.”

Q: How large a factor is the growth of Tech Valley?

“From a jobs growth portion, it will benefit Albany County. One of the most positive things I’ve seen is Governor Pataki’s efforts working with the State University (SUNY). The Sematech project (from Austin, TX) is a large investment. It presents jobs at the higher end pay. At Tech Valley, most jobs are generated by small businesses, and that’s been helpful.

The biggest challenge that the county faces has to do with the level of poverty. We should be more aggressive fighting poverty at the grassroots level. And to also hold people accountable. This is a two-way street. You just can’t walk away from people. You’ve gotta spend more to help people who are in more trouble get back into the workforce. About 80% who receive welfare benefits are in and out in less than two years worth of eligibility, but long term problems we face is the growth of the permanent poor. I believe we have to do more to get people out of that permanent poverty class.”

Q: Are poverty issues more important at this stage than the growth of Tech Valley?

“I think the growth of Tech Valley is being done by the private sector. I don’t think the county has had a role in the growth of those jobs, which have been driven by the university system. The major role for the county is the provision of services for the poor. There’s a role for the county to try and help coordinate efforts on development, and that has been a real problem. You have 19 different localities within the county, so you have all these ways to jump through the hoops on economic development. There’s a wealthy county out there, and we’ll continue to have efforts at that level.”

Q: What is your favorite part of the job?

“The most enjoyable part of it is the interaction with people I work with. People in Albany County and the staff have been phenomenal. They’re dedicated and highly professional. It’s been a lot of fun. One of the biggest challenges is coming up with creative alternatives to financial problems. That’s always difficult because you’re pushing through change ahead of the curve, so it does present problems for us when you look at Medicaid. In many cases, people have taken a simplistic approach of, ‘Let’s just cap state funding.’ I believe you have to reform the system to have the system better. So, it’s frustrating. It’s a very short-sighted idea to say, ‘You limit what our costs are going to be.’ If you limit the county’s costs you are going to increase the costs at the state level. It’s our taxpayers who are paying the county, state, and federal taxes. It makes more sense to improve the system overall. I might be a little ahead of my time, or it may be an idea I’m not as effective at selling. I do get a chance to weigh in on issues and use the office to act as the people’s watch dog. That’s obviously a lot of fun.”

Q: What is your least favorite part of the job?

“The frustration of people not looking at innovative programming as a solution. I see an unwillingness or inability at the state level to deal with the problems facing them-for logjam reasons, for money or power, or absolute power you get from special interest groups. We ought to challenge the county governments. We balance our budgets every year. We pass our budget on time every year. They may have a better idea in Erie county that we have, or we may have a better idea. If you do more to encourage the local governments to do more creative innovative programming, you can improve the quality of life, help build economic development within your own area, and share ideas. You can even have the local governments competing on whose got a better idea or way. Looking at what my responsibilities are, it is frustrating that you can’t get change to take place as quickly as you’d like, but that’s one of the realities of dealing with government.”

Q: What would you like our readers to know?

“You’ve got tremendous employees here who are dedicated professionals who do a great job. As a team we have worked to save over $50 mil in the last two terms of the year. It’s a real honor and privilege to serve as Comptroller and it’s the job I very much enjoy and look forward to continue serving. If your readers have suggestions or complaints, we have a very open approach. If someone is aware of fraud or believes something improper is going on in the county government, we are open from 7:30 to 5:30, and there is an online hotline to send anonymous emails. We’ll follow through on that complaint. We look forward to having as much contact with the public as possible.”

Contact: (518) 447-7130
mconners@albanycounty.com

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