June is a big month in Albany.  After Memorial Day, lawmakers have just 13 days in their schedule to wrap up the legislative session.  In June of last year, the state Senate and the state Assembly each approved about 2/3 of all bills passed during the entire 6-month session.  When it comes to moving on legislation, June is the biggest month.

While there is a large number of bills moving this June, the big question will be whether the legislation under consideration actually addresses the important issues facing the state.  One of those important issues is whether the governor and state lawmakers will act to curtail the incredible corruption that has plagued New York.

In just the past few months, a top aide to the governor was convicted of corruption, the former Speaker of the Assembly was convicted of corruption, a former state Senator pleaded guilty to illegal use of campaign funds, a member of the Assembly resigned after corruption charges were filed against her, and top public officials on Long Island are in court right now waiting to see if they will be convicted of federal corruption charges.

And over the past decade, dozens of public officials have had to resign or were convicted on charges related to ethical misconduct.

Yet despite this awful track record, the governor and the legislative leaders don’t appear interested in agreeing to needed anti-corruption reforms.

Also scheduled for mid-June is the beginning of the trial examining allegations of widespread corruption in the state’s so-called “Buffalo Billion” program.  That economic development project was heralded by the governor as a massive $750 million stimulus to jump start the Western New York economy.

Whether the program’s stimulus succeeded is still unclear, but what is clear is that federal prosecutors believe that a favored company had a multi-million-dollar contract awarded to it because it hired allies of the governor.  The company has also been one of the biggest campaign contributors to the governor.  The former members of the Administration who have been charged have maintained their innocence and there have been no charges involving the governor himself.

Whatever the outcome, however, the case presented by federal prosecutors will further fuel the perception that New York’s governments are too susceptible to corruption.

Governor Cuomo and state lawmakers must act to counter both the perception and the reality of a campaign financing system and an economic development approach that are all too easily gamed for the benefit of individuals and companies that are cozy with elected officials and that operate far too often at the expense of the public.

Given the sweeping scale of the corruption convictions in New York, there is no “silver bullet” response.  Instead a comprehensive package is needed to reduce the risk of corruption.  Reformers have pushed for measures they call the “Restore Public Trust”:

• Clean Contracting. Pass legislation to strengthen the state Comptroller’s independent oversight of government contracting and boost public disclosure of those subsidies. The Senate has approved bills to achieve these goals.  The Assembly should too.
• Ban “Pay to Play.” Enact strict “pay to play” restrictions on state vendors. Evidence at the recent trial showed that state vendors clearly want to influence state contract awards by giving campaign contributions to elected leaders.
• Close the “LLC Loophole.” Ban unlimited campaign contributions via Limited Liability Companies. LLCs have been at the heart of some of Albany’s largest scandals. The Assembly has acted on this bill, the Senate should too.
• Establish an Independent Ethics Watchdog. Replace the state’s current ethics watchdogs, the Joint Commission on Public Ethics and the Legislative Ethics Commission, with an independent one, an entity free from political allegiance to those it is supposed to monitor. And one with authority over both the executive and legislature, lobbying and campaign financing.
• Real Budget Transparency. Make lump-sum budget appropriations and the resulting expenditures fully transparent.
• Strict Limits on Outside Income. Set real limits on the outside income for legislators and the executive branch. Moonlighting by top legislative leaders and top members of the executive branch has triggered indictments by the federal prosecutors.

The baker’s dozen of legislative work days after Memorial Day will tell New Yorkers whether the governor and state legislators are serious about combatting corruption.

None of us wants to think about this, but getting good medical care isn’t a sure thing.  While the vast majority of providers meet minimum requirements or better, many Americans are injured or killed by the medical care they receive.

Nearly two decades agohe National Academy of Sciences’ Institute of Medicine issued a national report, “To Err Is Human”, estimating that as many as 100,000 American hospital patients died in one year due to medical mistakes.  Subsequent studies have established a range that is even higher, from a low of 250,000 to as many as 440,000 hospital patient deaths annually.

No matter what the number, they are staggering.  And experts now consider deaths due to medical mistakes as the third leading cause of death in America, behind heart disease and cancer.

The Institute of Medicine’s 1999 report called for sweeping changes to substantially reduce the number of medical errors.  Improving patient safety is where policy makers must place their focus.

Positive medical care outcomes depend on carefully-coordinated care, communication, and policies designed to protect patients from harm.  Not all hospitals are alike.  Choosing the right hospital can be even more important than picking the right doctor.

New York State offers some information in this area.  The state Health Department has a program, hospital profiles (https://profiles.health.ny.gov/hospital/), which provides some useful information on the frequency of medical procedures that are performed at each hospitals.  It also offers doctor profiles (https://www.nydoctorprofile.com/), which allows patients access to background information on physicians.

But these profiles are often incomplete and do not rank providers by the quality of care.

In light of that vacuum of medical provider quality performance data, outside private groups have developed their own measures.  US News & World Reports magazine issues an annual “Best Hospitals in the U.S.”  Healthgrades.com also issues quality information on doctors and hospitals.

Perhaps the most comprehensive is the annual hospital ranking issued by The Leapfrog Group (http://www.leapfroggroup.org/).  Leapfrog was created over 15 years ago by large businesses that were frustrated by the lack of quality health data.  The businesses usually negotiated coverage for their employees, yet lacked the data to comparison shop.

Leapfrog’s Hospital Survey is considered by many to be the “gold standard” for comparing hospitals on standards of safety, quality, and efficiency.  Leapfrog collects voluntarily-provided surveys from nearly 2,000 hospitals and cross checks it with other publicly-released data and medical experts to issue annual rankings.  The annual ranking shows that hospitals across the country show a lot of variation when it comes to patient safety.

Leapfrog then ranks the states based on the number of hospitals that have achieved an “A” ranking.  This year, the state of Maine topped the list with nearly 70 percent of its hospitals earning an “A.”  Rounding out the top five this year were Hawaii, Oregon, Wisconsin and Idaho.

New York State ranked poorly, as it usually does, this year ranking 48^th in the nation, with only 6 percent of its hospitals getting an “A” ranking.

That means that it’s critically important that patients choose a hospital with a good track record on keeping its patients safe from harm.  In addition to researching the sources mentioned earlier, here are some other ways patients can be vigilant right now:

Ask questions. Gain as much insight as you can from your health-care provider.  Ask about the benefits, side effects and disadvantages of a recommended medication or procedure.

Seek a second opinion. If the situation warrants or if uncertainties exist, get a second opinion from another doctor:  A good doctor will welcome confirmation of his/her diagnosis and resist any efforts to discourage the patient from learning more.

Bring along an advocate. Sometimes it’s hard to process all the information by yourself.  Bring a family member or a friend to your appointment — someone who can take notes and help you understand the information and ask questions.

Hopefully, you won’t need to use this information any time soon.  In the meantime, we should all be pushing for better healthcare oversight, more transparency so that consumers have data to make medical care choices and ultimately better outcomes, a healthcare delivery system where medical errors are rare.

Last week was quite a week at the state Capitol.  It started off on Monday with the shocking resignation of the Attorney General within hours of detailed allegations of sexual assaults appearing in media reports.  The week ended with the second conviction of the former Speaker of the Assembly on federal corruption charges.  And in between, an accomplice to a former top aide to Governor Cuomo pled guilty.  In that last one, the former top aide to the governor had already been convicted of corruption; the accomplice was an energy executive who admitted to lying to federal investigators about his role in giving a high-pay, “low-show” job to the former top aide’s wife.

It makes your head spin to keep track of it all; as a New Yorker, it is the latest in a nauseating string of scandals.

In the last decade or so, dozens of lawmakers have been convicted of crimes, a governor and now an attorney general have had to resign over misdeeds, another governor was forced to pay a fine for lying under oath, a comptroller was convicted of corruption, and – as mentioned earlier – a top aide to the current governor was convicted as well.

Despite the repetition, it is shocking.

And it’s not over; in June there will be a federal trial over alleged corruption in the state’s economic development programs in Buffalo and the retrial of the former Senate Majority Leader is scheduled as well.

Yet, there has been little progress on fixing what ails state government.  While the legislative session still has six weeks to go, there is scant evidence that the governor and the state legislative leaders are focused on a package of meaningful measures that would reduce the risk of corruption in New York.

During the budget, the governor advanced a proposal to limit campaign contributions from those seeking government contracts.  But the plan was weak and he did little to advance it.  The Assembly has passed some campaign finance reform measures, including closing the so-called Limited Liability Company (LLC) loophole, which allows those controlling these secretive business entities to essentially ignore campaign contribution limits.  And this week, the Senate passed legislation to increase public accountability of the state’s economic development programs.

But there has been no agreement among the major players on what should be done and the “solutions” are piecemeal.

If anything meaningful is to happen, it will take leadership from the governor.  Without the governor’s advocacy, each house will point to their own reforms and blame others for failing to actually enact impactful reforms.

Since the corruption scandals have been so numerous and the crimes so wide-ranging, there is no single “silver bullet” that will solve all the problems or weaknesses in the current system.  Instead, there will need to be sweeping changes to fix Albany.  And while there are many solutions that are needed, there are a few at the top of the to-do list:

1. Expand the role of the state Comptroller to oversee state contracts, complete transparency in the awarding of such contracts, and dramatic campaign contribution restrictions for those seeking and holding state contracts.
2. Close the LLC loophole. That loophole has been repeatedly exploited and of its use to funnel enormous sums has been at the heart of many scandals.
3. Limit public officials’ outside income. State lawmakers are considered “part time” and are allowed outside income.  Such “moonlighting” has figured prominently in some of the corruption convictions.  The former top aide to the governor also exploited state laws in order to have outside income while running Governor Cuomo’s 2014 re-election effort.
4. Establish an independent ethics watchdog. The current system of oversight is based on political appointments and provides little independence for the staff of such agencies.  One of the reasons federal prosecutors have led corruption-busting efforts is that state watchdogs cannot adequately monitor state government.  New Yorkers spend millions on ethics agencies; they deserve ones who enforce the law without fear or favor.

There are other problems that have been highlighted in the federal investigations.  But if Albany is serious about fixing its problems, a better system of contracting, new limits on campaign finance, new ethics restrictions on outside income, and the creation of an independent enforcer, are major components of meaningful reforms.

Finally, Spring has arrived.  The weather is warming up and many think of lying in the sun to get some relaxation and a tan.  Others look to a short-cut: Indoor tanning.  You can see it already, with high school prom and other big events, like graduations, looming, many high schoolers are rushing to look their best, some go to indoor tanning salons.  That decision could change their lives.

Indoor tanning raises the risks of skin cancer as well as immune suppression, eye damage, and premature aging of the skin. The World Health Organization has elevated tanning beds to the highest cancer risk category – group 1 – “carcinogenic to humans.”

Subsequent research by the nation’s top medical facilities, including Harvard Medical School and the Yale School of Public Health, has reinforced that finding.  In New York, according to the American Cancer Society an estimated 4,920 people will be diagnosed with melanoma this year. Tens of thousands more will be diagnosed with basal or squamous cell carcinomas of the skin.  Many of those will be the result of frequent use of indoor tanning.

UV radiation exposure, particularly from indoor tanning, is a leading risk factor for the development of skin cancers. While excessive exposure to the sun permanently increases one’s cancer risk through cumulative damage, indoor tanning compounds the risks by delivering concentrated bursts.  This results in faster mutations in the body, as the UV rays alter the configuration of human DNA. This explains why individuals who have used tanning beds have a much greater risk of developing skin cancers as compared to those who have never used tanning devices.

The risk is significant to all users, but there has been increasing data showing the impact it can have on younger people, particularly those under the age of 18.  Currently, a substantial number of young teens are using tanning beds, with use increasing with age.  Among those teens, the rates were highest among female 17-year-old high school students.

Peer-reviewed scientific studies strengthen the indoor tanning-cancer connection.  A recent review of 27 European studies concluded:

Sunbed use is associated with a significant increase in risk of melanoma. This risk increases with number of sunbed sessions and with initial usage at a young age (<35 years). The cancerous damage associated with sunbed use is substantial and could be avoided by strict regulations.

Here in the United States, a growing number of researchers have identified the use of indoor tanning to be linked to cancers.  Some key findings:

• There has been a dramatic increase in the use of indoor tanning facilities – particularly among teenagers. Since 1998, teens reporting use of tanning beds has increased from 1% to 27%.  The more you expose yourself to UV radiation, the more likely you are to get skin cancer.
• When the World Health Organization determined that the UV rays found in indoor tanning booths were a human carcinogen, they also stated that individuals who used indoor tanning devices before the age of 30 increase their risk for melanoma by 75 percent.
• People who use indoor tanning equipment face a 59 percent higher risk of melanoma than those who do not, according to the American Academy of Dermatology.

The American Medical Association, American Academy of Pediatrics, American Academy of Dermatology, the Skin Cancer Foundation and World Health Organization all have called on states to bar children under 18 from tanning salons.

According to the National Conference of State Legislatures, 16 states and the District of Columbia ban the use of indoor tanning beds and booths for people under 18.  New York is not one of them.

Those over the age of 18 also need to know the facts.  Unfortunately, New York’s warning labels at indoor tanning facilities and its mandated disclosures say little about the cancer dangers associated with the use of indoor tanning.  The Cuomo Administration has the regulatory authority and obligation to strengthen those warnings.

States across the nation have already responded to the weight of scientific evidence and the staggering harm caused by indoor tanning by banning its use by minors.  New York should act too.