I think back to a time when I was young and growing up in Rochester. Back then there were not as many restaurants as there are today. If there came a night when my dad said we were going out to dinner it meant one thing. We all knew we were heading to "Carrols". Carrols was a hamburger joint that was the precursor to all the chain hamburger choices that we see today. The one bad thing about Carrols was that you basically got what they gave you. There was no choice of what toppings or flavoring went on the hamburger or fish sandwich. Everyone got the same thing and you either liked it or you didn't. Several years later a place came along called Burger King. Their slogan was "have it your way". You could order a burger any way you wanted with anything on it or not on it. It was amazing. From then on we all wanted Burger King. Today this all seems a little silly but I think we can learn something from that experience.
It has been a wild roller coaster ride in New York State government since Andrew Cuomo took the reigns. Governor Cuomo was saddled with a very tough financial situation and has made some good headway in beginning to get our State back on it's feet again. One thing that everyone agrees upon is that there is still a long way to go. As we search for solutions, one basic concept seems pretty clear. State government is either going to need to do more with less or completely discontinue programs and services that have been offered in the past. The last few months has revealed what some of these changes are to be in the area of Medicaid reimbursement for Long Term Care. Providers are beginning to see what the future will look like.