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THE TORCH: December 2006

THE BOTTOM LINE

     Hugh M. Spoljaric, President

              Kingston Teachers’ Federation 

                       ‘“I see!”, said the blind man.’    

Here is a quote that I discovered and your job is to identify its source; its speaker and its time period.          

     “A little patience, and we shall see the reign of witches pass over, their spells dissolve, and the people, recovering their true sight, restore their government to its true principles. It is true that in the meantime, we are suffering deeply in spirit, and incurring the horrors of a war and long oppressions of enormous public debt…If the game turns, and then we shall have an opportunity of winning back the principles we have lost, for this is a game where principles are at stake.” *      

     I know what you’re thinking, but think a little more! Every generation believes that they are unique and that the events of their life are specific to their time. Yet, isn’t it true that it may be yin and yang, the cycle of life, déjà vu, the balance of nature? For those who do not learn from history are bound to repeat it? Is there nothing new under the sun? Hasn’t it been different people, different times, different circumstances, but the same concerto? Hasn’t it all been done before? Or, is everything unique and specific?

     Might it encompass local situations involving family, work, and politics? Don’t we all fight our own daily wars? Are there not situations where we are disadvantaged and we look for the tools to leverage the situation? Haven’t we all experienced some of this in education during our careers? Aren’t dedicated trusting people basically sincere and willing to persevere, patient, sometimes to a fault? Is that when we are open to deception? Does the sincerity of a person begin to turn to hypocrisy when a second person enters? Does fear spring from ignorance? Don’t many get hurt when we compromise our principles? Is luck really the residue of design?

     Is this a unique time for us, or is it the innate characteristic of the human condition that repeats itself? There is always the struggle between good and bad. Doesn’t self-interest struggle with the common good? What goes ‘round, comes ‘round. Doesn’t every dog have his day?

     Perhaps, we are at a time that is exciting and opportunistic. What can we expect? Has it all happened before? When it’s all changing around us, can we figure out the answer before we endure the event? Is that what experience provides for us?

    The principled life includes support for the principled right and dissent for the oppressive wrong, the wisdom to know the difference, and the courage of your honest convictions. Otherwise, we live in blindness of the truth.

     And, that’s the Bottom Line.

* Thomas Jefferson, 1798, in response to the Alien and Sedition Act that outlawed certain instances of dissent.

                     IDEA Changes---Maria Neira, VP, NYSUT                         

     As you know, effective October 13, 2006, the rights of teachers and other providers have been changed by the federal regulations under IDEA (Individuals with Disabilities Education Act).  The major change, which NYSUT and our national affiliates opposed, allows parents and the school district to exclude teachers, both special education and general education, or other members from participating in decisions affecting the education of students with disabilities.  The State Education Department (SED) will issue guidance memoranda and adopt conforming state regulations.  We encourage you to discuss with your Superintendent or Director of Special Education how they intend to implement these changes.
     Last year, NYSUT was able to block the immediate implementation of these federal requirements against groups such as the school boards and administrators that wanted to immediately implement them in New York State.  Unfortunately, now that the United States Department of Education (USDOE) has adopted final regulations, the state laws and regulations must conform to them.
    NYSUT is concerned that the inappropriate implementation of the new regulations will compromise the rights of parents rather than strengthen them as was intended by the federal legislation.  We are concerned that students will not get the services they need without a teacher advocate directly involved in the process.
Following is a summary of the provisions:
     Excluding Committee on Special Education (CSE) Members from Attending IEP Team Meetings
§   USDOE has said that a state must allow a school district and parent to excuse a CSE member as described below.  Additionally, the USDOE indicates that states may not impose restrictions which would prohibit the excusal of a CSE team member.
    - School districts and parents can consent in writing to excuse a member of the CSE whose area of curriculum or related services is being discussed, if the member submits written input into the development of the IEP prior to the meeting.
    - School districts and parents can agree in writing that a member of the CSE is not required to attend the IEP meeting, if the member's area of curriculum or related services is not being modified or discussed.
Amending the IEP after the Annual Review
§   School districts and parents can agree to make changes to a child's IEP after the annual meeting without a CSE meeting.
Triennial Evaluation
§   The school district and parent may agree in writing to waive the triennial evaluation before the parent and other CSE members review existing data to determine whether additional data are needed to determine the child's continuing eligibility and educational services.
Use of Response-to-Intervention (RTI) in Determining a Learning Disability
§   School districts may use the results of a student's response to a scientific, research-based intervention as part of the evaluation process to determine whether a student has a learning disability.  School districts are no longer required to use a model that examines the discrepancy between the student's intellectual ability and achievement in making a determination of a learning disability. 
§   While the response-to-intervention process may provide instructional information in relation to the student's learning problem, it should not delay providing services to students once they are referred to special education.  NYSUT is concerned that school districts will not identify research-based interventions or provide the professional development and adequate supports needed to successfully use the RTI approach.  If school districts are considering using a response-to-intervention process, local leaders should work closely with school administrators in developing its implementation plan.
     We are in the process of setting up a monitoring mechanism on NYSUT's website for locals to report concerns with the implementation of these new requirements.  Additional information will be provided on this initiative in the near future.  Fact sheets, including additional information on each of these topics, are currently available on NYSUT's website at: www.nysut.org.  These fact sheets provide links to information on the State Education Department's website.

                          SOME KTF HISTORY 

   As our demographics continue to change, it’s important to absorb some interpretations and understandings that got us here. Here are a couple of tidbits. 

FACULTY MEETINGS: are not general staff and building meetings. They are for faculty only. Other staff should not be present unless they are presenting and are excused afterwards. Administration, unless invited, does not stay for the KTF section of the meeting.

 AGENCY FEE: All unit members, whether they join the KTF or not, pay Federation dues. The KTF represents you in the collective bargaining process and is compensated. There are Teachers and ESP who have not joined and this is their right. The benefits of KTF and NYSUT that go beyond basic representation, like the Moore Days Sick Bank, are available only to enrolled members.

 

Kingston Trust Fund

307 Wall Street, Suite 6

Kingston NY 12401

             (845) 338-5422E-Mail: KTF781@aol.com

Dear Trustees and Trust Members,

     I wanted to express my sincere thanks to everyone for the overwhelming cards, flowers and well wishes that included lots of hugs received during my recent illness.  It all provided important comfort during this difficult time.  I am happy to report that my treatment is complete and I am back at the office as your proud office manager.  Wishing you all a happy holiday season and new year….Miriam

                               NHAI Health & Rx Coverage

Ö Dependent Child Verification Due

Document is required before 01/31/2007 for all children ages 19 – 25 pertaining to the Spring 2007 college semester.  Verification is also required for any covered non-students between the ages 19 – 23.

Ö Replacement Identification Cards   

Members must purchase replacement id cards.  The cost is $3.50 per card. Submit a check made payable to the Kingston Trust Fund, indicate whether a medical or dental card, and forward to the Trust Office.

                             NHAI Dental Coverage

Ö Dependent Child Verification Also Due

Members enrolled in NHAI dental only, are also required to submit documentation as explained above.

Ö Retiree Dental Premiums Due

Premium payments for the six-month period 01/01/2007 – 06/30/2007 are now due.  Lavender colored invoices have been mailed.  Payment is due by 01/31/2007.

Ö Dental Enrollment Period – Now Open

Active and Retired teaching/professional staff are welcome to enroll in the NHAI dental coverage, if not previously enrolled. Contact the Trust Office for the enrollment form.  Deadline to enroll is 01/31/2007

**ESP: Pending negotiations with the district later this month, ESP dental coverage may begin with NHAI. Currently dental enrolled active and retired ESP will be informed if a change is in place.

 

NOTICE OF MATERIAL MODIFICATION AND CHANGE

    TO THE KINGSTON TRUST GROUP HEALTH PLAN

                        Effective January 1, 2007

     Effective January 1, 2007, there will be three (3) benefit tiers: Premier PPO, Standard PPO, and Indemnity non-PPO. For Medicare primary members, benefits covered by Medicare are fully coordinated and will be paid in full under all three tiers so long as the provider is a Medicare provider. Annual limit (dollar or number of visits) are applied to services on a combined basis.

     Changes are necessary to adjust benefits for inflation and the actual experience of the Kingston Trust. The average increase in medical costs has been 18% per year for the past 3 years (57% higher than the national average increase of 11.4%). The plan changes are summarized below. A new Schedule of Benefits is available on the KTF website under Kingston Trust Fund.

There shall be three (3) tiers for benefits.

v  Tier 1 – NHAI Premier PPO (PPPO)

v  Tier 2 – Standard PPO (MultiPlan and Three Rivers Network) and Out of Area members (SPPO)

v  Tier 3 – Out-of-Network (OON or NPPO)                     

  1. Basic Copay for Office Visits:  Tier 1 remains at $15 and $25; Tier 2 increases to $20 and $30; Tier 3 will be subject to 30% coinsurance after the deductible
  2. Medical Deductibles/Out-of-Pocket Limits: Tier I remains the same, Tier 2 provides a deductible of $100 Individual and $250 Family, Tier 3 remains the same. In both Tier 2 and Tier 3, the current out of pocket limit of $1500 Individual and $3000 Family remains the same on a combined basis. Additionally, BOTH medical copays and coinsurance will be credited toward the Out-of-Pocket (OOP) limit for all three tiers.(Currently, copays are not credited toward the OOP limit.)

(Individual/Family)             Deductible         Out of Pocket             Combined

 Tier 1:                                 none              $1,000/$2,500             $1,000/$2,500

       Tier 2:                            $100/$250          $1,500/$3,000**          $1,600/$3,250

       Tier 3:                            $500/$1,000       $1,500/$3,000**          $2,000/$4,000

**The out-of-pocket limit for Tiers 1 and 2 are a combined single limit and is separate from the Tier 3 out-of-pocket limit.

  1. Hearing Aids:  Will be changed from $750 every 5 years to a benefit of 50% of the cost of the hearing aid up to $1,500 as a lifetime limit.
  2. Basic Coinsurance:  Tier 1 will remain at 90%; Tier 2 is at 80%; and Tier 3 is at 70%. Therefore, the coinsurance paid by the member is 10% for Tier 1; 20% for Tier 2; and 30% for Tier 3 subject to the Out-of-Pocket Limit.  Tier 2 and 3 benefits are paid after the deductible is met.
  3. Annual Physical:  Increase annual limit for annual physical to 100% of the first $500 for Tier 1 with excess charges covered subject to 10% coinsurance.  Maximum benefit for Tier 2 and 3 would be 100% of the first $400.
  4. Rx Copays:  Rx costs per member have increased at over 16% per year for the past three years with increased utilization of brand drugs. There will now be two levels for brand drugs – Single Source Brand and Multi-Source Brand.  The new Rx copays will be as follows for retail and mail order.

Generic:                               $10 (no change)    Mail Order=      $15(no change)

Multi Source Brand:             $20                         Mail Order=      $30

Single Source Brand            $30                        Mail Order=      $50

 

  1. Transplants:  Any transplant equates to a Specific claim of $150,000 to as high as $1.6 million for a double transplant. Therefore, the plan encourages members to go to a pre-certified Center of Excellence in that it:

q  Provides members with the absolutely best surgeons and facilities for their particular transplant; and

q  Provides the plan with a guaranteed contract cost that is significantly less than what other providers would cost due to pre-negotiated discounts through a special program negotiated for the Plan. 

Therefore, any member choosing not to go to a pre-certified Center of Excellence will have an additional copay of $5,000 and this copay will not be applied toward the Plan Out-of-Pocket Limit.

q  Travel expenses for immediate family members will be covered at 80% up to a maximum of $100 per day/$10,000 in total while patient is confined in a Center of Excellence pre-certified by the plan.

9.   Weight Loss Program:  Obesity is now recognized as a disease and a serious health factor. To encourage members to lose weight and to maintain a healthy weight, the following weight loss program will be adopted:

·         For any member or their spouse/domestic partner who is at least 20 pounds over their recommended weight, they will be reimbursed a Fitness or Wellness Benefit of $150 for 15 to 25 lbs., $200 for 26 to 50 lbs., and $250 for over 50 lbs. Will be paid upon completion of any successful weight loss program where they have lost a minimum of 15 lbs and have maintained their weight loss for a minimum of 6 months.  The weight loss program will have to be certified by an independent certified weight loss professional or M.D. verifying the weight at the beginning of the program and the end of the program.

The above amendments were approved by the Board of Trustees as noted above by unanimous vote on the 28th of November 2006.

 

 WOMEN’S HEALTH AND CANCER RIGHTS ACT OF 1998

Under Federal Law, the Trust Fund plan provides benefits for mastectomy-related services including reconstruction and surgery to achieve symmetry between the breast, prostheses, and complications resulting from a mastectomy (including lymph edema).

These benefits may be subject to annual deductibles and coinsurance provisions that are appropriate and consistent with other benefits under the plan. As such, the plan is obligated to provide related information, correspondence, ID cards, etc. to the custodial parent or guardian even though the parent or guardian is not covered under the plan.

     For additional information or pre-certification, please refer to the plan document or contact the NHAI Compliance Office at 1-888-679-2400.

                      HEALTH TRUST PLAN REMINDERS

Trust Plan members must enroll in the following programs in order to receive the special benefits offered by these programs.

PRE-NATAL: enrollment must occur in the first trimester. All maternity benefits will be paid at 100% after initial office visit copay, including nursery care for the newborn. Otherwise, maternity benefits are paid as any other benefit and are subject to Tier deductibles, copays, and coinsurance.

DIABETIC: once enrolled, diabetic supplies, Glucophage and Metformin will be covered at 100%. Otherwise, normal copays apply.

OUT OF AREA: for any student attending school or for any retiree who is permanently domiciled, in both cases outside of a 50 mile radius of the Kingston area, they are eligible for benefits under Tier 2.

INFERTILITY: only members who have been enrolled and covered continuously for 18 months or more under the Trust Fund plan are eligible for the fertility program. Infertility benefits, including infertility drugs, are paid at 80% up to $10,000 per year up to a lifetime maximum of $25,000 for infertility benefits. The member’s coinsurance is not credited towards or subject to the plan’s out of pocket limit. Benefits are subject to compliance with the plan’s infertility rules.

WEIGHT LOSS: the new benefit is listed under the Amendments and Modifications (#9) in this Torch.