Looking back on the LSU Hospital privatization fiasco, it becomes easy to point the finger of blame in several directions.
And to a lesser extent, though by no means blameless, is the Louisiana Legislature.
The legislature has been complicit in many of Gov. Bobby Jindal’s other misadventures, most notably the unorthodox—and, it turned out, unconstitutional—method of funding the governor’s school voucher program. Lawmakers fell all over themselves in 2012 in approving that little scheme that eventually blew up in everyone’s faces when the courts rejected the manner in which Act 2 diverted money from local school districts to cover the cost of private or parochial school tuition.
In fact, Jindal’s entire education reform package, passed in such haste in 2012, quickly grew to more resemble a train wreck than legitimate reform.
But the legislature, even though it never drew a line in the dust even as it capitulated to Jindal at every turn, in the final analysis, had little say-so about nor any recourse in preventing the wholesale giveaway—disguised as privatization—of the six hospitals, a maneuver that imploded Friday with the decision by the Centers for Medicare and Medicaid Services to reject the deals that would have turned over to private operators the LSU medical centers in Shreveport, Monroe, Lafayette, Houma, Lake Charles and New Orleans.
Even as Jindal’s rubber stamp LSU Board of Stuporvisers was rubber-stamping a contract containing 50 blank pages in the infamous conflict-of-interest deal handing over University Medical Center of Shreveport and E.A. Conway Medical Center of Monroe to the Biomedical Research Foundation of Northwest Louisiana (BRF), legislators were voicing concerns over the warp speed at which the administration was moving to ram the agreement down the throats of an unsuspecting public.
In fact, a resolution passed unanimously in the Louisiana Senate at the urging of Sen. Ed Murray (D-New Orleans) called for the Joint Legislative Committee on the Budget to agree on the privatization plans before any details were to be finalized. A similar resolution was also passed in the House.
Resolutions are just that: resolutions, with no power of law. Jindal said—and an attorney general’s opinion supported the position—that legislative approval was not required in order for the LSU Board to agree to lease the hospitals. An attorney general’s opinion, like a legislative resolution, does not carry the weight of law, but does give the governor stronger footing.
Jindal, for his part, made it abundantly clear that he would move the privatization plan forward with or without legislative support. He said the legislature did not have the authority to vote down the proposals—in effect, saying his administration was ready to ram through the proposals without regard for even a pretense of democratic procedure.
Of course he did say that he would agree to take any advice from the legislative committees into consideration. “If they propose changes to the law, we’ll look at that legislation,” he said.
But we all know what happens to those who have the temerity to disagree with Jindal, don’t we? They’re summarily teagued, as in Tommy Teague, erstwhile Director of the Office of Group Benefits (OGB), who was shown the door on April 15, 2011, when he didn’t jump on board the OGB Privatization Express quickly enough. Six months before that, it was his wife Melody was fired from her state job after she testified before the Commission for Streamlining Government. More than a dozen met the same fate, including LSU President John Lombardi and at least four legislators who found themselves suddenly removed from their committee assignments for “wrong-headed” voting.
But easily the most significant, most ill-advised, most flagrant, most unwarranted demotions were those of two respected doctors who didn’t bite when Jindal dropped his privatization bait into the water—doctors any organization would be proud to have on staff (and now, two such organizations indeed have them after in sheer frustration, they finally left Louisiana).
LSU Health Care System head Dr. Fred Cerise and Interim Louisiana Public Hospital CEO Dr. Roxanne Townsend were demoted just days apart in 2012—Cerise in late August and Townsend in early September—following a July 17 meeting at which former Secretary of health and Hospitals (DHH) Alan Levine first pitched a plan to privatize the state’s system of LSU medical centers.
Levine was at the meeting on behalf of his firm, Health Management Associates (HMA).
Also present, besides Cerise, Townsend and Levine were then-LSU President William Jenkins, DHH then-Secretary Bruce Greenstein, LSU Medical Center Shreveport Director Dr. Robert Barish, HMA CFO Kerry Curry, LSU Health Science Center Shreveport Vice Chancellor Hugh Mighty and LSU Board of Supervisors members Rolfe McCollister, Bobby Yarborough, John George (remember that name) and Scott Ballard. LSU Health Science Center New Orleans Chancellor Larry Hollier and Vice Chancellor for Clinical Affairs at LSU Health Sciences Center New Orleans Frank Opelka participated by teleconference.
The meeting was held in the LSU president’s conference room.
Both Cerise and Townsend expressed reservations about Levine’s proposal but several members of the LSU Board of Supervisors who were present at the meeting “indicated they want LSU’s management to pursue this strategy,” according to a summary of the meeting prepared for Jenkins by Cerise.
Along with his two-page summation of the meeting, Cerise also submitted a third page containing a list of five concerns he had with the privatization plan pitched by Levine. It was that list of concerns which most likely got Cerise teagued as head of the LSU Health System via an email from Jenkins.
Levine, according to Cerise’s notes, recommended as an initial step that LSU sell its hospital in Shreveport (LSU Medical Center) and use the proceeds to “offset budget cuts for the rest of the LSU system.”
He suggested that the buyers would form a joint venture with LSU, invest capital into the facility and develop a strategy for LSU “to more aggressively compete in the hospital market.”
“The LSU board members present indicated they want LSU’s management to pursue this strategy,” Cerise’s notes said. “Greenstein stated that LSU should look to generate two years of funding to address the state funds shortfall in the system through the sale of Shreveport’s hospital.”
It was at that point that Cerise indicated his concern that such a strategy would take time to develop and that LSU would likely need to go through a competitive public procurement process and “likely legislative approvals.”
It was subsequently determined that legislative approval was not legally required; all that was required was for the legislature to be informed of the administration’s actions.
“There appeared to be agreement that LSU develop a plan that would not result in closure of hospitals,” Cerise’s notes said. “When the question was posed to the group, ‘Will LSU close hospitals,” George responded, ‘We hope not.’ The clear message was that the board members did not want LSU to proceed with any hospital closures at this point.”
Since that meeting, Earl K. Long Medical Center in Baton Rouge and W.O. Moss Medical Center in Lake Charles have each closed.
“I am asking that you share this memo or at least the substance of it with the full board to ensure they are informed and that their direction to us that we delay definitive budgetary action until the end of August to better assess the likelihood of a Shreveport sale with a statewide distribution of the proceeds is clear and unambiguous,” Cerise said in his memorandum to Jenkins.
At the conclusion of the meeting, Jenkins called for the creation of a task force to include then-Commissioner of Administration Paul Rainwater, Greenstein, George, Yarborough, McCollister, Ballard, Mighty, Barish, Hollier, Cerise and Townsend.
But in a matter of weeks, Cerise and Townsend were removed from their respective positions and reassigned and Opelka was promoted to Cerise’s position.
Last May, only months before he resigned to take a position in Texas, Cerise was invited by Sen. Murray to testify at a meeting of the Senate and Governmental Affairs Committee. What ensued speaks volumes about the administration’s penchant for secrecy and its intolerance for dissenting viewpoints and is illustrative of Jindal’s general arrogance and disdain for the legislative process.
The committee wanted more information about the proposed privatization of the LSU system’s hospitals and the obvious choice as the most knowledgeable witness was Dr. Fred Cerise, whose integrity is the very antithesis of Jindal’s.
So, naturally, Cerise was barred from testifying. Dissenting opinions—even intelligent, reasoned ones—are not welcomed by this governor who simply cannot bring himself to listen to the advice of others. Murray said he was told that Cerise’s request for a personal leave day to testify was denied. Murray was joined by several other senators in complaining that the denial of an information request from a lawmaker was inappropriate.
Board members, Dr. John George and Ann Duplessis, apparently with straight faces, disavowed any knowledge about Cerise’s not being able to attend the meeting and promised to look into the matter and report back to the committee.
Amazingly, lawmakers appeared to ignore that conflict of interest we alluded to earlier even as the LSU Board of Stuporvisors unanimously approved that contract. No one uttered a peep as that same Dr. John George of Shreveport, sitting as a voting member of the LSU Board, cast his vote.
The CEO of BRF, which awarded the contract for the Shreveport and Monroe medical facilities, is (trumpet fanfare) that same Dr. John George but not to worry: Jindal assured us there was no conflict of interest there.
Almost lost in all of this is the fact that more than 5,000 employees were laid off as a result of the privatizations which now have been disallowed. And for that, we look to the Louisiana Civil Service Commission as the third culprit behind Jindal and the LSU Board of Stuporvisors.
After all, you can’t put the genie back in the bottle.
The Civil Service Commission, which must approve any layoff plan, first rejected the administration’s privatization by a 4-3 vote but agreed to reconsider the proposal when the administration said it would provide additional information.
The next week, the board met again and commission member D. Scott Hughes of Shreveport apparently saw the light and inexplicably switched his vote from no to yes. More importantly, two other members, Dr. Sidney Tobias of LaPlace and commission Chairman David Duplantier of Mandeville, took the easy way out: they simply did not attend the meeting and the final vote that put 5,000 employees on the street was 3-2 in favor of Jindal.
Granted, commission members don’t receive a salary for their service but if Hughes could drive in from some 250 miles away—even with his yes vote—then surely commission Chairman Duplantier and Tobias could have, should have, found a way to drive in from about 75 and 50 miles out, respectively.
On a matter of such import, their no-show was nothing less than gutless and both should resign from the commission. They agreed to serve and their votes on this issue were of extreme importance—to the administration of course, but especially to those 5,000 employees whose livelihoods depended on the whims of seven five people they’d never met.
And then there’s that almost overlooked matter that’s lost in all the frenzy—one of utmost urgency: where will the state’s poor now seek medical care?
And the fingers of blame point directly at Jindal, the LSU Board of Stuporvisors, and the Civil Service Commission.
So now, after the approval of a contract with its 50 blank pages, after the termination of all those employees, after Jindal’s flimflamming his way around the legislative process, after the demotion and eventual loss of two valuable members of the medical profession, after DHH Kathy Kliebert’s assurances (as late as last week) that everything was just peachy, another wing of Jindal’s house of cards has come tumbling down.
If this is indicative of the way he runs a state—and all the evidence says it most assuredly is—imagine how, as president, he would fare in a faceoff with Vladimir Putin—even with the help of Jimmy Faircloth.
Someone needs to get Kenneth Polite’s office or the FBI involved. It appears that federal laws have been broken. http://www.law.cornell.edu/uscode/text/18/1031
What happens now? The closure of “Private/Public Hospitals” and no place for Medically Indigent patients to seek care?
While the privatizations have been implemented with five former LSU-run Charity hospitals, they are still required by state law to provide “Free Care” for persons with incomes up to 200% of the federal poverty level by family size. With the CMS decision, the private operators are ‘holding the bag’ (which underscores our continued vigilance, as these private operators could exercise CEA exit clauses with up to 90 days notice in most cases).
The W.O. Moss (Lake Charles) and Earl K. Long (Baton Rouge) situations are another matter, as the original LSU hospitals have closed. Both however have outpatient clinics run in LSU-owned facilities, so the Free Care provision for the medically indigent may remain in force under the terms of the authorized concurrent resolutions (though I am not an attorney — this bears deeper investigation).
To be sure, a budget hit the amount as reported by Tom / Louisiana Voice also will likely mean severely curtailed services. And if SCR 48 passes this session, central Louisiana won’t even have permanent outpatient facilities ready by the time Huey P. Long is scheduled to close June 30, 2014 (but the legislature CAN reject SCR 48, and the Civil Service Commission CAN reject that deal, under its requirement for “rational business reasons” — the cloak of which has been removed and laid bare thanks to the CMS decision. Unfortunately Kenneth Polite is not still on the SCS Commission (though as the other post suggests, Polite will have the opportunity to uphold federal law).
K. Brad Ott
Advocates for Louisiana Public Healthcare
What if LCMH executes their CEA exit rights? Will there no longer be a medical facility to render health care to patients that need care in Lake Charles and surrounding areas?
What I want to say cannot be printed. I’m sick and tired of this! What has happened to our state????
Critically, the 2013 agreements to privatize the Charity hospitals contained tens of blank pages, evidence of bad deals rushed ahead to deal with budget problems created by Jindal’s difficulty paying the state’s bills. Despite these blank pages, the Jindal Administration pressured the LSU Board of Supervisors to approve the deals, ensuring taxpayers would be bilked by rash decision making (Learn more about the contracts here). http://karencarterpeterson.com/2014/05/04/cms-rejects-jindal-plans-to-privatize-charity-hospitals/
The question (again) is what is the state legislature going to do now that it knows this privatization scheme is a farce. There remains a few privatizations unfinished, including Huey P. Long (which its closure as proposed by SCR 48 comes up for a vote in House Health and Welfare Tuesday May 6) that the legislature can directly block and ‘call the question’ of the probity of the entire LSU Charity Hospital system privatization.
I disagree that the state legislature is “not culpable.” Senate Finance Chair Jack Donahue, blocked legislative attempts to challenge the privatizations during the regular 2013 session, bottling up Representative Jared Brossett’s HCR 74, which would have required “submission for approval by the Joint Legislative Committee on the Budget of any cooperative endeavor agreements between the LSU Board of Supervisors and a private entity involving the change in management of a public hospital.” The House voted 69-28 to pass; and had Donahue authorized consideration, this would have become laws. Likewise, the Joint Legislative Committee on the Budget, also chaired by Donahue, had the statutory authority to defer action on the six cooperative agreements for their very incompleteness alone.
Recall too that Earl K. Long and W.O. Moss were CLOSED by legislative action under concurrent resolutions. Unless the state legislature starts to challenge Governor Jindal knowing what it knows now, Huey P. Long Medical Center will be the next closure (and the legislature again will be culpable in furthering the Jindal privatization disaster).
K. Brad Ott
Advocates for Louisiana Public Healthcare
The attorney general opinion said that if a hospital is not being closed down, the legislature has no authority to intervene with the privatization plan. Accordingly, you are correct in asserting the legislature did have a say-so in the cases of East Louisiana State Hospital, Earl K. Long, W.O. Moss and, depending on how the vote goes Tuesday, Huey P. Long.
But as for the six hospitals affected by last Friday’s CMS decision, the legislature had no power to stop Jindal’s privatization—W.O. Moss excepted.
Your clarifications are greatly appreciated—and encouraged.
Perhaps our next post should be the votes of the individual legislators on those resolutions to close EKL, W.O. Moss, and East Louisiana.
Governor Jindal and his entire staff should be jailed for trying to privatize our public health system.
Great Reporting!
While I was not the first to call attention to another one of Jindal’s debacles, I did write this letter to the Advocate, our daily newspaper, and it was published the 1st week in Oct. 2012. It stayed on their letters to the editor website for several weeks. By the way, we did not get the help we needed, as cited below, from the state legislature.
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Letter: Jindal hurting state health care
October 19, 2012
15 Comments
I voted for Bobby Jindal three times, contributed to his campaign and was upset when he lost to Gov. Kathleen Blanco. Now, I am very disappointed in his performance and would not vote for him again.
The first omen appeared when he opposed mandating the wearing of helmets by motorcyclists. Yet, helmets increase safety and reduce costs because of injury.
He opposed a bill to maintain a tax on cigarettes, the income of which was vital to some health programs.
He is so often out of the state on fundraising ventures that he should be paid only for the days he is in Louisiana working.
Recently, Jindal unwisely rejected federal Medicaid dollars that could have helped fund mental-health programs and aided the state hospitals budget. This folly ends up with Louisianians paying taxes that go to other state Medicaid programs, while we suffer for lack of funding.
Jindal is currently making massive cuts in the state hospital system. This will be destructive not only to medical care to the poor and uninsured, but will severely and permanently damage the training of physicians in Louisiana. Predictably, there will be devastating effects on LSU and Tulane Medical Schools to educate physicians.
With a reduction in hospital beds, and training programs for primary care and specialties, there will be a decrease in the number of new doctors who will establish practices in Louisiana, as most physicians practice in locations where they are trained. Too, the reduction of beds will cause many patients to go untreated or have the cost absorbed by private hospitals. Additionally, there will be a huge loss of jobs in health care, adding to the economic woes of our state. The Lallie Kemp Hospital in Independence is their only local source of jobs.
What is it about Jindal that he cannot comprehend this unfolding travesty? He appears obsessed with running for “higher office.” He apparently chooses to do or not do something depending on how it might affect his attractiveness to prominent Republicans, even though the choices hurt his people and his state.
What can be done to block what is going on in mental health care and the LSU State Hospital System? Unfortunately, we citizens have no real power other than to push for a recall or voice public opposition. He, however, has declared he does not care what his constituents think of him. State hospital administrators have been told to resign when they have opposed Jindal. LSU board members have been replaced. This is too much power.
The only hope is that the members of the state Legislature must rise up and oppose what is going on. They need to be challenged to protect us.
Joseph Biundo
physician
Metairie
Great post and extremely good comments!
The privatization of our charity hospitals was a philosophical/ideological decision consistent with the ALEC-inspired far right agenda. Louisiana was the only state in the nation with a comprehensive, state-run charity hospital system. In other states city, county and private hospitals provide indigent care and always have.
There was NEVER any evidence city, county or private hospitals could provide the same services for less money than our hospitals. Many studies proved quite the contrary. So, the real issue is access. Many argued, often in private, our indigent population had too much access to free medical care. Generally speaking, those same people oppose the Affordable Care Act.
Closing our state charity hospitals has clearly burdened our private and parish hospitals with a patient load for which they were not prepared and, therefore, made access to care for the uninsured much more difficult. This will appeal to those who believe the indigent had it too good and it MAY actually save some money in the short run simply because people who had been getting care are no longer getting it. The philosophical/ideological question is: Is it okay to increase human suffering and deaths to save money? One, among many financial questions is: Does even limited early intervention result in health care savings in the future? Many, including me, believe it does. And, even if it doesn’t, the very human ideological question remains.
Speechless. Thank you for keeping us so well informed.
Just a followup on the status/culpability of the Legislature: Regardless of this instance, I suspect quite a few people hold legislators responsible, in general, for fostering an environment that has not only allowed but tacitly encouraged the governor to use our state as a laboratory and litter box. I appreciate that Louisiana is constitutionally unique when it comes to balance of power: the administrative branch is inordinately stronger than the legislative one. Nevertheless, individuals such as Senator Carter-Peterson—a political hero of mine who’s commented above—are rare gadflies and exemplars of a loyal opposition. Important exception: the legislative coalition built by liberals and old-school conservatives shooting down last year’s harebrained income tax scheme was a pleasant surprise. In view of the avalanche of bad (some unconstitutional) decisions that has descended from the governor’s office over six years, with seldomly more than symbolic legislative resistance, I sometimes wonder why we have a legislature. My hope is that the legislature will be compelled to increase its governing presence after having its work on the already-challenging budget utterly destroyed by the implosion of the administration’s hospital-privatization scheme.
I respectfully disagree with your assertion that “…Louisiana is constitutionally unique when it comes to balance of power: the administrative branch is inordinately stronger than the legislative one.”
Many others and I consider that a popular myth. Our legislature simply bows to the governor and, as I’ve said before, that let’s each of them use each other as scapegoats for our problems.
Consider that the greatest of all powers of the legislative branch is that of appropriation. Then consider that our legislature, for most of this administration in particular, has acted as if the governor has that power. Sure, he, like many other governors, has veto power, but the legislature has the power to override vetoes if and when they have the guts to do so. Can you remember the last time they did? I certainly agree the administrative branch is inordinately stronger, but it has very little to do with the state’s constitution or the federal doctrine of separation of powers.
Stephen – thank you for shedding light on that enigmatic point. Since I moved to Louisiana from Alabama (hardly the pinnacle of just government) nearly twenty years ago, I would ask, “Why in the world [fill in the blank]?” Without variation—from politically-knowledgeable people whom I respected—I’d be told the truism that you say is far from true. (To be honest, I never really believed it, but I got weary of being treated like a fool in political conversations.) If what you claim is so—and I have little reason to doubt you—then the situation is more distressing than it already was, and my negative perception of the legislature is not negative enough. It also means that the legislature is as responsible as the governor, if not more so, for what he’s done to this state. We really, therefore, shouldn’t let them off the hook for even this failed hospital scheme.
Even in Louisiana signing off on a blank contract should be illegal. Boo LSU supervisors.
Jindal is an asshole! He is a complete waste of skin!
Why don’t you tell how you really feel, Melody;-)
What a catastrophe the privatization of the charity hospital system proved to be. No surprises here. There is so much more we will never know due to key state employees who were pushed out before they spoke out. Greenstein was Jindal’s puppet master who knew the charity hospitals were to be closed. Look at his face during interviews and newspaper photos and one could tell by his tight-lipped expression (which non verbally is indicative of keeping a secret).
This morning when and if the legislators answered their phone calls from the private hospitals CEOs who will no longer be reimbursed by the federal government for Medicaid services, one must wonder what they will say. The truth is Jindal never cared about…well, really anyone in the state. But he has targeted a population of people who are not able to fight the system, such as the indigent, imprisoned and disabled. For those who have tried to speak for them risked the backlash of the governor’s administration. What is to come will most likely be a devastating loss of services and higher education will and is the place where the money has to come from. ACA, or Obamacare (as some refer to it) was and is the only viable solution for this problem. How in the world can anyone argue that point now?
God help us all!
Thank you Tom.
There must be some confusion here. Gov. Jindal just relayed in Forbes magazine what a huge success all his privatization plans have been. If posts to this article are accurate, that would mean Jindal was less than forthright in his Forbes article. I sure hope Forbes wasn’t hoodwinked!
😉
I, too, do not give the legislature a pass in this healthcare mess, at least not all of them. I worked at EKL for 30 years so I know firsthand the service provided to Baton Rouge and neighboring parishes by our hospital. I also was involved in the futile attempt to save our hospital, but the fix was in long before the vote was cast. Legislators were given ample information to make an informed decision as to the problems that would be created by our closure, yet the majority caved in to Jindal’s wishes and allowed him his privatization agenda. We set up a meeting before the budget committee vote and invited all the legislators on that committee to come listen to the employees, patients, and physicians and hear their side. The room was full with people wanting to have their voice heard but no one showed except Senator Broome and Representative Barrow. Employees and physicians sent emails and met privately with legislators to make sure they were informed as to the need for Baton Rouge to keep a public hospital. They could not testify openly without fear of retaliation. Legislators were even given alternate solutions for the building replacement but alternate options were never explored because Jindal wanted to privatize. Not building a 400 million dollar new hospital kept being touted as the savings. With that logic, we could have not built a billion dollar hospital and saved even more.
The day of the budget committee vote, hundreds of people showed up in opposition. In fact Representative Fannin, the committee chairman, waved the stack of opposition cards and commented on the number of opposition cards and the number of citizens in overflow rooms opposing this. Yet when Senator Broome made a motion to delay the vote at least until all the missing pieces were in place, a Jindal ally made a motion to vote now, and Fannin said “we’ll go with his motion” and completely ignored Broome’s motion. They then (including Fannin) voted to close EKL without a solution for OB/GYN patients, prisoners, and the mental health emergency room extension which were the three components of EKL care that OLOL did not want. They still do not have a solution for the mental health patients and one recently died in jail because without our MHERE (Mental Health Emergency Room extension) building , ER’s get bogged down with mental health patients so often times they are now sent to jail. Prisoners now have to go to New Orleans which costs more in transport but health care has been improved in Baton Rouge and is much cheaper, right?
Dr. Cerise tried to work with this administration and allow Jindal to privatize the in patient component only. He was told the outpatient component would stay with LSU and so we could continue all the progress we had made with Disease Management clinics that rated LSU very high nationally using defined benchmarking data. Employees were told to stay to the end and there would be jobs for them in the outpatient setting. Then in January, before the closure in April, employees were told they would all be laid off. (This was the plan all along but they needed the employees to the end and everyone knows state workers are useless and their welfare does not need to be considered when the governor is running for president.)
So no, I do not give legislators a pass. At the end of the day, the majority give Jindal what he wants. I could go on and on about the loss to La of the LSU public hospital model that could have become a model for the nation. In fact in 2012 LSU was touted on Capitol Hill by the American Public Hospital Association as just that. So sad……..
When we wrote this, we were referring to the decision to close the six hospitals that were subject to last week’s decision by the CMS. Our giving the legislature a pass was limited to those six facilities. Obviously, as I noted in reporting the attorney general’s opinion, any decision to close a facility must be concurred in by the legislature—and concur they did on the closures of EKL in Baton Rouge, W.O. Moss in Lake Charles and, today, May 6, on Huey P. Long in Rapides Parish.
As has been shown by several readers, we were being far too charitable to the legislature. As many times as we have trumpeted the shortcomings of the legislature (the education reform that was rushed into law simply because Jindal said they should, for example), we should have been more candid in assigning a share of the blame to the weak-willed lawmakers led in the Senate by a president who has been shown to be widely abusive of campaign expenditures for personal purposes and in the House by a man of absolutely zero willingness to man up to the governor.
It’s a shame we have 144 legislators who cannot find it in themselves to unite to force the governor to back down on his policies designed to adversely affect the poor and middle class while showering political favors on his well-heeled allies.
Thanks so much for keeping this issue alive.
Those of us who invested our heart and soul into the public hospital system are just sick that all our hard work is just being discarded as the system is being recklessly and rapidly dismantled.
I wish the mainstream media did their homework as much as you.
Thanks for keeping us informed and for caring about the real losers in this – the poor and uninsured.
I appreciate your update and willingness to assign at least some blame to the Legislature. Having closely followed all aspects of this train wreck I remember all the details. In reality I feel most of the blame is at their feet. Important in this whole discussion is the lack of movement by the Legislature, particularly in the realm of appropriations. As stated above, this entre issue is only allowed to happen because over the years the Louisiana Legislature refuses to act as the third branch of government. They simple will not serve as a check against the Executive Branch.
While I agree their is much blame on the LSU Supervisors, particularly with the approval of an incomplete contract and the obvious conflict of interests that existed, especially with Mr. George and the Shreveport deal, it is hard to throw much blame at the Civil Service given the circumstances they were put under once that contract was approved and the failure to act by the Legislature.
To recap, as we all seem to agree, the first “Deal” was actually different in that the Legislature did by act close EKL in BR. It was this move, right or wrong, that set the whole ball rolling. The Legislature agreed in the closing that privatization was the way to go and signed off on such a plan. When this one finally got to Civil Service they were only being requested to approve the layoff plan to close us out. In fact, the layoff plan was eventually moved up several months due to our staff leaving at a rapid pace. They never had to approve a contract for EKL since we were closed by Legislative Act.
When the next four came along, which I think is the bulk of this conversation, it was different. This time the LSU Supervisors never produced the documents and eventually signed off on contracts with many missing or blanks pages, as has been properly reported. But the vital missing piece here is during this whole time the Legislature was in session, with the State Budget, and failed to act. The proposed budget had zero, none, nothing in it for these four hospitals effective the start of the new fiscal year. And there was zero effort from anyone in the Legislature to attempt to amend the budget to put the money back in. Now I was never sure if they simple missed it or they did not want to deal with trying to place hundreds of millions back into the budget in bad times, but that was a fact. And as the contracts moved to Civil Service in June of that year with the Legislature days away from final adjournment, there was no money. I remember watching Mr. Ott make great arguments but in the end the option Civil Service had been given was to approve privatization or close the facilities in three weeks.
At the first meeting that June I attended and watched the State present nothing. It was a simple 5-7 page powerpoint with no real numbers or contracts. It was a heated meeting by Civil Service standards and in the end the vote came down 3-4 with the primary argument to not approve as some felt they did not have enough information to evaluation the deal against their standard. When they met again about a week later they suddenly had complete contracts, read no missing pages, and complete financials. That was the first time those had been seen and now were public records. That vote was 3-2 in favor, but again, the other option as clearly outlined was closure. And the Administration made it clear they were moving ahead. That was in effect a battle within one branch of government for information.
Following that the Legislature did attempt one more veiled stab through the Joint Committee now that the full contracts had been put in play by Civil Service, but that groups lacks any real authority to control contracts since they are the funding and policy body. They had missed their chance to allocate dollars earlier in the month. They too knew at that point the only two likely outcomes were closure, since they had failed to allocate any funds, or a court fight where no one had established standing and Jindal clearly had the Supreme Court opinion as to Constitutional powers to act and economy and efficiency as the prime standard on his side. You could argue Civil Service could have voted no to simple establish standing but they would have lost the case in Court as the legal standard is well established in Louisiana law once the Executive branch acts.
Sorry for the long rant, but to try and excuse the Legislature on this one is silly. They are the sole and only reason we ended up here beyond Jindal’s ego and lust.
It is the “here” I now question. I will admit I have been surprised by the lack of public upheaval over the transition. Even CMS acknowledged the “deals” are legal if they correct the upfront payment issue. It appears on the surface level the care issues are not near what I and many others thought. The big surprise seems to be the manner in which our indigent population is now using any hospital for care and not just the assigned” charity hospital. How we all missed this in the discussion is amazing. In the end the model, if it survives, will have to be changed to account for this spreading of the load issue. The new charity hospitals are not having the load they thought of free care but the other hospitals who were not part of the deal are now shouldering a higher percentage of the load. And do we know if people are not getting care. That is my main question today. I see the reports of the backlogs being reduced and waiting times reduced but has anyone done any real research or investigation with the users of the care. Honestly I walked away and have not looked back in terms of the care issue. But the outcry I expected has not come. Any insights here?