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Archive for the ‘Contract’ Category

Jimmy Buffett sang about clichés and we hear them every day:

  1. Life’s not fair. We learn that quickly in our lives.
  2. Those who make the gold make the rules: a subsection of Number 1.
  3. What’s good for the goose is good for the gander. Well, not necessarily.

Here’s another one: Get over it. That’s what those with the gold would tell us.

What’s the point of all this?

Well, for starters, the average salary for state classified (Civil Service) employees in Louisiana was $44,737 per year in 2017. After four years of virtually no growth, the 2017 average salary represented a 6.3 percent increase over the four years of 2010 through 2013 (2.1 percent per year), when the averages were, in order, $42,187, $42,208, $41,864, and $42,140.

If you followed those figures closely, you saw that the average salary for classified employees actually decreased by $47 from 2010 to 2013.

Contrast that with the average salary for unclassified (appointive) employees. Those average salaries increased by $1,565 (2.5 percent) from $61,861 in 2010 to $63,426 in 2013 and were $65,357 in 2017, a difference of $20,620 over their classified counterparts.

Okay, it’s somewhat understandable that unclassified employees would make 46 percent more than their counterparts. They are, for the most part, in managerial positions, after all.

For the most part. But it’s important to keep in mind that these appointees are there only as long as the governor. Generally, a new administration brings in its own personnel to replace those of the previous governor.

Unclassified employees are generally along for the ride and they’re basically temporary employees who come into an agency knowing little of its workings or its personnel. Others are just political hacks who were awarded jobs for supporting the right candidate. The classified, or civil service employees, the ones who do the actual work of keeping the state running, are career employees there for the long haul.

Article X, Paragraph 9 of the Louisiana State Constitution lays out some specific prohibitions for classified employees:

Prohibitions Against Political Activities:

(A)”No…employee in the classified service shall participate or engage in political activity; make or solicit contributions for any political party, faction, or candidate; or take active part in the management of the affairs of a political party, faction, candidate, or any political campaign…”

(C) “As used in this Part, ‘political activity’ means an effort to support or oppose the election of a candidate for political office or to support a particular political party in an election.”

These restrictions were put in place to protect classified employees from pressure from political bosses to ante up campaign contributions or to campaign for a particular candidate. But they also placed limits on other outside activity.

But, no matter how closely you study the Constitution, Civil Service, or Ethics Commission rules, you will not see any reference to activity restrictions on unclassified employees

So, why are the rules that govern ethics and conflicts of interest for classified employees different than for unclassified employees? Why is there an uneven playing field?

Take, for example, the case of Andrew Tuozzolo. He’s the Chief of Staff for Rebekah Gee, Secretary of the Louisiana Department of Health (LDH).

Tuozzolo, who was hired on Feb. 1, 2016, and who earns $105,000 per year, is the manager of WIN PARTNERS, LLC, of New Orleans, a political consulting firm.

By its very name and function, Win Partners necessarily involves its manager in political activity such as supporting candidates, soliciting contributions and taking part in the management of affairs for political candidates.

And it’s perfectly legal—because he’s unclassified.

Incorporation papers for Win Partners were filed with the Secretary of State on Aug. 18, 2010, and the firm began receiving fees almost immediately. Since Sept. 1, 2010, only two weeks after it was incorporated, Win Partners, and to a much lesser extent, Tuozzolo personally, have combined to receive $1.95 million in fees from candidates and political action committees.

Some of those candidates included State Reps. Walt Leger, Austin Badon; State Sens. Karen Carter Peterson, Butch Gautreaux, and Jean Paul Morrell; New Orleans City Council members Joseph Giarrusso and Helena Moreno, New Orleans Mayor Mitch Landrieu, and at least one statewide candidate (Buddy Caldwell).

Since his hire by Gee on Feb. 1, 2016, Win Partners has slowed somewhat in activity but that can be attributed mainly to the fact that the only major elections were for New Orleans municipal offices.

Since beginning his employment with LDH, Win Partners has collected $36,900 in fees for working in the campaigns of Moreno, Giarrusso, and Leger.

Without even taking into consideration the question of when he would have time to devote to a political consulting company, the work itself is enough of a conflict of interest to get a classified employee fired.

And then there’s the matter of Dr. Harold D. Brandt who, from April 7, 2016 to Sept. 2, 2017, served as the Medical Vendor Administrator for LDH. Brand’s salary was $156.25 per hour which, based on a 40-hour week, comes to $6,250 per week, or $312,500 for a 50-week year, allowing a couple of weeks for vacation.

Begin Date End Date Agency Job Title Biweekly Pay Rate
9/2/17 Present Resignation
4/7/16 9/1/17 LDH-Medical Vendor Admin Physician IV $156.25/hour (4/7/16 to 9/1/17)

 

The only problem with Brandt’s serving as the Medical Vendor Administrator for LDH is that he also is on the STAFF of Baton Rouge Clinic.

Since April 7, 2016, Dr. Brandt’s date of employment, Baton Rouge Clinic has received more than $83,000 in PAYMENTS from LDH.

If, as the LDH Medical Vendor Administrator, Dr. Brandt’s duties included approval of vendor payments to Baton Rouge Clinic, that would place him in a position of a potential ethics violation, unclassified or no, but only if he owned greater than a 25 percent share of Baton Rouge Clinic.

The wording of the ethics laws says if an employee owns greater than 25 percent of a business, that enterprise is prohibited from doing business with the employee’s agency. Dr. Brandt likely does not hold a 25 percent interest in Baton Rouge Clinic but he certainly has a financial stake in its serving as a vendor for the state.

That 25 percent interest certainly didn’t come into play with one classified employee a few years back. A state vendor sent her, unsolicited, a baked ham for Christmas. It was delivered to her office unbeknownst to her. She was fined $250 by the Ethics Commission.

That’s because classified employees are prohibited from accepting anything of value (other than a meal, to be eaten at the time it is given) from vendors.

But unclassified employees running a political consulting firm on the side or monitoring payments to a clinic where he is employed apparently are okay.

So, there’s no point in even discussing legislators who purchase season tickets for LSU and Saints football and Pelicans games, leasing luxury cars, or who even pay personal income taxes from campaign funds—all prohibited on paper but certainly not enforced.

Is a level playing field really too much to ask?

At the end of the day, ethics violators are as thick as thieves but it’s just the low hanging fruit that the Ethics Commission, the OIG and the Attorney General’s offices go after—like a kid in a candy store. The tough cases they avoid like the plague. If they would only think outside the box, there’re plenty of fish in the sea for them to go after if they’d just take the tiger by the tail.

(How many clichés did you count in that last paragraph?)

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By now, thanks to the Internet and network TV news, virtually everyone in the U.S.—and apparently some foreign countries—knows about the ham-handed manner in which the Vermilion Parish School Board shut down one of its teacher’s comments during a recent board meeting.

The manner in which Kaplan middle school English teacher Deyshia Hargrave’s was cut off from speaking and subsequently manhandled by a city marshal was carried out with all the tact, consideration, delicacy, and diplomacy of Donald Trump discussing immigrants from $*%#hole countries.

And the fact that the school board employed the CITY MARSHAL who was previously accused of using excessive force against a 62-year-old man in poor health to carry out the handcuffing and arrest of Hargrave certainly didn’t help matters in what overnight brought national and international negative attention to Louisiana.

And the announcement by the city prosecutor that Hargrave would not be prosecuted only enhances her chances of reaping a financial settlement subsequent to the lawsuit she is almost certain to file for her rude treatment and public humiliation.

To provide a little background for anyone who may not have heard, Hargrave was at the board meeting to protest a $30,000-per-year proposed salary increase for School Superintendent Jerome Puyal (from $110,190 to $140,188) while teachers, cafeteria workers and, support staff received no salary increases. School Board President Anthony Fontana, an Abbeville attorney who has been on the board about a quarter-of-a-century, promptly gaveled her into silence, proclaiming her comments were not germane to the board’s agenda.

One report had Fontana referring to Hargrave, parish’s 2015-2016 teacher of the year, as “the poor little lady” in an INTERVIEW subsequent to the meeting. That charitable reference is almost certain to absolve him of any culpability in what has become a public relations nightmare sufficiently grievous to attract the attention of the ACLU and teachers’ unions, not to mention network television news.

But that all could have been avoided had Fontana simply consulted in advance with the good folks at Gravity Drainage District 8 of Calcasieu Parish Ward 1. Not those folks know how to shut a dissident up quietly and efficiently.

The secret is to get an attorney who isn’t afraid to threaten the dissident and a judge who can ignore the First Amendment to the U.S. Constitution and issue an order that the dissident may not make public records requests nor have any contact with any members or employees of the gravity drainage district.

Or, better yet, have a gaggle of judges file suit against a newspaper to prevent it from seeking public records from the court.

Problem solved.

Never mind that the gravity drainage district hired with Billy Broussard to remove debris from drainage canals following Hurricane Rita under a FEMA contract and then instructed Broussard to remove older pre-storm debris and that he would be paid to do so.

But when FEMA said the older debris was not part of the project, the drainage district flat-out refused to pay Broussard about a million dollars that was due him for the work. Moreover, some of that older debris consisted of large cypress logs—still very much useful in construction—which mysteriously disappeared.

So, when Broussard attempted unsuccessfully to get reimbursed for his work, RUSSELL STUTES, Lake Charles attorney for the drainage district, wrote a testy letter to Broussard in which Stutes, elevating himself to judge status, threatened Broussard with jail time “the next time any Calcasieu Parish employee is contacted by you or any of your representatives with respect to the project…”

Stutes even filed a petition for injunctive relief to bar Broussard from contacting members or employees of the drainage district and from seeking public records. Incredibly, 14th Judicial District Judge David Ritchie signed the order for the INJUNCTION that bars Broussard from his constitutionally-guaranteed right to seek answers from a public body. That right is also guaranteed under Louisiana R.S. 42:4.1 et seq.

Likewise, the judges of the 4th JDC up in Monroe filed SUIT against the Ouachita Citizen newspaper in West Monroe in order to stymie the newspaper’s efforts to obtain public records from the court.

So, you see, Mr. Fontana, it really wasn’t necessary to shoot yourself in the foot by having the city marshal strongarm Ms. Hargrave, your defense that he was authorized to do so notwithstanding. That just brought unwanted attention to a board what was already contentious in its membership makeup—some of that disharmony stemming from the performance of the very superintendent to whom you trying to give an extra $30,000 per year.

All you had to do was have the board attorney (and you are an attorney yourself) to find a judge who would sign an order for injunctive relief which, while questionable in its legality, would nevertheless have shut Ms. Hargrave up.

For a minute, anyway, to borrow a phrase from Ron “Tater Salad” White, one of my favorite stand-up comics, which he tags at the end of this joke but which is deleted from this VIDEO.

 

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Thank goodness for late-inning rallies Thursday and Friday nights by LSU’s No. 1-ranked baseball team to beat No. 2 Texas A&M 4-3  and 9-6, respectively. Otherwise, the news just keeps getting worse for Louisiana.

That’s right; we had to flip all the way back to the sports section to find anything good to write.

That’s because even as the legislature grapples with that $1.6 billion budgetary shortfall, things were becoming unraveled elsewhere as the administration was hit this week not with a double- but a triple-whammy that could end up costing the state hundreds of millions of dollars and could conceivably end up costing another LSU president his job.

We will try to take the events in chronological order.

On Tuesday, the administration received word from the Center for Medicare & Medicaid Services that CMS AGAIN REJECTS the administration’s Cooperative Endeavor Agreements (CEAs) in connection with the controversial state hospital privatization plan pushed by Bobby Jindal “because the state has not met its burden of documenting the allowability of its claims for Federal Financial Participation (FFP).”

The decision apparently will cost the state $190 million, according to a letter to State Medicaid Director Ruth Kennedy from Acting CMS Director Nikki Wachino.

On the heels of that letter, Commissioner of Administration Kristy Nichols received notification from Attorney General Buddy Caldwell on Thursday that the state had been OVERPAID BY $17 MILLION in tobacco settlement money and would have to repay that amount to the tobacco companies who then will redistribute it to states that were underpaid.

And on Friday, State Treasurer John Kennedy announced that national investors had pulled out of a large portion of a major bond deal for LSU after concerns were raised on Wall Street by LSU President F. King Alexander who announced on Thursday that he was preparing paperwork for the state’s flagship university to file for financial exigency, or academic bankruptcy. http://www.nola.com/politics/index.ssf/2015/04/lsu_academic_bankruptcy.html

Kennedy, in a Friday news release, said his office was “trying to sort out the facts,” but essentially, a $114 million bond issue that was in the works appeared to fall flat when investors pulled out on about $80 million in commitments. The bond sale was to have funded a Family Housing Complex, residence halls and a Student Health Center and also would have saved interest on existing debt. http://campaign.r20.constantcontact.com/render?ca=e9da20fd-7c07-4e6d-9d75-82afa4fb05a9&c=cdce75a0-62fb-11e3-959d-d4ae52a459cd&ch=ce38f740-62fb-11e3-95d9-d4ae52a459cd

A BloombergBusiness report said that while investors who bought the $114 million of debt sold by LSU they were not told the school was considering filing for exigency. http://www.bloomberg.com/news/articles/2015-04-23/louisiana-state-bond-buyers-greeted-by-insolvency-plan-next-day

A declaration of exigency by LSU and other colleges and universities across the state would open the way for the schools to fire tenured professors. http://www.bloomberg.com/politics/articles/2015-04-23/louisiana-state-to-draft-insolvency-plan-as-jindal-plans-cuts

One state official confided in LouisianaVoice that Alexander, in his attempts to underscore the severity of the financial crisis in Louisiana higher education, currently facing still more deep budgetary cuts, may have overplayed his hand in making a “premature” announcement of such magnitude.

Meanwhile, word leaked out of a Board of Regents committee meeting Friday afternoon that as many as one-half to 75 percent of Louisiana colleges and universities may be unable to meet payroll by June unless some solution is found quickly to the fiscal crisis that has spread a mood of imminent doom across state campuses. That source said he does not believe a solution will be found until the last week of the session—if then.

With a vengeful governor like Bobby Jindal, anything perceived by him to place him in a bad light is met with severe repercussions, namely teaguing, and Alexander’s pronouncements have certainly reflected poorly on the administration.

For new readers who may not be familiar with the term, teaguing refers to Jindal’s firing of Melody Teague because of her testimony before the state government streamlining committee and the similar firing of her husband, Tommy Teague, only six months later from his job as Director of the Office of Group Benefits (OGB) when he failed to go along with the ill-fated privatization of that agency. Dozens of other state employees and legislators have been either fired or demoted from committee assignments by Jindal for lesser sins. LouisianaVoice learned today that Melody Teague, who was suffering from ALS, died in March. http://www.legacy.com/obituaries/theadvocate/obituary.aspx?pid=174404543

For his part, Jindal, after more than seven years in office, has finally admitted there is a problem with “corporate welfare” in Louisiana, i.e. corporations that do not pay any taxes to the state.

One classic example cited by Steve Spires of the Louisiana Budget Project was Wal-Mart, which is a Delaware-based corporation. Spires, speaking at a State of (Dis)Repair conference in Hammond on Thursday, noted that Louisiana Wal-Mart stores are leased by local entities who pay exorbitant rent to the corporate parent in Delaware, a state with no state income tax, thus avoiding income tax in Louisiana while reaping the benefits of other incentives such as Enterprise Zone designation and 10-year property tax exemptions.

Jindal has only in the past couple of weeks so much as acknowledged the state has a problem with its generous tax breaks for corporations which cost the state billions of dollars per year.

Thus, as the budget crisis grows progressively worse with each passing year, Jindal has resorted to more and more sleight of hand in patching over budget holes with one-money.

Caldwell, in his letter to Nichols and Kennedy, said a number of states had been underpaid in tobacco fund settlement money by the tobacco companies because of accounting errors, and that a corresponding number, including Louisiana, had been overpaid.

Louisiana, he said, was overpaid by about $17 million which will have to be repaid so the money can be redistributed to the proper states.

The CMS rejection has been a problem for the administration since the privatization deals with several private hospitals were signed, though DHH Secretary Kathy Kleibert has attempted to see the world through rose-colored glasses, always expressing optimism that the state’s plan would be approved.

Not so.

In her three-page letter to Ruth Kennedy, Wachino said, “After careful consideration, CMS cannot accept the arguments advanced by the State in its Request for Reconsideration. While CMS recognizes the State’s efforts at corrective action, such measures do not address the State’s noncompliance for the period in question (Jan. 1, 2013 through May 23, 2014). For the reasons stated above, as well as in CMS’s Dec. 23, 2014, disallowance letter, the…disallowance is affirmed.”

All in all, the state has seen better weeks.

Go LSU! We need a sweep badly!

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Dr. Randall M. Wilk operates a medical practice in Gretna dedicated to the surgical treatment of diseases in the head and neck. http://www.drrandallwilk.com/#

Approximately 25 percent of his patients are cancer sufferers. Licensed to practice medicine in the state of Louisiana (License No. MD022962), Wilk earned his medical degree from the LSU School of Medicine in New Orleans. He did his general surgery training at the Ochsner Medical Institutions and did his head and neck surgery training in Portland, Oregon.

He also has a Ph.D. in anatomy from LSU and a DDS from the Baylor College of Dentistry and has a certificate in oral surgery.

But even though he does not operate a dental facility, that DDS degree has cost him more than $100,000 in legal fees because of the heavy-handed tactics of the Louisiana State Board of Dentistry which carried its badgering of Wilk all the way to the floors of the Louisiana House and Senate.

“Since graduating from dental school 25 years ago I have never filled a tooth, made a denture, made a crown, cleaned teeth, restored a tooth, or anything that one would consider a dental practice,” Wilk says, adding that he went “from graduating dental school in 1987 to starting graduate school” that same year.

Wilk noted that the dental board, in its 2009 financial statement, reported a loss to the Department of Health and Hospitals (DHH) of more than $60,000 and that the only plan put forth for managing that loss was “higher revenue from the collection of fines.”

Within weeks of that report, Wilk said, “I received a letter from the board sating that they had received a complaint on me from a Camp Morrison.”

Morrison, a private investigator, has worked for the board for numerous years under a series of contracts totaling more than $1 million. Moreover, even though he is an independent contractor, he is given free office space in the board’s suite at the high-rent One Canal Place office building in New Orleans.

Dating back to 1997, Morrison was issued nine consecutive contracts totaling more than $1.8 million. Most of his contracts were for two-year durations. His first, from March 1, 1997 to Feb. 28, 2000, was for $45,000. But from Sept. 1, 2000, through Aug. 31, 2002, his contract more than trebled, to $150,000 and increased again to $200,000 with his next contract which ran from Sept. 1, 2002 through Aug. 31, 2004.

Beginning on Sept. 1, 2004, he was awarded four consecutive two-year contracts of $240,000 each. Those four contracts combined to run through Aug. 31, 2012.

For whatever reason, on Sept. 1, 2012, the board cut his contract back to nine months and $110,000 but when that pact expired on June 30, 2013, he was issued a new contract, this one for three years, from July 1, 2013 through June 30, 2016, for $340,000.

Wilk said he was told that Morrison had reported to the board “that they had no record of me having an anesthesia permit from the dental board in 2007, that they had no record of me having a certificate in oral surgery, and that I was suspended from the Medicaid and Medicare programs.

“All of those are false statements,” he said, but the board refused to produce a copy of Morrison’s report. “I believe that filing a false report is a crime.”

Wilk said a meeting was scheduled and at that meeting two board members said they wanted him to sign a consent decree and to pay the board $5,000.

When Wilk said he had no intention of signing anything without first having his attorney examine the document, they left the room for a short time and returned with an adding machine “and told me that if I did not sign the document right then and there, that they could levy fines of over $100,000.”

He said the two handed him the adding machine tape “and placed the consent decree in front of me. For those familiar with the Godfather movies, the only thing missing was Luca Brassi with a pistol to my head.” He said a board member said it appeared that he (Wilk) felt his medical degree was more important than his dental degree.

“This was a pure and simple shakedown,” Wilk said.

He said it’s not unusual for medical specialists to obtain a dental degree prior to going to medical school and residency. “In the state of Louisiana, dozens of doctors are in this position. At least half-a-dozen are otolaryngologists, several are plastic surgeons, general surgeons, head and neck surgeons, orthopedic surgeons, gastroenterologists, anesthesiologists, even psychiatrists.

“Having a dental degree does not make your medical practice a dental practice,” he said.

Apparently the dental board and its investigator, Camp Morrison, disagree. Here are minutes of a 2011 dental board meeting at which Wilk’s case is discussed. DENTAL BOARD MINUTES MAY 20, 2011 (bottom of page 14)

Moreover, the DENTAL BOARD BULLETIN also mentions disciplinary action against Wilk (Item no. 14 in the left column near the bottom of page 3).

Wilk obtained legal counsel but the barrage from the dental board continued “for almost two years,” he said. “They subpoenaed me five times, requested copies of my patient records for several years and required my staff to go over 12,000 records. The final documents sent to them weighed several hundred pounds.

“Despite my being represented by counsel, Mr. Morrison continued to serve me subpoenas, to appear in my office waiting room, the operating room at Ochsner Hospital and at my home,” all the while passing out his cards to people and saying he was the investigator for the board of dentistry.”

Eventually, the board relented somewhat by notifying Wilk’s attorneys that if he paid the board $10,000 the matter would “go away.” Wilk said he feels that such tactics are tantamount to corruption or shakedowns. Again, he refused to pay.

Louisiana Revised Statute 37:793 (H) (2) says:

  • A personal permit is not required when the dentist uses the services of (1) a trained medical doctor, (2) doctor of osteopathy trained in conscious sedation with parenteral drugs, (3) certified registered nurse anesthetist, (4) a dentist who has successfully completed a program consistent with Part II of the American Dental Association Guidelines on Teaching the Comprehensive Control of Pain and Anxiety in Dentistry, or (5) a qualified oral and maxillofacial surgeon provided that the doctor or certified registered nurse anesthetist remains on the premises of the dental facility until any patient given parenteral drugs is sufficiently recovered.

When Wilk’s pointed out that the statute “specifically exempts me from what they are fining me for, their lawyer stated that he will have to ‘get that law changed.’” Wilk said. He said the board, which in 2010 reported an operating loss of $104,000, “held its own trial and fined me and held me for the board’s legal costs, totaling about $100,000.” They are their own judge, jury, and executioners,” he said. DENTISTRY BOARD 2009 FINANCIAL STATEMENT

The board subsequently prevailed on then-State Rep. Herbert Dixon to introduce legislation giving the dental board the necessary leverage to pursue claims against medical practitioners like Wilk who were not practicing dentists.

Wilk was scheduled to testify in committee against Dixon’s bill, HB 172, at 10 a.m. on May 15, 2012 but upon arriving, learned that the bill had been moved up to first on the calendar and had already been discussed and passed by the committee. It subsequently passed unanimously in both the House and Senate, yet more evidence that legislators often pass bills without really knowing what they contain or the implications of the language.

Wilk said that State Sen. David Heitmeier (D-New Orleans) had a discussion with Peyton Burkhalter, who had by then succeeded Barry Ogden as executive director of the board, and that Burkhalter had assured Heitmeier that the board had decided to drop the charges against Wilk. “He said that Mr. Morrison’s Gestapo tactics would end,” Wilk said.

State Sen. Fred Mills (R-Breaux Bridge) told LouisianaVoice on Thursday that he and former House Speaker Jim Tucker (R-Terrytown) had experienced clashes with the board in the past. “They’ve got some problems with that board,” he said, “and I believe the answer in the end will be the establishment of oversight over them,” he said. “We’ve had to threaten them with legislative action, including replacing the entire board, in order to back them down in the past.”

Wilk said he feels there is outright corruption on the board and that its shakedowns of dentists and non-dentists alike constitutes extortion. “Knowing that no violation of any statute occurred but demanding payment under threat of costly litigation is unethical conduct,” he said.

“I believe that their changing the law was intended to persecute me but also puts many other practitioners at risk. The implications…are far-reaching and as such constitute a restraint of trade. The precedent set by this bill (HB 172) (allows) other boards to reach beyond their jurisdiction. This law does nothing to protect the public,” he said.

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Gov. Bobby’s ill-fated, self-serving decision to opt out of a Medicaid expansion for Louisiana is beginning to pay off in an ever-expanding crisis in medical care for the indigent population of Louisiana—on at least two fronts.

An occasional admission of error could go far in establishing a politician’s credibility but it is downright exasperating when this governor is so blind, so stubborn, so obnoxious, so obstinate, so pig-headed, and so disconnected that he cannot bring himself to cross Grover Norquist, the American Legislative Exchange Council, or the tea party—even when his decision endangers the health and even the lives of more than a quarter of a million of his constituents.

http://www.latimes.com/business/hiltzik/la-fi-mh-more-evidence-medicaid-20141027-column.html

Of course it was only a matter of time before the chickens would come home to roost but Gov. Bobby, Timmy Teepell, Kristy Nichols, et al, figured they would long gone and on their way to the White House before the fecal matter hit the oscillating air circulation device.

They were wrong and now they’re covered with the metaphoric filth of their own making with no one to blame but themselves.

The details of the latest developments are so horrific as to defy logic but tragically, they are true.

When Gov. Bobby decided to privatize the state’s charity hospital system (which, by the way, accounts for most of the state employee cuts he loves to crow about on Faux News, in his op-ed pieces, and speeches to his right-wing zealot faithful), he closed Earl K. Long Medical Center (EKL) in Baton Rouge.

That, of course, forced many low-income residents in the northern part of East Baton Rouge Parish to go to Baton Rouge General’s Mid-City medical center for emergency room treatments.

The only problem with that was Gov. Bobby had entered into a cooperative endeavor agreement with Our Lady of the Lake (OLOL) in south Baton Rouge. Consequently, OLOL was—and is—one of only two facilities in East Baton Rouge Parish receiving payments from the state. The other is Woman’s Hospital. Neither of the Baton Rouge General facilities (Mid-City and Bluebonnet), Ochsner Medical Center, nor Lane Memorial in Zachary received a dime from the state.

Because of that, Baton Rouge General recently announced that its Mid-City facility would cease operating its emergency room, effective March 31, because of the financial strain placed on it by the overflow from EKL.

When Gov. Bobby announced the cooperative endeavor agreement with OLOL in January of 2010, he was quite specific in saying the agreement to pay OLOL something on the order of $34 million ($14 million as per the agreement, plus the $24 million already appropriated for the LSU Medical Center which previously had trained its residents at EKL; some estimates put the state’s payments as high as $100 million) would “improve and expand access to health care services for the poor and enhance graduate medical education for Louisiana’s doctors, nurses and health care professionals.” (Emphasis ours.) http://dhh.louisiana.gov/index.cfm/newsroom/detail/88

Moreover, the cooperative endeavor agreement with OLOL says on pages 7 and 8:

  • WHEREAS, LSU is obligated by Louisiana law to provide free or reduced cost care to certain patients who qualify for such care;
  • WHEREAS, the State’s purpose of this initiative, which is recognized by OLOL and LSU, is to provide Medicaid recipients with integrated, coordinated care, management of chronic disease, improvement in access to preventive and diagnostic services for children and adults, improve recipient satisfaction with access to care and the care experience and provide the State with improved budget predictability;
  • WHEREAS, in the interest of advancing the State’s goal of improving integration and coordination of health care services for the low-income populations, and recognizing the opportunity presented by the integration of outpatient and community-based services provided by LSU, inpatient and outpatient services provided by OLOL, and a payment mechanism being made available by DHH (Department of Health and Hospitals) that integrates all services through a prepaid model, the State, OLOL, and LSU intend to participate as a coordinated care network within Medicaid as proposed by DHH;
  • WHEREAS, in order to successfully meet their respective purposes, OLOL, LSU, and the State intend to enter into this public/private collaborative whereby certain residency positions in the LSU GME (Graduate Medical Education) programs and patient care services will be relocated to the OLOL campus. (Emphasis ours.)

Click here to read the CEA.

But wait. Could there be a loophole in that agreement?

Apparently OLOL thinks so.

LouisianaVoice has learned that OLOL is taking the position that its only obligation under terms of the now infamous cooperative endeavor agreement is for residency training of LSU medical students. Apparently care for the indigent is off the (examination) table.

That should come as no surprise. After all, OLOL had already dug in its heels and had begun refusing to take indigent transfers from Baton Rouge General Mid-City’s emergency room if they were not already in the LSU system—and some, apparently, who were.

Woman’s also is refusing to take indigent patients.

Of course, it was also to the state’s advantage that OLOL and Woman’s not treat indigent patients or accept indigent transfers from Baton Rouge General because as long as those patients never see the inside of the OLOL emergency room or Woman’s treatment center, the state does not have to pay for their treatment (as in the decision to lower health insurance premium rates for state employees—not so much to help the employees as to lower the state’s premium share which in the long run only resulted in the depletion of Group Benefit’s $500 million reserve fund. Are we seeing a pattern here?).

All of which raises the obvious question: could all this be by design?

Obviously, no one would admit to any conspiracy.

But how could OLOL refuse indigent patients if it is the only facility in East Baton Rouge Parish receiving payments from the state for treating indigent patients?

Good question and the answer to that goes a long way in the decision by Baton Rouge General to shut down its Mid-City emergency room, leaving indigent patients with no apparent place to go for emergency treatment—in flagrant violation of clause in the agreement that says the state is obligated by Louisiana law to provide free or reduced cost care to certain patients who qualify for such care.” (Emphasis ours.)

Sometimes those WHEREASes can come back to bite you.

LouisianaVoice also has learned that Gov. Bobby’s latest round of budget cuts may have figured in the decision by Children’s Hospital in New Orleans to delay taking over operations of the state’s new billion-dollar University Medical Center New Orleans (UMCNO) from May 15 to at least August. http://www.umcno.org/about-us

Gov. Bobby’s budget cuts, necessitated mainly by his squirrely fiscal policies, leaves all of the LSU hospitals across the state woefully short of the funding needed to keep them open under the various agreements the state has entered into with private hospitals for their management. http://theadvocate.com/news/11751470-123/state-hospital-operators-say-jindal

In the case of UMCNO, built to replace the old Big Charity that was destroyed by Hurricane Katrina, the state is coming up $88 million short of needed funding, according to Children’s CEO Gregory Feirn.

“If the state does not restore the funding, then the state is deciding not to allow for care for the people of New Orleans, deciding not to open their state-of-the-art facility that is nearly finished and striking a crippling blow to medical education in Louisiana,” he said in a prepared written statement.

Strong words indeed, but then Gov. Bobby long ago, with his decision to opt out of the Medicaid expansion, made that decision.

Rep. Walt Leger (D-New Orleans), House Speaker Pro Tem, was especially critical of Gov. Bobby. “The budget is in such a mess,” he said. “We keep hearing from (Commissioner of Administration) Kristy Nichols that they are in negotiations to work matters out.

“We expect to operate a world-class facility that we invested a billion dollars in but now we learn that the date for Children’s Hospital to take it over has been pushed back,” he said.

State Treasurer John Kennedy, appearing on a New Orleans radio talk show, said the news concerned him. “Feirn is a very able administrator and I think they’ll be able to manage that facility better than the state could. We’ve invested and we’ve got to make that facility work. We do not have a choice,” he said. http://www.wwl.com/Garland-Is-the-University-Medical-Center-ready-to-/10773584?pid=461170

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