Feeds:
Posts
Comments

Archive for the ‘Health Care’ Category

First Bobby Jindal failed to elect a governor of Virginia, now can’t pick a Louisiana congressman; McAllister crushes Riser

Posted in Campaign Contributions, Congress, Elections, Governor's Office, Health Care, House, Senate, Legislature, Legislators, Lobbyist, Vouchers on November 16, 2013| 29 Comments »

The results of the 5th District congressional race are in and the message has been sent loud and clear—surely loud enough to be heard in Baton Rouge.

With political newcomer Vance McAllister walloping State Sen. Neil Riser (R-Columbia), the heir-apparent to Rodney Alexander’s 5th District seat not by a comfortable but by an astounding and resounding 60-40 margin (an actual vote count of 54,449 to 36,837), the Louisiana Tea Party and Bobby Jindal have to be reeling and wondering what the hell happened. And Riser especially has to be feeling quite flummoxed and embarrassed at this juncture—particularly given the fact that he could muster only 3,800 more votes than he got in the Oct. 19 primary while McAllister pulled in an additional 36,000 votes, a margin of nearly 10-1 in the number of votes gained.

Actually, when you break it all down, there was more than one message sent in this election that Riser entered as the odds-on favorite to walk into office on the strength of the fast one that the Jindalites tried to pull off, not the least of which is that the Duck Dynasty’s political clout appeared to eclipse that of the governor (Gotta give credit where it’s due). Jindal clumsily overplayed his hand when he maneuvered Alexander into “retiring” halfway into this two-year term of office so that he could take a cushy state job as head of the Louisiana Office of Veterans Affairs at $130,000 per year, a job that stands to boost his state pension (he was a state legislator before being elected to Congress) from about $7,500 per year to something north of $80,000 per annum.

Then, as part of the bargain, Riser formally announced the day after Alexander’s announcement that he would seek the position and miracle of miracles, large—no huge—Riser campaign signs literally (as in the day after Riser’s announcement) appeared overnight in Ruston. Political pundits all over the state all but conceded the seat to Riser but then who would bet against him given the fact the job was all but handed to him on a platter? Or so it seemed at the time.

One message was that voters resent being taken for granted, considered a pesky afterthought as it were. Since when does the coronation precede the decision of the electorate in this country? As comic Ron White is fond of saying, you can’t fix stupid and assuming the job was his by Divine Right was stupid—even if that Divine Right was the coveted Jindal anointment.

A second lesson that should sink in on the fourth floor of the State Capitol: instead of flitting around the country like a hummingbird on crack, perhaps Jindal should stay home and do the job to which he was elected—you know, Bobby, that of governor, the job you said you wanted. Forget Iowa. Forget New Hampshire. Forget Faux News. Forget those op-eds for the Washington Post. Do your damned job. Don’t worry about Obama; my grandfather always told me, “If you do your job and quit worrying about the other fellow doing his, you’ll find your own path much easier to walk.” Being absent from the state the equivalent of two of the first 10 months of the year just doesn’t cut it when there is plenty to do right here.

And while Riser was wearing his “guns for felons” NRA mantle like the breastplate of righteousness (Isaiah 59:17), Vance McAllister had the guts look to look beyond that easy position and to say that Medicaid should be extended in Louisiana because of the 400,000 citizens of this state who have no health insurance. And, the message that was apparently lost on Jindal, Riser and the rest of the Tea partiers, is that not all of those are deadbeats; many of them are the working poor—those working but earning too little to afford health care.

And they vote.

A lesson that the remaining 143 members of the Louisiana Legislature might do well to ponder: Despite recent evidence to the contrary, Louisiana apparently is not for sale. When the light is shone on privatization, campaign contributions, health care, inept and unqualified appointees such as Superintendent of Education John White and general mismanagement of the state’s finances, people don’t like what they’re seeing.

As the count mounted Saturday night, two stars—that of Neil Riser’s hopes to move on to Washington and that of Jindal’s already fading aspirations of occupying the White House—were for all intents, snuffed out, obliterated, imploded like a supernova. Jindal, instead of being sought after by the right wing talking head zealots, should now be shunned given that he can’t even deliver votes for a congressional candidate (or for a Republican candidate for governor of Virginia).

Legislators need to take a long, hard look at Jindal’s record of late. It’s really not all that impressive. He has lost court case after court case over retirement reform, vouchers, budgetary matters and public records even as he paid a single attorney more than a million dollars to defend those dogs. The FBI is looking into contract irregularities between DHS and CNSI. He fires anyone who disagrees with him, including members of a levee board who wanted to hold oil companies accountable for the egregious coastal erosion so that he could protect big oil (but he can’t fire the local political leaders in Plaquemines and Jefferson parishes who followed with litigation of their own).

Those legislators would do well to understand that we the citizens of Louisiana are starting to take an interest in what goes on in Baton Rouge. Using campaign funds for such things as installment payments, gasoline and insurance on personal vehicles, paying for “campaign work” when there was no campaign, paying for roof repairs, purchasing LSU football tickets and pricey tabs in the Senate dining hall are perks not available to the great unwashed and we kind of resent that abuse. And make no mistake about it, it is abuse. You are not royalty; you work for us. Never forget that.

Accepting a hundred or so contributions from political action committees tends to drown out the voices of the school teacher, the retail store clerk, the truck driver, and hundreds of thousands of others who cannot afford to go up against those well-heeled corporate lobbyists who ply lawmakers with meals during the legislative session each year. It raises the question of just whom do you represent, the voters or the fat cats who pour money into your campaign so that they will have your ear when push comes to shove in Baton Rouge on key issues while the interests of those who elected you are ignored?

And finally, to Vance McAllister: Congratulations. Enjoy the moment because once you take office, you will be inside the Beltway and somehow that becomes intoxicating and those who go there with good intentions often fall victim to the lure of the siren song of power and influence.

Don’t let that happen because we will be watching and if you screw up, LouisianaVoice will treat you no differently than it treats any other crooked politician (I hate redundancy) who violates the public trust.

Perhaps it is fitting in this, the 100th anniversary of Sam Rayburn’s taking the oath of office in 1913 to begin his 48-year tenure in Congress, that we give McAllister the same advice Rayburn’s father gave him as he departed Texas for Washington following his first election:

Be a man.

Read Full Post »

For mega dose of humility, try testifying before legislative committees without having answers to important questions

Posted in Auditor, BESE, Boards, Budget, Commissions, Education, Health Care, House, Senate, Legislature, Legislators, LSU, Privatization, Public Records, Recovery School District, RSD on October 21, 2013| 11 Comments »

If public humility is your thing, all you have to do is appear before a state legislative committee or state commission unprepared to provide answers to even the most basic of questions.

That’s what happened last Friday in two separate legislative committee rooms during meetings of the State Bond Commission and the Joint Legislative Committee on the Budget (JLCB) during discussions of capital outlay projects and BA-7 requests, respectively.

BA-7s are budget request forms used to make changes in revenues and/or expenditure line items during the year. Agencies submit them to the Division of Administration (DOA) Budget Office and if approved there, they are placed on the monthly agenda of the JLCB for consideration.

Bond Commission Chairman State Treasurer John Kennedy was particularly rankled over the shifting of construction projects to be replaced by $5 million in capital improvements to the LSU Health Sciences Building in Shreveport which is being taken over by Biomedical Research Foundation of Northwest Louisiana (BRF).

After Mark Moses of State Facility Planning and Control submitted changes to the commission, Kennedy said, “In July, you said the list was top priority and shovel ready. Now you’re saying they are not. What changed?”

“Cash flow needs have changed,” Moses said. “We’re shifting money. Eighteen projects are complete and on 76 others, there has been no activity and if the need is not there, we shift the dollars.”

“Why did you say in July that they were top priority?” Kennedy asked again. “The problem is if we replace them with something else, the original projects go to the back of the line. We’re shutting 90 projects down even though we have already spent money on some of them and now we’re sending those projects to the back of the line.”

Kennedy then launched into his ongoing criticism of the privatization of the Louisiana Medical Center at Shreveport and E.A. Conway Medical Center in Monroe. “We’re making $5 million in capital improvements to the Health Science Center. Who’s going to own that?”

Liz Murrill, DOA chief legal counsel, said, “We own the building. They (BRF) are leasing it.”

“We’re spending $4.8 million on scanner clinical and research imaging equipment for Biomedical Research Foundation…”

“This is a non-state entity. The dollars are being used for a public purpose,” Murrill said.

“Like an NGO (non-government organization)? We’re just giving it to them?”

“We’re providing money for this piece of equipment,” she said.

“Do we require them to file quarterly reports?”

“It’s contemplated it will be used for a public purpose,” she said, failing to answer his question.

Kennedy then asked if the legislative auditor would be able to audit the expenditure of the funds to which Murrill said, “I assume so, just as with any capital outlay projects.”

“One of the conditions of the agreement is there would be no public record,” Kennedy said, referring to a clause in the certificate of agreement between the LSU Board of Stuporvisors and BRF which says, “Financial and other records created by, for or otherwise belonging to BRF or BRFHH (BRF Hospital Holdings) shall remain in the possession, custody and control of BRF and BRFHH, respectively,” and that “such records shall be clearly marked as confidential and/or proprietary,” and thus protected from Louisiana public records laws.

“A public record is a public record,” Murrill said somewhat tentatively. “We have procedures to decide what is public record.”

“Who decides what’s public?” Kennedy asked.

“It depends on who gets the request.”

“Do you have a problem adding a condition to these purchases on the legislative auditor’s being able to audit the purchases?”

“I think that’s the case now,” Murrill said.

“Why are we buying this for the Biomedical Center instead of LSU?” Kennedy asked.

Mimi Hedgecock of the LSU School of Medicine—and formerly Jindal’s policy advisor—said the purchase was part of the partnership with BRF prior to the certificate of agreement between LSU and BRF.

“Is it accurate to say we have not picked an operator of the hospital yet?” Kennedy asked. “The testimony before the Louisiana Joint Budget Committee was they (BRF) were going to pick an operator. We’re entering a 99-year lease and don’t know who is even going to run the facility. The legislature has no say. How can we audit if we don’t know who’s running it? We can’t audit HCA (Hospital Corp. of America).

“This makes a mockery of the capital outlay procedure,” Kennedy said. “You’re supposed to be building a priority of projects. In July, you cam to us and said these projects were absolutely top priority and (were) shovel ready. Now they’re not shovel ready or top priority. Now we have new projects and these projects are going to the back of the line. I don’t think this is a good way to do business.”

Joint Budget Committee

Things got even testier at the Joint Budget Committee, thanks to the amateurish performance of witnesses appearing on behalf of the Recovery School District (RSD), just another ongoing embarrassment for the Louisiana Department of Education (DOE).

The fun began when committee member Jim Fannin (R-Jonesboro), who also serves as House Appropriations Committee chairman, questioned RSD’s claim to having $34 million in self-generated funds for the projects it was submitting.

“Explain how you self-generated $34 million,” he said. “It’s unusual for RSD to self-generate that many dollars.

The breakdown given was $27.13 million in new market tax credits, $3.37 million from insurance proceeds and $4.05 million from Harris Capital funding for construction of Wheatly and McDonough 42 schools.

Fannin responded that the way the budget was presented was “confusing.” He said he was seeing too many “other” expenditures on the BA-7 submitted by RSD. “You have legal expenses of $800,000,” he said. “I never saw legal expenses of $800,000 to rebuild two schools.”

“Those legal fees pay for 82 schools—the entire master plan,” said RSD spokesperson Annie Cambre.

But it was Sen. Ed Murray (D-New Orleans) who peppered the RSD types with a barrage of withering questions—withering because the RSD representatives were woefully ill-prepared with answers much as State Superintendent John White has been since his appointment in January of 2012.

Murray asked about the expenditure of $375,000 in funds for engineering and architectural costs before RSD had authority to spend the money. “Are we using any of this $375,000 to pay them already?” he asked.

“Most were paid from multiple fund sources,” responded a young, unidentified red-headed RSD representative who more resembled a high school FBLA member than a public education professional.

“Let me ask my question again,” Murray said. “Are we using any of this $375,000 to pay them already?”

“For some of them, yes. Some are eligible from FEMA, some not,” said Red.

“Then why are we just now getting this request if we’re already using the money?”

“We already had some authority but we just realized we need additional authority.”

Murray, beginning to show his exasperation, then asked, “How much of the $375,000 have we spent so far?”

“I don’t know,” said Red. “I can get that for you.”

“It disturbs me that we’re spending money without authority to do so,” Murray said. “Let’s go to the legal expense of $800,000. How much of that have we spent?”

“Again, I don’t have that exact number,” said Red. “I can get that for you.”

“Mr. Chairman,” Murray said to committee Chairman Jack Donahue (R-Mandeville), “can we get them to come back next month when they have answers?”

“That would seem appropriate,” said Donahue. “There’re a lot more questions than answers.”

Bordelon, in a last-ditch effort to salvage the request said, “It’s important that everyone understand the timing of the Wheatly-McDonough projects. There will be several thousand students affected by any delay. The New Market tax programs and closing times are specific. Timing is of the essence.”

“We’d like to help you guys,” Donahue said, “but when you come here you don’t have sufficient information to answer questions. I don’t know how you think we can approve something when you can’t answer questions about the money you’re asking for that you’ve already spent and how many dollars are involved.”

“We were utilizing previously granted authority,” Bordelon said.

“I appreciate that,” Bordelon said, “but on the other hand, you’re already spending it and didn’t come for authority to do that until you started spending the money. And when members ask how many dollars have already been spent, and you can’t answer, that’s a problem.”

“It was my understanding we were operating under previously granted authority,” Bordelon persisted.

“That’s not what was said,” Bordelon said. “That was not the testimony. The testimony was you were already spending that money but you don’t know how many dollars were spent.”

Murray’s motion to defer action until next month passed unanimously and Murray then had one last word of advice to Bordelon.

“You say this is going to affect ‘several thousand students.’ I’m pretty familiar with Wheatly and McDonough 42. You don’t have several thousand students in those two schools. We want you, when you come before this committee, to tell us accurate information.”

Sen. Dan Claitor (R-Baton Rouge) added, “When you come back, be prepared to discuss the oddly round legal expenses and issues related to that.”

Read Full Post »

State Treasurer John Kennedy adds his voice to concerns over questonable LSU hospital privatization saving claims

Posted in Contract, Contracts, Guest Columnist, Health Care, Higher Education, LSU, Privatization on October 18, 2013| 7 Comments »

The following is a press release by State Treasurer John Kenney. LouisianaVoice presents it here as a guest column that we feel underscores the concerns expressed in our Sept. 29 post entitled False prophets, false profits—and false reasons to privatize LSU Hospital System (or trolling for more Medicaid dollars)

The reason advanced by the Jindal Administration for privatizing Louisiana’s charity hospitals is that a private hospital like Lafayette General or Ochsner, for example, can manage a hospital more efficiently, and therefore cheaper, than the state.

That’s why I was taken aback when the chairman of the private entity taking over the Shreveport state hospital testified before the Joint Legislative Committee on the Budget that the private contractor’s costs to run the Shreveport facility will be the same as the state’s. Where, then, will the Jindal Administration’s promised annual savings of $150 million come from if not from achieving operational efficiencies?

Dig deeper into the details and it becomes apparent that the planned “savings” won’t result from lower costs but from getting more money from the federal government through an accounting change. This won’t make the charity hospitals or Louisiana’s Medicaid program, which pays for the hospitals, more efficient. It will just make them more expensive, fueled by additional federal (American taxpayer) money.

Here’s how the new financial strategy will work: Medicaid, which is government health insurance for the poor, is a federal-state program. The states run it but the feds put up most of the money. In Louisiana, for every $1 in state taxpayer money we contribute, the feds contribute $2. The more money we put up, the more money the federal government contributes.

Under the Charity Hospital privatization, the state will “lease” the charity hospitals to private hospitals, which then will be responsible for treating our low-income and uninsured citizens. The state will pay the private hospitals to do this with large amounts of federal money from our Medicaid program. The private hospitals will then return some of those federal dollars to the state as “lease payments.” The federal dollars paid to the state as “lease payments” now become new state dollars, which the state can use to draw down even more federal money.

This accounting maneuver is undeniably clever. The question is whether it is legal. It must be approved by the federal Centers for Medicare and Medicaid Services (CMS).

Louisiana’s track record with CMS is not good. CMS has previously rejected similar financing strategies designed to leverage federal money. In the early 1990s, for example, Louisiana and other states adopted financing strategies such as “provider taxes,” “provider donations,” and “intergovernmental transfers,” designed to launder federal Medicaid funds into state funds in order to draw down more federal funds. CMS and Congress spurned them all. (The Medicaid Disproportionate Share Hospital Payment Program: Background and Issues, The Urban Institute, No. A-14, October 1997). http://www.urban.org/publications/307025.html

In fact, Louisiana was more aggressive than most states in trying to leverage federal dollars. Our health care budget grew from $1.6 billion in 1988 to $4.48 billion in 1993, of which 90% was federal funds. The amount of money actually contributed by the state during this period declined from $595 million to $462 million. (Washington Post, Jan. 31, 1994, page A9).

When CMS and Congress stepped in to stop what then-Congressman Bob Livingston called Louisiana’s “abuse” of Medicaid financing, and, in Livingston’s words, the “unjustified and unwarranted benefits” came to an end (The Advocate, Feb. 6, 1997, page 1A). Newly-elected Gov. Mike Foster was faced with a $1 billion deficit in the health care budget. To clean up the mess, Foster appointed Bobby Jindal as DHH Secretary, who sought special relief from Congress. As The Advocate newspaper editorialized, “Louisiana pleaded guilty as charged, threw itself on the mercy of the court and got off easy,” because “the state for years ran a scam using ‘loopholes and accounting gimmicks’ to justify fantastic increases in federal payments.” (The Advocate, April 29, 1996).

Perhaps this time is different. Perhaps CMS will view the new “lease payments” being used to obtain additional federal money more favorably han the strategies CMS has rejected in the past.

One thing’s for certain, though. We need to find out. The state should seek CMS review of its new strategy immediately—not “soon” as DHH has promised—but now. Until then, our entire state health care delivery system for more than two million of our people is at financial risk.

Read Full Post »

Notable Quotables (in their own words)

Posted in Congress, Health Care, House, Senate, Legislature, Legislators, Notable Quotables on October 1, 2013| Leave a Comment »

“Proposed law creates the Louisiana Health Insurance Exchange in the Department of Insurance. Provides for the powers, duties, functions, responsibilities and obligations of the Exchange.”

—The Digest of Senate Bill 307 of the 2007 Louisiana Legislature by then-State Sen. Bill Cassidy. The bill, had it passed, would have created a Louisiana version of ObamaCare while Barrack Obama was still a U.S. Senator from Illinois and more than a year before he was elected President.

“The House has repeatedly passed legislation to fund the government and protect millions of American families from the devastating effects of Obamacare.”

—Sixth District Congressman Bill Cassidy, in a prepared statement on Tuesday, Oct. 1 about the government shutdown.

Could there be a reason that public opinion of Congress is at an all-time low?

Read Full Post »

Cassidy and ObamaCare: like Kerry and Iraq, he was for it before he was against it; now helps shut down government

Posted in Congress, Governor's Office, Health Care, House, Senate, Legislature, Legislators on October 1, 2013| 13 Comments »

For pure political expedience, one would be hard-pressed to top the example set by Sixth District Congressman Bill “Newt” Cassidy (R-Louisiana).

Cassidy was among those House members who sold their souls by voting with the Tea Party on its crusade to overturn the Affordable Health Care Act, otherwise known as Obamacare.

And let’s not give Gov. Bobby Jindal a pass on this, either. While he had nothing to do with the action—or inaction—of Congress, he has remained strangely quiet on the shutdown of the federal government, a move that will adversely affect countless numbers of federal employees, social security applicants and disability recipients, to name just a few.

Even Arkansas Gov. Mike Beebe, a Democrat, had the decency to at least issue a public statement, saying, “The inability of Congress to do its most basic job will put many Arkansans out of work and leave Arkansas children in peril.

“…It will greatly hinder the ability of the Arkansas Department of Human Services to investigate claims of child abuse and neglect,” he said. “More than 85,000 meals for Arkansas children will not be provided and protection for nursing home residents will be reduced.”

In addition, he said 2,000 newborn babies “will not receive infant formula through the Department of Health’s WIC program. That number includes more than 300 special-needs babies who soon run out of special formula they can only receive through a certified program like WIC.”

Beebe said as many as 2,000 state employees will be furloughed and if the shutdown is sustained, that number could be much larger. “It also hurts our local and state economies (and) that economic damage will be compounded by the furlough of federal employees in Arkansas, as well.”

Jindal, meanwhile remains mute. Except, that is, when the federal government happens to step on his delicate toes as with the litigation that has thrown a monkey wrench into his school voucher plan. Oh, can he wail and whine when his own agenda is threatened. But when the Tea Party-Cassidy crowd throws the metaphoric pie in the face of Obama, he remains mute.

Even when the collateral damage of that juvenile pie-throwing tantrum adversely impacts millions upon millions of American families, he remains mute.

Where is our state leadership? Shouldn’t Jindal, as with his counterpart in Arkansas, at least be paying lip service to the potential suffering of Louisiana citizens? Instead, he chooses to ignore the shutdown in much the same manner that he ignored that expanding Bayou Corne sinkhole in Assumption Parish.

But we digress.

Let us return to Cassidy, who, with his strategy, may have just given U.S. Sen. Mary Landrieu the momentum she needs to withstand his challenge in 2014.

That’s right. Cassidy’s behavior with ObamaCare can best be described as pandering to everything anti-Obama. While somewhat short of grandstanding, his actions are certainly of an ulterior, self-serving motive.

It ain’t pretty when you are so blatantly hypocritical.

Hypocritical?

Yep.

It’s not that we’re giving the rest of the state’s Republican congressional delegation, including U.S. Sen. David Vitter a pass, either. They are complicit in this mess as well.

But we have a special reason for singling out Cassidy.

Let’s flash back to 2007, his freshman year in the Louisiana Senate. He won the seat in a special election in 2006 to succeed former Sen. Jay Dardenne who had been elected Secretary of State. (Darden is now Lieutenant Governor and has voiced his intention to run for Governor in 2015.)

The year 2007 is important in the brief political career of Cassidy. That was the year he introduced Senate Bill 307 http://www.legis.la.gov/legis/ViewDocument.aspx?d=427610&n=SB307

And just what was SB 307?

While not nearly as voluminous as the Affordable Health Care Act passed by Congress, SB 307 (all of 22 pages) would have created the Louisiana Health Insurance Exchange and the Office of the Louisiana Health Insurance Exchange within the Department of Insurance.

The intent of SB 307 was to allow individuals to shop for the best insurance plan for them and at the same time would have offset the cost of health insurance premiums for Louisiana’s low-income citizens by providing tax credits (Jindal’s gift of choice for business and industry) in order to make their insurance more affordable.

Cassidy said at the time the intent of his bill was to create a statewide Health Insurance Exchange to lower premiums and administrative costs and to allow flexibility in which benefits workers might choose.

He also said his plan would allow for the portability of health insurance, thus allowing workers to keep their insurance if they switched jobs—all while emphasizing public health and preventative care as a means of lowering overall health care costs.

In other words, what Cassidy, a physician, was proposing was passage of the state version of Obama Care—before many people had ever heard of Barack Obama, then still a freshman U.S. Senator from Illinois and still considered a long shot at defeating Hillary Clinton for the Democratic presidential nomination.

The merits—or lack thereof—of ObamaCare aside, suffice it to say that Cassidy was a supporter of the concept long before the idea made its way into the national debate.

So what changed between then and now?

Political expediency—nothing more, nothing less. There was nothing ideological about it. Principles never once entered into the equation.

Mary Landrieu, the incumbent whom Cassidy is challenging, voted for ObamaCare.

Accordingly, if he is running against her, he must attack at her most vulnerable point: the politically and emotionally charged issue of Obamacare.

But never forget that like John Kerry, who was for the Iraq war before he was against it, Cassidy was for ObamaCare before he was against it—when it was CassidyCare.

Read Full Post »

« Newer Posts - Older Posts »