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Archive for the ‘Health Care’ Category

Who knew? Tomorrow’s vote on OGB privatization appears close; opponents, proponents conducting intensive lobbying

Posted in Attorney General, Budget, Civil Service, Governor's Office, Health Care, House, Senate, Jobs, Layoffs, Legislature, Legislators, OGB, Office of Group Benefits, Privatization on October 17, 2012| 10 Comments »

Members of the House Appropriations Committee and the Senate Finance Committee were being lobbied heavily by both sides on Wednesday in the final hours leading up to Thursday’s joint committee meeting to consider the privatization of the Louisiana Office of Group Benefits (OGB).

State Rep. Katrina Jackson (D-Monroe) said on Wednesday that she was concentrating on members of the House Appropriations Committee “because the concurrence of both committees is required.”

She said by mid-morning there appeared to be four undecided votes on the House committee.

“We need two votes,” she said, to block the move by Gov. Piyush Jindal. “Neither side can say it has the votes,” she added.

For those who might be interested in getting in their two-cents worth, here are the links to the names, phone numbers and email addresses for the members of each of the committees:

http://house.louisiana.gov/H_Cmtes/H_Cmte_AP.asp

http://senate.legis.louisiana.gov/Finance/Assignments.asp

The privatization, which would have Blue Cross/Blue Shield of Louisiana (BCBS) take over the operations of the agency’s Preferred Provider Organization (PPO), was approved by the State Civil Service Commission in August but State Rep. Katrina Jackson (D-Monroe) requested and got an attorney general’s opinion that said the administration must obtain the concurrence of the legislature to finalize the transfer.

BCBS already serves as the third party administrator (TPA) for OGB’s HMO program.

OGB has accrued a fund balance in excess of $500 million over the past six years since Tommy Teague took over as director of OGB. But he was fired on April 15, 2011 when he did not get on board the Jindal privatization plan quickly enough. His successor lasted only six weeks before he, too, was gone.

Jindal has claimed that a private TPA would be able to run the various health and life insurance plans of about 225,000 state employees, retirees and their dependents.

A Legislative Auditor’s report, however, said that privatization could lead to increased health insurance premiums because of a private insurer’s higher administrative and marketing costs, its requirement to pay taxes on income and its need to realize an operating profit. The state does not pay taxes nor is it required to turn a profit.

The Jindal administration has employed tactics bordering on the clandestine in efforts to shore up its position. At one point it even refused to release a report by New Orleans-based Chaffe & Associates with which it contracted to determine the “fair market value” of OGB’s business.

When a copy of the report was released, however, questions arose immediately because of conflicting dates given by the Division of Administration (DOA) as to its receipt date and by the fact that none of the pages of the report was date-stamped.

DOA routinely date stamps every page of documents it receives to indicate the date and time the documents were received.

This led to speculation that there may have been two Chaffe reports. Even so, the one that was leaked to the Baton Rouge Advocate said that a private insurer would be required to build in the extra costs of taxes and profits when setting premiums.

Once considered a slam-dunk for approval, the vote now appears much closer on the eve of the meeting of the two committees.

Much of the reason for the change may have to do with growing resentment on the part of legislators who have seen hospitals and/or prisons closed in their districts, actions they say were taken by the administration without the benefit of giving lawmakers a heads-up.

Jindal, in closing prisons and hospitals, has done so while leaving it up to area legislators to try and explain to constituents why they will be out of work or why health care will be either cut back or unavailable.

Only this week, notices went out to 41 employees at E.A. Conway Hospital in Monroe that they would no longer be employed after Nov. 30—just in time for the Christmas holidays. Twenty-five of those were nurses.

Similar cutbacks have taken place at health care facilities all over the state and in August, Jindal abruptly announced the closure of Southeast Louisiana Hospital in Mandeville, effective this month, throwing some 300 employees out of work.

Moreover, with the earlier closure of a mental health facility in New Orleans, the entire area of Orleans, Jefferson, Plaquemines, St.

Bernard, Tangipahoa, Washington and St. Tammany will be without access to mental health treatment at a state facility.

The proposed privatization of OGB will put about 120 workers out of work.

“It’s going down to the wire,” Jackson said of the vote to turn the PPO over to BCBS. “It’s going to be close.”

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Notable Quotables (in their own words)

Posted in Governor's Office, Health Care, Layoffs, LSU, Notable Quotables on October 16, 2012| 3 Comments »

“The layoff is necessary after other budgetary measures were taken, as a layoff avoidance measure, that did not meet the total dollars needed to match the reduction.”

—Dr. Robert Barish, chancellor of University Medical Center in Shrevrport, justifying the layoffs of 41 employees of E.A. Conway Medical Center in Monroe in an Oct. 15 letter to State Civil Service Director Shannon Templet.

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Merry Christmas! E.A. Conway Hospital in Monroe receives word that 41 employees to be laid off effective November 30

Posted in Budget, Economy, Governor's Office, Health Care, Jobs, Layoffs, LSU, Revenue, State Agencies on October 16, 2012| 4 Comments »

A new survey by 24/7 Wall Street has revealed that the Monroe Metropolitan Area, which includes 11 northeast Louisiana Parishes, is the sixth-poorest metropolitan area in the U.S. and at 27.9 percent, has the eighth-highest percentage of households living below the poverty line.

Accordingly, The LSU Health Sciences Center in Shreveport sent out notices to 41 employees of E.A. Conway Medical Center in Monroe Tuesday that they will no longer have jobs after Nov. 30.

Merry Christmas to E.A. Conway employees who will soon be unemployed. Great timing.

University Medical Center (UMC) Chancellor Dr. Robert Barish simultaneously notified E.A. Conway employees and State Civil Service Director Shannon Templet that 25 of the 41 employees targeted for layoffs are nurses.

Others include four police officers, two nursing assistants, two administrative coordinators, and (one each) respiratory care therapist, speech/audiologist specialist, EKG technician, radiologic technician, social worker, electriction, mobile equipment operator and printing operator.

The layoffs, Barish said, are the result of a reduction in federal Medicaid dollars to the state and are necessary “after other budgetary measures were taken, as a layoff avoidance measure, that did not meet the total dollars needed to match the reduction.”

The overall impact of the layoffs and cutbacks to E.A. Conway will be $8.5 million, he said.

With such a high poverty rate, many of the 178,000 residents of the Monroe Metropolitan Area rely on Conway for health care. Now, those health care services will either be cut back drastically or delayed for many who need them most.

Merry Christmas to tens of thousands of northeast Louisiana residents who will soon find medical care more difficult to obtain.

While median income across the nation decreased by $642 per year from 2010 to 2011, it went into a free-fall in the Monroe Metropolitan Area, plummeting by $5,434.

At the same time, the area’s poverty rate rose by an eye-popping seven percentage points. Moreover, the 11.4 percent of households earning less than $10,000 in 2011 was the third-highest percentage of all metropolitan areas.

The cutbacks and layoffs at Conway would appear to have been implemented with no planning and little consideration given to the needs of the areas served just as other policy moves have been made.

The Jindal administration, for example, privatized the John Hainkel Home and Rehabilitation Center in New Orleans in 2011 and in June of this year, Department of Health and Hospitals Secretary Bruce Greenstein quietly notified the facility that it was revoking its license, ostensibly because of deficiencies found during inspections.

A more likely reason for the action is that 73 of the home’s 82 patients pay for their care at the Hainkel Home through state Medicaid funding. Ergo, close the facility and if those 73 patients are unable to enter another facility that accepts Medicaid patients, Jindal gets to cut Medicaid costs in a furtive move that flies under the radar.

And it won’t be a simple task for those patients to find a new care provider. The Hainkel Home is one of the few remaining options in New Orleans for Medicaid patients and Veterans Administration patients. Most nursing homes will not accept Medicaid and V.A. patients and are actively purging current Medicaid and V.A. patients from their populations.

So, while Piyush Jindal continues to push for corporate tax breaks and exemptions for campaign contributors, he embarks on a campaign of slashing budgets and cutting services as a means of making up revenue lost by what can only be described as to poor—or perhaps contrived—administrative decisions.

Such are the methods of the Piyush Jindal administration.

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π-yush has the job he wants–again: absentee governor will serve as ‘leader’ of nation’s Republican governors in 2013

Posted in Budget, Campaign Contributions, Economy, Education, Governor's Office, Health Care, Legislature, Legislators, LSU, Transparency on October 15, 2012| 6 Comments »

Gov. Piyush Jindal had barely recovered from the bitter disappointment of being snubbed for a spot on Mitt Romney’s ticket than he was off and running for yet another national office—that of president.

His preference these days seems to be anything to avoid addressing the real problems that face Louisiana.

For a man who insists that he has the job he wants, he certainly seems to devote a minimal amount of time doing it.

Jindal’s travel miles this year alone have surpassed those of the James Brown extended post mortem farewell tour of a few years back.

Piyush is on the road again more than Willie Nelson.

His campaign appearances rival in number those of President Barrack Obama and Mitt Romney combined—and he’s not even an official candidate for anything. Yet.

He has the job he wants, which apparently is making more public appearances than the Harlem Globetrotters.

He’s more difficult to locate than Sasquatch.

When it comes to answering reporters’ questions, Jindal makes the late Marcel Marceau seem like a chatterbox.

So now, with the sound and fury of the vice presidential selection process behind him, he goes and gets himself picked to head up the Republican Governors Association next year—a job that will no doubt necessitate his absence from the state even more, if that’s possible.

The position is a plum in that it theoretically gives him a leg up on the Republican president nomination in 2020 (or 2016, should Romney lose in November).

He will chair the organization in 2013 and will be followed by New Jersey Gov. Chris Christie the following year. The post is considered a springboard to higher office. Romney and Texas Gov. Rick Perry each served as chairman prior to launching their presidential campaigns.

The Associated Press speculated that the position could help Piyush gain momentum and support for a future White House bid, “if he’s interested.”

If he’s interested?

That’s like saying a hyena will attack a wildebeest if he’s hungry.

The same AP story notes that in five-plus years as Louisiana’s absentee governor, he has promoted his book, given campaign speeches, attended fundraisers and Republican events in 39 states and the nation’s capital. He has managed to pop up in key presidential primary or caucus states like New Hampshire and Iowa on numerous occasions—sometimes even being asked by the locals to leave. Quickly.

More than a third of his 160 or so out-of-state trips have taken place since January.

Ironically, most of his travels have been to support state candidates or Republican causes and to collect campaign contributions for Piyush Jindal.

His campaign trips on behalf of Romney, on the other hand, are merely an afterthought.

Rather like his occasional attention to matters in Louisiana—little insignificant matters like budget shortfalls, cuts to state hospitals, litigation over his education and retirement reform packages in Louisiana and growing resentment on the part of legislators over the closures of prison and health care facilities.

So basically, he believes he received a mandate in last year’s underwhelming re-election vote of 67 percent of 20 percent of the voters—against only token opposition, no less.

Piyush may want to consider the fact that 80 percent of the voters yawned their way to a state of languid indifference on the question of whether or not he should be awarded a second term.

And he’s going to try and parlay those results into becoming leader of the free world?

But he must first prove himself a leader of the nation’s Republican governors.

If his leadership of Louisiana is an indication of his capabilities, it should be fun to watch—if you like watching a delusional political wannabe.

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π-yush obsession with secrecy, loyalty comparable to aura of paranoia that permeated darkest days of Nixon White House

Posted in Boards, Governor's Office, Health Care, Higher Education, LSU, Public Records, Transparency on October 15, 2012| 5 Comments »

In the past we’ve compared Piyush Jindal to Richard Nixon, primarily in the context of Jindal’s desire for absolute power and his intolerance for dissent. For the most part those comparisons were tongue-in-cheek, intended to show the governor’s absurd propensity toward micromanagement.

The comparisons were metaphors as much as anything else and not to be taken literally.

That was then.

Now, less than a year into his second term, Jindal, much like Nixon, is becoming more and more obsessed with secrecy.

Nixon’s attempt to conceal public documents behind a cloak of “executive privilege” has been supplanted by Jindal’s even vaguer term—something called the “deliberative process.”

Jindal demands complete and total loyalty from his minions with no room for dissent.

He is certainly entitled to expect—and demand—loyalty from his appointees. That is his right.

But his problems run much deeper; Jindal’s administration, much like that of Nixon’s is being permeated with the destructive mentality of paranoia.

That is, without question, the most serious and debilitating characteristic that can plague any elected leader and whether one likes Jindal or despises him, it is both sad and disturbing to watch the slow unraveling of what could have been. The realization that his mistrust of anyone who might pose a question about any of his decisions is slowly starting to paralyze the state he was elected to serve. The story of his administration will read not as history as it should, but more like a Shakespearian tragedy.

Now we have proof that he, like Nixon, is not beyond concocting outright lies to conceal his real intent and to advance his agenda. We have known this all along but now we have written documentation and, strangely enough, LouisianaVoice was the catalyst in this new, unfolding drama.

But this isn’t about LouisianaVoice.

This is a much larger and more important issue.

It’s about trust and credibility.

Jindal has steadfastly maintained that he has taken a “hands-off” approach to the day to day operations at LSU, even to the point of the governor’s executive counsel Elizabeth “I didn’t know there was a State Constitution” Murrill’s outright denial on Oct. 9 that she instructed LSU to hide behind the deliberative process privilege.

But nearly two months earlier, on Aug. 16, LSU attorney Shelby McKenzie wrote LSU Interim President William Jenkins that Murrill had specifically asked to review documents requested by LouisianaVoice.

The documents were also shared with Lee Kantrow, a private Baton Rouge attorney who serves as legal counsel to the University Medical Center board.

It seems they were shared with virtually everyone but the media which had requested the information in the first place.

Murrill, along with the rest of the governor’s office, of course, have employed the bunker mentality as they hunker down and now refuse to comment publicly on their being caught in the big lie.

Deliberative process is a legal term that never existed before Jindal took office in 2008.

It powers the process of deciding what qualifies as public record and what does not in that it protects deliberations in the governor’s office as well as in recommendations to the governor by agency officials.

A 45-page report by the Louisiana Law Review at the LSU Law School says of the deliberative process:

• The statutory deliberative process privilege allows the governor to fight the disclosure of any government record (emphasis ours) used in his decision-making process, even if that record is located outside the governor’s office. Some scholars criticize the very concept of the deliberative process privilege as eroding the “power and effectiveness of the citizens who we regard as sovereigns.” By adopting the phrase “deliberative process,” the legislature has attempted to implicate a body of law interpreting a particular exemption under the federal Freedom of Information Act (FOIA). But it is not quite the clean fit the legislature might have envisioned. Left unsettled is whether Louisiana courts will or should embrace all the various intricacies in FOIA jurisprudence or craft solutions more faithful to Louisiana’s historically liberal public records doctrine.

• Under Act 495, the governor will also be able to deny access to “intra-office communications” between himself and his staff. Courts will have to decide just what types of communications qualify for this exemption, as a broad interpretation will result in this “new” addition to the statute amounting to little more than a smaller version of the governor’s prior custody-based exemption.

• Finally, Act 495 raises an interesting dilemma: are governors now required to archive records, rather than shred them upon leaving office? One reading of the new law seems to allow governors to shield forever the documents that they independently deem as revealing of their deliberative process, denying potentially valuable and enlightening information to historians and future generations.” (emphasis ours)

Apparently, all an agency head has to do to protect public records from scrutiny is to couch them in the form of recommendations to the governor.

To be fair to McKenzie, he apparently recognized the legal problems of hiding behind the deliberative process shield and attempted to straddle the issue with his letter. “The express provisions of the statute are not broad enough to apply to the current public records request,” he said. “An argument could be raised that the privilege is grounded in constitutional principles (oops! Just lost Murrill) “of separation of powers and personal freedom of expression,” adding that a resolution of the issue “is a genuine legal dispute” that only a court could resolve.

He said that because the deliberative process is being invoked by several state agencies, “it is unlikely that LSU will be the target of any legal attack on the privilege.”

So, while the prevailing philosophy seems to be to employ the deliberative process so liberally and so often that those seeking information to which the public is entitled become so confused and exhausted in their efforts that they will give up.

Don’t count on it.

Nixon did.

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