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Archive for the ‘Health Care’ Category

Let the dismantling begin.

The LSU Board of Supervisors, packed with 11 of its 15 members who contributed an aggregate of more than $225,900 to Gov. Piyush Jindal’s political campaigns, voted Friday to take the first official step toward what will likely become the complete destruction of the LSU Health System.

The board, which since April has fired, demoted or reassigned LSU President John Lombardi, health system head Dr. Fred Cerise, Interim LSU Public Hospital CEO Roxanne Townsend and LSU System General Counsel Ray Lamonica, voted on Friday to authorize LSU hospitals in Shreveport, Monroe and Alexandria to develop requests for proposals (RFPs) for public-private partnerships for the three hospitals.

Jindal has already slashed $14 million in appropriations for Lallie Kemp Regional Medical Center in Tangipahoa Parish. That represents nearly 35 percent of the facility’s total budget and will mean the loss of surgery, cardiology and ICU services and dramatic cuts to oncology, gynecology and disease management as well as up to 150 staff members who stand to lose their jobs.

Additionally, the LSU Hospital in Bogalusa had its budget cut by $3 million, forcing the facility to close several clinics and to absorb pediatrics into primary care.

In Mandeville, Southeast Louisiana Hospital is slated for closure beginning next month, leaving the Florida parishes, Orleans, Jefferson, St. Bernard and Plaquemines parishes with no state mental health treatment centers.

W.O. Moss Regional Medical Center in Lake Charles also was designated for massive budget cuts and University Medical Center (UMC) in Lafayette was earmarked for $4.2 million in cuts but Jindal said the LSU plan would “protect critical services.

In an apparent effort to head off employee protests, UMC administrator Larry Dorsey notified employees not to attend a public rally—on or off the clock—protesting the cutbacks subject to disciplinary measures. That email was in stark violation of state civil service rules which specifically allow employees to attend such rallies as long as it is on their own time.

The Shreveport Times Friday morning published a story saying that LSU System supervisors would vote later in the day on beginning the process to develop RFPs on public-private hospital partnerships for hospitals in Shreveport, Monroe and Alexandria.

LSU Health spokesperson Sally Croom said the resolution, which was not added to the board’s agenda until Thursday, apparently after Lamonica was forced to resign as general counsel, and after the reassignment of Townsend, would give officials authority to develop an RFP.

Late Friday, as has become the custom of the administration, the announcement was formally made. Robert Barish, chancellor of LSU Health Shreveport, notified “faculty, staff and friends” by memorandum.

“As promised, I wanted to update you on the most recent activity regarding our continuing efforts to ensure a successful future for LSU Health Shreveport in the wake of the federal cuts to Louisiana’s Medicaid budget,” he said. “As you might recall, we were asked to explore several approaches to address the continuing budget challenges or our hospital system.

“Today, the LSU Board of Supervisors authorized us to explore public-private partnerships for our three hospitals. It is important to note that this is being done to see how collaboration with other hospitals might look and whether this may be a workable option.

“We will follow the Board instructions to explore this option, which is among several we are looking at during this fact-finding process. We have been looking at other hospitals which have faced similar situations successfully.

“We are committed to a thorough fact-finding process and exploring possibilities that would ensure continuation of our important missions of education, patient care and research.

“I will keep you updated as more information becomes available.”

It was not immediately known if similar messages were sent to employees of the facilities in Monroe and Alexandria.

The resolution passed by the board said:

BE IT RESOLVED by the Board of Supervisors of Louisiana State University that LSU Health Sciences Center Shreveport and Health Care Services Division are hereby authorized to develop and seek a Request for Proposal for the purpose of exploring public private partnerships for the LSUHSC-S affiliated hospitals, namely the LSU Medical Center in Shreveport, the E.A. Conway Medical Center in Monroe and the Huey P. Long Medical Center in Pineville/Alexandria and each of the hospitals in Health Care Services Division; and

BE IT FURTHER RESOLVED that this is necessary for identifying potential partners and long-term strategies which may help ensure the organization’s clinical services and financial stability in light of budgetary challenges caused by the recent decrease in federal Medicaid funding; and

BE IT FURTHER RESOLVED that the authority to seek a Request for Proposal does not mandate the Request for Proposal be released, nor does it mandate a proposal be accepted should one be released. The President shall have the discretion to authorize the release of the Request for Proposal and to accept the proposal that he deems in the best interest of the university.”

So, there you have it. A figurehead president brought out of retirement to replace a president who had a bad habit of being candid and outspoken is given the final authority to release the RFP and to accept the proposal “that he deems in the best interest of the university.”

What are the odds that this interim president and his hand-picked board will take any action, up and including taking a bathroom break without the approval of Piyush Jindal?

We already have more than sufficient evidence that Jindal is rapidly moving toward successfully destroying public health care in Louisiana. The closure of Charity Hospital in New Orleans following Hurricane Katrina, though nearly three years before he came to power, lay the groundwork for his later actions.

The federal government’s decision to slash Louisiana’s Medicaid appropriation by more than $572 million—along with state cuts of $287 million, bringing the total loss of funding to $859 million—simply gave him a convenient opportunity to accelerate a program he already had in place.

One need only look at what Jindal has done to higher education and public education to see a dangerous trend of cutbacks in crucial public services. His obsession with granting tax exemptions totaling $5 billion a year for corporate donors, transferring funds from parish school boards to private, for-profit schools, and forcing state colleges and universities to increase tuition to cover budgetary cuts has put the state on a dangerous collision course with fiscal reality that will remain long after Jindal has moved on to a cabinet position or in pursuit of higher office.

Jindal won’t be around to answer for his policies…but 144 legislators will be.

And so will Louisiana voters.

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“Ray is a distinguished and brillant attorney who helped lead us through the tough days following Hurricane Katrina and who was instrumental in refining many of the LSU System bylaws and procedures that tightened overshight of LSU System institutions, set up a central audit committee, ensuring the financial and legal integrity of system operations as well as requiring (Board of Supervisors) approval of any project worth more than $100,000.”

–Obligatory pat on the butt from interim LSU System President William Jenkins with one hand as LSU System General Counsel Raymond Lamonica is shoved out the door with the other.

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As reported by LouisianaVoice earlier this week, LSU System General Counsel has resigned, reportedly under pressure, as the chief legal advisor to the state’s flagship university’s administration.

Dr. Roxanne Townsend, CEO of the Interim LSU Public Hospital in New Orleans, was relieved of her position and reassigned by Dr. Frank Opelka, head of LSU’s health care system on Wednesday of this week.

Lamonica is the fourth LSU official to resign, be fired or reassigned by the Jindal administration in less than six months. System President John Lombardi was fired in April by the LSU Board of Supervisors acting on directions from the governor and on Aug. 26, Dr. Fred Cerise, head of the LSU health care system similarly dismissed and replaced by Opelka late last month.

Reached at home Wednesday, Lamonica acknowledged that he had resigned. When asked if he was asked or pressured into resigning, he declined to comment further except to say that he is remaining on as a tenured professor at the LSU Law Center.

Lamonica was appointed as United States attorney for the middle district of Louisiana in 1986 by President Ronald Reagan. President Bill Clinton appointed L.J. Hymel to replace him in 1994. Prior to that, Lamonica worked as executive counsel to Gov. Dave Treen.

He becomes the latest in a growing line of rank and file state employees, administrators, agency directors and cabinet secretaries who Jindal has either fired outright or, in the case of two legislators, demoted from committee assignments.

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“We’re the only state in the country that runs our own government-owned, government-operated hospitals. I’ll be the first to tell you that’s not the best way to provide health care. And we’re replacing that. We’re transitioning folks on our Medicaid program to privately-run insurance coverage.”

–Gov. Piyush Jindal, to Greta Van Susteren in a Fox News interview about his plans to dismantle Louisiana’s Medicaid program in favor of private insurers, neglecting to mention that those “government-run hospitals” also serve as teaching hospitals for medical students at both the LSU and Tulane university schools of medicine.

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Chester Lee Mallett of Iowa likes to spread his money around but his political involvement is mostly restricted to conservative Republican candidates at both the state and federal levels.

Described as a “well-established businessman” and “a true conservative,” Mallett has served on the board of Louisiana’s Citizen Insurance Company and the State Licensing Board for Contractors—appointed to both boards by Gov. Bobby Jindal. More recently, Jindal appointed him to serve on the LSU Board of Supervisors.

The reasons for Jindal’s continuing to call on Mallett to serve in various capacities are not difficult to understand. Like many of the governor’s appointees, he has proven himself to be a generous donor to Jindal’s campaigns through personal contributions ($10,000) and seven of his companies ($148,500) since Jindal’s first gubernatorial campaign of 2003.

Mallett does not limit his largesse to state political candidates (although he has chipped in another $61,000 to other Louisiana candidates). Since 2004 alone, he contributed an additional $166,400 to national Republican candidates, all but one of whom are from Louisiana, and three separate contributions of $30,800 each to the Republican National Committee and another for $5,000. Additionally, Brad Mallett of one of Lee Mallett’s companies contributed another $30,800 to the RNC.

Republican congressional beneficiaries include U.S. Sen. David Vitter ($6.400), congressmen Jeff Landry ($5,000), Charles Boustany Jr. ($5,000) and Bill Cassidy ($5,000). Other prominent Republicans receiving contributions from Mallett include Congressman Sean Duffy of Wisconsin ($2,500), Newt Gingrich ($1,000), Texas Gov. Rick Perry ($2,500) and Republican presidential nominee Mitt Romney ($2,500).

Though a Republican loyalist, he did contribute $2,300 to Democratic U.S. Sen. Mary Landrieu in 2007 and $3,700 to the State Senate campaign of Democrat Willie Mount of Lake Charles in 2004.

Described as “an avid social reformer,” Mallett counts as his greatest achievement the creation and operation of The Academy of Training Skills (ATS) in Lacassine. ATS, whose corporate offices are located at the same Iowa address of all of Mallett’s other companies, opened in 2008, and serves as an alternative facility for individuals who are at risk of going to prison. Those with non-violent or non-sexual offenses are given an opportunity to reside at ATS and to enroll in any of several training programs.

ATS, approved by the Louisiana Department of Corrections, takes residents by referral from local court jurisdictions. The facility’s web page says it is seeking accreditation from the American Correction (sic) Association (ACA) and that a trade school was planned for the site. The website also said plans were in place to expand to a 1,000-resident capacity.

The American Correctional Association, located in Alexandria, Virginia, confirmed that ATS received accreditation in 2010, an indication that the ATS website has not been updated for at least two years.

Claims by ATS that residents are trained for jobs and that they receive counseling and medical treatment for addictions, however, are in dispute.

While the ATS web page touts training in pipefitting, welding, electrical, millwright, heavy equipment operator and instrumentation fitter, at least one district attorney who refers offenders to facilities such as ATS said he has experienced numerous complaints about the program and no longer refers offenders to ATS.

A spokesman for the district attorney, who requested that he not be identified because of political implications, said all his referrals now go to Cenikor Foundation, a Houston-based center with facilities in Baton Rouge.

“We just stopped sending people to ATS,” he said. “The jobs they were getting our people were jobs hamburger flipping at fast food restaurants, not technical skills. The claims that they are providing medical treatment don’t seem to be valid, either, because our referrals told us they received no medical treatment.

“Moreover, ATS works these people and pays money into personal accounts for each resident, which is certainly an accepted practice,” he said. “However, without exception, when our referrals completed their programs there, instead of receiving the money in their accounts, they wound up owing ATS money.”

He also said ATS appears to have difficulty in retaining facility directors. “There’s a lot of turnover there,” he said. “No one seems to stay more than a few months. Some of the directors seemed to try to do what the program advertises but they don’t last long before they’re gone.”

Now, it appears that Mallett may be expanding his operations to include online classes as part of the Louisiana Department of Education’s (DOE) Course Choice Program.

The Course Choice Program ostensibly provides students at failing schools the opportunity to take the online courses instead of continuing in their old schools. All the classes are online and providers are allowed to set their own course fees.

One of those approved by DOE is ATS Project Success of Michigan, which claims on its web page to offer courses in 41 states, including Louisiana. Academy of Training Schools (ATS) of 21089 South Frontage Road in Iowa, which is the same corporate address as Mallett’s seven other enterprises (including Academy of Training Skills), appears to be the Louisiana ATS entity through which courses are to be offered.

The Academy of Training Schools also contributed $6,000 to Believe in Louisiana, a 527 tax-exempt political organization founded by Baton Rouge Business Report Publisher Rolf McCollister.

McCollister was Jindal’s campaign chairman in his successful 2007 run for governor and served as chairperson of Jindal’s transition team.
Julio Melara, president of the Baton Rouge Business Report, was appointed by Jindal to the Louisiana Stadium Exposition District (Louisiana Superdome) Board in February 2008, a month after Jindal first took office.

Jindal appointed Mallett, a Republican insider, to the LSU Board in July and all the pieces now appear to be in place for Jindal to do whatever he wants with LSU in general and the LSU Medical System in particular. The recent firing of Dr. Fred Cerise and the reassignment of Dr. Roxanne Townsend would seem to support that theory.

Jindal said as much on July 2 in an interview with Greta Van Susteren of Fox News:

“We’re the only state in the country that runs our own government-owned, government-operated hospitals. I’ll be the first to tell you that’s not the best way to provide health care. And we’re replacing that. We’re transitioning folks on our Medicaid program to privately-run insurance coverage.”

Jindal, of course, neglected to mention that those state hospitals, particularly Charity Hospital in New Orleans served, not only as a medical safety net for indigent citizens of the state and as teaching hospitals for both the LSU and Tulane University schools of medicine.

Charity was never reopened after Hurricane Katrina in 2005 even though only the basement of the 21-story facility was flooded and more than 200 military and medical volunteers restored the hospital to conditions that many said were superior to the hospital’s pre-storm state. For whatever reasons, however, electricity, which was working in the hospital, was ordered turned off and the doors were locked.

With all but one of the LSU Board members appointed by Jindal, the governor now has carte blanche to bulldoze ahead with dismantling the state’s Medicaid program—just as he promised he would in his interview with Van Susteren—in favor of privately-run insurance coverage, most likely administered by large campaign contributors.

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