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LouisianaVoice reveals pair of frustrating episodes that reveal problems of state hospital privatization, closures

Posted in Contract, Contracts, DHH, Earl Long, Governor's Office, Health Care, Higher Education, Privatization on February 17, 2016| 26 Comments »

Bobby Jindal: the gift that keeps on giving.

It’s bad enough that colleges and universities are facing the threat of temporary closures, cancellation of summer school, and loss of accreditation. But coupled with the bad news on higher education is an equally grim outlook for health care.

A sample of the legacy left us by Jindal’s hospital privatizations and closures:

In Baton Rouge, the closure of Earl K. Long (EKL) Medical Center had a ripple effect on the low income residents of North Baton Rouge. The emergency room patient care shifted onto Baton Rouge General Regional Medical Center Mid-City became such a money loser that it closed its emergency room on March 31, 2015. That moved emergency room care 30 minutes further away to Our Lady of the Lake (OLOL) Medical Center, located in largely white South Baton Rouge. One emergency room doctor confided to the author that it was his feeling that Jindal wanted to create “a medical wasteland north of Government Street.” Government Street, which traverses Baton Rouge in an east-west direction is a roughly-defined dividing line between South and North Baton Rouge.

Mid-City was hemorrhaging $2 million a month through its emergency room because Jindal refused to expand Medicaid and rejected any idea of putting up state money to keep the facility open. With the closure of its emergency room, residents of North Baton Rouge, which is largely low-income black in its demographic makeup, had few medical choices. With Our Lady of the Lake so far away, the alternatives were two urgent care clinics operated by the partnership of LSU and Our Lady of the Lake. The clinics were located on North Foster Street and Airline Highway. The North Foster clinic has no onsite doctor and the main Airline High clinic has a doctor onsite only until 7:00 p.m.

The same emergency room doctor who related the “medical wasteland” story told of the tragic case of an elderly African-American couple. “I felt sick reading this report,” he said. He said it involved “an old black couple who were paying $40 per month on their existing medical bill” to another Baton Rouge hospital.

The report read said the decedent was found “supine on bedroom floor. His wife told EMT personnel that her husband had congestive heart failure and that fluid had been building up. He did not go to the emergency room because the couple owed money to the hospital. She said he had been short of breath through the night and when she awoke, he was not breathing. CPR and advanced cardiac life support were initiated but were terminated after no response. “If he had gone to the LSU urgent care center, likely as not, no doctor would have been on duty,” the ER doctor said.

The closure of EKL and the decision by Baton Rouge General Mid-City to close its ER necessarily imposed a heavier workload on OLOL which entered into a partnership with the state for treatment of Medicaid patients. That increased workload has understandably also produced greater pressure on doctors and staff which in turn has apparently led to lapses in quality of care.

Consider the following brief email thread:

“Please see the email below sent from one of vascular consultants to our Associate Chief Medical Officer Dr. (redacted). My purpose for forwarding this email to you is not to criticize anyone nor is (it) to elicit a string of email responses. The sole purpose is to make all of us aware of the perception some of our consultants and primary care teams have of us. Increasingly of late, I am getting this type of feedback, be it real or otherwise.

“Doctors, we must elevate our game to meet the expectations of all our physician colleagues. I know you guys are working hard, but I am asking each of you to pay attention to the finer details.

“As Dr. (redacted) aptly said to me last night, our physician colleagues are our customers; we need to put ourselves in their shoes, be their voice, the voice of our customer.

Dr. (redacted)”

The email to which he referred read:

“I had a very irritating call last night from the ER. It bothers me that the environment around our hospital is deteriorating into a stereotypical dysfunctional training facility that we are all too familiar with and probably chose to go into private practice to avoid.

“I received a call at about 11:30 p.m. The answering service informed me who the call was about. When I called back a resident picked up and started telling me about ‘an endostent that had an endoleak with pain, transferred from Lake Charles.’ Knowing I was on city call, I figured I’d investigate this to expedite patient care. The resident told me they had already spoken to a doctor but it didn’t make sense when I couldn’t get the specifics I was asking for. At that point, I asked to speak to the attending whom (sic) was able to figure out they got the wrong guy. However, it’s a little disheartening that he didn’t readily know who the surgeon was they had spoken to that was assuming responsibility for the patient. He did mention ‘Dr. (redacted)” who is our resident (redacted)—but I’m not sure he knew it was a resident. It’s my feeling that in a patient potentially critical as this one—the attending should have his finger on the pulse a litter better than it appeared last night.

“After those 15 minutes I again informed the attending I was Dr. (redacted)…returning a page. At this point the attending gave me to ‘Dr (redacted), first year (emergency room) resident.’ The resident reports a consult on a patient with WBC (white blood cell) 19, blisters on cellulitic foot…When I ask asking info, it turns out the patient ‘has been on the board over 7 hours.’ When I ask to speak to attending who saw the patient—no longer working. At this point, I’m given back to the same attending who gave me to the first year resident he was covering. This attending was covering the resident, had taken sign-out, and expected the resident to call me and report but had never seen the patient. This reminds me of something I would get from the old ER at Mid-City, not what I would have received from OLOL in first 12 years of practice.

“I do realize we are a training facility but you and I both recognize that happens to a private practice service when run by residents. I’m sure the ER has exploded with new personal (sic) during this growth phase, but part of their responsibility is to know who the doctors are that routinely admit to this facility. To say the least, I was discouraged at the attending’s ‘finger on the pulse’ of what he was responsible for last night.

“This email is not to condemn any individual but to raise flags over the environment. Please forward to the appropriate people.”

(Sender’s name redacted)

Such is life in the aftermath of Bobby Jindal’s grand state hospital privatization scheme.

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Dedications: Does eliminating them give Louisiana an easy way out of the state’s fiscal crisis? Is there an easy way out?

Posted in Budget, Ethics, Finances, Governor's Office, Health Care, Higher Education, House, Senate, Legislature, Legislators, Politicians, Taxes on February 16, 2016| 85 Comments »

By Stephen Winham

Every day we hear the same thing: “If we could just get rid of those dedications, we could fix the budget and not have to always hit higher education and health care so hard when times are tough. There are plenty of things we could cut without hurting anybody or anything.”

It sounds so easy. You hear, in very broad terms, how the budget has grown and how out-of-bounds spending has gotten. Our current budget totals about $25 billion, of which $10 billion is federal. I will focus on state funding in the official revenue forecast – about $10.4 Billion in the current year, with strongest emphasis on the $7.9 Billion in state general fund spending we can most readily control. The official forecast numbers for next year are $10.4 billion and $8.2 billion, respectively.

We hear about $4.3 billion in dedicated funds ($3.5 billion in the currently-proposed FY 2016-2017 budget) that could be eliminated and go a long way toward fixing our budget problems. What we rarely hear about is the additional $4 billion in the state general fund that is allocated and/or protected by the State Constitution.

For starters, almost a half billion dollars comes directly off the top of the general fund, but IS NOT APPROPRIATED. That’s right, you don’t see or hear much about this money because it is not appropriated – rather, it is a direct draw on the state’s general fund.

If you go to page 177 of the FY 2016-2017 Executive Budget, you will find Schedule 22, Non-Appropriated Requirements. This schedule allocates $496.5 million from the state general fund in the treasury, pursuant to the State Constitution, for the following:

$404.8 M – General Obligation Bond Debt Service

[IMPORTANT DIGRESSION: G. O. Debt service is increasing by over $211 million (109%) next year due to one-time savings utilized in the current year from defeasance of debt – In other words, this is part of the one-time “fix” in the current budget that has to be covered next year.]

$90.0 M – General Revenue Sharing – goes to local governments as a partial offset for local property tax revenue lost due to the State Homestead Exemption

$ 1.7 M – The Interim Emergency Board – provides emergency funds during the budget year

Now I ask you, which of these would you be willing to vote out of existence? Eliminating or changing them would require constitutional amendments and a vote of the people.

The one of these three I would not cut, for sure, is our $405 million in debt service. Defaulting on our debt would cause immediate loss of a marketable bond rating and send a message to the rest of the country that we are truly bankrupt.

Cutting the other $91.7 million in non-appropriated items would have very serious implications, particularly for local governments. Even if you think local governments shouldn’t get the revenue sharing, how do you think they would make it up, if they didn’t?

In addition to non-appropriated allocations, the State Constitution also mandates general fund spending for a number of appropriations. The state’s Minimum Foundation Program for public elementary and secondary education is required by the constitution and has a $3.4 Billion state general fund appropriation. You might be inclined to cut administration and other programs in the Department of Education, but are you willing to vote for a constitutional amendment eliminating basic state support for our public schools, or even allowing for substantially reducing it? You may not directly use public education, but you have to agree we absolutely have to have it and it should be funded at no less than its current level. The education provided by our public schools is vital and is finally improving. We can’t afford to lose the ground we’ve gained.

So, between just the General Obligation Bond debt service and the MFP requirements for next year, we have $3.8 Billion of General Fund (46% of the total) expenses it would be simply stupid to cut.

In addition to the MFP, another $600 million of our general fund expenditures are currently required by the State Constitution. State supplemental pay for local law enforcement alone is $124 million of this. Also included are salaries of statewide elected officials and the costs of elections. You might not be happy with the salaries of your statewide elected officials, but we have to pay them and I don’t think you could possibly support not having the money to hold elections. If you think locals ought to fully fund the salaries of law enforcement personnel, where do you think they might get the money to do so?

[Digressing again and focusing on local government funding for a moment, what if we decided to cut it all? Except for capital outlay projects, we indirectly fund recurring local services, so we would, in essence, be shoving our problem down to the local level – and we all live somewhere.  If local governments were unable to raise local taxes to support the services, they would be eliminated or significantly degraded.  If they were able to raise local taxes to support them, how would the taxpayers see a difference?]

What other general fund expenditures, currently considered mandated should we consider cutting? How about the $130 million in appropriated debt service (in addition to G. O. Debt)? How about the $400 million plus it costs to incarcerate adult inmates in our state prisons? Or, the $157 million we pay local sheriffs to house state inmates? The $27 million we pay in District Attorney and assistants’ salaries? How much of the $73 million legislative and $160 million judicial general fund appropriations are we and the legislature willing to cut? How much of the $848 million in general fund we consider sacrosanct because of federal mandates should we cut and what will happen if we do? How much can we realistically cut from our Medicaid program and still attempt to meet the health care needs of our citizens?

Finally, how about the elephant hiding behind the sofa, our annual payments via the state payroll system toward the Unfunded Accrued Liabilities of our state retirement systems? I’m no actuary, but using the actuarial reports generated by the Legislative Auditor, I estimate annual payments toward this liability, in state funds, is no less than $600 million and growing rapidly because of the way the amortization is structured. The State Constitution requires this debt to be liquidated by 2029.

We often hear that 67% of our general fund budget is non-discretionary. Let’s pretend we don’t have to do a lot of these things and, just for the sake of argument, say only 55% should not be touched. That still leaves only $3.7 billion of state general fund on the table subject to cut and we certainly aren’t going to cut over half of that to solve a projected $2 Billion problem next year. And, by the way, remember that any of the current year deficit not liquidated this fiscal year will, by law, have to be added to that problem.

Take a look at John Bel Edwards’ first Executive Budget. It is balanced to the official revenue forecast of general fund revenue. Look at what is cut and where. Look closely.

http://www.doa.la.gov/opb/pub/FY17/FY17_Executive_Budget.pdf

For more details, look at the supporting document:

http://www.doa.la.gov/Pages/opb/pub/FY17/FY17ExecBudget.aspx

Now, finally, let’s get back to those dedicated funds. The Legislative Auditor has just released a comprehensive document detailing these dedications. He points out there were 370 dedicated funds in Fiscal Year 2013-2014 (the last year for which complete documentation is available), 344 statutory and 26 constitutional. Let’s see which ones of these we want to eliminate.

How about the $1.4 Billion Transportation Trust Fund? Our roads are in great shape, right? Plus, we blow part of this on public safety rather than roads and public safety certainly isn’t important, is it?

How about the $159 million in Lottery proceeds? Surely we can find a better use than education for that money. The $184 million in the Medicaid Trust Fund for the Elderly? We only have to change a statute to cut the old folks off. The Oil Spill Contingency Fund at $52.7 million? We never have oil spills, do we? And, why should we share $39 million of our severance taxes with the parishes where the minerals are severed? TOPS is draining us dry, so let’s free up that money and spend it elsewhere.

I’m being facetious, but, seriously, don’t you think there is a constituency for every one of those 370 dedications (except maybe the 21 that have no revenue or expenditures)? How many times have dedications been studied and how many have been eliminated so far? The Joint Legislative Committee on the Budget has reviewed 25% of these dedications every other year since 2009, but has made no recommendations for modifying or eliminating any of them.

Whatever we do with dedicated funds can’t and shouldn’t be done overnight. Many of them support local governments, but the Transportation Trust Fund is the largest of them all and, in addition to the Department of Transportation, other state departments and agencies derive substantial operating funds from dedications, most notably the Public Service Commission, the departments of Environmental Quality, Wildlife and Fisheries, Economic Development, Agriculture and Forestry, Natural Resources and Public Safety Services.

Shouldn’t we look at each dedicated fund in depth to determine it source, its purpose, and the extent to which collections exceed needs? Isn’t this just what the Joint Legislative Committee on the Budget should have done? Wouldn’t it have made a lot more sense to examine the historical inflows and outflows of each of these dedicated funds before creating a $442 million Overcollections Fund from their balances in FY 2014? This was yet another statutory dedication and a big reason statutory dedications spending rose so much. Worse, we then used the Overcollections Fund to pay for recurring expenses elsewhere – a significant part of why we are in our current mess.

Obviously, some collections in excess of needs should revert to the general fund. Others, justifiably, should not. In many cases, these funds are created from fees people pay for which they expect certain services. Some dedications to locals are used to service bonds.

Should we continue to look at potential modifications or eliminations of statutory dedication as a partial solution to our problems? Absolutely, but given our history and the realities of today, should we place an inordinate amount of blame for our current problems on them, or expect a miraculous cure to emerge from further study? I frankly don’t see why we would.

I urge you to look at the Legislative Auditor’s report here:

http://app.lla.state.la.us/PublicReports.nsf/0/13D9277344A19B9086257F560076E83A/$FILE/0000CAA1.pdf

It will give you a much better understanding of the dedications and is formatted in such a way as to drill down from a relatively high level to a very detailed level, so you can stop where you’d like and still gain valuable insight.

Let’s face it, as Gov. Edwards has said, if it is so easy to cut the budget, why has it not been cut to size long before now? This is particularly true in light of the fact we had a governor who travelled the United States for the past 8 years professing to be a budget cutter extraordinaire. If he actually cut expenditures to meet revenues and wrought such an economic miracle why do we find ourselves so out of whack? No, Virginia, it’s not just oil prices.

State Treasurer John Kennedy and others point to things the administration should do to eliminate fraud, abuse, and waste in state government. Who can disagree? To the extent these occur, we are all losers – the biggest are the intended beneficiaries of the services.

It is important that citizens believe their tax dollars and fees are being spent as wisely as possible or, at the minimum, that somebody is consistently and comprehensively trying to ensure this is the case. In my opinion, the accountability for this lies with the administration, not the legislative auditor or anybody else.

The administration has not yet provided specifics or even examples of what it plans to do about specific contracts that make no sense, bureaucratic structures that may be bloated, and more effective and efficient delivery of health care services. Gov. Edwards has said he will do something about these things, but he is yet to provide even anecdotal evidence like Kennedy and others to support his claim.

The executive branch needs to hold its appointed officials to the highest standards and demand they investigate dedications and everything else in the departments they are paid well to manage toward doing everything they possibly can to make our government as efficient and responsive as it can be. The public needs to know this is being done. They should not have to see an increasing succession of negative findings by the Legislative Auditor or, worse, disturbing reports of mismanagement and abuse in the media and elsewhere that go largely unanswered.

But, all that said, can these efforts bear fruit overnight? Can they come close to eliminating the gap? Look deeper than the rhetoric and you have to answer “no” and “no.”

One more link is below – an excellent presentation by the Louisiana House Fiscal Division done just a month ago. Check it out:

http://house.louisiana.gov/housefiscal/0112_16_OS_FiscalBriefing2.pdf

There is a lot of really good information out there from a variety of sources inside and outside government. Our decision-makers need to use it.

 

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They helped create current problems; now retread legislator, bureaucrat being asked to solve them—at six-figure salaries

Posted in ALEC, American Legislative Exchange Council, DHH, Ethics, Governor's Office, Health Care, House, Senate, Legislature, Legislators, Politicians, State Agencies on January 30, 2016| 53 Comments »

It was bad enough Friday when Gov. John Bel Edwards announced that career politician and former national chairman of the American Legislative Exchange Council Noble Ellington as his legislative director.

But at the same time, he announced the appointment of Marketa Garner Walters as secretary of the Louisiana Department of Children and Family Services (DCFS) at $129,000 per year.

Ellington, besides serving as national chairman of ALEC, was twice named Legislator of the Year. He left the legislature to take a cozy $150,000-a-year job as Chief Deputy Commissioner of the Department of Insurance in 2012 even though he had no background in the insurance industry.

And it was during his tenure as ALEC’s national chairman that Bobby Jindal was presented the organization’s Thomas Jefferson Freedom Award (you may want to check with the descendants of Sally Heming on that freedom part). http://www.alec.org/press-release/hundreds-of-state-legislators/

It’s beginning to look a lot like business as usual for the new administration. Like pro football and major league baseball, Louisiana’s elected leaders seem to keep recycling the same old familiar faces in and out of various state offices. The problem is, they are the ones who helped create the problems. So what makes anyone think they have the solutions now?

Take Garner Walters, for example, who served as Assistant Secretary for the Office of Community Services within DSS (DCFS) from January 2004 until November 2008, when she went by the name Marketa Garner Gautreau.

“A national leader in the field of children and family services, Marketa Garner Walters has worked for more than 20 years to improve the lives of children,” the governor’s announcement said. “As a public servant, a national consultant, and an advocate with deep roots in her home state of Louisiana, Walters has been able to create meaningful change in the lives of family and children over the years.”

So what’s so wrong with that?

Well, not much. Unless one considers her explanation for an incident in which a 17-year-old mentally challenged boy raped a 12-year-old boy in a group home during the time she served as assistant secretary for the Office of Community Services.

“Retarded people have sex—it’s what they do,” she said, sounding more like a GEICO commercial than someone responsible for children’s welfare. That bit of wisdom was imparted during her testimony before the Juvenile Justice Implementation Commission in 2008.

The Office of Community Services is a sub-office of the Department of Children and Family Services, formerly the Department of Social Services (DSS).

A former employee of the Office of Juvenile Justice (OJJ), then the Office of Youth Development, witnessed Gautreau’s testimony.

“In late 2008, DSS and OJJ were called before the Juvenile Justice Implementation Commission about a situation at a Baton Rouge group home housing both OJJ and DSS youth (and) where a 17-year-old mentally challenged boy raped a 12-year-old boy,” the former OJJ employee said.

“OJJ removed our youth from the group home at once and put a moratorium on placement there. DSS, the licensing agency for group homes, left their kids there,” she said.

When questioned by JJIC members, including (then) Lt. Gov. Mitch Landrieu and (then) Louisiana Supreme Court Chief Justice Kitty Kimball, Garner Gautreau offered a bizarre explanation. She said it was really not rape because the youths were of similar mental capacity.

When asked why there was not better staff security to keep the children from roaming around and molesting others, she replied, “Retarded people have sex. It’s what they do.”

The former OJJ employee was aghast. “I told my colleagues I’d wring their necks if they ever made statements like that in public hearings.

“We figured that (Gautreau’s testimony) was a career-limiting speech and we were not surprised when Ms. Garner Gautreau was shortly looking for another job,” the former OJJ employee said.

She added that OJJ stopped placing children in the same facilities as DCFS children.

There was “a consistent pattern of DSS failing to properly monitor and supervise group home operations and looking the other way when deficiencies were noted,” the former OJJ employee said. “Group homes were even re-licensed when still deficient and corrective actions plans were not being followed.

“The DSS review committee was a joke – the agency’s monitors looked the other way and ignored problems at the group homes, even when OJJ removed kids and notified DSS of deficiencies,” she said.

The intent is for private group homes to provide a safe, homelike setting for abused and neglected children who have been removed from their families. But the safety factor appears to have come up far short. Four rapes were reported over a 15-month period at two Baton Rouge group homes.

The Advocacy Center, a nonprofit organization, released a 41-page REPORT ON GROUP HOMES in early 2008 that described filthy conditions and neglect of children’s education and medical needs at many facilities. Additionally, a 2007 report by the legislative auditor found that 90 percent of the group homes had deficiencies when their licenses were renewed.

Garner Gautreau, however, told the Baton Rouge Advocate that she had “a high level of comfort” in the knowledge that 80 percent of homes scored at an acceptable level.

Its report included problems that staff members observed themselves but also cited violations found in previous inspection reports filed by the state from 2004 to August 2007. Those include failure to assure proper medical care at 53 percent of the facilities and failure to assure proper physical environment in 69 percent of homes.

State inspectors cited 18 facilities for failing to have sufficient staff and found cases where homes failed to provide criminal background checks and in some cases knowingly hired people with criminal records, the Advocacy Center report noted.

“In some cases, we found evidence that the Bureau of Licensing had identified the same problems and cited the same facility over and over again. However, nothing changed,” said Stephanie Patrick, who oversees visits to homes for the Advocacy Center.

“I started following DSS failures when our staff consistently documented problems that DSS ignored,” the former OJJ employee said.

“Louisiana’s licensing statute for these facilities fails to provide an adequate framework for assuring the health, safety, and welfare of children in these facilities,” the Advocate Center report said.

What?!!

The state doesn’t assure the safety and welfare of children it is charged with protecting?

Among the deficiencies of the statute, the report said were:

  • That it grants final authority over residential facility licensing regulations and standards to two committees, none of whose members is required to be an expert in child residential care and treatment, and many of whose members are providers.
  • That it allows the issuance of licenses without full regulatory compliance.
  • That it requires the Department to seek the approval of the relevant committee before denying or revoking a facility’s license, and gives the committee veto power over such action.
  • That it does not permit DSS to assess civil fines and penalties when facilities violate minimum standards.

The Advocacy Center requested DSS’s Bureau of Licensing reports for the years 2004-2006 and up to August 2007. “A review of these reports shows that a shocking number of the facilities had serious violations of minimum licensing standards, including:

  • 38% of the facilities had violations relating to staff criminal background checks;
  • 62% of the facilities were found to violate minimum standards regarding children’s medications;
  • 53% of the facilities failed to assure that children received proper medical and/or dental care;
  • 33% of the facilities were cited for not following proper procedures or violating procedures pertaining to abuse/neglect;
  • 62% of the facilities were cited for not assuring their staff received all required annual training;
  • 69% of the facilities were cited for not assuring that children were living in a proper physical environment;
  • 36% of the facilities were cited for not having appropriate treatment plans or for inappropriate execution of children’s treatment plans;
  • 33% of the facilities were cited for not assuring that sufficient qualified direct service staff was present with the children as necessary to ensure the health, safety and well- being of children.

“Many facilities were found to be in violation of minimum standards on inspection after inspection,” the report added.

LouisianaVoice has been receiving unsettling reports of inadequate inspections of foster homes by unqualified DCFS employees. Those reports are currently being investigated by us and will be reported in future posts should they be substantiated.

Meanwhile, we can take comfort in the knowledge that Marketa Garner Walters nee Gautreau will be watching out for the children as the new secretary of DCFS.

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Ethics Board has feet of clay; withdraws opinion on Kristy Nichols lobbying questions; re-schedules for Feb. meeting

Posted in Boards, DOA, Ethics, Governor's Office, Health Care, Legislature, Legislators, Lobbyist, LSU, Privatization, Public Records, Transparency on December 21, 2015| 13 Comments »

It looks as though Bobby Jindal’s former commissioner of administration Kristy Nichols will finally have to comply with state regulations. Or maybe not.

The Louisiana Board of Ethics, in typical fashion first put the kibosh on any effort by Kristy Kreme to lobby state government on behalf of her new employer—and then promptly withdrew the opinion.

The board was essentially neutered by Jindal during his rush for ethics “reform” in his first days in office back in 2008. Because of those “reforms,” the board lost considerable steam and all its enforcement powers and it now appears it is missing a spine.

And one has to wonder if the Jindalistas had any influence on the decision to withdraw the unfavorable opinion.

Nichols served as Jindal’s commissioner of administration for three years, from October 2012 to October 2015. Those years were marked by consistent budgetary shortfalls, cuts to higher education and health care, the contentious revamping of premiums and benefits for state employees, retirees and dependents through the Office of Group Benefits and the equally controversial privatization of the state charity hospital system.

She also was sued twice by LouisianaVoice over her failure to produce public records in a timely manner. It was in that area that she enjoyed her greatest success by breaking even. She prevailed in the first lawsuit but lost the second one. She still owes a judgment of $800, plus attorney fees and court costs. She chose to spend even more state money in appealing the decision to the First Circuit Court of Appeal.

She announced in September that she would be going to work for Ochsner Health System as a lobbyist. Well, technically, her new title is vice president of government and corporate affairs. While state law precludes her lobbying the legislative or executive branches for two years, there appears to be no prohibition to her lobbying local governments (parishes and municipalities) on the part of Ochsner.

She contacted the ethics board on Nov. 5 through attorney Kimberly Robinson of the Baton Rouge law firm Jones Walker.

Robinson was recently named by Gov-elect John Bel Edwards to be the new secretary of the Department of Revenue and Taxation.

The board last Thursday (Dec. 17) addressed six specific areas about which Robinson sought opinions. The board shot down four of those and took no position on the remaining two because of what it termed insufficient information, according to Walter Pierce of the INDReporter Web site. http://theind.com/article-22377-Ethics-Board-blocks-Nichols.html

A spokesman for the ethics board, however, told LouisianaVoice on Monday that the opinion has been “withdrawn” and the entire matter re-scheduled for the board’s Feb. 19, 2016, meeting.

The opinion initially would have barred Nichols for two years from:

  • Direct transactions or communications with the Division of Administration;
  • Participating in any transaction, researching or preparing materials for use in or in support of a direct act or communication with a legislator;
  • Communicating or having a transaction with the Department of Health and Hospitals, and
  • Assisting Ochsner in communications or transactions with LSU. The LSU Board of Supervisors currently oversees the public-private partnerships between the state-run hospitals and private health care providers.

There was no immediate explanation of what the remaining two questions from Robinson concerned.

There are several areas of concern in allowing Nichols to lobby state government on behalf of Ochsner, not the least of which is the agreement between the state and Ochsner during her term that allowed Ochsner to partner with the state in running the Leonard J. Chabert Medical Center in Houma.

In 2013, the LSU Board of Supervisors signed off on the contract containing 50 blank pages. That contract handed over operation of state-owned hospitals in Lake Charles, Houma, Shreveport and Monroe. The blank pages were supposed to have contained lease terms. Instead, the LSU board left those details to the Jindal administration (read Commissioner of Administration Kristy Nichols).

Eventually details emerged about the contracts, including that of the Leonard J. Chabert Medical Center in Houma. And, thanks to the Louisiana Public Affairs Research Council, the picture began to come into focus.

Leonard Chabert Medical Center was opened in 1978 as a 96-bed facility with 802 employees but by the time it was privatized, it was down to 63 beds.

In 2008, a hospital-based accredited Internal Medicine residency program was begun. In 2011, the hospital’s revenue was 47 percent uncompensated care for the uninsured, 29.5 percent Medicaid, 13 percent Medicare, 5.5 percent state general fund and 6 percent interagency transfer from other departments with only 1 percent being self-generated.

When the Jindal administration moved to unload state hospitals, Chabert was partnered with Southern Regional Medical Corp., a nonprofit entity whose only member is Terrebonne General Medical Center (TGMC).

TGMC is slated to manage Chabert with assistance from a company affiliated with Ochsner Health System, Louisiana’s largest private not-for-profit health system with eight hospitals and forty health centers statewide. Terms of the agreement call for a five-year lease with an automatic renewal after the first year in one-year increments to create a rolling five-year term.

Though Southern Regional is not required to pay rent under terms of the agreement, the Terrebonne Parish Hospital Service District No. 1 is required to make annual intergovernmental transfers of $17.6 million to the Medicaid program for Southern Regional and its affiliates.

The cooperative endeavor agreement (CEA) calls for supplemental payments of $31 million to Ochsner. Small wonder then that the Houma Daily Courier described the deal as “a valuable asset to Ochsner’s network of hospitals” and that the deal expands Ochsner’s business profile.

Between 2009 and 2013, Ochsner’s revenue doubled from $900 million to $1.8 billion and the deal would mean more revenue for Ochsner, the Daily Courier said. http://www.houmatoday.com/article/20140325/articles/140329692?p=3&tc=pg

There has never been a reasonable explanation as to why the LSU Board signed off on a blank contract that the Jindal administration would fill in after the fact. Was it just by chance that Nichols, as Commissioner of Administration, was responsible for that task? And was it just happenstance that two years after Ochsner received that $31 million, it saw the need to bring Nichols aboard just as her employment with the Jindal administration was winding down?

LSU Board of Supervisors handed over University Medical Center in Shreveport and E.A. Conway Medical Center in Monroe to the Biomedical Research Foundation (BRF) even though the CEO of BRF was a sitting member of the LSU board at the time.

Within two years, that deal fell apart and the board and BRF are now involved in complicated litigation.

Meanwhile, the Center for Medicare and Medicaid Services has yet to approve the Jindal/Nichols privatization plan.

 

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LouisianaVoice holding first ever ‘Boob of the Year’ contest

Posted in Attorney General, Boards, Broadband, Internet, Budget, Campaign Contributions, Charters, Contract, Contracts, Corruption, Courts, DOA, Education, Ethics, Governor's Office, Grant, Grants, Health Care, Higher Education, Lawsuits, Legislature, Legislators, Office of Group Benefits, OGB, Office of Group Benefits, PACs, Politicians, Privatization, Retirement, State Police, Taxes, Vitter, Vouchers on December 11, 2015| 61 Comments »

As we face the end of eight years of ineptitude, deceit, and whoopee cushion governance, LouisianaVoice is proud to announce our first ever election of John Martin Hays Memorial Boob of the Year.

There are no prizes, just a poll of our readership as to whom the honor should go in our debut survey.

Hays was publisher of a weekly publication called appropriately enough, the Morning Paper in Ruston until his death last year. He relished nothing more than feasting on the carcasses of bloated egos. He single-handedly exposed a major Ponzi scheme in North Louisiana, sending the operator to prison. That got him some major ink in the Atlanta Constitution and the New York Times.

The problem of course, is trying to narrow the field to make the final selection manageable.

The obvious choice for most would be Bobby Jindal, but there are so many other deserving candidates that we caution readers not to make hasty decisions. After all, we wouldn’t want to slight anyone who has worked so hard for the honor.

So, without further ado, here are the nominees, along with a brief synopsis of their accomplishments.

  • Bobby Jindal: Mismanaged the state budget for an unprecedented eight consecutive years. At least there’s something to be said for consistency. In his eight-year reign of error (mostly spent in states other than Louisiana) he managed to cut higher education more than any other state; he robbed public education to reward for-profit charter schools and virtual schools; he gave away the state’s Charity Hospital system (he awarded a contract to the new operators—a contract with 50 blank pages which is now the subject of what is expected to be a prolonged legal battle; he appointed political donors to prestigious boards and commissions, including the LSU Board of Supervisors which, under his direction, fired two distinguished doctors, the school’s president and its legal counsel; He trumped up bogus charges against the director of the State Office of Alcohol and Tobacco Control (ATC) to appease mega-donor Tom Benson and to appoint the husband of his children’s pediatrician to head up the agency; he forced state offices to pay higher rent in order to again accommodate Benson by signing a costly lease agreement with Benson Towers; rather than consider alternative ideas, he simply fired, or teagued, anyone who disagreed with him on any point; he refused Medicaid expansion, thus depriving anywhere from 250,000 to 400,000 low-income citizens needed medical care; he tried unsuccessfully to ram through pension reform that would have been devastating to state employees; he insisted on handing out contract after contract to attorney Jimmy Faircloth who is still searching for his first courtroom victory after receiving well more than $1 million in legal fees; he spurned a major federal grant that would have brought high-speed broadband internet to Louisiana’s rural parishes; he stole $4 million from the developmentally disadvantaged citizens so he could give it to the owner of a $75 million Indianapolis-type race track—a family member of another major donor and one of the richest families in the state; he abandoned his duties as governor to seek the Republican presidential nomination, a quest recognized by everyone but him as a fantasy; he ran up millions of dollars in costs of State Police security in such out-of-state locations as Iowa, New Hampshire, Ohio, and South Carolina; he had the State Police helicopter give rides to his children, and the list goes on.
  • Attorney General Buddy Caldwell: All he did was completely botch the entire CNSI contract mess which today languishes in state district court in Baton Rouge; He consistently turned a blind eye to corruption and violations of various state laws while ringing up what he thought was an impressive record of going after consumer fraud (Hey, Buddy, those credit care scam artists are still calling my phone multiple times a day!); and his concession speech on election night was one for the books—a total and unconditional embarrassment of monumental proportions.
  • Kristy Nichols: What can we say? This is the commissioner of administration who managed to delay complying to our legal public records request for three entire months but managed to comply to an identical request by a friendly legislator within 10 days; We sued her and won and she has chosen to spend more state money (your dollars, by the way) in appealing a meager $800 (plus court costs and legal fees) judgment in our favor; it was her office that came down hard on good and decent employees of the State Land Office who she thought were leaking information to LouisianaVoice (they weren’t); she first reduced premiums for state employee health coverage in order to free up money to help plug a state budget deficit all the while whittling away at a $500 million reserve fund to practically nothing which in turn produced draconian premium increases and coverage cuts for employees and retirees (and during legislative hearings on the fiasco, she ducked out to take her daughter to a boy-band concert in New Orleans where she was allowed to occupy the governor’s private Superdome suite.
  • Troy Hebert: appointed by Jindal to head up ATC which quickly turned in a mass exodus of qualified, dedicated agents; he used state funds to purchase a synthetic drug sniffing dog (hint: there is no such thing as a synthetic drug sniffing dog because synthetic ingredients constantly change; this was just another dog, albeit an expensive one); he launched a racist campaign to rid his agency of black agents; while still a legislator, he was a partner in a firm that negotiated contracts with the state for hurricane debris cleanup.
  • Mike Edmonson: Oh, where do we start? Well, of course there is that retirement pay increase bill amendment back in 2014; there is the complete breakdown of morale, particularly in Troop D; then, there was the promotion of Tommy Lewis to Troop F Commander three years after he sneaked an underage woman into a casino in Vicksburg (he was subsequently fined $600 by the Mississippi Gaming Commission but only after first identifying himself as the executive officer of Troop F and asking if something “could be worked out.”); allowing Deputy Undersecretary Jill Boudreaux to take advantage of a lucrative buyout incentive for early retirement (which, in her case, came to $46,000, plus another $13,000 of unused annual leave) only to retire for one day and return the next—at a promotion to Undersecretary. She was subsequently ordered to repay the $56,000 but thanks to friends in high places, the money has never been repaid (maybe incoming Commissioner of Administration Jay Dardenne would like to revisit that matter); consistent inconsistency in administering discipline to officers who stray—such as attempting unsuccessfully to fire one trooper for assaulting a suspect (even though the suspect never made such a claim) while doing practically nothing to another state trooper who twice had sex with a woman while on duty—once in the back seat of his patrol car.
  • David Vitter: what can we say? The odds-on favorite to walk into the governor’s office, he blew $10 million—and the election. His dalliance with prostitutes, his amateurish spying on a John Bel Edwards supporter, an auto accident with a campaign worker who also headed up the Super PAC that first savaged his Republican opponents in the primary, turning Lt. Gov. Jay Dardenne and Public Service Commissioner Scott Angelle irreversibly against him and driving their supporters to Edwards’s camp. In short, he could write the manual on blowing an election.
  • The entire State Legislature: for passing that idiotic (and most likely illegal) budget on the last day of the session but only after Grover Norquist was consulted about the acceptability of a little tax deception; for allowing Jindal to run roughshod over them on such matters as education reform, hospital privatization, pension reform and financing recurring expenses with one-time money; for being generally spineless in all matters legislative and deferring to an absentee governor with a personal agenda.

Those are our nominees but only after some serious paring down the list.

Go to our comments section to cast your vote in 25 words or less. The deadline is Friday, Dec. 18.

As much as you might like, you are allowed to vote only once.

 

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