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Archive for the ‘House, Senate’ Category

While we normally do not delve into national politics (we have quite enough to do to keep up with the jesters on the fourth floor of the State Capitol), we have decided to offer up our solution to the impasse in Washington, aka the federal government shutdown.

If the board of a larger corporation like, say, Wal-Mart disagrees with the company’s CEO or president, there are no closures of Wal-Mart stores. That would be self-defeating in every respect. Corporate profits would plummet, consumers would buy elsewhere and the stockholders would elect new board members and new officers.

So how is it that Congress—America’s corporate board—can shut down company operations because of disagreements among themselves and with the President—the country’s CEO? Is our national company that near bankruptcy, financial collapse, that hysteria is now the order of the day when it comes to running the store?

To borrow a line from the television sitcom Two and a Half Men, our elected representatives appear to have the emotional stability of a sack of rats in a burning meth lab. Come to think of it, the analogy might not be that far off.

When either side of the aisle in Congress, whether Republicans or Democrats, takes it upon itself to hold the entire country hostage over its inability or unwillingness to compromise, drastic measures are in order.

When 535 men and women can cancel services to more than 300 million Americans on a whim, the system is broken and is in immediate need of repair.

When either side of the issue comments that it is “winning” and that it “doesn’t matter” to them how long the shutdown lasts—and please remember that there are cancer patients and wounded veterans who run the risk of not receiving needed medical treatments—then arrogance has supplanted diplomacy and common sense in our nation’s capital and something must be done.

When Rep. Randy Neugegauer (R-TX) can publicly insult a park ranger for doing her job in closing access to the temporarily closed World War II Memorial in Washington because of the government shutdown—a shutdown brought about by congressional stupidity and not by any action of the park ranger—then he, not she, should be ashamed.

And then we have Rep. Lee Terry (R-NEB) who said he cannot afford to give up his salary during the shutdown. He was dismissive of those who are declining their pay, saying, “Whatever gets them good press.” Good press seems the do-all, end-all for elected officials these days but they often miss the mark by a wide margin. “I’ve got a nice house and a kid in college,” Terry sniffed in refusing for relinquish his salary. “Giving our paycheck away when you still worked and earned it? That’s just not going to fly.”

Rep. Kevin Cramer (R-N.D.) expressed similar sentiments, saying he’s keeping his money because he’s “working to earn it.”

Certainly not like those federal employees who also have houses and kids in college and credit card debt and utility and grocery bills but who aren’t working because they were furloughed as a result of increasingly recurring—and tiresome—congressional gridlock and 535 megalomaniacs jockeying for “good press.”

Unfortunately, the solution to this idiocy cannot be implemented overnight; it will take several years.

Nevertheless, here is our solution:

Fire every damned one of them.

That’s right. Put them on the street for a change. Let them struggle to make ends meet each month. In short, put them back in touch with their constituents by making them one of us. We at LouisianaVoice have long felt that if we sent the politicians into battle before sacrificing our young men and women, there well might be fewer unnecessary, foolish, and costly wars like Vietnam, Iraq, Afghanistan and possibly Syria that benefit only the defense contractors.

So why not take that idea further and whenever federal employees are placed on furlough because of a federal shutdown resulting from sheer pigheadedness and some philosophical point, stop the pay for members of Congress and put them on furlough—permanently.

Constitutionally, it cannot be done in one fell swoop. Senators are elected on a rotating basis—one-third every two years. But in 2014, we could fire 468 of ‘em—all 435 members of the House and one-third, or 33 senators. Two years later, in 2016, send another one-third of the senators home and the final one-third in 2018. (Somewhere along the way, of course, there would be 34 senators up for re-election to account for all 100, but it should be just as easy to fire 34 as 33.)

None are righteous, no not one. All 535 have lost touch with the American people. Witness the shabby way in which 5th District Congressman Rodney Alexander “retired” with little advance notice, all so that (a) Gov. Bobby Jindal could install his choice, State Sen. Neil Riser, into Alexander’s seat and (b) Alexander could be rewarded for opening the door to Jindal’s boy via his appointment as head of the State Department of Veterans Affairs, a position which, incidentally, will bump his state retirement from his tenure in the state legislature before his election to Congress from approximately $7500 to about $82,000 per year.

He’s not alone, of course. Far too many members of Congress have parlayed their time in Washington into small—and not-so-small—fortunes.

Jindal, for example, spent a tad more than three years in Congress and emerged a multi-millionaire, a status he was far from enjoying when he entered.

And at least four of our own former congressmen—Sen. John Breaux and congressmen Bob Livingston, Richard Baker and Billy Tauzin—simply retired and moved over to K Street as highly paid lobbyists. There are others, but those come to mind quickly. Tauzin, it should be noted, used his position in Congress to set up his future employer—and himself—in a way we can only dream of. He rammed through a Medicare bill that prohibited the federal government from negotiating the cost of prescription drugs with pharmaceutical companies, meaning that the pharmaceutical companies set the prices—and that was that. And then he resigned and went to work as a lobbyist for (you guessed it) the pharmaceutical industry.

Other members of Congress (and some governors) establish non-profit, tax-exempt foundations that allow well-heeled donors to circumvent laws that limit campaign contributions to $5,000 per election cycle. Donations to foundations such as the Supriya Jindal Foundation for Louisiana’s Children and Jindal’s Believe in Louisiana, however, have no such restrictions placed on them.

As might be expected, contributions to these foundations from individuals seeking lucrative appointments and corporations seeking favorable legislation tend to spiral out of control.

And there are members of Congress, Democrats Nancy Pelosi and Harry Reid among them, who use their positions to garner inside information that allows them to anticipate and profit from stock market fluctuations or to make property investments that enrich them personally.

There is less controversy in Congress over the issue of the NSA’s spying on American citizens—an issue that should prompt outrage on the part of the American people.

And now these self-righteous hypocrites beat their breasts as each side waits for the other to blink—all over the issue of ObamaCare which, good or bad, passed Congress and was ratified by the U.S. Supreme Court.

The American people should be asked to tolerate only so much from these miscreants. Our patience should be wearing a bit then with these spoiled brats.

The only reasonable solution, therefore, is to fire them all.

No exceptions.

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“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?

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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.

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Editor’s note: This essay is more than twice the length of our usual posts but with the takeover of LSU Medical Center in Shreveport and E.A. Conway Medical Center in Monroe set to take effect on Tuesday (Oct. 1), we felt it vital to provide more detailed information about the administration’s smokescreen that it likes to call a $125 million taxpayer savings. Please take the time to read it in its entirety.

False reasons for privatizing

The governor’s stated purpose of privatization was to improve quality, improve medical education, and save the taxpayers about $125 million (The Advocate 9/4/13).  His actions, however, support none of these stated purposes.

  • Improve quality?  There are many measures of quality, safety, and patient satisfaction that Medicare and others publish (see the discussion on NOLA.com September 14, 2013 story on East Jefferson and West Jefferson Hospitals).  Through a public records request I asked DHH what measures of quality they used in concluding that quality would be improved with these privatizations.  To no surprise, they did not attempt to review any data on quality despite this being one of the governor’s primary reasons for privatizing.  If you look at Medicare’s website http://www.medicare.gov/hospitalcompare/search.html  the LSU facilities compare very favorably to the new private partners.  Furthermore, the Cooperative Endeavor Agreements (CEAs) do not have requirements of the partner hospitals to measure, report, and be held accountable for any quality measures.
  • Improve medical education?  This is vintage Jindal.  He creates a crisis to force change then regardless of the outcome, declares victory for staving off the crisis he created.  Compared to not having hospitals to train in, the partnerships are better, but the public hospital system under LSU prior to Jindal’s meddling was very supportive of medical education and programs were performing well there.  Since the governor slashed funding for the hospitals, however, the programs ran into difficulty because of the governor’s actions.
  • Save taxpayers about $125 million?  Go back to the Medicare website (http://www.medicare.gov/hospitalcompare/search.html ) and compare the cost to Medicare for care delivered around a hospital stay at the LSU hospital and at the private partner.  In every case the care associated with the LSU hospital was much cheaper than the private partner.  The truth is the governor’s team never asked the private partners what their costs were.  In response to a public records request in which I asked DHH for their analysis comparing costs, DHH was unable to provide any documents demonstrating they compared the actual cost of care at the public and private hospitals prior to entering into the CEAs.  Even though the CEAs commit the state to paying the cost of care at the private hospitals, no one from the administration bothered to ask them what their costs were.  The LSU Board signed off on these agreements without knowing this basic information – an action they were willing to take with the public’s money but that none of them would be so irresponsible to do with his own business.

Here is the breakdown for all cost to Medicare for a patient from 3 days prior to hospitalization to 30 days after the hospital stay (from the Medicare website):

LSU     Hospital Private     Partner(s)
Medical Center of Louisiana     (Charity): $16,698 Touro: $20,022
University Medical Center     (Lafayette): $11,781 Lafayette General: $18,578
Leonard Chabert (Houma): $13,356 Terrebonne General: $18,961
Ochsner: $19,571
W.O.Moss (Lake Charles): $9,299 Lake Charles Memorial: $18,262
Earl K. Long (Baton Rouge): $12,017 Our Lady of the Lake: $21,133

 

So despite the governor’s claim, DHH has no evidence that these deals will save taxpayers $125 million and in fact the public data available indicate just the opposite.  The governor’s real plan is to quietly shift this added cost from state funds to federal funds.  It may save state funds but this approach does not match his public stance on rejecting additional spending, even federal funds since those are taxpayer dollars too.

 Examining the money

Why would the state agree to pay these private partners their costs without knowing how much that is?  Why would the state move its patient care from the lower cost state providers to higher cost private providers?  One explanation is that the higher cost will be borne by the federal government, not the state.  Last year, the public hospitals were appropriated $955 million.  Commissioner of Administration, Kristy Nichols, testified that in 2014 that number will exceed $1 billion.  As reported in The Advocate (May 28, 2013), “The total operating expense associated with the privatization of the LSU hospitals will hit $1 billion during the next fiscal year, Commissioner of Administration Kristy Nichols said Thursday. That’s more than there is in the current year’s budget – $955 million for the state to operate the charity hospitals…”

The private partners will participate with the state in a financing scheme that will allow the state to withdraw its support of the LSU hospitals while increasing the flow of federal funds.  The scheme involves at least 3 different components.  In isolation, each component may be (MAY BE) deemed allowable by the federal government but viewed together they demonstrate an effort to skirt federal requirements that the state put up its fair share of funding for the Medicaid program.

  1. Supplemental or extra payments from Medicaid to private hospitals using federal Medicaid dollars
  2. Lease payments including “up front” payments, in effect, the state “borrowing” funds from a private Medicaid provider (that it just prepaid a supplement using federal funds) in order to cover a state budget shortfall
  3. The state using the private hospital lease payments as match to draw more federal funds and then paying a portion of that back the private provider.

The entire process is designed to cut out the state support and increase the federal support.

Reducing state support

In September 2011 a consulting group named Verite hired by DHH submitted a business plan review that was considered by the Joint Legislative Committee on the Budget at its September 2011 meeting when it voted to approve contracting for construction of the new hospital www.newhospital.org.  The report points out the average state funds in the Interim LSU Hospital (ILH or “Charity”) from 2006 – 2011 was $42.8 million.  It projected an average annual amount of state funds in years 2015-2020 of $52.5 million necessary to pay for the cost of caring for uninsured people.  The JLCB approved construction based on these expectations.

However, the 2014 state budget includes zero state funds for ILH.  How can this be?

Here is the scheme:  The private hospital pays LSU money to lease the LSU hospital.  That money does not stay with LSU; it ends up (directly or indirectly) being used as match in the Medicaid program.  After matching those lease payments with federal funds, the total, larger amount is paid back to the private partner in the form of a Medicaid payment.   The lease payments supplant the state funds.  However, the legislative fiscal office has already raised concerns about the leases being $39 million short which is  why the Division of Administration has already begun planning on “double” lease payments this year.  http://www.nola.com/politics/index.ssf/2013/09/new_orleans_shreveport_hospita.html

For years states have devised schemes to receive additional federal funds while reducing the state contribution for Medicaid.  There is a problem with these schemes, however.  Consider this from a 2009 report by the Congressional Research Office:

“In 1991, Congress passed the Medicaid Voluntary Contribution and Provider-Specific Tax Amendments (P.L. 102-234). This bill grappled with several Medicaid funding mechanisms that were sometimes used to circumvent the state/federal shared responsibility for funding the cost of the Medicaid program. Under these funding methods, states collect funds (through taxes or other means) from providers and pay the money back to those providers as Medicaid payments, while claiming the federal matching share of those payments. States were essentially “borrowing” their required state matching amounts from the providers. Once the state share was netted out, the federal matching funds claimed could be used to raise provider payment rates, to fund other portions of the Medicaid program, or for other non-Medicaid purposes.”

https://opencrs.com/document/RS22843/

DHH’s current scheme includes a “borrowing” component that looks similar to the practices this legislation was aimed at preventing.  Medicaid rules do not allow a Medicaid provider (read “hospital” here) to voluntarily donate money to the state when they know they will get this money back plus more (the federal share) as part of an increase in their Medicaid payments.  The federal oversight agency, CMS, has already expressed concerns to state officials that these lease payments could qualify as non bona fide provider donations https://louisianavoice.com/2013/06/26/cart-ahead-of-the-horse-cms-letter-to-sen-ben-nevers-continues-to-leave-jindal-hospital-plan-approval-up-in-air/ and they will be examining the hospital leases to determine this.    If CMS determines these are conventional fair market value leases, they will allow the payments.  Beyond the basic annual lease payments, the deals include “double lease payments” and other large up front lease payments designed to fix the state’s budget problem raising the specter of non bona fide provider donations.  If these payments are deemed to be non-allowable, the federal government will recoup any federal funds that were paid as match for these state funds https://louisianavoice.com/2013/06/26/cart-ahead-of-the-horse-cms-letter-to-sen-ben-nevers-continues-to-leave-jindal-hospital-plan-approval-up-in-air/.  This will likely be resolved after Jindal leaves office and can just be added to the huge mess the state will need to clean up when he departs.  The legislature is derelict in counting on these up front lease payments for at least two reasons: First, if they are legitimate, they are still borrowing from future years, and second, there is a good chance that they are not legitimate and will not be allowed by CMS.

A key question is, “Are these fair market value leases?”  The state and the complicit private hospital want the lease amounts to be as high as possible – this is how they will maximize the fund shift from private hospital to the state; then the funds will be used to generate the maximum amount of federal match which will be paid back to the hospital.  The state did not engage in a competitive bid process to determine the value of the leased facilities.  Instead, the state identified existing in-state private hospitals that it could pay additional funds through the Medicaid program to make the funding scheme work.  After receiving large up-front extra Medicaid payments, these hospitals would agree to lease the LSU hospitals and the lease payments would be used (recycled?) as match to replace the state funds the governor cut out.  The annual lease amounts are presumably based on an appraised value of the property being leased, but the actual payments which include large up-front amounts and multiples of the annual lease amounts – have nothing to do with the value of the property and everything to do with the state’s budget holes.  Furthermore, it is all but certain that none of the hospitals would garner the large lease amounts without the corresponding agreement by DHH to pay them higher Medicaid payments once they agree to lease the facilities.

Let’s take a closer look at the New Orleans deal.

The LSU Interim Hospital will be leased by Louisiana Children’s Medical Center (LCMC), a health system that includes Children’s Hospital and Touro Infirmary.  In addition to the annual lease LCMC agreed to pay $110 million in an “up front” lease payment to be repaid by the state over the next 20 years.  LCMC is in essence loaning the state $110 million for its use in the Medicaid program.  In addition, LCMC agreed to pay an additional $143 million to the state in order to build the parking garage and clinic office building at the new hospital in New Orleans.

  • $110 million payment.  This amount is notably similar to the state fund shortfall that the governor imposed on LSU shortly after the 2013 legislative session.  Remember the meeting of LSU leadership, board members, and Alan Levine that Fred Cerise documented in the recently circulated memo https://louisianavoice.com/2013/08/21/cerise-townsend-firing-came-soon-after-fateful-2012-levine-meeting-with-lsu-officials-to-discuss-lsumc-privatization/)? The supposed purpose was to identify a way to deal with the massive budget cut that the governor was laying at LSU’s feet.  Cerise outlined the magnitude of the cut which was equivalent to $122 million in state funds and a total – including federal funds -of $329 million and the impact would result in the closure of over half of the LSU hospitals.  Those cuts were never made, yet the governor never explained how the funds were restored to LSU’s budget.  In the New Orleans CEA, LCMC agreed to make an upfront lease payment of $110 million to LSU on or before June 24, 2013.  So with one week left in the fiscal year, LCMC paid LSU $110 million to avoid the massive budget cuts that were assigned to LSU by the governor to prompt the wholesale privatization.  But the cuts were never made, savings never achieved.  Instead, the administration borrowed the money from a private partner.  These funds will be repaid to LCMC over the next 20 years.  The state “borrowed” from LCMC, a private entity, funds to be used as match in the Medicaid program  – a practice that is at the very least against the intent of the federal Medicaid regulations and which the state will be repaying for many years after Jindal is gone from office.  If CMS does not approve of this trick, the state will be repaying the federal funds too (which is a much larger amount).
  • $143 million payment for parking and clinic buildings.  When LSU finally gained legislative approval of its business plan for the new hospital in New Orleans at the JLCB on September 16, 2011, there was a gap of $130 million in funding needed to complete the project (it appears that has grown to $143 million).  LSU explained at the time that it intended to use an LSU- affiliated foundation to provide that funding.  The approval to enter into a contract for construction was based on that assumption which was included in the business plan the JLCB considered.

The motion by Senator Murray (stated at 1:08 on the video archive of September 16, 2011 by Rep. Leger) was to “authorize the Office of Facility Planning and Control to enter into contracts up to the amount of funding in place for construction and completion of UMC in New Orleans.”

LSU received a commitment from the LSU Health Sciences Center – New Orleans Foundation as stated in this excerpt from a letter from LSU President John Lombardi to Thomas Rish, the senior manager for the Division of Administration.

“The mechanism for accomplishing such financing involves the UMCMC  [University Medical Center Management Corporation] Board entering into an agreement with LSU for LSU to provide services to the UMCMC Board, as represented by that board to the Joint Legislative Committee on the Budget on September 16, 2011, and in accordance with the business plan presented in open committee hearing at that time.  In carrying out that business plan and the above-described construction, it is expected and necessary for the UMCMC Board at the appropriate time to enter into one or more agreements with one or more other affiliated entities of LSU so that the affiliated entity will have a sufficient revenue stream to support the financing of the Ambulatory Care Building and the Parking Structure.  LSU has engaged in such financing methods in the past with great success, without affecting the state tax supported debt limit or relying upon the full faith and credit of the state.”

However, the UMCMC Board subsequently refused to commit to an agreement that acknowledged its support for LSU because a plan was already underway to reconfigure the governance structure into a private entity unencumbered with the commitments to LSU, commitments that LSU and UMCMC used in gaining approval for acquisition of private property and construction.  As a result, the LSU Foundation could not obtain this funding.

The Division of Administration proceeded to enter into a contract for construction of the entire project anyway (without the funding in place) in violation of the JLCB motion that authorized contracting for up to an amount of funding in place.  As construction proceeded and desperate for a funder so it could meet its obligations to the contractor, the Administration turned to LCMC for the funds which they agreed to provide on or before June 24, 2013.

Why would LCMC, in addition to an annual rent payment for the hospital agree to pay an additional $253 million up front to the state?  Likely because the state gave them the money first.  On June 18, 2013, DHH made a series of supplemental Medicaid payments to Children’s Hospital and Touro Infirmary in the amount of $250 million.  DHH made Medicaid payments (which include federal money) to LCMC affiliates so that LCMC could return those funds to the state to use as match for more federal funds.  You have to appreciate this scheme from a governor who doesn’t like federal money.

Annual lease payments.

In addition to the $253 million up-front payments, Children’s will make its first annual lease payment this year.   But that won’t be enough money to fill the budget hole for the 2014 budget year.  Remember, any lease payment Children’s makes is to be multiplied with federal match dollars and repaid to Children’s so they have every incentive to pay as much “lease” as possible.  Given federal prohibition on “provider donations” these lease payments must be restricted to fair market value amounts.  In order to address the state budget shortfall, the state will borrow from future year lease payments and have Children’s make a “double” lease payment this year (in addition to the $110 million “up front” lease payment to be repaid over the next 20 years).  The Times Picayune reported this plan by Commissioner Nichols’s to have Children’s make a “double lease payment” of $68 million to plug the current year’s budget hole by encumbering future administrations and legislatures with a payback of state funds and potentially the federal match as well.  http://www.nola.com/politics/index.ssf/2013/09/new_orleans_shreveport_hospita.html

The state will use this $68 million to draw down additional federal funds ($107 million in federal funds based on most recent match rate for Louisiana) and pay the entire amount back to Children’s or an affiliate of Children’s for Medicaid services.  Who wouldn’t put up a double payment?  Why not triple payment?  Quadruple?  Only CMS can put the brakes on this scheme.  They have been through this type of thing before in Louisiana and so will be closely scrutinizing the entire arrangement.  Jindal is calculating that any recoupment of funds will come well after he has destroyed the public hospital system and celebrated his success.  He seems to believe he can violate the CMS provider donation provisions by simply calling the donations “lease payments.”  We’ll see if CMS agrees.

Let’s review:

  1. The state is building a replacement hospital for Charity Hospital in New Orleans using $474 million in federal funds from FEMA and $300 million in other hurricane recovery funds.
  2. The state agreed to lease this facility built with federal funds to a private entity that is a Medicaid provider.
  3. Those lease dollars will be used annually as match in the Medicaid program to draw additional federal dollars.  “Monetizing” an asset built with federal funds, the state will generate additional federal funds as match dollars to support the operation. This will allow the Division of Administration to renege in its commitment of state funds to LSU (which the legislature accepted in the business plan submitted to JLCB as a condition for approval of construction).
  4. In addition, the state made a $250 million Medicaid payment to the private provider on June 18, 2013.  This Medicaid payment included roughly 2/3 federal funds.
  5. The private provider then made a $253 million payment back to the state on June 24, 2013.
    1. $110 million of that payment was directly or indirectly used as match in the Medicaid program to draw more federal money by which LSU was able to meet its budget for 2013.
    2. $143 million of that payment is targeted to complete construction of the new hospital in New Orleans (and qualify as all future rent payments for LCMC) that will be operated as a private facility.

That’s a lot of recycling federal dollars and private handouts, even for Louisiana.  Surely the governor must be proud of this innovation in financing.  Why is he not clearly explaining it to the public?

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Do it in the name of heaven,

You can justify it in the end.

 —One Tin Soldier by Dennis Lambert and Brian Potter

As more and more revelations come to light about the treatment of residents of the New Bethany Home for Girls and Boys in Arcadia and similar homes run by Rev. Mack Ford and wife Thelma in other localities, many serious questions remain unanswered.

  • Why, for example, have the Fords and employees of the home never been charged with felony child abuse?
  • How can a man (and dozens more like him scattered across the U.S.) mete out such barbaric treatment of children in the name of a Savior who’s every utterance of love, peace and forgiveness is in direct contradiction to the policies of these institutions?
  • How can the doctrine of separation of church and state trump state laws enacted to protect children who are unable to protect themselves from inhuman, sadistic and yes, anti-social treatment?
  • And most puzzling of all, how is it that Rodney Alexander and Neil Riser would each hire the grandson of New Bethany’s founder and who, along with his father, Ford’s son-in-law, sat on New Bethany’s board of directors?

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Besides the Arcadia home, the Fords also ran homes for boys in Longstreet in De Soto Parish and in Walterboro, S.C. One by one, the homes were eventually shut down by authorities, the Arcadia home in 1998 (some reports indicate that New Bethany boarded girls there as recently as 2004), but only after inestimable mental, spiritual and physical damage had been inflicted on hundreds of children, many of them in their early teens.

New Bethany is situated in a secluded spot deep in the piney woods south of Arcadia where the children’s screams could not be heard. Its remote location kept the facility out of the public eye and allowed Ford to give outsiders a look on his own terms—at church services, in a controlled environment, where the neatly scrubbed girls would sing and give emotional testimonials about past drug abuse and promiscuity (many of those “testimonials” contrived by Ford) and how New Bethany had turned their lives around—all orchestrated for the maximum emotional impact so as to extract “love offerings” from those in attendance.

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Ford resisted state inspections, claiming that he accepted no state funding and that he was not licensed by the state and was therefore not subject to state regulations under the doctrine of separation of church and state.

On one occasion a state inspector did manage to breach the normally chained front gates of New Bethany but that inspector died suddenly a short time later.

Ford used his death as evidence of God’s intention to protect New Bethany from state regulations, saying that the inspector had been struck down by God and a similar fate would likely await other state inspectors.

Still, the clock was ticking and eventually it was the State Fire Marshal’s Office that would prove Ford’s undoing. Not that he didn’t try to thwart state efforts. Ford, following the lead of those like him at other homes, would learn when inspectors were due and would force the girls to move items away from exits and windows and to clean up the facility. He also would go to the extreme of physically transferring girls and boys to a like facility in another state.

And now, 15 years after New Bethany in Arcadia was finally shut down—hopefully for good—we learn that Timothy Johnson, Ford’s son-in-law and a former vice president at Louisiana College in Pineville, is a volunteer in State Sen. Neil Riser’s campaign to succeed retiring 5th District Congressman Rodney Alexander.

Even more baffling is the fact that Ford’s grandson and Timothy Johnson’s son, Jonathan Johnson, is on the payroll of Riser’s campaign after having worked for Alexander for about a decade.

Alexander’s office said Wednesday that Jonathan Johnson, who made $75,000 a year as Alexander’s State Director, was on “unpaid leave,” and would not return until November. Apparently Jonathan Johnson is confident that he will continue working after next month’s primary and the November general election for Congressman-elect Riser.

But the fact remains that if these two men sat on the New Bethany board, they would have had to have known what was going on at New Bethany—the beatings, the mind control, the harsh punishments, and the rapes by Ford that so many of the former residents have come forward to claim.

If, in fact, Timothy Johnson did remove a former student-turned-staff member after she tape recorded a Ford sexual attack on her as claimed, then he not only had knowledge of the incident, but is complicit in concealing a violent crime.

And yet, despite all that we now know about New Bethany’s facilities in Arcadia, Longstreet and Walterboro, S.C., the only prosecutions occurred in South Carolina and even then the perpetrators were allowed to plea bargain their punishment down to probation.

So, why didn’t Louisiana authorities act?

That’s an excellent question for which there are no ready answers. Perhaps authorities were intimidated at the prospect of grappling with God. Authorities in Bienville Parish have claimed they were unaware of the rape allegations but several victims say that is simply not true, that they knew and did nothing.

One administrative employee at New Bethany said he, along with then-State Rep. Woody Jenkins of Baton Rouge, wrote legislation that exempted church-affiliated facilities such as New Bethany from state regulations.

If that indeed is the case, then the entire Louisiana Legislature that passed the bill is also complicit in any crimes that took place—as is the governor who signed it into law.

The responsibility for the agony and suffering of hundreds of girls and boys who were forced to endure the sadistic—and that’s the only word for it—treatment at the hands of Ford and his staff can be laid at the feet of Ford, his family and staff members, Bienville Parish law enforcement, the legislature and the governor’s office.

Next: If you support the education reform programs of Gov. Bobby Jindal and Superintendent of Education John White in their push for more church-affiliated charters and their fundamentalist curriculum, you may want to first examine how some of these schools operated in Arcadia and continue to operate in other parts of the country.

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