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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

“Do we require them to file quarterly reports?”

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

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

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

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

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

“It depends on who gets the request.”

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

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

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

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

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

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

Joint Budget Committee

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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The exercise of catching Education Superintendent John White in a lie has become almost boring, certainly routine

Posted in BESE, Education, Public Records on October 16, 2013| 16 Comments »

It has become so easy to catch Superintendent of Education John White in a lie that the exercise has also become boring.

The latest fabrication to come out of the Department of Education (DOE) was a simultaneous falsehood delivered to both LouisianaVoice and Crazy Crawfish and we’re both calling him out on it—simultaneously.

On Sunday, Oct. 14, LouisianaVoice submitted a public records request to White at 7:08 p.m. and a read receipt showed that he opened our email at 11:32 p.m. that same day.

Our request was straightforward enough, asking that White provide us with “all documents which indicate which employees, including your executive staff, in the Louisiana Department of Education have or will receive pay increases.”

A simple request to be sure and one with which it should have easy to comply.

Instead, the response we received on Monday, Oct. 14, was a lie, pure and simple.

“Our public information office has requested that I inform you that the Department is not in possession of any public records responsive to your request,” said the letter from department legal counsel Troy Humphrey.

That was a lie, as we learned from a similar request made to the Department of Civil Service. More about that later.

Fellow blogger Jason France, aka the Crazy Crawfish, http://crazycrawfish.wordpress.com/ has encountered similar difficulty getting straight answers from White and called the superintendent out on Wednesday.

Crazy Crawfish reprinted a Sept. 27 memorandum from White to DOE personnel in which White said budgetary constraints forced him to implement a hiring freeze after Oct. 7. He also said the department “will not provide performance adjustments (raises) this year.”

He said he would re-evaluate that decision later to determine if “one-time incentive award(s) to our employees” could be made.

While technically correct, there are no fewer than 43 DOE employees who received pay increases totaling nearly $500,000 (an average of $11,600 each) from September 2012 to October 2013.

What’s more, there were 40 new hires during this same time period totaling $3 million, or $75,000 per new employee.

So how could White say there would be no raises but at the same time bumped the salaries of 43 employees by an average of $11,600—some by as much as $40,000 and more?

Simple. He borrowed a page from the playbook of Wisconsin Gov. Scott Walker.

The Department of Civil Service, in providing figures to LouisianaVoice, noted that the majority of the salary increases “are the result of reallocations in career progression group, promotions, or movement from part-time to full-time.”

That’s what Walker did in Wisconsin, according to a story published this week. He created what is classified as “phantom jobs” to boost the salaries of his top aides. He simply shifts employees from one position to another, and back again, giving them healthy pay bumps at each stop along the way, thus circumventing state personnel rules limiting pay increases.

One employee, for example, received an increase of $11,100—from $60,902 to $72,000—when she was promoted from an Education Program Consultant 2 to Education Program Consultant 4.

Another got a $13,000 bump—from $65,200 to $78,200—when promoted from Education Consultant to IT Management Consultant I.

Three others received pay raises of $40,500, $49,400 and $54,200 respectively when they went from, in order, Educational Assistant to Educational Program Consultant 3, from Educational Assistant to Executive Management Officer 1, and from Instructor to Educational Program Consultant 3.

As noted by our friend the Crazy Crawfish, White brought in new hires with such vague titles as “Advisor” ($60,000), “Director” ($90,000), “Consultant” ($95,000) and “Fellow” ($100,000, $95,000 and $70,000). Apparently some fellows are worth more than other fellows.

White also “promoted” one employee from Computer Graph Designer at $39,000 to Public Information Officer 1 at $44,200, an increase of $5,200, and he had a new hire of a Public Information Officer 2 at $50,600.

This from a department that steadfastly refuses to release any public information unless threatened with litigation—with litigation sometimes even becoming necessary.

And keep in mind, these new hires and pay raises disguised as promotions and reassignments came during a time when White claimed it was necessary to lay off dozens of DOE employees.

Crazy Crawfish said it best when he said John White is just not honest.

“Unclassified personnel can be fired at will,” he said. “They should have been the first to go before scores of classified employees were laid off. He was not honest about raises to select employees. He was not honest about being under financial hardship and needing to lay off scores of employees when he can hire dozens more…”

To that we can only refer that that infamous email to the governor’s office in which White said he planned to “take some air out of the room” in upcoming testimony to legislators about the approval of 315 vouchers for New Living Word school in Ruston, a facility lacking in classrooms, textbooks and staff.

That is his M.O. It always has been and, with the backing of Board of Elementary and Secondary Education President Chas Roemer, that’s the way it will be as long as this state is saddled with this albatross of a superintendent.

In short, nothing the man says can be trusted and the time is long past when we should be asking if this is the type person we want in charge of our state education system.

After all, if he will so easily lie about something as basic as pay raises for department employees, why should we expect the truth about school performance scores?

We made that request also and we were told the report is not available.

And it’s only been eight months.

Perhaps he needs time to cook the numbers to support his claims.

Which, of course, would be yet another lie.

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False prophets, false profits—and false reasons to privatize LSU Hospital System (or trolling for more Medicaid dollars)

Posted in ALEC, American Legislative Exchange Council, Boards, Contract, Contracts, Governor's Office, Health Care, Higher Education, House, Senate, Legislature, Legislators, Privatization, Public Records, Transparency on September 29, 2013| 12 Comments »

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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‘Deliberative process’ defense used to protect ALEC records in Texas; reminiscent of 2012 LouisianaVoice experience

Posted in ALEC, American Legislative Exchange Council, Governor's Office, House, Senate, Legislature, Legislators, Public Records, Transparency on September 11, 2013| 7 Comments »

Because we have all the metaphorical snakes we can kill right here in Louisiana, it’s rare that we dwell on events in other states unless there is a direct link to developments in the Louisiana political arena.

But a request for public records in Texas pertaining to the American Legislative Exchange Council (ALEC) under that state’s Freedom of Information Act raised a red flag when a favorite but questionable phrase of Louisiana officials was invoked by a Texas legislator in an effort to prevent the release of records.

For the record, we do not believe it a coincidence that the “deliberative process” ploy, so popular with Gov. Bobby Jindal and his minions reared its ugly head in Texas over the issue of whether or not ALEC records are public.

It is our opinion, impossible to prove because of the veil of secrecy thrown over this organization in an effort to conceal its agenda from public scrutiny, that Jindal did not originate the deliberative process maneuver to protect public records from becoming just that—public.

But he certainly knows how to use—perhaps abuse is a better word here—the exception that he slipped into a law that he proudly points to in his national travels as the “gold standard” of transparency that he rammed through the legislature in 2009.

While that 2009 law requires elected and appointed officials to disclose their personal finances, it did little to open up the records of the governor’s office to public examination.

Now, the Freedom of Information Foundation of Texas (FOIFT) has filed a brief with the Texas Attorney General in support of a request for records by the Center for Media and Democracy (CMD).

That request challenges ALEC’s efforts to declare its communications immune from state public records law—even communications with Texas elected officials.

FOIFT’s brief, filed late last month, supports CMD’s position and raises additional arguments countering claims by Rep. Stephanie Klick that the lobbying organizations communications with lawmakers are not subject to disclosure.

Texas was the first state in which ALEC made a formal request of the Attorney General that its records should be exempt from Texas sunshine-in-government laws. ALEC has even begun stamping documents with a disclaimer that says materials such as meeting agendas and model legislation are not subject to any state’s open records laws.

FOIFT counters that assertion by saying the arguments by Klick and ALEC are “mutually inconsistent.”

“Rep. Klick invokes the deliberative process privilege, which involves policy discussions internal to a governmental body,” not between a legislator and a third-party special interest group funded by lobbyists trying to influence legislation,” the brief says. At the same time, it says, “ALEC invokes its members’ First Amendment right of association, which involves its internal discussions and membership.”

Accordingly, it says, because ALEC is communication with Klick in her official capacity as a state representative, the requested documents should be officials records to which the public has a First Amendment right of access.

All of which raises the question of which came first the chicken (Jindal) or the egg (ALEC) insofar as the origination of deliberative process?

Our opinion, for what it’s worth, is that Jindal devised that ploy straight from ALEC’s playbook—just as have so many of his policies, from privatization of prisons and hospitals to school vouchers and charters to pension, healthcare and workers’ compensation reform to massive layoffs of state employees.

Jindal and his legislative floor leaders are in lock step with ALEC and that’s a sad commentary on those officials’ inability to think and act for themselves. Their every move is dictated by ALEC, which writes “model legislation” for its members to introduce in state legislators and assemblies back home.

Sometimes, lawmakers even forget to change key wording in their bills, exposing their efforts for what they are—shams, sacrifices offered up at the altar of profiteering enterprise either by puppets or co-conspirators.

It’s no wonder that ALEC wants to protect its records at all costs.

The affair in Texas is reminiscent of our own experience with Rep. Joe Harrison (R-Gray) in July of 2012.

Harrison, the State Chairman of ALEC, sent out a letter on state letterhead soliciting contributions of $1,000 each from an unknown number of recipients of his form letter to finance the travel of Louisiana legislative ALEC members to an ALEC conference in Salt Lake City set for July 25-28.

The letter opened by saying, “As State Chair and National Board Member of the American Legislative Exchange Council (ALEC), I would like to solicit your financial support to our ALEC Louisiana Scholarship Fund.”

Not college scholarships, mind you, but to support “over thirty Louisiana Legislators serving on ALEC Task Forces.” Contributions, Harrison said, “will allow the opportunity (for legislators) to attend conferences funded by the ALEC Scholarship Fund.

“The conferences are packed with educational speakers and presenters, and gives (sic) the legislators a chance to interact with legislators from other states, including forums on Medicaid reform, sub-prime lending, environmental education, pharmaceutical litigation, the crisis in state spending, global warming and financial services and information exchange. All of these issues are import (sic) to the entire lobbying community.

“I, along with other members of the Louisiana Legislature, greatly appreciate your contribution to the scholarship fund. Your $1,000 check made payable to the ALEC Louisiana Scholarship Fund can be sent directly to me at 5058 West Main Street, Houma, Louisiana 70360.

LouisianaVoice submitted a public records request to Harrison requesting, since the contribution solicitation was written on Louisiana House of Representatives letterhead, that Harrison provide the identities of every person to whom the solicitation was sent.

Harrison never responded to the request but House Clerk Alfred “Butch” Speer jumped into the fray, responding, “I have looked further into your records (omitting the word “public” from our request). Rep Harrison sent that one letter to a single recipient,” he said, overlooking the fact that it was a form letter that opened with “Dear Friend.” Not a very personal way for a letter to be sent to a single recipient.

Also unexplained by Speer was how a single $1,000 contribution might cover the travel expenses of “over thirty” legislators to attend the conference.

Speer, ignoring that the letter was printed on state letterhead, said, “The origin of a document is not the determining factor as to its nature as a public record. Whether the letter was or was not composed on state letterhead…does not, per force, create a public record.

“What Rep. Harrison was attempting is of no moment unless he was attempting some business of the House,” he said.

Speer again apparently ignored the fact that the House and Senate routinely pay per diem, travel and lodging for lawmakers to attend ALEC conference. In fact, between 2008 and 2011, the House and Senate combined to pay 34 current and former members more than $70,000 for attending ALEC functions in New Orleans, San Diego, Washington, C.C., Phoenix, Atlanta, Chicago, Dallas and Austin.

If those ALEC trips were not for state business, why in hell were the House and Senate shelling out that money for legislators’ expenses and per diem?

Mr. Speer’s reasons for protecting the names of the recipients of that letter was, to say the lease, quite disingenuous and his effort to protect that information goes against the grain of everything for which a public servant is sworn to uphold, protect and serve.

What’s more, his arguments don’t even come close to accurately defining what is and what is not a public record. We don’t claim to be attorneys at LouisianaVoice, but we can read the public records act.

For Mr. Speer’s erudition, it can be found in LA. R.S. 44:1-41 and Article XII, Section 3 of the Louisiana Constitution.

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Deloitte Consulting representative said to have boasted company has inside track for IT consolidation contract

Posted in Computers, Contract, Contracts, Governor's Office, IT, OGB, Office of Group Benefits, Public Records, RFP, Request for Proposals, State Agencies, Transparency on September 4, 2013| 8 Comments »

Ten companies have responded to that request for proposals (RFP) calling for the consolidation of information technology (IT) but because of the number of submissions, the scheduled awarding of the contract was moved back “seven to 14 days,” according to an email to bidders by Neal Underwood, assistant director of Statewide Technology.

One of the vendors being mentioned as the potential winner of the contract, expected to be worth millions of dollars, is Deloitte Consultants, one of three companies that met regularly with Division of Administration (DOA) representatives and state IT executives over the past year in discussions of what services they could provide the state.

Moreover, a confidential source said a Deloitte representative has already confided in several persons that the company “had a good shot” at winning the contract because it had been meeting with state officials over the past year.

That scenario evokes memories of the privatization of the Office of Group Benefits (OGB) a couple of years back. DOA brought Goldman Sachs in to help formulate the RFP for the privatization and the Wall Street banking firm was subsequently the lone bidder—at $6 million.

Goldman Sachs subsequently withdrew from the project in a dispute over indemnification but re-bid when the RFP was issued a second time. Blue Cross Blue Shield of Louisiana eventually landed the contract to administer the agency’s claims.

So now we have Deloitte working with state officials for a year to help formulate the RFP and the company is now said to have the inside track to winning the contract. Déjà vu all over again.

At least two other companies, including IBM, were said to have held meetings with the state in the months leading up to the issuance of the RFP. One of those reported to have attended those meetings was Northrop Grumman but that company was not one of the 10 companies submitting proposals, sources say.

Several other companies reportedly requested permission to attend the pre-proposal meetings but were denied the opportunity.

The meetings would seem to fly in the face of a July 19 memorandum from Richard “Dickie” Howze, interim state chief information officer, to DOA section heads and Council of Information Services directors in which he cautioned against any contact with potential vendors during the RFP process at the risk of possible termination.

“During this procurement process it is crucial that you and your staff do not have any contact with vendors who are potential proposers or who may be part of a proposals as a subcontractor regarding this RFP or other related RFPs,” the memo read.

Besides Deloitte and IBM, companies submitting proposals included Dell Marketing, First Data, Gabriel Systems, Information Services Group (ISG), KPMG, Peak Performance Technologies, RNR Consulting and Tecknomic.

Even though the RFP was only for “Information Technology Planning and Management Support Services,” the state wrote into the RFP that the vendor awarded the planning RFP would not be precluded from the implementation of the consolidation, in effect guaranteeing the winner of the planning contract the contract for implementation of the plans.

It also alluded to recommendations for “potential legislation to support effective implementation and administration” for “effective governance models for the statewide centralized IT services organization.”

It was not immediately clear why “potential legislation” would not have been addressed during the 2013 legislative session and prior to the issuance of the RFP as opposed to issuing a contract and then attempting to address legislative issues as they arose during the course of the contract.

In conjunction with the RFP, DOA also issued a request for information (RFI) for business reorganization (and) efficiencies planning and implementation consulting services which would seem to be an exercise in redundancy given the fact that a similar efficiency study was conducted during the tenure of former Commissioner of Administration Angele Davis and that yet another such study is already underway using Six Sigma methodology.

Six Sigma is a methodology that employs tools and techniques for process improvement. The concept was pioneered by Motorola in 1981 and is widely used in different sectors of industry.

Just as with the RFP for the planning and management support services, several vendors responded with proposals. Oral presentations, as with the RFP, however, were limited to a select few companies, including Deloitte, McKinsey & Co., Alvarez & Marsal and CGI Technologies.

McKinsey & Co. is primarily an organization offering internships to trainees for conservative political causes. Gov. Bobby Jindal, who seems hell bent on privatizing virtually every agency and service in state government, worked for McKinsey & Co. for less than a year in the only private sector job he has ever held.

The RFI required that vendors, among other things, present their approach/methodology to identify operational efficiencies, experiences in other governmental settings, and the areas of governmental services “that would produce the maximum benefit.”

Portia Johnson, executive assistant to Commissioner of Administration Kristy Nichols, sent an email to companies who submitted responses to the RFI. That email said:

“Thank you for your interest in RFI 107:01-000001238 Business Reorganization Efficiencies Planning and Implementation Consulting Services. Due to the vast response and in the interest of time, the State has chosen several vendors representative of the industry to interview. Although you have not been selected to proceed in the process, we have taken any documents submitted by you under advisement.”

Said another way: “You have been eliminated for consideration because we have other vendors with whom we prefer to do business. But we are going to go through your proposals and we will probably steal some of your ideas and you won’t get a dime for your efforts. Thank you for your trouble.”

  • CNSI and the federal investigation of its $200 million contract with the Department of Health and Hospitals (DHH) and the ensuing resignation of DHH Secretary Bruce Greenstein, who had maintained continued contact with his old bosses at CNSI during the bidding, selection and contract awarding processes;
  • Biomedical Research Foundation (BRF) and its inside track advantage by virtue of its CEO/President also serving on the LSU Board of Stuporvisors, which issued the contract to BRF to run the LSU Medical Center in Shreveport and E.A. Conway Medical Center in Monroe;
  • Goldman Sachs helping to write the RFP for the takeover of OGB and subsequently being the only bidder on the RFP;
  • Meetings between state officials and vendors for a year leading up to the issuance of an RFP for the consolidation of IT services in more than 20 departments within the state’s executive branch;

Folks, we’re beginning to detect a pattern here.

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