Mayor C. Ray Nagin testified today before the U.S. House of Representatives Committee on Energy and Commerce Subcommittee on Oversight and Investigations as part of the hearing on “Post Katrina Health Care: Continuing and Immediate Needs in the New Orleans Region, Part II.”

Mayor Nagin’s testimony focused on the status of health care provision in the region, noting that the poor and uninsured have little access to primary and mental health care services, the area’s emergency rooms are crowded, and death rates have increased to an alarming level. He also spoke about the urgent need for the Veterans Administration to construct its new hospital facility in downtown New Orleans.

The full text of Mayor Nagin’s testimony follows:

I am C. Ray Nagin, Mayor of New Orleans, one of America’s most beloved and culturally distinctive cities, and a city which is facing the challenge of recovering and rebuilding smartly, soundly and strategically after the worst natural and man-made disaster to occur in the United States of America. As we rebuild, we want to ensure that our citizens will have even better access to services and opportunities than they did in the past. One of the most important of these is access to quality healthcare, to which every citizen is entitled.

            To Chair and Congressman Bart Stupak, Ranking Member and Congressman Ed Whitfield, Vice Chair Charles Melancon, distinguished members and guests of the House Committee on Energy and Commerce Subcommittee on Oversight and Investigations: Thank you for calling this hearing today on the progress and continuing challenges we face in providing basic and quality health care that our citizens need and deserve. We are grateful for your support of our recovery efforts during the last two years. And we thank the American people and our friends throughout the world for their donations of resources, labor, prayers and positive thoughts as we rebuild.

            Most of all, I want to thank you for following up on the issues and needs discussed in your March hearing on this topic. The attention that you brought to these issues has helped us begin to repair critical aspects of our health care system, which was decimated by Hurricane Katrina and the subsequent flooding.

I. The Impact of Hurricane Katrina

I would like to take a few moments to talk about the great strides we have made in our recovery and to discuss the significant challenges that remain. Hurricane Katrina and the subsequent flooding caused unprecedented damage in New Orleans and the Gulf Coast region. Thousands of residents lost their lives. The uninsured property losses from Katrina are estimated to be in excess of $60 billion. Residential damage in New Orleans alone was $14 billion. Every level of our health care delivery system was affected. Every hospital and medical facility in Orleans Parish was shut down and since the storm only four of the eight hospitals have reopened, most at decreased capacity. The City of New Orleans Health Department, which employed more than 200 health professionals, lost more than 60 percent of its staff and closed eight of its 13 clinics.

The impact that Hurricane Katrina had on people’s lives is also evident in the increased mortality and mental health problems that New Orleans is experiencing. Dr. Kevin Stephens, the City’s Health Director, stated in his article in the American Medical Association journal “Disaster Medicine and Public Health Preparedness,” that obituaries published for New Orleans residents – some of whom were still displaced – increased 47 percent during the first six months of 2006. Even state statistics showed a 20 percent increase in deaths in Orleans Parish for the same period, a still alarming death rate almost twice the national one of 8.1 deaths per 1,000 residents. Federal, state and local health leaders must strive to identify the causes of this crisis and develop appropriate interventions to end it. A copy of the article is attached for your review.

II. What We Are Doing Now

Since your March hearing on this issue, Secretary of Health and Human Services Michael Leavitt invoked his authority under the Deficit Reduction Act (DRA) of 2005 to make $100 million available to restore and expand access to primary care in the Greater New Orleans area. We appreciate that $4 million of these funds were earmarked specifically for the City of New Orleans Health Department.

We will use this money to provide staffing for clinics set to open within the next few months. The first clinic will open in New Orleans East and will provide primary and obstetrical services. Since Hurricane Katrina, the only public clinical services in New Orleans East have been provided at a temporary site staffed by Operation Blessing, a faith based nonprofit.

The second clinic funded by this grant will be Mandeville-Deteige in the Gert Town neighborhood adjacent to Xavier University.  This clinic experienced severe flooding after Hurricane Katrina, but will be repaired to partner with Xavier University and its renowned School of Pharmacy. The Mandeville-Deteige Clinic will reopen as a primary care clinic offering pharmacy services.

In addition to the clinic openings, the DRA funds will enable us to operate a mobile dental clinic and a mobile vision and hearing clinic. These health services are critically needed by our citizens, many of whom were insured before Hurricane Katrina but have since lost their jobs, insurance and security.

Another concern, which your committee highlighted and which additional DRA funding is helping to address, is the need to attract and retain medical professionals to our region to fill critical shortages of doctors, nurses and other medical staff. Secretary Leavitt has made an additional $35 million available to tackle this problem. These funds, along with an earlier $15 million grant, are being administered by the Louisiana Department of Health and Hospitals and will provide incentives for retaining and recruiting health care professionals.

III. Ongoing Challenges and Immediate Needs

               A particular problem is created by the shortage of specialty care physicians. With the closure of Charity and other area hospitals, many specialty care physicians such as oncologists, hematologists, orthopedists and cardiologists have left the region. This affects the speed with which people who have insurance can obtain services and makes it almost impossible for the uninsured and indigent to receive specialty care. Because of the reduction in access to primary care, many illnesses are much more severe by the time the patient seeks emergency help, making specialty care essential to reducing mortality and enhancing the quality of life.

               We also remain concerned that no solution is imminent that would guarantee our poorest citizens access to key technologies and treatments. For example, with Charity Hospital closed, uninsured patients with cancer or other illnesses requiring surgery or ongoing special treatment can receive emergency care, but will need to travel out of the area to another public hospital facility for chemotherapy, radiation or other life-saving interventions. If they have no money for transportation or lodging, they will not be able to get treatment.   In order to address this issue, we must create a system in which the uninsured and underinsured have access to appropriate care regardless of their income. 

               This decreased access to primary care and mental health services is severely impacting hospital emergency departments throughout the region. Before Katrina, the state fulfilled its mandate to provide urgent medical and mental health care through Charity Hospital, the largest single point of entry in the state. With Charity and several other hospitals still closed, the emergency department inpatient bed capacity of the region comprised of Orleans, Jefferson, Plaquemines and St. Bernard Parishes is now just more than half of pre-Katrina capacity. For mental health beds, the capacity is about one-third. 

IV.  Importance of VA Hospital

               I appreciate the opportunity this hearing gives me to highlight one of the most important Post-Katrina recovery projects in the region - the proposed construction of the Veterans Affairs Medical Center in downtown New Orleans.  The VA Hospital has traditionally played an important role in providing quality health care for the hundreds of thousands of veterans living throughout the Gulf Coast, as well as the thousands who visit New Orleans as tourists and for special events and conventions. We look forward to its continuing to offer that level of services in downtown New Orleans, complementing the existing synergy of many components of the downtown medical district, and bringing major economic investment to the regional economy. 

               In 2006, the Veterans Administration committed to creating a partnership with the Louisiana State University teaching hospital that would bring state-of-the-art medical care to downtown New Orleans. They signed an agreement with LSU to work together on plans for new medical facilities for both institutions.