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LSU, Louisiana deserves better than Jindal's war on public health

Jindal-smileTVWhen the LSU Medical Center, aka Charity Hospital of New Orleans, was closed for good following Hurricane Katrina, then-Gov. Kathleen Blanco managed to gain a legislative appropriation of $300 million for the construction of a new University Medical Center. The state secured another $475 million from the Federal Emergency Management Administration (FEMA) for the project.

 

 

Originally approved to “serve the public purpose,” the mission of the new $1 billion facility quickly changed from a public to private purpose after Gov. Piyush Jindal was inaugurated in January of 2008.

There are several problems with this scenario, however.

First, a private board was created with a purpose to support the educational research mission of LSU, according to the board’s bylaws. Then, the board, known as the University Medical Center Management Corp. (UMCMC), had to be appropriately stacked with members favorable to Jindal. That took a little chicanery, but it was done.

When the makeup of the 11-member board was finally agreed upon, seven of the members, their family members and businesses turned out to be major contributors to Jindal, combining to give nearly $205,000.

Those seven include;

• Robert Yarborough of Baton Rouge—$73,500;

• Donald T. “Boysie” Bollinger of Lockport—$58,850;

• David R. Voelker of New Orleans—$45,000;

• Thomas A. “Tim” Barfield of Baton Rouge (recently appointed by Jindal as Secretary of the Department of Revenue)—$15,000;

• Dr. Christopher J. Rich of Alexandria—$5,500;

• Stanley Jacobs of New Orleans—$5,000;

• Darryl Berger of New Orleans—$1,000.

Additionally, three of the seven contributed more than $157,000 to Believe in Louisiana, a political slush fund set up for Jindal’s use by Rolfe McCollister, former Jindal campaign manager and publisher of the Baton Rouge Business Report. Those include:

• Bollinger—$125,000;

• Voelker—$25,000;

• Yarborough—$7,700.

While the stated purpose of the board is to support the education and research mission of LSU, the board does not include anyone directly involved in education and research at LSU, and requests by then-LSU President John Lombardi to appoint such individuals were rejected by the governor’s office.

Board members and Jindal spokespersons have consistently asserted the need for the board to be “independent” of LSU, which is not consistent with the public function of the hospital. To construct the new hospital, considerable private property in downtown New Orleans was expropriated, or taken at market value for the overall good of the public. Private entities are forbidden by law to expropriate property—for any purpose.

So, that naturally brings up the question of what happens to all that property that was expropriated in the name of LSU and University Medical Center for the good of the public?

Before the first meeting of the Jindal dominated UMCMC board the chairperson, who was appointed by Lombardi and who had the fault of being loyal to LSU and not to Jindal (read: no campaign contributions), was replaced by Jindal loyalist, Bobby Yarborough.

Color her teagued.

Yarborough, owner of Manda Fine Meats of Baton Rouge, served as campaign finance chairman for Jindal’s gubernatorial campaign. He now is not only chairman of UMCMC, but also chairman of the LSU Board of Supervisors, which oversees the LSU medical system.

On Aug. 28, 2009, a Memorandum of Understanding (MOU) for governance of the UMC was unanimously approved by Jindal’s hand-picked LSU Board of Supervisors. The MOU was signed by Jindal, then-Department of Health and Hospitals (DHH) Secretary Alan Levine, John Lombardi and Tulane University President Dr. Scott Cowen.

Though there was a MOU, there has never been an agreement between the administration, LSU, DHH and the legislature whereby the legislature authorized a private corporation to manage this public hospital.

Original plans called for the new facility to be the primary teaching hospital of the LSU Health Sciences Center in New Orleans and to also serve as a teaching affiliate of Tulane University School of Medicine.

The business plan for the medical center called for a three-year construction period with opening in 2015 with clinical education and research activities now being provided at the Interim LSU Hospital to be transferred to the new hospital upon completion.

With drastic reductions already implemented and more planned at the Interim LSU Public Hospital (ILH), one has to wonder what the board and the governor’s plan is to meet the expectations outlined in the business plan approved by the legislature.

That plan depends on continued care for the insured and includes the assumption that Medicaid coverage for the poor would expand under ObamaCare. Now the governor is headed in the other direction: cutting services at ILH and rejecting the Medicaid expansion.

Can he tell us what the new plan is? How will this private entity fulfill its public mission to provide care and to support the education and research missions of LSU? It is an issue worth following, particularly since those involved in crafting the original agreements for LSU—Lombardi, Cerise and Townsend—have all been teagued.

Those personnel changes are not surprising, given the fact that the administration makes a habit of regularly calling LSU Board of Supervisors members, even during meetings, with instructions on what to say and what not to say.

That practice would appear to fly in the face of oft-repeated claims by Jindal—particularly in his many out-of-state appearances at fund raisers and television interview shows—that his is the “most transparent,” most open and accountable administration in Louisiana history.

It does, however, appear to dovetail with his growing reputation of micro-managing all facets of state government, his propensity to take a dim view of dissent and to fire or demote any subordinate who disagrees with him, be they employees, cabinet members or legislators.

Now, he has ordered a new round of deep budget cuts for seven public hospitals in south Louisiana. The new directive calls for budgets to be slashed by 34.5 percent.

Significantly, the closure of any hospital or emergency room or any cut of 35 percent or more requires the concurrence of the legislature. The 34.5 percent cut manages to conveniently fall just below that plateau.

Legislators already are showing signs of frustration and discontent in the manner in which the administration is keeping them out of the loop in the decision-making process regarding the LSU system’s 10 statewide teaching hospitals that provide health care to Louisiana’s poor.

The 34.5 percent cutbacks are likely to result in the loss of up to 400 of the 1500 resident doctors at the 10 hospitals across the state, which can also cause yet another problem: the disposition of the contracts between those doctors and the state.

The administration’s belief that private hospitals would take those residents could be a miscalculation with serious legal ramifications.

The administration has already put staff and employees on notice at LSU Medical Center in Shreveport, E.A. Conway Medical Center in Monroe and the Huey P. Long Medical Center in Pineville/Alexandria that a request for proposals (RFP) will be issued “for the purpose of exploring public-private partnerships for the LSUHSC-S affiliated hospitals.”

Jindal’s latest ploy of keeping cuts half-a-percent below the level requiring legislative approval is not likely to sit well with many lawmakers, particularly those in districts served by the hospitals which both employ and treat constituents.

All of this is to say that the current state of the LSU health care system is one big mess, thanks in no small part to a state administration with chronic tunnel vision, a compliant LSU Board of Supervisors comprised exclusively of political cronies, and the loss through firings and reassignments of capable administrators.

Louisiana—and LSU—deserve better.

 

 

              

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