Protesters plead for Medicaid expansion

Advocate staff photo by SCOTT THRELKELD -- A state spokeswoman says Northlake Behavioral Health System is in compliance with the federal Medicare program. The private company took over Southeast Louisiana Hospital, near Mandeville, in January.
Advocate staff photo by SCOTT THRELKELD -- A state spokeswoman says Northlake Behavioral Health System is in compliance with the federal Medicare program. The private company took over Southeast Louisiana Hospital, near Mandeville, in January.

Concerned community members gathered at the gates of Northlake Behavioral Health System, formerly Southeast Louisiana Hospital, on Friday afternoon to call attention to cuts in health care and urge Gov. Bobby Jindal to join other states in a expanding Medicaid coverage under the Affordable Care Act.

“I’m here to stop Jindal from abandoning the poor and uninsured,” Linda Jenkins said.

After 26 years, Jenkins lost her job at Southeast as the pharmacy director on Jan. 1, when the state turned the hospital over to private control under Meridian Behavioral Health.

Mike Stagg, director on the nonprofit Forward LA, said he was at the gates Friday to put a human face on the policies being set in Baton Rouge. Stagg said that the Medicaid expansion as welfare is a misconception, in that the majority of people who would be covered are working but unable to afford insurance.

Stagg said that if the state joins the ACA in early 2014, the federal government will pick up 100 percent of the cost.

If not, “We lose out on free money,” Stagg said. “The only thing standing between the state participating and not is the governor’s national political ambitions.”

Cuts to Medicaid dollars and public health care services translates to cuts to jobs, he said, including those at Southeast.

Jenkins said she has not yet been able to find a new job and knows many others in the same position—some who are at risk for losing their homes and can’t afford health care.

Berton Broussard, who was fired from Southeast along with his wife in January, said he didn’t believe the hospital would be open for more than a year. “To say it will stay open is a sham—a joke,” he said. “When Gov. Jindal shut it down, he took money out of my family’s mouth. What he did here was wrong.”

Broussard said he didn’t know how he was going to afford treatment for an illness until his wife recently found a new job.

“The employees here saw it as a mission,” Jenkins said. “It was devastating when the hospital was torn apart.”

Jenkins held a sign that said “Life $, Not Politics, Not land $.”

Jindal’s recent budget proposal, in which he plans to bring in $47 million from the sale of properties, includes selling a portion of the Southeast campus.

Many see the wooded acreage as prime real estate for a golf course, condominiums or a gated community, said Mary Engel, who was also laid off in January.

When a current employee drove up to the demonstrators to ask that a vehicle be moved, she said out of her window, “I totally agree with you all. I work here. I hate it.”

Engel said that in conversations with employees who were offered jobs but have quit in the past two months, the most common reasons include “They say that staffing is inadequate, and they are afraid they are going to get hurt. They feel the whole thing has changed, and it’s not about the patient—it’s about the dollar.”

Engel said the salaries weren’t very high to begin with, but people believed in the place and felt good about what they were doing. Now she said people who were offered jobs are quitting without any other job on the horizon.

But state and hospital officials have a different view of how the hospital is operating. Kathy Kliebert, deputy secretary for the Louisiana Department of Health and Hospitals, said that she is very pleased with how the public to private transition is going. She said they are gradually adding back more beds and there are three on-site monitors who give daily reports about how things are progressing.

The biggest issue is with staffing, Kliebert said, but with a change in employer there are always people who decide that it is not the right fit.

Richard Kramer, CEO of Northlake, said the hospital is still in a transition period and working to bring in best practices and update policies and procedures. He said they are working to add psychologists, part-time nurses, social services and more beds.

There have been some resignations, he said, but not an unexpected amount.

Kramer said he did not know how many people had resigned or retired in the last two months, and Kliebert was not able to provide the numbers by the end of the day on Friday.

In response to claims that doctors are being pressured to discharge patients early, Kramer said, “That baffles me — that’s the whole point of the agreement with the state. If anyone feels pressure, I don’t know where that comes from.”

The cooperative endeavor agreement signed with the state protects uninsured or underinsured patients from being denied admission or discharged early, Kleibert said, even if the private Medicaid manager feels the patient doesn’t meet the criteria to stay. “That’s the beauty of the agreement,” she said.

Even in the absence of the agreement, Kramer said that it would be irresponsible as health care providers to discharge patients before they are ready.

But part of making the hospital efficient is making sure that the justification of continued treatment is documented and that resources are used wisely, Kramer said.

While the state says the uninsured are being protected at Northlake under the CEA, Stagg said he doesn’t see that issue being addressed at other hospital closures.

“I don’t think there’s any evidence the governor has any credibility or true concern for the uninsured,” Stagg said.

He said he also does not feel certainty about Northlake’s future. Families of patients at New Orleans Adolescent Hospital were told their relatives would move to Southeast. Now many of them have been moved to Pineville.

“The role access to family plays in behavioral health is huge,” Stagg said. “If the family can’t visit, they will be in the system longer.”

Brad Ott, a member of the group Save Southeast Louisiana Hospital, said there are many unfair misconceptions about mental illness. People are ostracized and marginalized when they should not be treated any differently than if they had Alzheimer’s or a brain tumor, he said. Ott said the term “Behavioral Health” disturbs him, because it suggests that the illness is something that can be remedied through a change in behavior.

And while there was a promise for no change in treatment, Ott said that from talking to current employees and those who have resigned, thingks like music and play therapies have not been sustained.

In January, Kramer acknowledged that addiction specialists had been cut but said those services were still being provided through other mechanisms.

Ott said that his group will continue to fight the legality of the layoffs, meet regularly, hold rallies and raise funds to provide assistance to fired employees.