By Marsha Shuler
Capitol news bureau
July 24, 2012
Republican and Democratic legislators said Monday they are skeptical of Jindal administration claims that health care would not suffer with more than $320 million in cuts to the LSU hospital system.
LSU’s 10-hospital system would bear 60 percent of some $522.5 million in health care spending reductions outlined so far in response to an unexpected cut in federal funding.
Gov. Bobby Jindal is counting on surplus revenues materializing to close the rest of an $859 million congressionally created hole in the Medicaid program for the state fiscal year that began this month.
Members of the Joint Legislative Committee on the Budget pressed Jindal’s top money manager and his health chief for details on how the LSU cuts would be managed. They heard talk about implementing efficiencies and new models for health care.
LSU System Vice President Fred Cerise, who oversees hospitals and medical education, said guidelines he’s operating under from the LSU Board of Supervisors are two-fold.
“I’ve got instructions not to close hospitals: Plan to spread those cuts and do not close any of the hospitals,” Cerise said.
And Cerise is supposed to give LSU System President William Jenkins an initial report Tuesday, he said.
Cerise said he has also been asked to pursue opportunities to increase revenues.
“I’m pursuing the direction of the board at this point,” Cerise said.
State Department of Health and Hospitals Secretary Bruce Greenstein said the administration has been looking at models in Maryland, New York, Ohio, Colorado and Alabama. He also said former DHH Secretary Alan Levine, now a Florida hospital executive, has come to discuss Florida’s setup.
Legislator after legislator complained about lack of information as they are being hammered with calls from constituents. Some said they wanted to be involved in such weighty decisions.
More than $300 million in cuts to LSU are dollars used to care for the uninsured. LSU provided 1.6 million out-patient visits last year through hospital clinics, half of them providing medical care for the uninsured.
“Everyone in here is one tragedy away from being uninsured and in need of the safety net of the LSU System,” state Sen. Fred Mills, R-St. Martinville, said.
Commissioner of Administration Paul Rainwater said Jindal has no plans to call a special session. He said legislators would have an opportunity to be involved in the next legislative session.
“I’m very concerned,” about the cuts in uninsured care, said Nevers, D-Bogalusa. “Do you think (the governor) would object to the Legislature calling ourselves in?”
“We are going to continue what we are doing,” Rainwater replied. “We believe what we have done is put together a prudent plan.”
State Sen. Francis Thompson, D-Delhi, pressed for details.
“I don’t like that trust me, I’ll do it,” Thompson said. “I don’t want to build an automobile as I’m driving down the road.”
“Sometimes you have to do that,” Rainwater replied.
Both Nevers and state Sen. Ronnie Johns, R-Sulphur, said they foresee people unable to get health care lining up at emergency rooms with lines running out the door.
Johns said clinics associated with LSU’s Moss Regional Medical Center in Lake Charles take care of 120,000 out-patients annually — 65 percent of those seen are uninsured. “That’s 78,000 people out there who do not qualify for Medicaid. ... Those numbers are going to be much larger at other (LSU) hospitals.”
“What do we do with these patients?” Johns asked. “How do we provide health care for these people? What are the modernization plans?”
Greenstein said Johns is premature in his assessment of what the cuts are going to bring.
“LSU needs some time to develop a plan. I ask that you wait for a plan before you start asking questions like that,” Greenstein said.
“I just worry how do we take care of those people if some of these doomsday scenarios happen?” Johns responded. “The private hospital sector is absolutely fearful of people showing up on the steps of their emergency room.”
State Sen. Sherri Buffington, R-Keithville, said she feared the Jindal administration is creating turmoil that will lead to Shreveport’s LSU medical school and its hospitals losing well-respected faculty-physicians. “I don’t want to lose them,” she said.
State Sen. Dan Claitor, R-Baton Rouge, chastised Jindal officials for their description of what’s ahead as another initiative to improve efficiency in state government.
“We cannot change baloney into gold or silver. Let’s be honest with our conversations,” Claitor said. “When I look at this picture there does not appear to be any solution other than closing hospitals or have some pretty cruddy services in some of the areas. Let’s steer clear of the baloney.”