“They have no clue ... I wish they had gotten a little closer to the boots on the ground.” BOBBY YARBorough, LSU board member and PAR member
The Public Affairs Research Council of Louisiana urged LSU and the Jindal administration Friday to slow down their efforts to downsize the state’s public hospital system and rely more heavily on the private sector.
“Despite the financial crisis that led to these changes, PAR believes that more transition time is needed for successful reforms,” according to a newly released commentary.
PAR is a government policy research group funded by members.
PAR suggested the administration adopt a multiyear phaseout of much of LSU’s current system of 10 hospitals.
“If near-term financial constraints require a special session to deal with this situation more adequately, then a special session would be warranted,” PAR said.
The nonprofit governmental research group’s report came in response to the recent adoption of a plan by the Jindal-controlled LSU Board of Supervisors that results in some LSU hospitals becoming “shells” of themselves and all of them losing medical care capabilities.
The plan calls for private hospitals to take up the slack but no such deals have been completed for patient care or the physician training programs that occur at the hospitals.
LSU is on a fast track to implement the changes, citing administration-directed budget cuts required to bring the state’s fiscal-year budget in balance. The latest LSU Board-approved plan calls for $150 million in cuts at seven hospitals across south Louisiana, including those in Baton Rouge, Lafayette and New Orleans.
The cuts are the result of a sudden reduction in federal support for Medicaid, the government’s health insurance program for the poor.
Gov. Bobby Jindal’s Chief of Staff Paul Rainwater, who until recently was his chief money manager, said the money is no longer there to fund the outdated system as it exists. The sudden loss of federal funds leaves an $800 million hole when state funds are taken into account, Rainwater said.
“There’s no option but to move now,” Rainwater said. “It is irresponsible for us to delay moving forward.”
“We have to move fast to protect the uninsured and protect GME,” he said, referring to Graduate Medical Education or physician training programs.
LSU Board member Bobby Yarborough, a PAR member who has been a point person on hospital-related issues, called the PAR report “academic.”
“I use that in the sense of really sounding great in a best-case scenario but how effective, how real can that be? ... They have no clue ... I wish they had gotten a little closer to the boots on the ground,” he said.
Yarborough said LSU is faced with making budget cuts now.
PAR president Robert Scott said the research group has long supported a revamp of the LSU hospital system.
“There’s a lot of good that can come out of this,” Scott said. “But we have said in the past and we are saying now that a good transition time for needed deliberations, transparent planning with partners and a lot of other people is needed to make this work — not just state government.”
The commentary notes Jindal has said Louisiana won’t participate in federal Medicaid expansion, which would provide insurance for some 400,000 residents starting in 2014. Instead the administration appears to be relying on Disproportionate Share Hospital (uninsured care) payments for funding these public hospital reforms.
“Details of the plan to provide coverage should be shared immediately,” PAR wrote.
For instance, Scott said the hurry-up plan gives no chance for local communities that “want to be part of the solution to respond. It’s hard to do overnight.”
“You need agreements. In some cases you are trying to do some public-private partnerships. All these things are hard to do on a fast-track schedule,” he said.