BR General, Jindal administration reach deal to keep ER open

Baton Rouge General Medical Center reversed plans Wednesday to close its Mid City emergency room, which would have left much of the city without close access to treatment for life-threatening medical calamities, after the Jindal administration agreed to come up with funding to cover the uninsured patients entering its doors.

“We began this day with heavy hearts, but now move forward with optimism and tremendous gratitude,” Baton Rouge General President and CEO Mark Slyter said Wednesday.

The “emotionally tolling” day started out with telling staffers about the decision to close the emergency room, then suddenly the call came from the Jindal administration. “They said Mark … ‘We have found the funds to keep your vital services open for our community.’ ”

“Mid City emergency room will remain open,” Slyter said to loud cheers and clapping at an afternoon news conference.

“With a collaborative spirit, we must continue working together towards innovative solutions that solve some of health care’s most complex challenges.”

Gov. Bobby Jindal said the state has identified $7.2 million in state dollars that when included with federal matching funds would provide $18 million to Mid City for indigent care.

The General’s board of directors had decided to shut the emergency room on Nov. 1, calling the move necessary because of growing red ink associated with uninsured patients. The hospital’s emergency room is required by law to provide care regardless of the patient’s ability to pay.

Private hospitals, like the Mid City campus of Baton Rouge General, reported the number of uninsured patients increased dramatically as the state moved toward privatization of its nearby charity hospital.

“It’s gotten to be unsustainable,” said the General’s medical director Dr. Floyd “Flip” Roberts. The General’s Mid City campus was impacted by the April 2013 closure of LSU’s Earl K. Long Medical Center, and that charity hospital’s mental health emergency room extension, as well as the relocation of Woman’s Hospital further south on Airline Highway.

Democratic state Sen. Yvonne Dorsey-Colomb said Kathy Kliebert, Jindal’s health agency chief, told her immediately after the General’s board made its announcement Wednesday morning that some financial relief would be forthcoming.

“They said they have found the money,” said Dorsey-Colomb, who lives five blocks from the Mid City hospital. “From my appreciation it is to help them for this year and they are going to work on something to sustain them for the long term.”

The closure announcement apparently put pressure on the administration, which had declined past overtures to come up with a solution to the growing problem of reimbursement for uninsured care. The General reported losses of $1 million a month. Officials projected the losses would reach $20 million next year.

“It’s been horrible,” said Dorsey-Colomb, who has been involved in discussions between the Jindal administration and the General, a nonprofit, acute care community hospital that opened as Baton Rouge’s first hospital in 1900.

State Department of Health and Hospitals Secretary Kliebert said in an email Wednesday afternoon that the administration is working with the General. “Our discussions with the Baton Rouge General leadership this morning confirmed that, as a result of this additional funding, they will continue to operate the ER. We’ll be working with all of our regional health care partners to develop a plan that ensures the sustainability of emergency services in Mid-City Baton Rouge,” Kliebert wrote in an email.

Calder Lynch, who is the chief of staff at DHH, said the state has identified $18 million needed to keep the emergency room open.

“We are working to determine how that reimbursement will go to them to meet that need and assure long-term sustainability,” Lynch said. “We did recognize the critical services they do provide to that community.”

Democratic state Rep. Ted James, whose district abuts Baton Rouge General-Mid City, pointed out that closing the emergency room would mean no urgent care would be available between Lane Regional Medical Center in Zachary and Our Lady of the Lake Regional Medical Center, in south Baton Rouge, a distance of about 25 miles that can take anywhere from 45 to 90 minutes to traverse.

The Jindal administration closed the LSU Earl K. Long Medical Center Airline Highway in north Baton Rouge and contracted with Our Lady of the Lake, off Essen Lane, to handle the services that had been provided by the charity facility known locally as the Earl.

Since the Earl closed, the Mid City emergency room had received nearly 400 more uninsured patients every month, that’s a 30 percent increase, Roberts said. In addition, there’s been a 60 percent increase in uninsured psychiatric consults; and a 70 percent increase in surgeries provided to uninsured patients, he said.

One of every three patients cared for at Mid City is uninsured, care for which the hospital receives little, if any, financial reimbursement. Physicians also are not reimbursed for the services they provide, Roberts said.

John Hilliard, who was sitting at a bus stop Wednesday in front of Baton Rouge General on Florida Boulevard, said he was homeless and had just been discharged from the General’s emergency room after being treated for fluid in his lungs.

Hilliard said he goes to the General emergency room “a lot.” “This is the closest place for me to get medical care now that Earl K. Long closed down,” he said.

Brianna Edwards, who lives about halfway between Lane Memorial and Our Lady of the Lake, said she often brings her two children to visit Mid City’s emergency room because public transportation to south Baton Rouge is so difficult. “It’s a good thing the General is here,” she said.

“If you don’t have transportation and you need to get to Our Lady of the Lake at 4 a.m., what are you going to do?” Marquise Craig said. “The buses don’t run at that time, do they?”

Baton Rouge Mayor-President Kip Holden said it would have been a “sad story in Baton Rouge history” if the closure was allowed to happen at the city’s first hospital. He praised the care provided and touted its role as an economic engine for Mid City — $19 million — and the greater Baton Rouge area — $162 million.

“Closure of services anywhere in our city has implications for the entire community,” K. Scott Wester, chief executive officer at Our Lady of the Lake, said in a prepared statement. “We recognize how important it is to have convenient access to care in a familiar site.”

Dr. Evelyn Hayes, chairwoman of the General’s board of directors, said the hospital could not afford to continue paying for the care of increasing numbers of uninsured patients and that was what led to the decision to close the emergency room.

General Health will continue to operate its Mid City hospital and remain an active part of the community, Hayes said, adding that the facility’s internationally reknowned burn unit would not be impacted.

“We will focus on some quality programs,” such as the nationally certified senior services offered within the hospital, outpatient cancer treatment care, behavioral health and continued emphasis on graduate medical education programs for physician training, Hayes said.

Advocate reporters Richard Burgess and Timothy Boone contributed to this report. Follow Marsha Shuler on Twitter, @Marsha ShulerCNB.