By Marsha Shuler
Capitol news bureau
July 12, 2012
Gov. Bobby Jindal said Tuesday the state would have a balanced budget that preserves critical health-care services, even when a new federally approved $860 million cut in Louisiana’s Medicaid program begins.
Jindal would not say how that would occur.
The governor met briefly with reporters after a ceremony marking the start of construction of the $19 million LSU Medical Education and Innovation Center on the Our Lady of the Lake Medical Center’s south Baton Rouge campus. Rain forced a planned groundbreaking indoors, complete with dirt and shovels for officials to use.
The 35,000 square foot, four-story building is part of construction taking place on the Lake’s campus, as LSU prepares to move its medical education and inpatient hospital operations there by 2013. With the move, LSU will close its Earl K. Long Medical Center on Airline Highway.
The public-private partnership will also result in the addition of a Level 1 trauma center at the Lake — the highest level of emergency care — which the Baton Rouge area is lacking today.
Jindal said federal changes in the health-care system, as well as budget cuts, won’t negatively affect the LSU-Lake deal.
Jindal said state health chief Bruce Greenstein has started meeting with provider groups — physicians, hospitals and others — preparing for an end-of-week release of the administration’s plan to cut $859.2 million out of the $7.7 billion Medicaid budget.
The rate at which the federal government contributes to Louisiana’s Medicaid program drops effective Oct. 1 — the start of the federal fiscal year. The reduction came via a provision added as part of efforts to get a compromise federal transportation funding bill passed last month.
At the time, Louisiana had already passed its $25.6 billion state operating budget, which went into effect for the fiscal year that begins July 1.
Jindal’s state Department of Health and Hospitals has been working on a plan to address the shortfall without impacting other parts of the state budget.
In a Tuesday interview, Greenstein said the state must look at “optional services, optional (service) populations, rates that we pay, facilities that we run.”
In addition, Greenstein said DHH is looking at the way the state finances health care.
“We are looking at the situation with an eye toward some transformative changes in the way we deliver services,” said Greenstein.
The reduction in federal reimbursement rate doesn’t begin until Oct. 1 but Jindal said it is important to implement required cuts as soon as possible.
“There’s no point in waiting until Oct. 1,” the governor said.
Greenstein said every day that goes by the chance is lost to reduce the impact by spreading the Medicaid cuts over the fiscal year. Providers are already grappling with how to handle other Medicaid cuts DHH implemented to balance the budget — prefederal funds reductions coming from congress.
“We are going to make program adjustments as soon as possible .... and spread them out,” Greenstein said.
“We know the pieces we can’t change,” said Greenstein, referring to mandatory Medicaid programs the state must continue.
He said all facets of DHH will be impacted from the Office of Citizens with Developmental Disabilities to the Offices of Public Health, Aging and Adult Services and all throughout Medicaid.
Greenstein said the department is not going to get rid of optional services that may save a dollar up front but end up costing many times more later. He cited the instance of a hemodialysis patient denied treatment who ends up in a hospital emergency room.
DHH continues to look for ways to parlay state dollars used to fund health care-related programs to attract federal dollars for health care, Greenstein said.
“We have been working very carefully with our federal partners. ... We are often at the innovative edge of policy. We are only going to do what we know will stand ... scrutiny and audit,” said Greenstein, a former federal Centers for Medicare and Medicaid Services officer.