LSU approves cost-cutting measures
by marsha shuler
Capitol news bureau
October 06, 2012
LSU plans to lay off 1,495 employees and reduce inpatient services at its seven hospitals across south Louisiana, leaving shells of facilities in such areas as Baton Rouge and Lafayette.
The LSU Board of Supervisors approved the revamped budget cut plan Thursday as it responded to Jindal administration budget cuts emanating from a reduction in federal Medicaid funding support.
The revised version cuts $151 million from hospital budgets — $35.9 million in state funds — making deeper cuts than those authorized by the LSU Board in August.
The new approach heavily relies on getting private hospitals to take care of the poor and uninsured in the communities impacted. Those agreements have not been finalized.
Asked whether LSU patients would continue to get hospital care under the new arrangement, LSU System health care chief Frank Opelka said “We are in discussions trying to achieve the highest level of confidence we can.”
Later Thursday, Opelka told a jam-packed legislative committee hearing room crowd that patient access to care will decrease as a result of the cuts.
The plan received a cool reception from legislators, including Gov. Bobby Jindal’s legislative leaders Senate President John Alario, R-Westwego, and House Speaker Chuck Kleckley, R-Lake Charles, both of whom complained about lawmakers being left out of the loop as decisions impacting their constituents were made.
“The worst thing we can do in a democracy is to keep secrets,” Alario said near the start of a four-hour session.
Legislators expressed frustration as Opelka time and again said no private sector arrangements had been finalized as plans moved forward to eliminate services and layoff employees. Employee layoffs are scheduled to take effect in January.
“You are demolishing what you have before you have something to transition to,” said House Democratic Caucus chairman Rep. John Bel Edwards, D-Amite.
Hospitals impacted by the cuts are Earl K. Long Medical Center in Baton Rouge, University Medical Center in Lafayette, the Interim LSU Public Hospital in New Orleans, Bogalusa Medical Center in Bogalusa, Lallie Kemp Regional Medical Center in Independence, Leonard Chabert Medical Center in Houma and W.O. Moss Regional Medical Center in Lake Charles.
EKL, UMC, Lallie Kemp and Moss would be reduced to 10 in-patient beds each for regular patients. Another three to five beds at EKL would be staffed for prisoner care. Emergency and operating room services would be cut.
Bogalusa would lose 12 of its 40 beds, Chabert would be downsized from 82 to 58 beds.
The Interim Hospital in New Orleans would drop by some 50 beds from its current 201 beds.
The plan adjustments would not impact LSU’s three north Louisiana hospitals located in Shreveport, Monroe and Pineville.
LSU Board members praised Opelka’s plan which keeps the public hospitals open in the current fiscal year, calls for a major redesign of the state’s physician training programs and uses public-private partnerships to deliver patient care and provide settings for graduate medical education.
The LSU board approved the plan “in principle” and gave interim LSU System President William Jenkins the authority to “develop further and implement a plan” based on Opelka’s proposal; and to amend the plan as necessary. The board also said it wanted to approve all contracts with outside entities.
“Yesterday’s delivery system ... does not get Louisiana from good to great,” Opelka said.
For the most part the 1,495 jobs targeted for layoffs are filled today with people who will lose their jobs, he said. The layoffs would begin in January, he said.
“We will be working with partners in the community trying to accelerate opportunities” for private hospitals to take over in-patient services, Opelka said. “A specific time line has not yet been developed.”
Board member Ann Duplessis asked Opelka what the impact of downsizing the LSU hospitals would have on the uninsured who use them. “When you are talking about shifting patient care to the private sector how is that going to impact the access to care?” Duplessis asked.
Opelka did not specifically address the question. He said the state Department of Health and Hospitals Secretary Bruce Greenstein will play a key role in developing a means of financing for the partners “to make this at least a stable business model.”
LSU already has an agreement with Our Lady of the Lake Regional Medical Center to become the home for its patients in the Baton Rouge area and graduate medical education programs, Opelka said. That agreement is undergoing a new review with an eye on expediting the transition from the current November 2013 date, he said.
In Lafayette, Opelka said discussions are underway with Lafayette General Medical Center.
The Franciscans have expressed interest in the LSU hospital in Bogalusa, he said.
Under the initiative medical residents would get more of their physician training in private hospitals where they will be able to see more patients and have access to modern technology, Opelka said.
Opelka said today 43 percent of residents associated with the LSU Health Sciences Center in New Orleans get their training in a community hospital.
Board member Scott Ballard, who said he has a brother and sister who did their physician training in Louisiana, said the change is welcome. “In my opinion, we are not giving our residents the opportunities the LSU System should,” Ballard said.
Opelka said caution must be exercised as the residency programs are moved because they must pass approval of the graduate medical education accrediting agency to stay in existence. “We will have to demonstrate we have stabilized or improved the situation or end up on probation,” he said. “We don’t want to stumble.”