Inside Report for July 10, 2013

Transparency has been a big buzzword since Gov. Bobby Jindal took office.

Jindal touted the benefits of transparency during his campaign. He pushed for more records openness in government after taking office.

In his first legislative session, back in 2008, Jindal pushed an agenda, arguing the changes would signal that Louisiana has nothing to hide.

Since then though Jindal’s approach has been more of “trust me.”

He shut off more and more records from public view, citing executive privilege and deliberative process. The governor argued that he would not receive unfettered advice on key budget, health care, higher education and other policy decisions, if that advice was subject to public disclosure.

His administration’s attorneys extended the privilege to other executive branch agencies.

His “trust me” approach extended into the health care arena, both in Jindal’s new privatization of LSU hospitals and in initiative that moved two-thirds of the Medicaid population to private sector-based managed care insurance plans.

Most recently full transparency has been missing as the Jindal administration dismantles the state’s network of public hospitals, more popularly known as the charity hospitals.

According to Jindal, a reduction in federal support and precarious budget times made it necessary to quickly move toward the privatization of the LSU hospitals.

So far, agreements have been reached in eight communities for private takeover involving local partners. The deals were reached behind closed doors negotiations and without a competitive process or input from the public.

Called “cooperative endeavor agreements,” the LSU Board of Supervisors signed off on documents with numerous blanks — including 50 pages in one — and missing attachments. Board Chairman Hank Danos said the omissions were not concerning because board members trusted then LSU System President William Jenkins, who was given the authority to sign agreements to make sure all was well.

Several of the deals involve side agreements that are key to the public-private partnerships. Those have not been publicly disclosed.

The Joint Legislative Committee on the Budget has reviewed several agreements but it, too, was given documents lacking in details.

Frank Opelka, the LSU System executive in charge of the public-to-private transition for the hospitals in south Louisiana, provided a bullet-point presentation keyed to certain pages in the agreements. Frustrated legislators didn’t have the latest version of the agreements. There were side notes on their copies.

Commissioner of Administration Kristy Nichols said the hospital operations would cost the state $1 billion in this fiscal year.

As a result of some pushing, the administration agreed to add a provision allowing the legislative auditor access to records and operations at the new privately managed hospitals.

After vetoing the transparency legislation for two years, Jindal recently signed a law that would make public a wide variety of Medicaid information that would, for instance, report whether claims had been denied and for what reason.

The information would help lawmakers determine whether the program is working and improving the health of patients at a lower cost, as Jindal has promised.

Two-thirds of Louisiana’s Medicaid recipients get health care coverage through private managed care companies. The price tag approaches $3 billion annually and had no public oversight.

To his credit, Jindal signed the health care transparency bill, this third time around.

It won’t be a “trust me.”

It will be accountability.

Marsha Shuler covers health care policy for The Advocate’s Capitol News bureau. Her email is mshuler@theadvocate.com