Monday, November 10, 2014

Monday, November 10, 2014

Charity privatization no cure-all for medical safety net; Another year, another spending freeze; Amendments make budgeting more difficult; and Funding shortfall plagues Pre-K revamp

Charity privatization no cure-all for medical safety net

With the “disproportionate share” dollars that fund Louisiana’s public hospitals scheduled to shrink in the coming years, Governing magazine wonders how the state can maintain its health-care safety net without some form of Medicaid expansion.

 

The problem is that Louisiana’s pool of DSH funding goes almost exclusively to the now public-private hospitals. That’s causing short-term headaches as more nonpartner private hospitals take on indigent patients who previously went to now-shuttered public facilities. In one case, a hospital nearly closed its emergency room until the state offered $18 million in aid. But the long-term situation is what most worries critics in Louisiana and across the U.S.

 

Another year, another spending freeze

With Louisiana’s Medicaid program running over budget and revenues coming in slower than expected, Gov. Bobby Jindal ordered a freeze on “nonessential” state spending late Friday. As with previous spending freezes – which have become an annual event under this administration – the latest one gives broad discretion to the Commissioner of Administration to decide what is essential. The Legislature and most activities of statewide elected officials are exempt. As the Associated Press reports:

 

Louisiana has been borrowing hundreds of millions of dollars from treasury funds to pay expenses because state general fund revenue has been slow to arrive to keep the state’s $25 billion budget on track. In addition, a $1.2 billion budget gap is projected for next year, and lawmakers have yet to decide whether the state finished the last fiscal year with a surplus or a deficit.

 

Amendments make budgeting more difficult

The Advocate was the first major newspaper to come out against constitutional Amendments 1 and 2 on last week’s ballot, which locks up Medicaid dollars for hospitals, nursing homes and other institutional providers. In a Sunday editorial, the newspaper says it understands why a majority of voters acted the way they did:

 

Years of tight fiscal cycles prompted Gov. Bobby Jindal and lawmakers to use all sorts of gimmicks to balance the budget, including raids on other funds to pay for expenses elsewhere. It’s the equivalent of fishing for change between the sofa cushions to pay the light bill — an exercise in expedience that, quite naturally, has diminished public confidence in the budget process. In approving these amendments, voters sent the message that they don’t trust the people they elect to manage the state’s finances. Given the state’s sorry fiscal condition these days, who can blame voters for being skeptical?

 

Funding shortfall plagues Pre-K revamp

An advisory panel that’s helping the state implement its ambitious plan to overhaul early-childhood education met well into the evening last week. When it was all over, the battle lines had been drawn: Child-care providers on one side, who say they can’t afford to comply with the rigorous new standards contained in Act 3, versus advocates who say the new rules are critical if Louisiana is ever to rise above its dismal education rankings. But both sides agree that more state dollars are needed before the promise of Act 3 can become reality. As Will Sentell reports in The Advocate:

 

John Warner Smith, vice chairman of the advisory panel, was part of last week’s lengthy discussion of licensing rules for pre-K centers that BESE will consider next month. “Our main concern, and big focus outside of this piece, is the funding for Act 3,” said Smith, who is chief executive officer of Louisiana’s Next Horizon, a nonprofit education advocacy group. “In order for Act 3 to work, that has to be some additional investment for access, for quality, for equity,” he said. Leaders of the push for improved pre-K options have made similar points for months. They said the issue is especially pressing amid a 58 percent funding cut in the Child Care Assistance Program, which helps low-income families pay for pre-K and child care while parents are at school, working or undergoing training.

 

Number of the Day

$194,000 – Amount of “inflated” state tax credits issued to the producers of “Sports Trivia Clash,” a game-show series filmed in Louisiana that is now the subject of an FBI investigation. (Source: The Advocate)