Monday, March 30, 2015

Monday, March 30, 2015

Hospital partnerships are in peril; Budget hearings unravel mysteries; LSU Board of Supervisors tries to grow a spine and; “Small move on reform”

Hospital partnerships are in peril

The public-private hospital partnerships that are charged with providing safety-net care for Louisiana’s medically uninsured population are in jeopardy unless the Legislature goes along with Gov. Bobby Jindal’s plans to scale back state tax credits. Nearly one-third of the funding for the partnerships – in which private operators agreed to oversee charity care previously provided by LSU hospitals – is tied to contingency funding in the governor’s executive budget that has run into strong opposition from legislators and business groups. The governor proposes saving $526 million next year by curbing 12 refundable tax credits. Of that amount, $407 million is plugged into next year’s health care budget, and $332 million is slated for the charity hospital partners. As Scott Rogers reports in the Monroe News-Star:


Health and Hospitals Secretary Kathy Kliebert told lawmakers without the base funding, these hospitals could see their private-sector partners requesting out of their contracts or reducing services offered by the hospitals. If a partner pulled out of the agreement, the hospital would revert to LSU.

State Sen. Francis Thompson, D-Delhi, said the state must find additional funding to keep all nine of the hospitals at the minimal level of operation. “If we don’t pass these measures to create more revenue, we will not be able to meet our contractual obligation, and that’s when they can back out. It could break up a lot of hospitals,” Thompson said. “If we don’t have enough funds we face the option of losing partners that are doing a good job.”


In Baton Rouge, meanwhile, residents in the heart of the city will wake up Wednesday morning without the emergency room that has operated in mid-city for decades and served 45,000 patients last year. As Marsha Shuler reports,


It’s the second emergency room shutdown within two years in the urban environs of Louisiana’s capital city. The first came as LSU’s charity hospital closed for good in April 2013 and the nearby Mid City emergency room saw a sharp rise in uninsured patients entering its doors.The Mid City ER closure will create similar ripple effects that other hospitals in communities across the nation have experienced, said Lorrie Metzler, of the American College of Emergency Physicians, predicting increased demand on facilities outside Mid City. “Those patients have to go somewhere,” Metzler said. “This is happening all over the country.”


Budget hearings unravel mysteries

The Legislature’s department-by-department review of the executive budget is always a useful way of learning exactly what changes are in the works. But the stakes are higher than normal this year due to the massive size of the budget deficit, and some legislators are openly worried that the state will run out of cash in the middle of the fiscal year, just as Gov. Bobby Jindal leaves office. As Melinda Deslatte of the AP reports,


No money was included for Louisiana to hold a presidential primary in spring 2016. LSU hospital privatization deals rely largely on dollars that require lawmakers to scale back tax break spending, and the New Orleans hospital operator says it still would be more than $80 million short of what is needed to open its new facility this summer. The Medicaid program could have a $200 million gap, even if all the uncertain financing assumptions pan out. After hearing Jindal’s budget proposal for the Secretary of State’s Office wouldn’t pay for elections past December — which also happens to be the governor’s last month in office — Rep. Walt Leger said lawmakers need to comb through the spending plans carefully.“It concerns me that there is a budget that has been recommended to us that authorizes funding for elections through the end of December, and then, beyond that, ‘You’re on your own,’ ” said Leger, D-New Orleans, the No. 2 ranking House member.


LSU Board of Supervisors tries to grow a spine

It’s not often that a newspaper columnist gets the kind of reaction that’s Bob Mann saw this weekend after demanding the resignation of the entire LSU Board of Supervisors for its collective failure to stand up to the devastating budget cuts facing higher education.


Within hours of Mann’s column, Board member Stanley Jacobs responded in the Times-Picayune:


If Mr. Mann is looking for a statement from an LSU board member, I would like for him to know that I understand the significance of these draconian cuts. I feel like I am standing on the Titanic and that the LSU I graduated from and love so much is about to go under academically.It is my opinion that unless we can identify a steam (sic) of income dedicated to higher education, I feel that the doomsday scenario predicted by Dr. Alexander will become a reality.  I know that this would not only have implications for LSU and the LSU System, but also for every higher education and community college in our state.


That was followed by a rare joint statement – issued on Saturday afternoon – from the entire board, insisting that they stand united with LSU Chancellor F. King Alexander in opposing the cuts.


The entire LSU Board of Supervisors stands solidly with President King Alexander, students, the entire higher education community and concerned citizens in expressing our collective anxiety and concern relative to the potentially devastating cuts facing our colleges and universities starting July 1. …

All 16 members of the Board of Supervisors representing the entire state of Louisiana are united in our call for restoration of funding and we will continue to use our collective experience and ability to access key policy makers to advance LSU’s position.  


It was too little, too late for Mann, as he made clear on his blog, Something Like the Truth.


Anxiety and concern?? Gents and lady, I hate to tell you this, but anxiety and concern are emotions you should have expressed six years ago, when state appropriations made up about 60 percent of the school’s budget. Today, it’s 13 percent. If Jindal’s additional budget cuts take effect, that number will plummet to 2 percent and the university will cease to exist. Anxiety and concern is what I feel as I’m teaching my teenager daughter to drive. The proper responses to what Jindal and the legislature are doing to LSU is fury, outrage and disgust.


“Small move on reform”

The Advocate’s editorial board takes note of the latest economic analysis that shows Louisiana’s film subsidies return between 18 and 24 cents of tax revenue for every dollar spent by the taxpayer.


Even for government, that’s towering inefficiency. But another piece of news that hasn’t gotten as much attention is the move by Michigan’s House of Representatives to get out of the movie subsidy business. Michigan, which has an economy roughly twice as big as Louisiana, has spent $500 million since 2008 luring filmmakers. By contrast, Louisiana has spent nearly that much in the past two years. Louisiana’s program is uncapped, which means that a state facing a $1.6 billion shortfall has no control over how much it will have to spend on money-losing subsidies to actors and investors who, for the most part, do not live here.


Number of the Day

$123 million – Amount of state appropriations to public higher education next year under a “doomsday” scenario – an 82 percent drop over the current year. (Source: Board of Regents via The Advocate)