LA saves for real with Medicaid user responsibility

Members from Louisiana’s House of Representatives blocked immediate approval of Medicaid managed care contracts over cost concerns, but requests for more efficient delivery only scratch the surface of how state government can save money.

The Joint Legislative Committee on the Budget last week asked the Department of Health to come back with better offers to the five providers of these services. Almost all Medicaid enrollees in the state potentially at least partially have services rendered to them mediated by these outfits. Without dramatic changes in spending patterns, the 23-month deals worth $15 billion will eat up a quarter of all state expenditures in this period.

Republican members of the committee, comprised of budget leaders from each chamber, led the charge to slow the process. Their Senate counterparts had no objection, but majorities of both must agree and the GOP makes up most of the House contingent. They argued the state should negotiate more savings and tighter oversight, pointing to recent audits that revealed problems in enforcing accountability.

Better chance lightning strikes than Schroder loses

It ain’t going to happen, unless he gets caught with a live boy or dead girl.

My Baton Rouge Advocate colleague Mark Ballard recently mused about whether Republican former state Rep. John Schroder possibly could lose the Nov. 18 special election for treasurer. While he finished runner-up to lawyer Democrat Derrick Edwards, trailing Edwards’ 31 percent by 7 points, other GOP candidates drew the remaining votes in this race. Schroder spent about 100 times what Edwards did and may do so again in the runoff; he remains a heavy favorite.

Ballard did his best to come up with a scenario that gave Edwards, who received votes merely as the only Democrat on the ballot, the victory. He figured that if statewide turnout could dip by almost half but Orleans Parish saw an increase by one third – stimulated by a mayoral runoff election – if the proportions voting for Edwards stayed the same, then it would be neck-and-neck.

Prator right to note how reform can go wrong

Last week Pandora’s box opened, according to some northwest Louisiana crime-fighters, when Democrats Gov. John Bel Edwards took the next step in making good on a risky campaign promise.

On Wednesday, the state began to release prisoners as a result of new guidelines. Legislation passed earlier this year shortened sentences for some, an estimated 1,900 or a bit over 5 percent of the state’s total prison population. Designed to give a break to non-violent, non-habitual offenders who did not misbehave while in prison, this meant the vast majority would come from parish prisons housing state offenders. Given that the typical month sees 1,500 or so set free, the freeing acted as if an extra month’s worth appeared, distilled into a few days.

Skeptics including both sheriffs and district attorneys spoke warily of the event’s impact. Caddo Parish Sheriff Steve Prator emerged as perhaps the biggest critic, maybe as Caddo saw the most convicts of any parish released early courtesy of the new law. He gained a lot of publicity for his negative remarks about it, including lamenting that the ones leaving early disproportionately could work on jail duties or on work release, saving or earning his office money.

Data must drive policy to halt LA STD epidemic

Grasping fully the implications and necessities of public policy in combatting sexually transmitted diseases (STDs) requires some amplifications and extensions of remarks I made in my recent Baton Rouge Advocate column.

Online publication not tied to a physical presentation liberates one from space constraints. Yesterday, I had published a barebones argument about government’s shaping and pursuing policy that would ameliorate Louisiana’s alarmingly-high rates in the three most commonly tracked STDs, syphilis, gonorrhea, and chlamydia. To quote:

Political, civic and religious institutions must do what they can to affirm the values of chastity and self-respect for all citizens. By promoting government policies that advance self-reliance and celebrate the sanctity of life, the state’s leaders can nurture a culture that values delayed gratification as a personal and civic good. More aggressive enforcement and prosecution of sex trafficking and prostitution would help, too.

The Advocate column, Nov. 5, 2017

New ranking for Louisiana's overlooked STD problem should be a wake-up call for action
http://www.theadvocate.com/baton_rouge/opinion/jeff_sadow/article_e5c0776e-c006-11e7-bba0-d303368a563c.html

Links:
http://www.nola.com/health/index.ssf/2017/10/std_health_louisiana_rankings.html
https://www.cdc.gov/std/stats16/CDC_2016_STDS_Report-for508WebSep21_2017_1644.pdf
https://www.cdc.gov/nchhstp/atlas/
https://www.bea.gov/newsreleases/regional/spi/2017/pdf/spi0317.pdf
http://new.dhh.louisiana.gov/assets/oph/HIVSTD/2015_STDHIV_SurveillanceReport.pdf
http://dhh.louisiana.gov/assets/oph/Center-PHI/2016HealthReportCard/Live_Births_by_Parish.pdf