The counterattack has begun – nursing home interests looking to siphon money out of taxpayers against the public interest. Such was the gist of ads run in the press; the Louisiana Nursing Home Association ran a full-page advertisement in Tuesday's edition of The Advocate asking residents to tell Gov. Kathleen Blanco to put the brakes on the cuts to its member homes.
Never mind that Louisiana currently reimburses nursing homes at a rate far more generous than the typical state. Never mind that instituting standards promoting efficiency would save the state $97 million, according to the Legislative Auditor. Never mind that the current system prevents truly free choice for deciding the best care for those who need long term care and that it come perilously close, if it does not already to violating court orders regarding those in need of long term care.
The ad declares that “slashing $60 million from Louisiana's nursing homes will cut health-care jobs and jeopardize quality care for Louisiana's most frail, vulnerable citizens.” That’s a lie: Louisiana’s nursing homes are making a good profit, and the governor is asking to cut less than 10% from their current revenues, such as refusing to pay them for unoccupied beds as is the current practice, which would still leave these properties on average with a profitable situation.
The head of the interest group said the cut in reimbursement rates is equal to the loss of an average two nurses and eight nurses' aides per home. No -- state law dictates the number of employees per home which, according to the Legislative auditor, already is ridiculously low; they can’t cut jobs. In fact, refusing to pay these institutions for empty beds merely will eat into the profits of them which, yes, may drive some of them out of the nursing home business and into other uses, as the marketplace always dictates when poor business decisions create overcapacity.
The callousness of the industry, if not indicated by the poor quality of the care many of them give, certainly comes through when these operators continue to try to extract money out of the state taxpayers regardless of the best use of that money for taxpayers and for those who need long term care. The governor and legislature need to stand fast against these jackals and approve her budget regarding this issue.
27.4.05
Blanco aides plead not to have taken away from them what they took from us
The refrain came through loud and clear: “Please don’t make it worse” begged Gov. Kathleen Blanco’s chief of staff Andy Kopplin, to the state Senate’s Revenue and Fiscal Affairs Committee. Imagine the mentality it takes to consider giving a small portion of the people’s money back to them as “worse.”
This comment came in references to the myriad of tax cut measures introduced into the Senate, and House. Some look popular enough to pass, thus the Blanco effort to prevent giving the people a bit of their money back rather than doing what’s really necessary to cover necessary government activities more efficiently.
For example, restructure affairs concerning Medicaid as recommended by the Legislative Auditor and the approximately $125 million shortfall for the program almost disappears. Or, instead of trying to tie together two disparate things that have nothing to do with each other, the revenue stream of sin taxes and teacher raises, forget about the raises and attach those health matters to funding Medicaid – after all, likely a good chunk of Medicaid spending comes as a result of people smoking.
Instead, Kopplin tried to fake out the inattentive, apparently getting wind of some numbers coming out of the Census Bureau today, by trying to run the argument that Louisiana is “undertaxed” by being only “38th” among the states in state tax burden, so there’s no reason to cut taxes. This lame excuse fails on three accounts.
First, it is always disingenuous to argue an absolute point on relative terms. It doesn’t matter where Louisiana ranks, what matters is whether the burden is commensurate with the proper aims of government and its efficiency in pursuing them. Certainly Louisiana fails on the second account, which should invalidate any argument that a tax cut is unneeded (indeed, it might spur state government on to a proper level of efficiency). In other words, Kopplin’s argument is akin to somebody who commits manslaughter who argues he ought not make it right by saying, “At least I didn’t commit murder like other guys.”
Second, let’s go ahead and use the relativism paradigm anyways. In that case, Kopplin was slightly wrong because Louisiana actually ranks 34th. But it’s a minor point.
Third, however, is the major point that this cited statistic is only state taxation. If you include state and local taxation (remember, all local governments are fully controllable by their state governments), Louisiana actually ranks 16th in highest tax burden (and fees aren’t even included). It doesn’t matter which level of government taxes, it’s all the same thing – absconding with the people’s money hopefully for a worthy purpose. Just because one level of government does not tax that heavily does not give it the right to raise or to not lower taxes when another level of government it controls is allowed to tax heavily.
It’s as simple as this – concerning all taxes that ultimately, one way or the other, are controlled by the state, Louisiana’s 10.4 percent rate is above the national average. Louisianans definitely are not “undertaxed” even on a relative basis.
Blanco needs to recognize that the only taxes that should remotely be considered being raised would be her sin taxes if they are tied into the ills of the sins being taxed – health care and gambling addiction – and that other taxes should be cut. If raising sin taxes for teacher salary raises and no tax cuts are Plan A, then the sooner she understands it’s bad, the quicker we can get to implementing the better and badly needed Plan B in part described above.
This comment came in references to the myriad of tax cut measures introduced into the Senate, and House. Some look popular enough to pass, thus the Blanco effort to prevent giving the people a bit of their money back rather than doing what’s really necessary to cover necessary government activities more efficiently.
For example, restructure affairs concerning Medicaid as recommended by the Legislative Auditor and the approximately $125 million shortfall for the program almost disappears. Or, instead of trying to tie together two disparate things that have nothing to do with each other, the revenue stream of sin taxes and teacher raises, forget about the raises and attach those health matters to funding Medicaid – after all, likely a good chunk of Medicaid spending comes as a result of people smoking.
Instead, Kopplin tried to fake out the inattentive, apparently getting wind of some numbers coming out of the Census Bureau today, by trying to run the argument that Louisiana is “undertaxed” by being only “38th” among the states in state tax burden, so there’s no reason to cut taxes. This lame excuse fails on three accounts.
First, it is always disingenuous to argue an absolute point on relative terms. It doesn’t matter where Louisiana ranks, what matters is whether the burden is commensurate with the proper aims of government and its efficiency in pursuing them. Certainly Louisiana fails on the second account, which should invalidate any argument that a tax cut is unneeded (indeed, it might spur state government on to a proper level of efficiency). In other words, Kopplin’s argument is akin to somebody who commits manslaughter who argues he ought not make it right by saying, “At least I didn’t commit murder like other guys.”
Second, let’s go ahead and use the relativism paradigm anyways. In that case, Kopplin was slightly wrong because Louisiana actually ranks 34th. But it’s a minor point.
Third, however, is the major point that this cited statistic is only state taxation. If you include state and local taxation (remember, all local governments are fully controllable by their state governments), Louisiana actually ranks 16th in highest tax burden (and fees aren’t even included). It doesn’t matter which level of government taxes, it’s all the same thing – absconding with the people’s money hopefully for a worthy purpose. Just because one level of government does not tax that heavily does not give it the right to raise or to not lower taxes when another level of government it controls is allowed to tax heavily.
It’s as simple as this – concerning all taxes that ultimately, one way or the other, are controlled by the state, Louisiana’s 10.4 percent rate is above the national average. Louisianans definitely are not “undertaxed” even on a relative basis.
Blanco needs to recognize that the only taxes that should remotely be considered being raised would be her sin taxes if they are tied into the ills of the sins being taxed – health care and gambling addiction – and that other taxes should be cut. If raising sin taxes for teacher salary raises and no tax cuts are Plan A, then the sooner she understands it’s bad, the quicker we can get to implementing the better and badly needed Plan B in part described above.
26.4.05
EBR teachers play hooky in attempt to pick taxpayers' pockets
So many teachers from East Baton Rouge Parish attended a rally at the state capitol Monday that school had to be called off. At least it looks like the day missed will be made up, which I’m sure thrills the students.
Let’s hope it gets made up, because these schools need all of the help they can get – and part of it is the teachers’ fault. A look at district statistics tells us that (using the most recent 2003-04 data available).
Over a third of schools there are on academic warning or are unacceptable. Five-eights of them either are making no progress towards accountability goals or are in decline. Almost 30 percent of high schoolers either were suspended or expelled. Standardized test scores are bad. These statistics will become worse if the second-best performing high school, Central, gets removed as part of an effort to create a separate school district. And all happening in a parish with a much higher average income and much lower rate of unemployment than typical in the state.
25.4.05
Queen Bee gets a B-
Being a university professor I have the impulse to grade, and why not do so when it is a teacher-turned-politician you are grading. Gov. Kathleen Blanco delivered her State of the State Address Monday afternoon, with few surprises (perhaps the biggest being, when the images of state Rep. Francis Thompson and state Sen. Mike Smith flashed across the screen, I couldn’t see the strings attaching them to Agriculture Commissioner Bob Odom’s hands).
Her overall tone seemed somewhat defensive. She took pains to point out economic development success stories (while neglecting to point out the numerous failures) and reeled off a litany of reports testifying that Louisiana was making progress in the areas of governance, economics, and education. She sounded at times almost like somebody trying to cognitively bolster her self-esteem representing the state.
On the positive side, everybody expected her support for strengthening ethics (singling out apparently HB 694 and HB 712), greater educational accountability (although she did not make negative remarks specifically about bills to weaken it, such as HB 575 and SB 283), promising $20 million to attract matching federal dollars to get I-49 construction going, and, most significantly, reiterating her pledge to improve the efficiency of Louisiana’s health care system especially in the areas of long term care and decentralization of primary care service provision.
But on the negative side, she remained fixated not only on the idea of teacher pay raises (to be more precise, anybody certified as a teacher which include many outside of the classroom), but by raising taxes to do so. Interestingly, the only bill she seemed to single out for criticism concerned this, Rep. Mike Powell’s HB 588 which seeks to draw any funds underpredicted by the Revenue Estimating Conference into teacher pay raises as long as their average salary remained below regional averages, saying any “excess" funds that came this way were going to be eaten up by tax credits to make movies! In other words, she’d rather continue corporate welfare to moviemakers that costs more than it brings in revenues and raise taxes than give teachers a raise without raising taxes.
(Of course, teachers in Louisiana right now are overpaid compared to their performances. And there are other workable ideas to give out these raises without raising taxes.)
Blanco also criticized those who would offer tax breaks (mainly a series of bills to allow more items deductible on federal income taxes to also be deductible of state income taxes, as they once had been), using a flawed family analogy. “Don’t take away our income,” or something like that, she begged lawmakers supporting these. Note her mentality here: she says the money you get taxed isn’t your money, it’s ours.
It got worse with her remarks about escalating health care costs. She drew the analogy that medical costs for the “family” were going up. While it’s true that the total number of dollars spent by the state on health care likely will go up this year, the reason why the state will have to spend more is really because of a shell game played with the federal government’s reimbursement of Medicaid that it finally caught on to and stopped, after years of warning. In short, it’s largely state government’s fault.
Nonetheless, there was more good than bad in the address. Not only does she pass, but she’ll get to keep her TOPS scholarship: B -.
Her overall tone seemed somewhat defensive. She took pains to point out economic development success stories (while neglecting to point out the numerous failures) and reeled off a litany of reports testifying that Louisiana was making progress in the areas of governance, economics, and education. She sounded at times almost like somebody trying to cognitively bolster her self-esteem representing the state.
On the positive side, everybody expected her support for strengthening ethics (singling out apparently HB 694 and HB 712), greater educational accountability (although she did not make negative remarks specifically about bills to weaken it, such as HB 575 and SB 283), promising $20 million to attract matching federal dollars to get I-49 construction going, and, most significantly, reiterating her pledge to improve the efficiency of Louisiana’s health care system especially in the areas of long term care and decentralization of primary care service provision.
But on the negative side, she remained fixated not only on the idea of teacher pay raises (to be more precise, anybody certified as a teacher which include many outside of the classroom), but by raising taxes to do so. Interestingly, the only bill she seemed to single out for criticism concerned this, Rep. Mike Powell’s HB 588 which seeks to draw any funds underpredicted by the Revenue Estimating Conference into teacher pay raises as long as their average salary remained below regional averages, saying any “excess" funds that came this way were going to be eaten up by tax credits to make movies! In other words, she’d rather continue corporate welfare to moviemakers that costs more than it brings in revenues and raise taxes than give teachers a raise without raising taxes.
(Of course, teachers in Louisiana right now are overpaid compared to their performances. And there are other workable ideas to give out these raises without raising taxes.)
Blanco also criticized those who would offer tax breaks (mainly a series of bills to allow more items deductible on federal income taxes to also be deductible of state income taxes, as they once had been), using a flawed family analogy. “Don’t take away our income,” or something like that, she begged lawmakers supporting these. Note her mentality here: she says the money you get taxed isn’t your money, it’s ours.
It got worse with her remarks about escalating health care costs. She drew the analogy that medical costs for the “family” were going up. While it’s true that the total number of dollars spent by the state on health care likely will go up this year, the reason why the state will have to spend more is really because of a shell game played with the federal government’s reimbursement of Medicaid that it finally caught on to and stopped, after years of warning. In short, it’s largely state government’s fault.
Nonetheless, there was more good than bad in the address. Not only does she pass, but she’ll get to keep her TOPS scholarship: B -.
24.4.05
Will new Central touch off incorporation/secession fever?
It’s not an easy process, but if there’s a lot of will you can make a new local government in Louisiana. Just such has happened over the span of the last couple of months, culminating in Saturday’s election to create the new city of Central in East Baton Rouge Parish.
It may not yet be over because opponents, who already have tried to block the election, have 30 days to contest it. But give the five-to-three ratio for approval, any successful challenge seems unlikely. Even though opponents argued a good reason to vote against the incorporation was the new city government wouldn’t have enough resources to maintain the city in the manner in which its residents had come to expect, the real reason may be the parish government would take nearly a million dollar a year hit on its bottom line.
Proponents argued that the area, north of central city Baton Rouge and mainly residential and rural, had little in common with city itself. More specifically, some see it as a first step to creating a separate school district from East Baton Rouge, following the lead of the other two cities in the parish outside of Baton Rouge, Baker and Zachary.
It may not yet be over because opponents, who already have tried to block the election, have 30 days to contest it. But give the five-to-three ratio for approval, any successful challenge seems unlikely. Even though opponents argued a good reason to vote against the incorporation was the new city government wouldn’t have enough resources to maintain the city in the manner in which its residents had come to expect, the real reason may be the parish government would take nearly a million dollar a year hit on its bottom line.
Proponents argued that the area, north of central city Baton Rouge and mainly residential and rural, had little in common with city itself. More specifically, some see it as a first step to creating a separate school district from East Baton Rouge, following the lead of the other two cities in the parish outside of Baton Rouge, Baker and Zachary.
21.4.05
Wooley's arrogance gives Odom a run for his money
Insurance Commissioner "Pimp(le) My Ride" Robert Wooley is giving Agriculture Secretary Bob Odom a run for his money as the most arrogant elected official in Louisiana. Not only does he not reverse or apologize for his having the state’s taxpayers buy him another luxury vehicle after just one year, he tries to justify it.
Some gems from this public servant:
The House Appropriations Committee hardly bothered to vet his department’s budget, which its chairman John Alario argued was because “Since it's not general fund you're tapping into, I guess it doesn't bother us as much.” Wooley was next to him and announced that he took this to mean that he was a model public servant because he cut his agency's spending 5 percent at the governor's request. Great; so did almost everybody other department head. But you didn’t see the likes of Treasurer John Kennedy then rushing out to buy a new vehicle after your present one got only a year’s use. And the reason hardly anybody raised a fuss was the committee is stacked 17-2 in favor of good old boy and girl Democrats who probably would do the same thing if they could get away with it
Wooley also said that he opted for a regular paint job rather than the flame decals that were part of the package. I am so impressed with the concern for the public weal this man Wooley has! What a sacrifice he made, sticking it to the taxpayers for only about $40,000 instead of $41,000!
The truck replaced a 2004 Ford Eddie Bauer-designer edition Expedition that had 30,000 miles on it. Uh, OK, I have a shade under 75,000 miles on my seven-year old van. Maybe he might try to squeeze a few more miles out of his state vehicles if he rather than the taxpayers paid for it.
Wooley said he declines other perks, such as having the state charter him a plane or pay for his cell phone calls. Wow, so it’s all right to abuse the taxpayers a lot, instead of a whole lot?
Wooley said he has saved the state millions of dollars by paying cash for the new building his department occupies. He said he didn't fuss when asked to cut his budget or when told to lease equipment that the state owns free and clear. That is so big of him! Imagine a state official actually treating the resources of his agency not as his own but as the taxpayers’? In other words, actually doing what his job requires? To what do we owe for this munificence?
Wooley said his enemies are trying to embarrass him. “They're not going to intimidate me out of doing my job,” he said. Sounds like he’s doing a good job of embarrassing himself by himself, and if he means living high of the taxpayers, he’s doing a good job of that already.
We don’t need this kind of arrogance in state government. It shows the lack of real understanding that Louisiana voters have about politicians to put this guy in office instead of an upstanding, citizen-conscious man like Dan Kyle as happened in 2003. We’re stuck with this loser for the next couple of years, but let’s at least control this disregard for taxpayers by passing bills like Sen. Art Lentini’s SB 44 which would stop abusive practices like Wooley’s.
Some gems from this public servant:
We don’t need this kind of arrogance in state government. It shows the lack of real understanding that Louisiana voters have about politicians to put this guy in office instead of an upstanding, citizen-conscious man like Dan Kyle as happened in 2003. We’re stuck with this loser for the next couple of years, but let’s at least control this disregard for taxpayers by passing bills like Sen. Art Lentini’s SB 44 which would stop abusive practices like Wooley’s.
20.4.05
Raising standards improves TOPS, saves money
Health care may be one area where common sense can bring costs under control, but another concerns the Tuition Opportunity Program for Students (TOPS). This program now is estimated to eat up $117 million which, frankly, has turned into another entitlement program.
TOPS has many goals, among which are to increase retention, both of in-state students going to a Louisiana public university and keeping them going to them, and to bring better education to a greater range of high school and college students. Its latest report shows it largely succeeds, but in an inefficient way. This has caught the attention of a Legislature eager to find money.
A vital reform would make those who fail to maintain the (low) standards – 2.3 GPA initially, 2.5 after the freshman year – liable to pay back their tuition reimbursements, although a waiver could be put in for those who graduate from college within three (associates) or six (bachelors) degree. From the latest report, using an estimate of 30% suspended or cancelled from the program, of which half would not then graduate within the above time limits, at present tuition rates, that would save nearly $6 million a year (assuming it all can be collected). With this potential penalty, more incentive gets created for recipients to stay eligible.
Another reform almost as important would be to raise eligibility requirements. Right now, to go to college the minimum of 20 to qualify is below the nationwide average on the ACT, and the maintenance criterion is just a borderline B/C (as noted, less the first year). Raising both of these would be good; in fact, bringing the standard for the basic award (Opportunity) up to the award at the next level (Performance), a score of 23, would dramatically cut costs, almost $80 million. (Note that a great many four-year public universities in this country have admission standards considerably in excess of the equivalent of a 23 on the ACT; only LSU is even close to this). Establishing a 2.75 GPA also would stimulate higher achievement and make the program more like an actual “scholarship.”
Exactly the wrong approach would be to lower or remove entirely the ACT qualification. Not only would this give a green light for high school grade inflation, already a rapidly growing problem, but it would cheapen the entire program. For example, several New Orleans high schools graduate nobody who qualifies for TOPS even with its present low standards, yet do manage to graduate a number of students. This means a 3.0 at these schools probably may not even equate to a 2.0 at a quality school yet many of these students would go off to college at the taxpayer’s expense (and then almost all flunk out).
One explanation for these results, that somehow standardized testing is “biased” against racial minorities, is a tired canard which the data solidly refutes. Indeed, the primary factor affecting scores is prior preparation, and all too many schools in Louisiana fail to do this job adequately. Higher ACT scores among Louisiana youth of all races will be reduced as a problem as secondary education teachers become more demanding and less indulgent, and discipline in schools improves (and not necessarily the provision of more money).
Even more disastrous would be to place a family income cap to limit eligible applicants. This is patently unfair, denying students who have done everything they need to qualify solely on the basis of the family into which they were born and punishing parents for trying to be successful and provide their families better lives. If this is truly a “scholarship” program, “need” has nothing to do with it. Otherwise, it should be changed into a grant-like program such as the federal government’s version, where any Lousiiana college-admitted student, subject to family income levels, gets a grant. TOPS is supposed to be about improving educational attainment of the state’s citizens, not a wealth redistribution program.
Replacing beneficial standards with artificial ones is not the answer. Insistence on higher standards will cut costs, provide more motivation (even for those who then miss out on TOPS money; nothing motivates a student to learn more than knowing he’s paying his own way), and, ultimately, a higher level of educational attainment.
TOPS has many goals, among which are to increase retention, both of in-state students going to a Louisiana public university and keeping them going to them, and to bring better education to a greater range of high school and college students. Its latest report shows it largely succeeds, but in an inefficient way. This has caught the attention of a Legislature eager to find money.
A vital reform would make those who fail to maintain the (low) standards – 2.3 GPA initially, 2.5 after the freshman year – liable to pay back their tuition reimbursements, although a waiver could be put in for those who graduate from college within three (associates) or six (bachelors) degree. From the latest report, using an estimate of 30% suspended or cancelled from the program, of which half would not then graduate within the above time limits, at present tuition rates, that would save nearly $6 million a year (assuming it all can be collected). With this potential penalty, more incentive gets created for recipients to stay eligible.
Another reform almost as important would be to raise eligibility requirements. Right now, to go to college the minimum of 20 to qualify is below the nationwide average on the ACT, and the maintenance criterion is just a borderline B/C (as noted, less the first year). Raising both of these would be good; in fact, bringing the standard for the basic award (Opportunity) up to the award at the next level (Performance), a score of 23, would dramatically cut costs, almost $80 million. (Note that a great many four-year public universities in this country have admission standards considerably in excess of the equivalent of a 23 on the ACT; only LSU is even close to this). Establishing a 2.75 GPA also would stimulate higher achievement and make the program more like an actual “scholarship.”
Exactly the wrong approach would be to lower or remove entirely the ACT qualification. Not only would this give a green light for high school grade inflation, already a rapidly growing problem, but it would cheapen the entire program. For example, several New Orleans high schools graduate nobody who qualifies for TOPS even with its present low standards, yet do manage to graduate a number of students. This means a 3.0 at these schools probably may not even equate to a 2.0 at a quality school yet many of these students would go off to college at the taxpayer’s expense (and then almost all flunk out).
One explanation for these results, that somehow standardized testing is “biased” against racial minorities, is a tired canard which the data solidly refutes. Indeed, the primary factor affecting scores is prior preparation, and all too many schools in Louisiana fail to do this job adequately. Higher ACT scores among Louisiana youth of all races will be reduced as a problem as secondary education teachers become more demanding and less indulgent, and discipline in schools improves (and not necessarily the provision of more money).
Even more disastrous would be to place a family income cap to limit eligible applicants. This is patently unfair, denying students who have done everything they need to qualify solely on the basis of the family into which they were born and punishing parents for trying to be successful and provide their families better lives. If this is truly a “scholarship” program, “need” has nothing to do with it. Otherwise, it should be changed into a grant-like program such as the federal government’s version, where any Lousiiana college-admitted student, subject to family income levels, gets a grant. TOPS is supposed to be about improving educational attainment of the state’s citizens, not a wealth redistribution program.
Replacing beneficial standards with artificial ones is not the answer. Insistence on higher standards will cut costs, provide more motivation (even for those who then miss out on TOPS money; nothing motivates a student to learn more than knowing he’s paying his own way), and, ultimately, a higher level of educational attainment.
19.4.05
Tame special interests to solve health care funding woes
The Times-Picayune continues its excellent series detailing how the nursing home industry in Louisiana tries to stay one step ahead of the law while at the same time keep its gravy train rolling to the detriment of the state’s elderly, disabled, and taxpayers.
The arrogance of their trade association, the Louisiana Nursing Home Association, rivals that of Agriculture Secretary Bob Odom. Even though they know they get favorable treatment relative to other states, even though the state is tight on money with so much of it going to health care, they howl when the slightest unfavorable change is threatened to be made.
One need only look at the Legislative Auditor’s April, 2004 report “Medicaid Long-Term Care Options for the Elderly and People With Disabilities: National and Louisiana Statistics” to see how seriously biased the system in Louisiana is towards nursing homes:
Louisiana ranked 1st in the nation in percentage of long-term care Medicaid expenditures used for institutional care in federal fiscal year 2002. Louisiana spent 90.2% of its Medicaid long-term care funds on institutional care.
Louisiana ranked 1st in the nation in the number of Intermediate Care Facilities for the Mentally Retarded (ICF/MRs) per 100,000 people as of June 30, 2002, and 2nd in the nation for per capita expenditures for ICF/MRs in federal fiscal year 2001. Louisiana spent $79.57 per person for ICF/MR care in comparison to $32.00 nationally and $33.95 for the Southern Regional Educational Board (SREB) states.
Louisiana ranked 4th in the nation in per capita expenditures for nursing facilities in federal fiscal year 2001. Louisiana spent $259.43 per person for nursing facility care in comparison to $148.70 nationally and $129.10 for the SREB states. Louisiana also ranked above both the nation and the SREB states in the number of nursing facilities per 100,000 people for calendar year 2002.
They are a fine example of everything that is wrong with government financing of anything, because they have removed themselves from the marketplace, which they cannot manipulate and forces them to provide efficiently and safely, and instead can control government to expropriate wealth from the state while forcing many people into nursing homes who could live with dignity outside of them. This was a point made by the Legislative Auditor’s recent Performance Audit Report in its “Summary of Matters for Legislative Consideration:”
The legislature should consider:
DHH’s plan for equitable funding of a full array of long-term care services
Repealing the Facility Need Review Law or amending it to eliminate problems and allow for open market competition among Medicaid long-term care providers (emphasis mine)
In this report, the auditors found that the state could have saved as much as $97 million by having a uniform assessment process that would place those with long-term care needs in their most efficient setting and by adjusting the reimbursement system to be in line with other states. As of the end of 2003, fewer than half of the eligible people that could receive community-based services did receive them (a gap of 11,338). If it costs for one year $7.2 million to create 800 more slots, these savings could have paid to wipe out almost the entire backlog.
In other words, the only thing standing between Louisiana providing almost every eligible person with long-term care services, in more appropriate environments, with no reduction in quality, is simply to change these standards noted in the report. And the nursing home industry is doing almost everything it can to prevent his from happening!
What we have to understand is that funding woes in Louisiana health care are not some insoluble dilemma – a problem that will only get worse given the next year $400 million will be yanked from the state’s Medicaid allocation short of an act of mercy by Congress. It just takes the simple will to pass the necessary legislation and the fortitude to stand up to those forces that, out of their own greed, don’t want this to happen. Gov. Kathleen Blanco has said she is going to change this system. This legislative session would be a great time to start.
The arrogance of their trade association, the Louisiana Nursing Home Association, rivals that of Agriculture Secretary Bob Odom. Even though they know they get favorable treatment relative to other states, even though the state is tight on money with so much of it going to health care, they howl when the slightest unfavorable change is threatened to be made.
One need only look at the Legislative Auditor’s April, 2004 report “Medicaid Long-Term Care Options for the Elderly and People With Disabilities: National and Louisiana Statistics” to see how seriously biased the system in Louisiana is towards nursing homes:
Louisiana ranked 1st in the nation in percentage of long-term care Medicaid expenditures used for institutional care in federal fiscal year 2002. Louisiana spent 90.2% of its Medicaid long-term care funds on institutional care.
Louisiana ranked 1st in the nation in the number of Intermediate Care Facilities for the Mentally Retarded (ICF/MRs) per 100,000 people as of June 30, 2002, and 2nd in the nation for per capita expenditures for ICF/MRs in federal fiscal year 2001. Louisiana spent $79.57 per person for ICF/MR care in comparison to $32.00 nationally and $33.95 for the Southern Regional Educational Board (SREB) states.
Louisiana ranked 4th in the nation in per capita expenditures for nursing facilities in federal fiscal year 2001. Louisiana spent $259.43 per person for nursing facility care in comparison to $148.70 nationally and $129.10 for the SREB states. Louisiana also ranked above both the nation and the SREB states in the number of nursing facilities per 100,000 people for calendar year 2002.
They are a fine example of everything that is wrong with government financing of anything, because they have removed themselves from the marketplace, which they cannot manipulate and forces them to provide efficiently and safely, and instead can control government to expropriate wealth from the state while forcing many people into nursing homes who could live with dignity outside of them. This was a point made by the Legislative Auditor’s recent Performance Audit Report in its “Summary of Matters for Legislative Consideration:”
The legislature should consider:
DHH’s plan for equitable funding of a full array of long-term care services
Repealing the Facility Need Review Law or amending it to eliminate problems and allow for open market competition among Medicaid long-term care providers (emphasis mine)
In this report, the auditors found that the state could have saved as much as $97 million by having a uniform assessment process that would place those with long-term care needs in their most efficient setting and by adjusting the reimbursement system to be in line with other states. As of the end of 2003, fewer than half of the eligible people that could receive community-based services did receive them (a gap of 11,338). If it costs for one year $7.2 million to create 800 more slots, these savings could have paid to wipe out almost the entire backlog.
In other words, the only thing standing between Louisiana providing almost every eligible person with long-term care services, in more appropriate environments, with no reduction in quality, is simply to change these standards noted in the report. And the nursing home industry is doing almost everything it can to prevent his from happening!
What we have to understand is that funding woes in Louisiana health care are not some insoluble dilemma – a problem that will only get worse given the next year $400 million will be yanked from the state’s Medicaid allocation short of an act of mercy by Congress. It just takes the simple will to pass the necessary legislation and the fortitude to stand up to those forces that, out of their own greed, don’t want this to happen. Gov. Kathleen Blanco has said she is going to change this system. This legislative session would be a great time to start.
18.4.05
Nursing homes fight to keep their gravy train rolling
How much more whining do we have to hear from Louisiana’s nursing home industry? For years the state budget has treated it so favorably, and it’s hardly been punished for its many problems (the Times-Picayune is running stories starting yesterday about the serious problems in the industry).
Now because the state tries to bring some rationality to its health care cost structure, the industry whines about losing its favored status. This is, of course, an industry worth close to $700 million in revenues a year of which 85 percent of its funds come from taxpayers – payments by government. It’s an industry who has one of its own, state Sen. Joe McPherson, now controlling his chamber’s Health and Welfare Committee as chairman, whose record of partiality to the industry deserves scrutiny, who parrots such a pro-industry, “help us pay our mortgages” attitude it’s sickening.
This is nothing new: it’s an industry that complains every single time any move is made to cut off its gravy train, in 2003, last year, and now – because nothing ever changes. Regardless of how much more efficiency in using and savings of taxpayers dollars in an era of severe pressure on health care spending would occur through restructuring, it keeps crying about how it’s going to be harmed:
Now because the state tries to bring some rationality to its health care cost structure, the industry whines about losing its favored status. This is, of course, an industry worth close to $700 million in revenues a year of which 85 percent of its funds come from taxpayers – payments by government. It’s an industry who has one of its own, state Sen. Joe McPherson, now controlling his chamber’s Health and Welfare Committee as chairman, whose record of partiality to the industry deserves scrutiny, who parrots such a pro-industry, “help us pay our mortgages” attitude it’s sickening.
This is nothing new: it’s an industry that complains every single time any move is made to cut off its gravy train, in 2003, last year, and now – because nothing ever changes. Regardless of how much more efficiency in using and savings of taxpayers dollars in an era of severe pressure on health care spending would occur through restructuring, it keeps crying about how it’s going to be harmed:
17.4.05
Bills want to drive stakes into dollar-sucking policies
As far as statewide policy goes, the number one vampire in Louisiana is Bob Odom. You can have statewide criticism of his notion to build a sugar cane processing plant with state backing without state oversight, you can have a report he helped commission to try to justify it end up showing it’s a bad deal for the state, but he just won’t give up the idea.
Odom said he still believes the project will help farmers in central Louisiana. "It keeps those farmers in business," Odom said, noting that the study says the plant might not be a failure for the first 10 years. "That is 10 years down the road."
So, maybe a dozen or two farmers might not be driven out of business by market forces with this mill, while Odom would make every single person in the state pay an average of almost $20 each to help prop them up with the mill – at least in the first 10 years. Assuming the cost isn’t really $105 million as the consultants say it really will be. Assuming the price of sugar doesn’t go noticeably lower (the likely scenario outlined by our very own LSU) as production and imports slowly rise while demand falls.
So he’s going to keep fighting for it at this Thursday’s meeting of the State Bond Commission. Might as well; it worked for the number one vampire of local policy in the state, Keith Hightower. Despite public opposition to the plan, despite no true feasibility study that would say building a publicly-owned hotel next to Shreveport’s convention center would not lose money, Mayor Hightower is still going after it.
But some wooden stakes may be on the way to help kill these policies that, even with every shred of evidence against their viability, somehow survive to waste huge amounts of taxpayer dollars. HB 232, prefiled the week before last by Rep. Shirley Bowler, aims to rein in Odom’s authority. Basically, it places almost all of the power that a Commissioner of Agriculture could exercise into the hands of the Legislature, provided the people pass it as a constitutional amendment. This would make it easier to counter such abuses of power as we’ve seen from Odom.
Regarding out-of-control Shreveport mayors, two local-area legislators are taking aim at Hightower. Rep. Wayne Waddell’s HB 259 would prevent (except by unanimous vote) the Bond Commission from approving any proposal that was being litigated (presuming that frivolous suits would be recognized as such by the Commission and would garner unanimous approval). It would be too late to stop the issuance of bonds for the hotel project, but perhaps the state will learn from its mistakes.
Sen. Max Malone’s SB 260 is much nearer to the point. It provides no bonds shall be issued, or no construction shall commence on a project for which bonds are issued, until an authority of a municipality having a population of more than two hundred thousand but less than two hundred twenty thousand (take one guess which municipality in Louisiana qualifies under this provision) has received prior approval by the electorate of the participating political subdivision on whose behalf or benefit the bonds will be issued.
The bill’s wording means, if passed, that construction of the hotel effectively would be halted. Normally, I’m not a fan of such specific local legislation, but desperate things become necessary to override a decision that is so at odds with the well-being of the people of Shreveport.
Odom said he still believes the project will help farmers in central Louisiana. "It keeps those farmers in business," Odom said, noting that the study says the plant might not be a failure for the first 10 years. "That is 10 years down the road."
So, maybe a dozen or two farmers might not be driven out of business by market forces with this mill, while Odom would make every single person in the state pay an average of almost $20 each to help prop them up with the mill – at least in the first 10 years. Assuming the cost isn’t really $105 million as the consultants say it really will be. Assuming the price of sugar doesn’t go noticeably lower (the likely scenario outlined by our very own LSU) as production and imports slowly rise while demand falls.
So he’s going to keep fighting for it at this Thursday’s meeting of the State Bond Commission. Might as well; it worked for the number one vampire of local policy in the state, Keith Hightower. Despite public opposition to the plan, despite no true feasibility study that would say building a publicly-owned hotel next to Shreveport’s convention center would not lose money, Mayor Hightower is still going after it.
But some wooden stakes may be on the way to help kill these policies that, even with every shred of evidence against their viability, somehow survive to waste huge amounts of taxpayer dollars. HB 232, prefiled the week before last by Rep. Shirley Bowler, aims to rein in Odom’s authority. Basically, it places almost all of the power that a Commissioner of Agriculture could exercise into the hands of the Legislature, provided the people pass it as a constitutional amendment. This would make it easier to counter such abuses of power as we’ve seen from Odom.
Regarding out-of-control Shreveport mayors, two local-area legislators are taking aim at Hightower. Rep. Wayne Waddell’s HB 259 would prevent (except by unanimous vote) the Bond Commission from approving any proposal that was being litigated (presuming that frivolous suits would be recognized as such by the Commission and would garner unanimous approval). It would be too late to stop the issuance of bonds for the hotel project, but perhaps the state will learn from its mistakes.
Sen. Max Malone’s SB 260 is much nearer to the point. It provides no bonds shall be issued, or no construction shall commence on a project for which bonds are issued, until an authority of a municipality having a population of more than two hundred thousand but less than two hundred twenty thousand (take one guess which municipality in Louisiana qualifies under this provision) has received prior approval by the electorate of the participating political subdivision on whose behalf or benefit the bonds will be issued.
The bill’s wording means, if passed, that construction of the hotel effectively would be halted. Normally, I’m not a fan of such specific local legislation, but desperate things become necessary to override a decision that is so at odds with the well-being of the people of Shreveport.
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