Search This Blog


LRA must challenge Legislature on hospital funding

Politics and principle collided when a Louisiana Legislature committee decided to change the funding decision of the Louisiana Recovery Authority in reference to building a new Louisiana State University hospital in New Orleans. Ostensibly, in tandem with an adjoining U.S. Department of Veterans Affairs hospital, it would replace “Big Charity.”

The political part comes in that the Joint Legislative Committee on the Budget decided to release $300 million rather than the $74 million recommended by the LRA. The lower amount would only have provided enough for planning the facility while the full amount can start in its building. There is some concern that the Legislature may wish to commit these funds to a hospital based upon its use as an indigent care facility, as its damaged predecessor structure has been in the past, as opposed to primarily a medical education facility.

The importance in distinction lies in that, with much federal government encouragement on the positive side, the state is deciding whether to scrap its outdated charity model, which herds uninsured people into a few locations run by the state, instead of the more efficient money-follows-the-person indigent health care model followed by the rest of the nation which allows for non-public sector providers primarily to provide care, giving clients more choice and producing better outcomes.

The more money the more quickly the state gets, the more likely the state will build the larger facility to keep it wedded to the old, inferior model because the releasing of the other $226 million was dependent upon production of a plan by LSU (who would run it) on how it would operate in the post-disaster environment. Presumably, the LRA would release the funds if the plan gravitated in the direction of the new paradigm, as some members of it indicate they favor. Or not, but LSU has shown a distinct aversion to a smaller facility, no doubt as larger means more power and money.

However, even if it will not impact the quality of health care in Louisiana, the principle part may be the more interesting issue here. The statute creating the LRA gives the panel only the ability to “review and approve” (after the governor does the same, and before the rest of the Legislature if the expense is over $10 million) decisions made by the LRA – in other words, the legal interpretation indicates that the governor, committee, and Legislature has only a veto power, not a power to amend, LRA decisions.

While some members of the body argue that is not what they thought the law they passed to set it all up meant, that is the way it reads. Among its options, the LRA could sue, and this should be done regardless of how the polling for the measure among the entire Legislature goes (legally it must conduct a mail ballot when not in session). If the Legislature truly meant it could adjust LRA plans as it pleases, during the next session it needs to amend the law to state this explicitly and not just take matters extralegally into its own hands as it has in this case.

No comments: