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Disabled, taxpayers to benefit by shifting state focus

While it is well known that Louisiana continues to operate state-owned hospitals that Gov. Bobby Jindal wants to wean out of state responsibility for indigent care through health care reform, perhaps less realized is that the state has a similar arrangement with homes for the developmentally (meaning mentally and physically) disabled. Fundamental reform should come to this area as well, but parochial attitudes of legislators may prevent that from happening.

Unfortunately, for decades the state has had a bias in all areas of health care towards the warehousing of individuals into large institutions, benefitting certain special interests and creating patronage tools for legislators. As the times have changed where technology has allowed solutions to severe health problems that permit more home- and community-based living at a reduced cost, this inertia now needlessly costs taxpayers – Louisiana on a per capita basis has more than double the number of people in developmental centers than the national average and thereby has the fourth most people in such centers out of all the states.

Testimony in front of the House Appropriations Committee’s Subcommittee on Health and Welfare illuminated the fact that the typical resident of the six remaining centers – New Orleans’ basically had to surrender its residents in the wake of the hurricane disasters of 2005 – costs the state $127,000 a year, while the typical participant in the state’s New Opportunities Waiver program which allows individuals to live at home or in a group setting using workers paid for by the state averages only $70,000 annually. The savings actually should be much greater, given that NOW’s participants are at the highest levels of disabilities and almost 20 percent of those currently in the centers are at the lowest levels – those most likely to benefit from home- and community-based care – where estimated costs under NOW are considerably lower. (As the program expands, the estimated cost for new entrants, who would be needing lower levels of care, this year is forecast to be only $44,208 each.)

The experience of the winding down of the New Orleans center was that over half of the residents and their families chose to have residents move into the community. If four of the six centers with residents were phased down at this same rate (the remainder choosing to move into supports and services centers that would remain open in Bossier City and Iota), savings could be over $38 million a year, and this doesn’t include money the state could bank by selling the unused facilities. If then the yearly savings were applied to fund new waiver slots (over 9,000 who have qualified remain on a waiting list, often for over a decade with some dying before ever receiving a waiver), at the predicted cost about 850 could be served.

If some legislators were not moved by the economics of the matter, they should have been by the human costs. Many families who have members in the centers resent being forced, with no options available, to have their loved ones have to live in these places when with some assistance from the state they could care for them at home, or at least in a community setting. Not only does this convey a psychological benefit, another economic benefit is present as well: outside of institutions, some of these disabled will be able to hold down jobs and contribute to the economy.

Some families do prefer having the centers around because they are unable or unwilling to care for their disabled member, and some residents have no family. A growing number of states have no such facilities at all now, instead having created programs that allow for their care in private sector settings, but even if the state did keep operating a couple of facilities the option would be there for state care. Certainly this might mean longer trips for families to visit and it might be initially disruptive for some residents to move. But it is unfair to ask taxpayers to surrender tens of millions of dollars annually extra just for the minor convenience of a few hundred families.

Yet legislators will often use this rhetoric on the issue about how they want to help these residents and their families (keep in mind many would far prefer the waiver solution) to mask their real motivation to continue to support the inefficiency of this system: it permits state money to pour into their districts and creates jobs, both of which assist them in their abilities to get reelected, as well as presents a veneer to some families about how a service (which could just as easily be done in the private sector without any state involvement) is being performed for them, again worth some votes.

It’s the same dynamic as witnessed in the case of the state’s charity hospital system and falls squarely into the state populist tradition of having government provide what can be better provided from other sources in order to attain power and prestige. If legislators prove too inured to this old siren song, hopefully Jindal will not be and will push a plan to move the state out of the disabled housing business and into policy that is more cost effective and overall improves the quality of life for the disabled in Louisiana.


Group puts politics before free inquiry by withdrawal

The initial reaction from the announcement by the Society for Integrative and Comparative Biology that it was cancelling holding its 2011 convention in New Orleans because it objected to a recently-enacted state law that supports academic freedom is that this organization is less interested in that and more interested in politics.

The group holds itself out as “dedicated to promoting the pursuit and public dissemination of important information relating to biology,” but with this announcement by its executive committee that it would shift this meeting to Utah as a result of the Science Education Act one supposes that “biology” should be replaced with “political correctness.” The law allows for supplementary materials to be introduced into science classes to better critically appraise theory, and specifically disallows any material that would promote any religious beliefs.

However, some individuals apparently that are so insecure in their own beliefs and/or who do not value critical thinking in the classroom have taken umbrage at the law and created a fictitious bogeyman surrounding it. Despite the law’s explicit wording, these opponents mistakenly claim it will allow some kind of religious content into instruction. Again, this straw man argument tells us more about them and their negative views on the topic of intellectual inquiry than it represents any realistic appraisal of the situation, for any person who can read and reason can look at the text of the law and figure out its unmistakable meaning.

Thus seems to be the attitude of this executive committee. I would recommend that SICB members, at the next opportunity, vote out such dullards who might well be first class scientists but clearly are second class leaders. It should also make members think twice about their own participation in an organization where political agendas get put ahead of the study of biology by its leaders.

Sure, this temper tantrum will take some sales tax dollars from state and New Orleans coffers but if the state must choose between a commitment to free inquiry versus lucre, waving goodbye to this politicized group is a no-brainer.


Genuine control over LA staffing entails changing policy

Gov. Bobby Jindal’s administration and Louisiana state legislative leaders have said they intend to look closely at the matter of state staffing levels as a means of controlling spending, making changes if necessary to facilitate administrative ability to affect the size of the state’s workforce. Understanding who is responsible for what is necessary even to begin to make the system more controllable.

In the broadest sense, if every single person that gets compensated in some way for some work on behalf of the state that is not a contractor is counted, the December, 2008 number would be over 105,000. Removing workers in the legislative and judicial branches, leaving only those drawing non-contractor compensation from the executive branch, produces a figure of 103,875. (Henceforth, “state employees” will be defined identically to “state executive branch employees.)

But this is not the figure of full-time employees in the state, because it contains employees such as part-timers, student workers, and those who receive only per diem compensation and the like such as those who serve on state boards and commissions. Remove those and combine the part-timers into full-time equivalents and they bring the figure reported by the government agency concerned with state employment, the Department of State Civil Service (the only cabinet department over whom the governor has no direct control that does not elect its members statewide) at the end of the last fiscal year (June 30, 2008) to 93,099 full-time equivalent employees.

However, this figure masks further delineations within it. One is that only 61,411 are in the state’s classified service, which gives greater controls over their hirings (and great protections to prevent firings) than the others that comprise the unclassified service. For example, college faculty are unclassified and decisions about the creation or abolishment of these positions are out of the hands of top budget planners.

Another is that state discretionary money is used for only a portion of these positions. This is why when checking the fiscal year 2008-09 budget documents, only 45,879 are listed as being paid from its general fund. And even this isn’t the actual number because it does not count higher education employees save those that work for one of the state’s four management boards and Board of Regents.

Note a final distinction as well with this figure: the general fund lists not employees, but positions, and with hundreds vacant at any given time the actual figure employed being paid for by state discretionary dollars (that is, not where some kind of revenue dedication over which policy-makers don’t control is forced into paying for filled positions) will be a little below that figure.

Thus, the starting point for figuring out who controls what begins with the governor and Legislature, who through budgetary maneuvers directly can affect the fate of roughly 45,000 current employees. After that, it gets much trickier.

Concerning the unclassified folks, budgetary control is diluted because the institutions make their own decisions about positions and people: the only way the governor and Legislature can shape this is by manipulating the bulk appropriation it makes to each institution. And a large number of state employees come from federal dollars to support various activities such as health, welfare, and education. They come courtesy of grants or matching funds, so it is not entirely the state’s choice. That is, if it wishes to accept funds from the federal government to perform a legal obligation (or mandate from the federal government), it must hire personnel to do it.

Finally, for comparative perspective, the number of FTE employees over the past several years actually has declined by a few hundred since 2004 and those tied to the general fund discretionary spending have declined by about a thousand from the fiscal year 2004-05 budget (these the last figures before the big drop and since then rise from the hurricane disasters of 2005). Relative to the rest of the nation, Louisiana is somewhat overstaffed, ranking just in the top third of states in per capita FTE staffing at 17.45 per thousand (but given health care reforms proposed by Jindal that would distance the state from direct provision of it, given that about a third of state workers are involved in health care these changes could drop Louisiana to about the national average).

So these considerations mean that, in trying to understand how to bring personnel spending under control in Louisiana:

  • Comparisons of the total numbers of all people drawing some remuneration for non-contractor work present a distorted picture in trying to gauge the actual direct control elected policy-makers have over the size of state government in terms of employment; more accurate would be using the FTE and most accurate the budgeted positions numbers, but none give an entirely accurate number of directly controlled positions by policy-makers
  • Greater control by elected policy-makers can be gained if statutes are changed to (1) give them increased control over decisions made in higher education, (2) reduce the size of the state-run health care sector, and (3) removing dedications of state revenues
  • Recent trends suggest a small downward movement in overall state employment (as well as in FTE per capita) even as the latest figures have increased due to state government (especially in the health care area) recovering from the hurricane disasters

    In the latest reporting period (7/1/2007 to 6/30/2008, under half of which time the present Jindal Administration and Legislature controlled), the FTE numbers have increased about 3,000 (almost two-thirds of that an increase in unclassified employees) and apparently much of that due to bringing the state’s health care system back close to its pre-disaster level and fully funding higher education to its recommended level for the first time in a quarter century. Outside of higher education, it largely seems to have involved federal dollars since the budget for general fund positions intended to lop off 1,316 unadjusted for higher education (note: budgeted numbers will be slightly different from what actually happens since the Legislature makes changes to the budget before its passage).

    Thus, the most valid statement regarding recent changes in state personnel levels is that Jindal and the Legislature have achieved a small reduction in the state workforce over which they have the most control. The areas over which they have less control grew more substantially, and there will have to be statutory, perhaps even constitutional changes for them to achieve the same degree of authority over those areas.
  • 16.2.09

    Hypocrite Melancon sabotages Senate chances with vote

    With his affirmative vote for the no government left behind spending package, Rep. Charlie Melancon showed not only that he is a fraudulent hypocrite but that he essentially has given up any realistic chance of claiming a Senate seat in 2010.

    Melancon regularly touts his membership in the “Blue Dog” coalition, now serving as its co-director of communication, meaning his House website hosts the group’s site. The site proclaims the group of Democrats is deeply committed to fiscal stability in national policy, supplies all sorts of news releases concerning the group’s articulated desires for fiscal responsibility, less deficit spending, and the like, and even has a debt calculator on its home page informing that the U.S. national debt is ready to hit $10 trillion and how each member of the public now owes over $30,000 to paying it off.

    Yet as did almost every single member of the caucus, Melancon laid down his principles to vote for the spending package that will increase that debt by 10 percent, tripling this year’s annual deficit. This reveals what Melancon tries to desperately hide, that he is nothing more than a tax-and-spend liberal, by distracting his right-of-center constituency in the Blue Dog rhetoric.

    Either that, or he’s just stupid or ignorant. Melancon attempted to justify his vote by saying, “To do nothing is to assure that the economy will collapse and the recovery period will be extended,” which shows he knows nothing about history involving the Great Depression, where the exact same approach President Barack Obama is taking with the bill made the situation worse and extended economic recovery years beyond what was necessary.

    (To make a bad week worse, Melancon also found time to look like an idiot when he complained about talk show host Rush Limbaugh’s quote “I hope he fails” that referred to Obama’s policy plans. Instead, Melancon mischaracterized the quote out of its context, criticizing Limbaugh for something he didn’t say, that he hoped Obama would fail the country on the economic recovery issue. Which means he needs to give a good talking to whichever staffer monitors Limbaugh’s program for getting that wrong.)

    But more than making a wrong choice for his constituents and his country, Melancon also completed the hat trick by putting himself on the wrong side of this issue if he has any ambitions to challenge Sen. David Vitter for his seat next year. Vitter was one of the leading opponents to the bill in the Senate, and anecdotal evidence is that a solid majority in Louisiana agree with him on that. If 18 months from now, as is likely a result of this bill, the economy is still in recession or worse, Vitter would annihilate him on this issue. Meaning that if a year from now conditions are like this, Melancon may have short-circuited his entire candidacy on this and therefore decide not to run. And it may cast such a pall over him that he may have a hard time fighting off a quality Republican challenger to his current position.

    Melancon, electorally lucky in the past, may have staked his entire political future on this vote. He had better hope his luck continues.


    LA budget reform ideas good, but start reviewing now

    Gov. Bobby Jindal got it right again with his stumping for greater flexibility for policy-makers to adjust Louisiana’s operating budget. But he needs to be even more ambitious in what he asks from the Legislature on this matter.

    Last week, Jindal outlined an agenda regarding this question for legislative consideration this upcoming session. The state faces a large projected deficit but due to the fact that the budget faces 391 different direct appropriations of funds for a particular purpose, it leaves little flexibility and forces reductions largely in the areas of health care and higher education.

    To change this situation, Jindal asked that the Legislature to send forth an amendment to the Constitution to give the governor authority to cut as much as 10 percent from anywhere in the budget (except for the Minimum Foundation Program which funds secondary and elementary education), doubling the current allowed standard that kicks in when the budget is sufficiently in forecasted deficit. He also asked that they change the statute to allow this to be a potential annual occurrence if needed, instead of the present standard of every other year. Finally, he also asked it to set up a mechanism to create sunset review of all dedications of funds every four years.

    These all are excellent (if not new) ideas. Not only would they present more options to deal with crises, but they wisely demand that priorities be reviewed on a regular basis. Still, Jindal can challenge the Legislature to go one step further. Over 90 percent (358) of the dedications are statutory; why not start the review process now in time for this year’s budget? That’s a lot to look through, but the Legislature start by reviewing the largest in dollar and/or the most obviously egregious. For example, what about the law that dedicates gambling proceeds to fund eradication of boll weevils, which for years has vastly exceeded needs and for years permitted former Agriculture Secretary Bob Odom to legally divert these funds for other dubious purposes?

    These bills need to be given high priority and the review process that would be enshrined into new laws should commence now before their passage in order to provide the most flexibility now that it is needed. Jindal should add this last provision to his shopping list for this year’s regular session.