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Draining nursing home fund money its best use for now

It should not have been unexpected that Louisiana would intensify its draining of the Medicaid Trust Fund for the Elderly after voters unwisely further cordoned off funds on behalf of a special interest. That response assuredly was the correct one.

At the turn of the millennium, the Fund was created by the state at the prodding of the federal government to deposit $500 million of federal Medicaid money as part of an agreement closing out a loophole a number of states had enjoyed that multiplied their receipts, but Louisiana more than any other by routing so much Medicaid bucks through the charity hospital system. Although backers claimed the principal should not be touched, the law clearly allows that any of it can be used to support funding paid to nursing homes, while the interest earnings from the principal essentially could be used for any purpose.

Last year, that latter possibility got removed through a constitution amendment, making this an even sweeter deal for nursing homes, which long have been favored by state policy despite their increasing inefficiency in care relative to home- and community-based solutions. Until the time the fund was created, policy deliberately favored them that created a situation where the typical nursing home in the state received over 80 percent of its revenue for Medicaid and among all of them the state had the nation’s highest per capita state payments to nursing homes with the lowest rate of bed occupancy.


Transformative Jindal hopes for better national reception

In the slow days after a regular legislative session has ended, complete with the governor’s chance to veto bills and line items and when it has become apparent there won’t be an unprecedented veto session, during this period of sparse political news in recent years it’s become fashionable for observers, looking for something to discuss, to assess the states of Louisiana and Gov. Bobby Jindal. With his relatively high national profile, there’s always something banging around in his political life that can provide fodder for commentary.

Thus we get an excursion into his national political health, on the assumption that he covets substantial elective office of some kind at that level; specifically, the nexus of how his state governance translates into future ambitions. From legislators who work with him and a pollster, we learn that his popularity has dipped into negative territory because reform is wearing people out and that he needs more engagement in order to succeed more with a reform agenda. Further, this engagement must be at a more personal and visceral and less nuanced level. Until he behaves this way, it is averred, he cannot create state policy-making success that pays dividends at the national level.

All of this is true, yet most of it is irrelevant to understand the state’s current policy-making environment that shapes and constrains Jindal. The clue comes from the notion of “reform fatigue,” because this reveals the motive force behind much of his policy-making and the reaction to it. Simply put, that is this: Jindal’s gubernatorial career has consisted of a radical and entirely necessary transformation of the state’s political culture that started behind the scenes and now has burst into full view that has challenged allies and enemies alike, and he’s paying for it at the state level.


Dueling voucher pieces shows opponents' desperation

I doubt it was planned, but what turned into a New Orleans Times-Picayune version of point/counterpoint on the issue of school vouchers illustrates well the poverty of the case against their use in Louisiana’s provision of education and in a way desperate enough to be telling that the real goal is distraction from the main issue.

Almost simultaneously published on site were a column wondering whether the several million of dollars that went into this year’s program was spent wisely and another concluding the initial indications showed the program’s administration was off to a good start. The program allows students who otherwise would attend a poorly-performing school to have the state pay for their tuition to attend a qualifying private or public school, at a level below what taxpayers would have to give to the public school that would have been attended.

The negative piece, written by former reporter and political shill for various elected Democrats, and current journalism school director Bob Mann, concentrated mainly on the one school where auditors discovered misuse of funds, and more generally charged that “education ‘reforms’ appear to be as shoddy and deceitful as the product” produced by that school, on the basis of that and that the large majority of audited schools did not keep records in a way that definitively allowed for determination that money used had proper accounting controls and was for educational expenditures. Throughout, rhetorical tricks were used in place of logical analysis to try to make these points, supplemented by the ignoring of any context at all.


Glover must relent, not hold out until last dog hung

Like fleas on a mutt, the dog park issue for Shreveport just won’t go away. (From now on, this author promises instead of inflicting a groaner every time this issue gets discussed, he’ll simply write, “Insert clever phrase about politics and dogs here.”) Throughout, the tide of political ramifications continues to turn against Mayor Cedric Glover.

Many moons ago (whether barked at; sorry, last time as well for deliberate use of phrases associated with dogs), proponents of using $280,000 given by the Red River Waterway Commission to build a dog park on the Shreveport river front brought in courts to intervene successfully in the matter. The RRWC has the authority to fund projects of this nature with its separate taxpayer dollars as long as they enhance the environment proximate to the river. The problem was they didn’t have the land to do it, and therefore would have to have the city agree upon putting it on city land, in particular in Hamel Park.

The City Council was quite receptive to the idea, but not Glover. In a thinly-disguised power play in order to extract money from the RRWC to pay for projects Glover valued, and had asked it to fund, but that the city could not afford as it tries to survive a strained budget that has been the hallmark of Glover’s administration, he said he wouldn’t sign unless they added the others. The RRWC stuck to its guns in stating it would fund only this project a long-standing request for many years to them by citizens who organized themselves as the Shreveport Dog Park Alliance, and only river front items.


Economic wisdom shown by refinancing proceeds now

While half-wise isn’t as good as totally wise, it’s much better than stupid, although certain pundits and politicians would have you believe otherwise.

That’s how to judge the reaction to the Gov. Bobby Jindal Administration’s completion of refinancing of debt tied to the massive tobacco settlement of 15 years ago. The state took money upfront from it for the majority of the value of the annuity in exchange for periodic payments to the lenders, backed by the annuity payments. At the beginning of the year, the Administration started the refinancing process to lower those payments to take advantage of very low interest rates.

When completed, the state saved about $83 million. But had the timing been just a bit better, with the sale having come perhaps a month earlier, it could have reaped another $59 million as rates went up in the interim. This has brought criticism from some predictable sources trying to use this as a tool for political gain, both using the same flawed argument.