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Charity Hospitals Expand Care Oil and Gas Windfall Raised Funding

Posted on: Monday, 4 July 2005, 21:00 CDT

In April, the state's charity hospitals faced drastic cuts in services. Today, they are expanding healthcare services for the poor and uninsured.

The state budget sitting on the governor's desk, awaiting her signature, marks a big improvement over the original proposal for hospital system funding, said Don Smithburg, LSU hospital system chief.

That original proposal would have triggered some $20 million in cuts across the eight public hospitals run by LSU. For instance, LSU was looking at trimming emergency room care at its public hospitals.

That proposal came in April, when the state was looking at a $400 million hole in its healthcare budget because of the loss of federal monies. In May, the state found it would reap an additional $360 million because of the escalating price of oil and gas.

On that news, lawmakers pumped more money into the hospitals.

The result was that the eight hospitals in LSU's Health Care Services Division got a boost of about $45 million in funding for the new state budget year that began Friday.

"We are able to stave off cuts," said Smithburg.

The new state spending plan also enables the charity hospitals to tap into more federal dollars for patient care, Smithburg said. If the hospitals provide the care, they'll get the reimbursement, he said.

"That could allow us to address some of the long waits for surgery and clinical appointments in our specialty clinics," Smithburg said.

He said top priority will be placed on hiring staff to serve more patients.

"Assuming we get the staffing, we should be able to open up more operating rooms and critical-care beds just to take care of existing demand," he said.

Each hospital will determine the most beneficial use of the extra funds based on guidelines set by system administrators.

At LSU's Earl K. Long Medical Center in Baton Rouge, the top priority would be to increase the hospital's emergency room capacity, EKL medical director Dr. Chapman Lee said.

"Following that would be additional beds in the hospital; following that, surgical services," Lee said.

The hospital had to divert patients to private hospitals in the area because of a lack of emergency room and in-patient bed capacity.

The eight hospitals in LSU's Health Care Services Division had a budget of $872 million during the last fiscal year. In the new fiscal year, the hospitals will have access to $916.2 million.

Hospitals sharing the money are EKL, University Medical Center in Lafayette, Lallie Kemp Medical Center in Independence, Bogalusa Medical Center in Bogalusa, Leonard J. Chabert Medical Center in Houma, Medical Center of Louisiana at New Orleans, Huey P. Long Medical Center in Pineville and W.O. Moss Medical Center in Lake Charles.

Houma-area lawmakers earmarked $200,000 in rural development funds for the Leonard J. Chabert Medical Center. Other legislators use rural development funds for local projects, such as refurbishing softball fields or buying fire equipment.

Houma-Thibodaux area lawmakers said during the session that health care for constituents was a higher priority for them. State Rep. Warren Triche, D-Thibodaux, encouraged other lawmakers to do the same.

No other delegation took him up on the proposal.

The hospital system's budget for the fiscal year that began Friday also contemplates the Medical Center of Louisiana at New Orleans taking over seven medical clinics currently run by the city of New Orleans, said hospital system financial officer Don Elbourne.

The idea is to use the funds the city invests in the clinics to draw additional federal dollars for uninsured care, he said.

Elbourne said the state budget for the hospital system didn't keep up with inflation in the last decade. "We have handled it, but over a 10-year period the services have deteriorated," said Elbourne.

Outpatient services remained stable, but the inpatient hospital capacity suffered, he said.

Smithburg said the hospitals asked the administration and legislators to lift a cap placed annually on the Medicaid dollars available for hospital-care delivery. "That would have put us in the same bucket as privates, which are reimbursed on the patients they see" without regard to a funding cap, he said.

Barring that equal footing, Smithburg said, LSU sought $38 million in additional Medicaid spending authority.

"We were not successful in getting that cap lifted, but our authority was increased by about $25 million. If we generate more than that, the administration and Legislature has to approve providing more funding," he said.

Source: Advocate; Baton Rouge, La.

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