Going to get worse before it gets better

The Lens reports on yesterday's city council criminal justice hearing on cuts to mental health services at the LSU Interim public hospital.

Dr. Roxanne Townsend, chief executive officer of LSU Interim Hospital, told the committee that the hospital has already seen its budget shrink by some $150 million since 2009, down from $955 million to $804 million.

“This is the first time we have had to touch behavioral-health services,” she said. “We do anticipate that there will be an overflow into the emergency room.”

Unfortunately, the emergency room is slated to lose four beds as well.

“These [proposed] cuts are happening to a system that has been on a road to improvement, but it is fragile,” said New Orleans Health Commissioner Dr. Karen DeSalvo.

She cited the “extremely short timeline and somewhat arbitrary nature of the cuts,” and noted that the city does not “have room to absorb these cuts,” given the various and ongoing post-traumatic disorders and social ills that continue to befall New Orleans.

The cuts to LSU dovetail with Governor Jindal's highly questionable medicaid privatization program. Funds that once went to provide these services will now be funneled through private managed care networks.

Jindal critics at the Advocates for Louisiana Public Healthcare maintain that the governor essentially raided $50 million in Medicaid money generated at LSU Interim and gave it to his Department of Health and Hospitals to shore up that department’s $489 million shortfall.

Those critics argue that Jindal has consistently tipped the scales in favor of reimbursing private Medicaid providers over public and charity hospitals such as LSU Interim.

Worse still, at about the same time this hearing was taking place, we learned that Louisiana's share of Medicaid funds is about to be slashed even further as a result of the congressional deal to extend the payroll tax.

The agreement also rolls back a special Medicaid funds deal for Louisiana, which critics decry as a backroom deal to win the vote of centrist Sen. Mary Landrieu (D-LA), and supporters say was necessary to help a state that’s still reeling from Hurricane Katrina. It additionally cuts Medicaid pay bumps for hospitals with a high proportion of uninsured patients.

And so if the overall Medicaid pie is shrinking again, don't be surprised if Jindal seeks to make up the difference for his pet private networks plan by coming back to raid the public hospitals a second time before the budget is passed.