[StBernard] Jindal's Record on McNiece -- The Facts

Westley Annis Westley at da-parish.com
Thu Sep 20 22:10:08 EDT 2007


For Immediate Release
September 20, 2007
"John" Ad Fact Sheet

Boasso for Governor
September 17, 2007
"John" :60 Television

NARRATIVE FACTS

Lynn McNiece: "My brother was in his 50s but he had the mind of a child. And
he had to live in a nursing home. I trusted the state; I trusted the
Department of Health and Hospitals."

Lynn McNiece: "But while he was Director, Bobby Jindal threw my brother out
on the streets and no one bothered to even call me. For two weeks, I just
about went crazy, not knowing where he was. I didn't know if he was dead, if
he was hurt somewhere, I didn't know. I had no way of knowing."

Bobby Jindal was Secretary of the Louisiana Department of Health and
Hospitals. From January 1996 to February 1998, Jindal was Secretary of
Louisiana DHH. (Bio, Bobby P. Jindal, National Bipartisan Commission on the
Future of Medicare)

Plaintiff McNiece was evaluated by independent PASARR screening, which
determined that he needed nursing home care. "As of March 1996, McNiece had
been a nursing home resident for eight years and the services were funded
through the state's Medicaid program. In March 1996, he was evaluated for
admission into a new facility. Part of that evaluation was a Pre-Admission
Screen ("PASARR") conducted through the state's Office of Mental Health. The
PASARR concluded that McNiece needed the level of care provided by a nursing
home." (Civil Action No. 97-2421, United States District Court for the
Eastern District of Louisiana, Filed 4/14/98, Decided 4/15/98)

DHH denied care in separate evaluation. "Subsequently, the Health Standards
Section ("HSS") within DHH's Bureau of Health Services Financing did its own
evaluation for purposes of deciding if the placement should be Medicaid
funded. That evaluation concluded McNiece did not need a nursing home
facility, so funding was denied. McNiece appealed the decision
administratively, and the denial was upheld." (Civil Action No. 97-2421,
United States District Court for the Eastern District of Louisiana, Filed
4/14/98, Decided 4/15/98)

Lynn McNiece: "What he did was so egregious and against the law, the state
rendered a summary judgment."

Court granted summary judgment against Jindal. "The court granted the
applicant's (Mr. McNiece's) motion for summary judgment and denied the
Secretary's motion for summary judgment." (Civil Action No. 97-2421, United
States District Court for the Eastern District of Louisiana, Filed 4/14/98,
Decided 4/15/98)

Court: Law not intended to deny services to those who need them.
"Significantly, while a prime motivation for the PASARR program was to
'eliminate inappropriate placement" of the mentally ill in nursing homes,
the law was not intended to result "in the denial of nursing facility
services to those who, because of their physical or mental conditions, need
them.'" (Civil Action No. 97-2421, United States District Court for the
Eastern District of Louisiana, Filed 4/14/98, Decided 4/15/98)

Court: Review was "protect individuals against erroneous State
determinations." "With that concern in mind, Congress provided appellate
review to 'protect individuals against erroneous State determinations' -
specifically, determinations by the state that the person does not need
nursing home facility services when in fact they do." (Civil Action No.
97-2421, United States District Court for the Eastern District of Louisiana,
Filed 4/14/98, Decided 4/15/98)

Court: Regulation "expressly prohibits" denial of funding. "Most significant
of all, however, is HN3 42 C.F.R. § 483.108 which explicitly describes the
'(r)elationship of PASARR to other Medicaid processes.' (a) PASARR
determinations made by the State mental health or mental retardation
authorities cannot be countermanded by the State Medicaid agency, either in
the claims process or through other utilization control/review processes or
by the State survey and certification agency. Only appeals determinations
made through the system specified in Subpart E of this part may overturn a
PASARR determination made by the State mental health or mental retardation
authorities. It is difficult to imagine a more explicit declaration of
finality or a more direct order to the Medicaid agency to accept the PASARR
evaluation as binding. The regulation expressly prohibits the state's
Medicaid agency from countermanding the PASARR decision, and even
anticipates the various administrative ways the Medicaid agency might try to
do so, all of which are forbidden." (Civil Action No. 97-2421, United States
District Court for the Eastern District of Louisiana, Filed 4/14/98, Decided
4/15/98)

Court: Interpretation of decision as "claims process" or "utilization
control/review" expressly prohibited. "In this instance, the PASARR
evaluation concluded that McNiece required the level of care provided by a
nursing home. The state Medicaid agency determined he did not and declined
funding. Whether this decision is interpreted as a part of the 'claims
process' or a 'utilization control/review,' 3
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Action No. 97-2421, United States District Court for the Eastern District of
Louisiana, Filed 4/14/98, Decided 4/15/98)

Court: DHH's "permissive gloss" on regulations is expressly prohibited.
"Clearly, a PASARR conclusion that nursing home care is required means that
lesser levels of care were considered and rejected. The defendant's (Mr.
Jindal's) permissive gloss on a PASARR evaluation is refuted by the statute
and regulations." (Civil Action No. 97-2421, United States District Court
for the Eastern District of Louisiana, Filed 4/14/98, Decided 4/15/98)

Lynn McNiece: "Bobby Jindal has no heart. He couldn't had a heart to put
people out of nursing homes and cut mental health care for people in this
state that so desperately needed it."

Lynn McNiece: "If I could tell Bobby Jindal anything, I would tell him,
shame on you. Shame on you."

Under Jindal, DHH adopted a new rule that prevented many mentally ill
patients from receiving medication. Jindal's DHH adopted a rule preventing
some non-Medicaid patients for certain prescription drugs. Advocates for the
mental ill stated that Louisiana was not only "denying patients critical
medications, but inviting more serious and expensive problems"( DHH Policy
Blocks Medicine, Group Says, The Advocate, 12/20/96)

State cuts under Jindal hurt facilities for the disabled . In 1997, Jindal
made state funding cuts to private facilities for the disabled, which
providers said would cause some group homes to close. Such private
facilities served about 3,000 mentally retarded and developmentally disabled
clients around the state. Richard Clark, executive director of the Community
and Residential Services Association, said that the $16 million cut was made
to help the state meet a targeted $ 91-million Medicaid reduction
system-wide. Even after the state legislature passed a resolution urging
that rates be held steady for several more months, Jindal and DHH refused to
do so. ( State cuts will hurt homes for disabled, director says, The
Advocate, 7/10/97)

Jindal cut payments to nursing homes. "In another cost-cutting move, state
health officials are moving to reduce the payments nursing homes receive for
the Medicaid patients in their care - a move that is already drawing the ire
of the industry. Department of Health and Hospitals Secretary Bobby Jindal
said Tuesday that various scenarios under discussion would lead to $ 45
million to $ 102 million in annual savings." ( Officials target nursing home
Medicaid funds, The Advocate, 2/14/96)

Jindal, DHH, laid off mental health workers, causing loss of mental health
services. "Jindal said some of the layoffs are coming because of extra costs
that must be absorbed, including pay raises for employees. DHH Deputy
Secretary John LaCour said 124 layoffs are anticipated, including 69 in the
Office of Public Health, 45 in the Office of Mental Health and nine in the
Office of Alcohol and Drug Abuse LaCour said the mental health layoff will
also cause the closure of 20 beds for patient treatment. The layoffs in
the Office of Alcohol and Drug Abuse will cause service cuts to about 1,500
clients." (DHH secretary says state can avert cuts for now , The Advocate,
3/25/97)

Mental health advocate: Budget cut in half under Jindal. "Jindal's severest
critics say he simply isn't keeping his word. Shannon Robshaw, a mental
health advocate, said Jindal has done little to fulfill an oft-stated goal
to move patients out of mental health hospitals and employ more preventive
care and treatment closer to home. Robshaw points out that the mental health
rehabilitation budget was cut in half last year and no increase is
projected. Meanwhile, although policy changes have cut the average length of
hospital stays in half, community-based mental health initiatives have been
slow unfolding, she said." ( In A Year, Medicaid Leaner, Stable; Top Health
Cop Aims At Fraud, Times-Picayune, 3/23/97)

Jindal criticized in letter from Mimi Jackson, President of Louisiana
Alliance for the Mentally Ill. "I just don't know what to make of Gov.
Foster and his Department of Health and Human Services Secretary Bobby
Jindal. They are giving the message to the legislators and the taxpaying
public that to rescind a temporary tax would have an adverse effect on
Louisiana's Medicaid funding; that, indeed, our entire health care system
provided by federal Medicaid funds would be jeopardized if other states see
a reduction in Louisiana's taxes. Concurrently, the governor makes it
abundantly clear that not one penny of any of the temporary tax nor any of
the year's budget surplus would go into the health care system despite the
drastic cuts to programs serving the indigent." ( We Must Not Forget Needs
Of State's Mentally Ill, Letter to the Editor, Times-Picayune, 2/11/97)

Jindal proposed cuts to mental health and other programs, including 185
layoffs. "Later in the day, DHH Secretary Bobby Jindal unveiled 18 changes
in DHH's mental health, public health, substance abuse and developmentally
disabled programs that will result in 185 layoffs - including the 110
employees who work in an adolescent unit at Greenwell Springs which will
close." ( State health agency to lay off 185, The Advocate, 3/6/96)





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