[StBernard] St. Bernard hospital money granted aka the Fix is in

[Westley Annis]

2 competing plans causing divisions 

Sunday, April 20, 2008

By Paul Rioux

St. Bernard Parish's quest to build a hospital got a major boost this week
when the Parish Council allocated up to $25 million in state redevelopment
grants for the project. But the financing comes with restrictions that
highlight deepening divisions over how large the hospital should be and who
will run it. 

In approving a resolution proposed by Parish President Craig Taffaro, the
council voted unanimously Tuesday night to limit the funding to a hospital
that could be built debt-free. 

That criterion fits just one of the competing proposals from two nonprofit
health care organizations: Ochsner Health System's offer to build a 20-bed
hospital at a cost of about $20 million, which would be covered by the grant
money. 

The other proposal from the Franciscan Mission of Our Lady Health System,
based in Baton Rouge, is for a $78 million, 60-bed hospital and medical
office building that would require more than $50 million in loans. 

While Taffaro has not explicitly endorsed the Ochsner proposal, he said the
cash-strapped parish cannot afford to be weighed down by debt as it
struggles to recover from Hurricane Katrina. 

Dr. Patrick Quinlan, Ochsner's chief executive officer, said health-care
providers in southeast Louisiana face brutal post-Katrina market conditions,
noting that hospitals in the region collectively lost $135 million in 2007. 

"It appears that the bigger you are, the more you lose in this market,"
Quinlan said Wednesday in a presentation to the St. Bernard Parish Hospital
Service District board. "We believe a 20-bed hospital is a prudent starting
point that we can make work, even though we know it's still going to be a
stretch." 

But some board members, who will ultimately decide which proposal to pursue,
said building a small hospital also carries risks. 

Dr. Bryan Bertucci, who serves on the board and is the parish's coroner,
said a 20-bed hospital won't be large enough to meet the demand and lacks
the symbolic impact to encourage former residents to return. He also
questioned the council's requirement that the hospital project be debt-free
to be eligible for the grant money. 

"If we're not willing to take a chance and invest in ourselves, then shame
on us," he said. 

Board member Dr. Paul Verrette said the parish would not be liable under the
Franciscans' proposal if the hospital defaulted on loans guaranteed by the
U.S. Department of Agriculture. He also dismissed a 20-bed hospital as a
"quick fix" that would be inadequate from day one. 

Quinlan emphasized that the hospital would be designed so that it could be
expanded by adding wings. 

Both proposals call for the hospital to be built on 20 acres in Chalmette
provided by the Arlene and Joseph Meraux Charitable Foundation, which has
endorsed the Ochsner plan. 

St. Bernard's lone hospital before Katrina -- the privately owned Chalmette
Medical Center -- flooded during the hurricane and has been bulldozed.
Medical care is available in a clinic run by the Franciscan Mission in a
network of trailers in a Chalmette parking lot, but parish officials have
long cited the lack of a hospital as the greatest roadblock to St. Bernard's
recovery. 

At Taffaro's urging, the council voted to allocate up to $25 million for the
hospital project from $91 million in community development block grants
awarded to St. Bernard Parish by the Louisiana Recovery Authority. 

Members of the hospital board said they didn't know about the financing
until it was included in a revised proposal Ochsner presented Wednesday
night. 

"I'm tickled pink that this money is available, but I'm disappointed that
I'm just finding out about it now," Chairman Daniel Dysart said. 

Dr. Redfield Bryan, a retired urologist and consultant for the Franciscans,
said that removing the debt-free requirement and applying the $25 million
grant to the Franciscans' proposal would greatly reduce the loan amount and,
hence, the risk. 

"The entire game has changed overnight," he said. "We have been scratching
and clawing and doing everything we could to find money for a hospital." 

The Franciscans worked with local legislators to secure $17 million in state
financing and a rural-health designation for St. Bernard that vastly
increases reimbursement for treating Medicaid and uninsured patients. 

While acknowledging board members face a weighty issue, Taffaro urged them
to press forward with a decision soon. 

"We need to keep in mind that we have had zero hospital beds since Katrina
and we will have zero beds for at least another two years while the new
hospital is being built," he said. 

+++++++++++++++++++++++++++++++++++++++

How long has this hospital board been constituted?  If the overriding
concern is the financial issue as Craig has stated, i.e. being on the hook
financially for whatever, then why did not someone, the Board or the
Council, investigate any *other* community hospitals to see how they have
fared financially, especially since rural designated hospitals are eligible
for higher medicare/medicaid reimbursements as the article stated.  No, it
appears the council merely voted yea en masse like the little herd of sheep
they apparently are, for a resolution thrown at them by the Prez.  





Out of curiosity, I wonder what the hospital associations or the Feds
recommend for bed size for a hospital serving an area of approx 30,000
residents?  Did the hospital board or the Prez bother to research this
before the Prez issued a de facto resolution for the Council to adopt?  From
reading the article and from what Craig has stated before I can see his
primary concern was financial obligations that might be incurred by the
parish.  That's fine and good.  But here's a thought...a 20 bed hospital,
assuming semi-private rooms, equals to a 10 patient- room hospital.  Will
that be sufficient?  If it's not Ochsner says they'll add on wings.  If it
takes 2 years to build a hospital, how long will it take to build add'l
wings?  If the bed count is insufficient from the beginning, will Ochsner
(now the apparent hospital choice) then farm out patients to ALL of their
facilities?  I doubt there will be a guarantee that if the local hospital is
full you'll go to Jefferson Hwy.  They will, in all likelihood, send
patients to *any* of their facilities, i.e. the Westbank, Elmwood, Kenner or
the main campus.



(sigh)  When Craig was *part* of the Council he used to preach here about
the fiscal authority the Council had; that the Prez could propose but the
Council disposed due to the power of the purse that the Council had.  It
seems that  difference is lost on the Prez now or else he has a good herd of
sheep he can dictate to.  Further, were there any public comment periods
prior to this resolution being adopted?  Did the Council even feel the need
to let the residents have any comments about it? 



It is truly a shame that the opinions of the physicians on the Board could
not be taken into account.  After all, it's only their profession.  What do
they know?  And btw, if Ochsner is chosen (and how can they not be since the
resolution was tailored to them?) I would not be the least surprised if OLOL
decides to pull out of the "clinic".  Why shouldn't they?  The Fix is in and
they didn't *win*.



#7409Z