- Associated Press - Sunday, May 15, 2016

BATON ROUGE, La. (AP) - While the House steered more dollars to Louisiana’s safety net hospitals, health care services remain short of the financing needed in next year’s budget to keep from shuttering services and threatening medical training, state senators were told Sunday.

The Senate Finance Committee was digging into the health care details of a nearly $26 billion budget proposal passed by their House colleagues a few days earlier for the financial year that begins July 1.

Louisiana’s health secretary said programs for people who are elderly and disabled would close. Leaders of the LSU medical schools in New Orleans and Shreveport said they’re training programs face damaging reductions. And operators of the safety net health hospitals that care for the poor and uninsured disagreed with assertions that they are fully funded.

Lawmakers are grappling with a $600 million shortfall for next year. Although Gov. John Bel Edwards wants to hold a special session on taxes in June, the Legislature is expected to pass a budget proposal before that session begins.



Health and Hospitals Secretary Rebekah Gee said “critical services, life-saving services” aren’t funded in the budget proposal. She said four Medicaid programs that help the elderly and people with developmental disabilities stay at home and out of more costly institutions like nursing homes would be eliminated.

The health department is limited in which Medicaid programs are discretionary under federal regulations and can be cut. In addition, the House budget prohibits cuts to rural hospitals and other health care programs, further restricting flexibility.

But if the department eliminates the programs for people who are elderly or disabled, “we run the risk of ending up in front of a federal judge,” said Jeff Reynolds, chief financial officer of the health department.

Gee also said her agency would have to cut restaurant inspections by half, along with other public health programs.



Leaders of the LSU medical schools in New Orleans and Shreveport said they’re slated to take a combined $50 million cut that could shutter programs and damage training programs. Larry Hollier, chancellor of the LSU Health Sciences Center-New Orleans, said he’d have to “start taking out programs” like dental hygiene and undergraduate nursing.

Plus, the medical school officials said they face further hits if the safety net hospitals and clinics where they train students take reductions and scale back patient care. But the Edwards administration and the safety net hospitals disagree over the financing needed to keep the facilities on track.

Hospital representatives said they’re about $150 million short to continue all services. Gee said the House-approved budget covers hospital costs, calling the financing “reasonable.”

“I’m scratching my head as to why we’ve spent so much time on that particular issue,” she said.



At issue is the estimate of hospital savings from the planned expansion of Louisiana’s Medicaid program and its enhanced federal financing rates. The hospitals say the savings estimate used by the administration is too high.

Tyron Picard, a lobbyist representing the hospitals, said the contracts that privatized the safety net care once provided by LSU has “zero profit built in.” Hospital leaders said they may have to ration care or rethink their deals with the state if they don’t get more than the $1.1 billion in financing proposed.

Finance Committee Chairman Eric LaFleur called it “absolutely ridiculous” to suggest the hospitals don’t make money off their contracts with the state.

“I don’t think anybody on this committee believes any of the testimony coming out of your mouths in that regard,” said LaFleur, D-Ville Platte. “There’s an economic benefit from it - come on.”



The budget hearing began with questions about $100 million the House proposed to cut across agencies by taking a more than 3 percent slice of the department’s fees for services and other dedicated sources of revenue to instead help shore up the TOPS college tuition program.

Senate President John Alario, R-Westwego, worried those cuts would too heavily hit the agriculture department, transportation projects, the state police and the legislative auditor. Senators also raised concerns the money wouldn’t meet the legal criteria for spending on ongoing programs.

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