- Associated Press - Wednesday, November 29, 2017

Recent editorials from Louisiana newspapers:

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Nov. 29

NOLA.com/The Times-Picayune on nursing homes in Louisiana:

Louisiana’s spending on nursing homes is clearly off kilter. Nursing homes are getting more and more Medicaid funding from the state even though the number of Medicaid patients essentially hasn’t changed, according to a new report from the legislative auditor.

This is not a small increase. Nursing home reimbursement rates increased by 54 percent between 2006 and 2016, even though occupancy rates grew by less than 1 percent, the audit found.

The increased investment has not resulted in better conditions at nursing homes, according to the auditor.

“Even with the increasing payments to nursing facilities, Louisiana continues to rank poorly in regards to quality of care. According to AARP’s 2017 long-term care scorecard, Louisiana ranks 49th for residents with pressure sores, 50th for the percent of residents who are hospitalized, and 51st for residents who are receiving antipsychotic medications,” the audit said.

AARP ranked Louisiana 40th overall for how it provides long-term care based on affordability and access, choice of provider and other measures. The worst ratings came in quality of life and quality of care (50th) and what AARP calls “effective transitions” (51st), which includes hospitalization rates and percentage of people who move back to their community.

The group, which advocates for improved services for senior citizens, also said Louisiana needs to do more to provide support for family caregivers to allow people to stay in their homes.

Louisiana’s political leaders have actually pushed in the opposite direction, and voters went along with them.

Legislators put a constitutional amendment on the ballot in 2014 to set a minimum state reimbursement for nursing homes, intermediate care facilities and pharmacies. It was a bad idea to put a specific rate in the Constitution because it limits the Legislature’s flexibility to balance the budget and provide for overall health care needs. But the measure passed.

Some elderly Louisianians need nursing home care. But there are others who could remain independent with a little support for their family or other caregivers, and lawmakers should provide funding for those services as well.

The audit outlined a number of changes the Department of Health should make, but it will take changes in state law to make some of them happen. For instance, the way Louisiana law requires DHH to calculate nursing home rates and rental values for facilities increases costs substantially, the audit said. Other states use only Medicaid patients to come up with the Medicaid rate, but Louisiana includes private and Medicare patients. If Louisiana used only Medicaid patients to figure the rate, it could have saved about $19.7 million in 2016, according to the audit.

A 2005 audit made the same suggestion about changing the way nursing home rates are set, and the department agreed. But it never happened.

Reducing the minimum percentage used to calculate rental values for a nursing home would save $57 million per year, the latest audit said. Health department officials agreed with this recommendation but said they don’t currently have the power to make the change. Lawmakers ought to give them that authority.

The Department of Health also doesn’t get full audits done on all nursing homes every year, so some reimbursement rates could be inaccurate, the audit found. Also, there are no penalties in place for nursing homes with repeated problems found by auditors. The state also should do more to identify improper payments to nursing homes.

And auditors said the state doesn’t ensure that spend as much Medicaid funding as the federal government requires on patient care. That could explain why the care isn’t rated better.

Historically, legislators have made sure that their buddies in the nursing home industry get a big slice of the state’s health care budget. But lawmakers are looking for ways to make up $1 billion deficit in 2018. This would be a good time to make that the state isn’t overpaying for nursing home care.

Online: http://www.nola.com/

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Nov. 26

The Advocate on finding a better way to draw electoral districts:

A grassroots group, Fair Districts Louisiana, is helping to host a conference at LSU in January on the problem of politically gerrymandered district lines for Congress, the Legislature and other bodies.

We need ideas for a better process.

In Louisiana, as in most other states, the Legislature determines the electoral districts for congressional, state House and state Senate seats. The maps have prompted lawsuits in several states, amid growing criticism that political parties are using legislative control to give themselves unfair advantages.

The U.S. Supreme Court is considering a case challenging the way Wisconsin Republicans drew districts that could lead to changes across the country.

Whether the court finds for or against the Wisconsin result, our state should join more progressive states who have tried to limit the politics of remapping districts.

The Public Affairs Research Council pushed reforms on this issue in a 2010 report before the last national Census.

The approach of the 2020 Census makes it imperative that PAR’s unheeded call last time should be on the agenda in Louisiana: “Although modern redistricting has been made more objective through the use of consultants and redistricting software, bodies responsible for redistricting still have great power to affect the types of people who can be elected by crafting districts that favor some more than others. It is imperative that redistricting be entrusted to those who are not directly affected by its outcomes and that the process be well controlled to limit the freedom that line drawers are given.”

Some states have independent commissions to draw the lines, with legislators adopting them in up-or-down votes; others may set guidelines to ensure nonpolitical lines but leave the process in the staff or in political bodies.

What we should not have, as Stephen Kearny, a founder of Fair Districts Louisiana is a process in which politicians choose their constituents instead of the other way around. “No matter how virtuous our politicians are, the conflict of interest in being able to choose your own voters in itself provokes bad behavior,” Kearny recently told the Press Club of Baton Rouge.

The LSU discussions hosted by the Reilly Center for Media and Public Affairs Jan. 19. We welcome those discussions and hope that a specific plan can emerge around which reformers can rally.

Politics in Louisiana is “the sport of kings,” Huey P. Long is said to have exulted. But like Long and others after him, political leaders have forgotten that the game is about the people and not about them.

Online: http://www.theadvocate.com/

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Nov. 24

Lake Charles American Press on buying damaged cars:

Louisiana Insurance Commissioner Jim Donelon recently advised consumers in the used car market to beware of flood damaged cars.

“Louisiana has been through enough floods to know that the aftermath can bring out scammers and people looking to take advantage of unsuspecting victims,” Donelon said. “Protecting yourself and your finances from vehicles that have been flooded or otherwise damaged beyond repair is important enough that consumers should be willing to walk away from deals that can’t be researched.”

He noted that under Louisiana state law, if a vehicle has been declared a total loss because it has flooded, it cannot be resold.

Any vehicle whose power train, computer or electrical system has been damaged by flooding is a total loss under Louisiana law. The law has an exemption for antique vehicles.

Consumers can check out a vehicle’s history with the National Motor Vehicle Title Information System. This system is designed to prevent concealment of flood damage and help consumers research a vehicle’s history.

A list of approved vehicle history report providers can be found on the NMVTIS website at https://www.vehiclehistory.gov/nmvtis_vehiclehistory.html

However, many car owners don’t carry comprehensive auto coverage that covers flood damage, so those vehicle histories may not reflect that they had water damage. Taking extra precautions can save you time and money when buying a used vehicle.

The Louisiana Department of Insurance also offers the following tips:

-Check the vehicle for hidden damage.

-Do your own inspection. Take time to inspect the vehicle yourself or arrange for it to be looked at by a mechanic you trust before purchasing.

-Know the signs of flood damage. Check for water damage to the carpet and remove the spare tire to inspect the area for water damage. Look for rust or corrosion on wires and other components under the hood and check under the dashboard for mud or moisture. You should be suspicious if the carpet smells damp and of mildew.

“Buyer beware,” or “caveat emptor” in Latin, is still wise advice for all consumers, but especially important after a widespread flood with thousands of damaged vehicles still around.

Online: www.americanpress.com

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