Ochsner, TGMC save Chabert from demise

Continued hemorrhaging of jobs and services at the only hospital in Louisiana’s Charity system serving the Tri-parish region has been clamped, officials announced Monday.

But so far they have offered few specifics on precisely how the Ochsner Health System, a private entity, and Terrebonne General Medical Center, a publicly-owned hospital, will manage the state-owned Leonard J. Chabert Medical Center, which until the announcement was a step away from life support.

Ochsner and TGMC have announced a tentative $12 million arrangement that will involve payouts over the next year from those institutions.

“The partner hospitals will lease the public hospital properties,” Louisiana Department of Health and Hospitals Secretary Bruce Greenstein said at a hastily-called news conference in the lobby of Chabert. “The hospitals and the clinics. This maintains the LSU hospitals as safety nets for their regions.”

Louisiana’s Medicaid reimbursement rates were cut in July, Greenstein said, to the lowest rate in 25 years. That meant the Charity system was on the ropes, with few choices but the huge cuts that were mandated by the LSU system’s governing board.

They ordered a cut of 245 jobs at Chabert and $14.3 million cut from its budget.

If the proposed cuts had not been halted, then three of Chabert’s six operating rooms would have been closed. The dental clinic would have been reduced by 30 percent. Inpatient and emergency would have been halved. Departments slated for closure included dermatology, neurology, ophthalmology, orthopedic services, outpatient lab and pharmacy, physical therapy, research and women’s health.

In March the hospital eliminated $2.9 million from its budget, closed its labor and delivery department and reduced its workforce by approximately 100 people. In July the hospital was hit with another order for cuts totaling more than $3.7 million.

The LSU system operates the hospital under a contract with DHH. Residents – physicians who are still learning – were working at Chabert through Ochsner. But LSU sought to move those residents to other hospitals in the state system.

LSU executive vice president Frank Opelka said Chabert will receive $2.5 million from TGMC and Ochsner when an initial memorandum of understanding is executed between them and LSU. A payment of $1.3 million will be forked over when a cooperative endeavor agreement is signed. Enactment of agreements will see a $1.3 million payout. Another $3 million is expected to come from Terrebonne and Lafourche.

Those payments, Opelka said, are what will keep the currently proposed cuts from occurring.

“You always have to have as consideration the natural relationship that pre-exists and that is Ochsner,” said state Sen. Norby Chabert (D-Houma), for whose father the Houma hospital is named. It was Sen. Leonard J. Chabert who pushed hard for the Tri-parish region to be part of Louisiana’s charity hospital system in the first place.

As he spoke of the hospital’s importance Monday, Chabert’s eyes glistened and tears ran down his cheeks.

“Since day one, this hospital has had to fight for its existence,” Chabert said, before offering thanks to Parish President Charlotte Randolph of Lafourche and Michel Claudet of Terrebonne.

“And down here that’s what we do. Charlotte and Michel exemplify what we do down here. When you are in trouble, you don’t ask for help, you help yourself, and without their immediate intervention, had they not stepped up we would not be here today.”

Chabert recalled a conversation earlier in the day with a disabled man who is a former Chabert hospital employee.

“We talked about this facility and how important it is and how much care that the people who work here give to the people who have no other place to go,” the senator said. “Because if you are poor and sick, you are still sick and somebody has to take care of you.”

There was strong evidence that local representatives had a desire for the Ochsner solution, before Monday’s announcement.

”It would be a very complicated deal,” Chabert said. “Anyone you partner with would have to be sure it is feasible and viable.”

“Ochsner I think is the direction we certainly have to go in,” said Rep. Joe Harrison (R-Napoleonville) “We are concerned with the state’s intrusion into our interns. We are in dire need of medical professionals … Ochsner? Absolutely. They are a financially sound institution, they run excellent facilities. A private-public partnership is the best thing that could happen to us. I want to get Chabert out of the LSU system. We allowed the medical community to run hospitals with little experience on the business side. Our whole delegation has been actively involved in it. We have counted on Sen. Chabert’s guidance on this and he is into it up to his eyeballs.”

A factor that some health care professionals say complicates the state’s hospital issues is Gov. Bobby Jindal’s refusal thus far for the state to opt-in on elements of the federal government’s Affordable Care Act, and in particular Louisiana’s stance thus far on Medicaid expansion, which it opposes.

Fewer health care options at Chabert could mean a spill-over to hospitals like Thibodaux Regional Medical Center and Terrebonne General. Those hospitals are already struggling with high rates of what they call “uncompensated care,” bills that cannot be paid by patients who currently do not qualify for Medicare or Medicaid but must nonetheless be treated when they show up.

U.S. Sen. Mary Landrieu (D-La.) wrote to Jindal last week urging him to change his stand on the Medicaid expansion and Louisiana’s acceptance of the Affordable Care Act.

“I know from your many speeches across the nation during the recent Presidential campaign your steadfast opposition to the Affordable Care Act. However, the election is over,” Landrieu’s letter states. “The ACA is the law of the land and it has been upheld by the United States Supreme Court. You have so far chosen to forgo the chance to address one of the most pressing issues of our time by rejecting these three opportunities. If you do not agree with the Medicaid expansion as proposed, or the insurance exchanges, or the Essential Health Benefits package, what specific ideas for addressing the serious problem of the 895,000 uninsured in our state, the thousands of businesses that have been priced out of our current market, and the downward spiral of hospitals, rural and urban alike, that are losing revenue?”

Jindal’s staff was contacted Friday for comment but did not respond.

Terrebonne Parish has offered to inject $1 million into the ailing hospital and Lafourche Parish government is considering a similar move.

Claudet noted the Chabert facility plays an important role for Terrebonne, in addition to overall care of residents, by treating and examining inmates from the parish jail.

”I have e-mailed the state asking a number of things,” Claudet said. “Particularly I wanted to make certain if any deals occurred that they continue to take care of prisoner health care which is a major thing for us because we get it done at Chabert. What I am hoping for is that the institution remains viable in some form, where it continues to service our community and the people retain jobs.”

Phyllis Peoples, executive director of TGMC, said she is not certain what specific role her hospital will play as of yet. TGMC board members met at noon Monday to discuss the matter, although Peoples said she is aware that is their decision to aid Chabert in any way possible.

State Senator Norby Chabert addresses the crowd at the Leonard J. Chabert Medical Center, Ochsner Health System and Terrebonne General Medical Center partnerhip announcement. Ochsner and TGMC have announced a tentative $12 million arrangement that will involve payouts after the LSU Health Care System Board of Supervisors ordered a $14.3 milion cut from Chabert’s budget.

CLAUDETTE OLIVIER TRI-PARISH TIMES