By Bruce Eggler
Staff writer
From musician Dr. John to a half-dozen real doctors,
dozens of New Orleanians turned out Thursday to
proclaim their affection for Charity
Hospital and its longtime
home on Tulane Avenue,
and to urge the City Planning Commission to get involved in efforts to derail
plans for a new state teaching hospital and medical campus across South Claiborne Avenue.
Only a handful of people in a crowd of nearly 200 at the City
Council chamber spoke in favor of plans to build new Louisiana State
University and Veterans
Affairs hospitals in lower Mid-City.
Most speakers endorsed a proposal to gut and renovate the
70-year-old state hospital, which has been closed since Hurricane Katrina.
LSU officials have dismissed that idea and insisted the
only feasible plan is to build a new hospital in the area bounded by
Claiborne, Tulane Avenue, South
Galvez Street and Canal Street.
The VA campus would be built on the other side of Galvez.
Many speakers objected to the planning commission's
calling the event a "public forum" and not a formal hearing on the
grounds that it has no jurisdiction over the state and federal projects and
has nothing on its agenda requiring a vote.
Lawyer Mary Howell said the commission's involvement in
planning $2 billion worth of medical facilities in the heart of the city has
been "minuscule."
William Borah, for years the foremost proponent of the
idea of creating a master plan with the force of law to guide New Orleans'
development, said it's "absolutely inexcusable" that the
consultants writing the plan have not been directed to evaluate the hospital
proposals, dubbing it "a threat to the integrity of the master plan
process."
"We look to you for leadership on this issue,"
Preservation Resource Center Executive Director Patricia Gay told the
commission.
Recovery Director Ed Blakely said the hospital sites were
chosen by the VA and the state, not the city, but he defended the way the
choices were made, saying the process "resulted in numerous safeguards
to protect historic properties."
Pam Perkins, general counsel for the state Division of
Administration, offered a strong defense of the plan to build a new LSU
hospital, saying Charity was threatened with a loss of accreditation before
Katrina because the building was outdated.
Steve McDaniel, an architect at RMJM Hillier who did a
study for the Foundation for Historical Louisiana of how Charity could be
reused, said the result would be "a completely up-to-date,
state-of-the-art hospital" inside Charity's shell.
He said reusing Charity could provide 1 million square
feet of hospital space at least two years sooner and at a construction cost
of $484 million, compared with a $620 million price tag for new construction,
and that tax credits available for reusing a historic building would boost
the savings to $283 million.
Perkins said such cost comparisons are invalid because the
RMJM Hillier plan does not include all the services and functions the new
medical center must provide. She said a true "apples to apples"
comparison would show new construction is actually slightly cheaper -- a
claim that McDaniel denied.
McDaniel said one solution might be to put the VA hospital
on the site now proposed as the LSU campus, with LSU using a renovated
Charity and with the potential to expand if needed into the former VA
hospital.
He said that approach would provide a "consolidated,
sustainable, walkable" medical center much
more like those in other U.S.
cities than the sprawling model envisioned by the VA and LSU planners, and at
a lower price.
One of the few speakers to defend the LSU and VA plans,
developer Pres Kabacoff, offered another idea:
combining the LSU and VA facilities on the campus now planned for the LSU hospital
alone by adding floors and reducing the number of beds in the LSU hospital.
But Kabacoff said that given a choice between only
the current plans and the idea of reusing Charity, he would opt for the
current plans.
Downtown Development District President Kurt Weigle also endorsed the LSU and VA plans, but critics
warned that creating the two new campuses would leave 2.5 million square feet
of empty space in Charity and nearby medical buildings. They said that is the
opposite of what the business district needs.
http://www.nola.com/news/t-p/neworleans/index.ssf?/base/news-10/1243575014153670.xml&coll=1
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by Laura Maggi, The
Times-Picayune
Two Ivy League graduates created fraudulent transcripts
and test scores to gain admittance to the LSU School of Dentistry, according
to a federal indictment that accuses the pair of financial aid fraud.
Anthony Juan Walker, 27, and Obialunamma
Agubuzu, 25, allegedly submitted fake transcripts
from Cornell University to the dental school last
August. They are also accused of creating fake standardized test scores for
themselves, as Agubuzu had never taken the Dental
Admission Test and Walker
had received low scores, according to the indictment.
If convicted, Walker and Agubuzu
both face up to five years in a federal penitentiary and $250,000 fines.
After they gained admission to the dental school, Walker and Agubuzu combined took out $75,000 worth of federally
subsidized loans to pay for their year in school.
The students caught the attention of LSU officials this
spring. In March, a computer consultant in California told the school that a
man who identified himself as Michael Smith, and was later identified as
Walker, had e-mailed asking him to break into an LSU faculty member's
computer account to get test answers, according to a complaint filed earlier
this month in the federal court record by a U.S. Department of Education
investigator.
A month later, Walker
was stopped by LSU police at 3:30 a.m. in a school building, kneeling by the
door of a faculty member's office with a backpack full of burglary tools.
These two incidents prompted Katherine Muslow,
the LSU Health Sciences
Center's senior
counsel, to look at the files of Walker and Agubuzu,
his roommate, according to the complaint.
Both Muslow and Special Agent
Marcus Culpepper found that the Cornell
University transcripts
submitted by the two students didn't match the transcripts provided by
Cornell after the investigation began. The differences were significant:
Their official transcripts did not show the 4.0 grade point average they had
touted to LSU, nor did they show the required science classes that would make
them eligible for dental school.
A November 2008 newsletter produced by the New Orleans
Dental Association, available online, shows both Agubuzu
and Walker listed as members of the 2012 class at the LSU School of
Dentistry. In addition, Agubuzu received a merit
scholarship from the Louisiana Medical Mutual Insurance Company.
In his complaint, Culpepper presented the students as
potential flight risks, noting that the LSU school year ends around May 27
and both have valid passports. Agubuzu's father is
a retired Nigerian ambassador and her parents live in Nigeria, while Walker's
mother lives in Chile,
he wrote.
It is unclear from the federal court record whether Walker is being held in
custody, but a detention hearing for Agubuzu is
scheduled for today.
http://www.nola.com/news/index.ssf/2009/05/lsu_dental_students_accused_of.html
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Shreveport Times | 05.29.09
By Bobbie J. Clark
While several topics were broached at the health care
reform roundtable Thursday, the general consensus was that education,
preventive care and proper reimbursement were the keys to success.
U.S. Reps. Rodney Alexander and John Fleming co-hosted the
event at Christus Schumpert
Sutton Children's Medical
Center.
Participants included Julie Trocchio,
senior director of community benefits and continuing care for the Catholic
Health Association; Peter Maddox, senior vice president of Christus Health; Mike Reitz, president and CEO of Blue
Cross Blue Shield of Louisiana; Willie White, executive director of David
Raines Center; and Dr. Terry Davis, of LSU Health Sciences Center.
Most people involved in the health care debate agree that
the keys to saving costs and having better outcomes are a patient-centered
home, primary care prevention and early diagnosis, said Fleming, who endorses
a private system to achieve those goals.
"We have to take down barriers today to allow
providers to coalesce into competing groups," he said. "We need to
convert patients into consumers so they can make wise choices."
Many panelists agreed that preventive and primary health
care would go a long way to reducing costs and creating a healthier
population.
Reform should ensure adequate reimbursement and incentives
for primary and preventive health care, White said.
Many people, who already have acute symptoms, visit
community health centers, like the David Raines center in Shreveport, White added.
"We see people who "» want to call a doctor when
they are hurt rather than going to an ER when they are in an acute
situation."
Health care costs could be reduced drastically if people
were more aware of indicators like cholesterol levels, blood pressure and
glucose levels, Reitz said.
Another problem many people face that adds to the cost of
health care is being health illiterate.
Terry Davis, a professor of medicine and pediatrics at LSU Health
Sciences Center,
presented a study titled "Health Literacy Is Essential To Healthcare
Reform."
Millions of Americans have trouble reading and understanding
labels on prescriptions and over-the-counter medication, she said.
"Ninety million Americans lack the skills to
understand health information," she said. "This costs us billions,
mostly in increased and unnecessary hospitalization and ER use."
The discussion then turned to reducing the cost of health
care.
Maddox said if a universal health care system is adopted,
then he believes costs would decrease over time.
There will be a spike in costs in the first three to five
years, but they will come down gradually, he added.
Fleming agreed with Maddox, but added that if the system
is run by the government, then costs would go up unless spending limits are
imposed.
Then, the problem becomes the rationing of care.
Wright then asked the panelists to discuss the problem of
senior citizens not being able to find primary care physicians because of
Medicare and Medicaid.
That problem could be solved if primary care physicians
were paid more, Fleming said. Many doctors are under-reimbursed for Medicare
and Medicaid claims, causing many of them to limit the number of patients
they treat under those plans.
The panel then turned its attention to the working poor,
who can't afford private health insurance.
Fleming said there is a "notch" effect happening
at many workplaces, where people are refusing promotions because it would put
them at an income higher than the threshold to qualify for Medicaid.
The answer would be to create a sliding scale where
subsidies would be given depending on income, instead of going from 100
percent covered to nothing at all, he said.
White said the reimbursement structure of Medicaid and
Medicare needs to be more equal.
"Medicaid patients have a significant difficulty in
getting access to health care because the reimbursements to doctors are so
low," he said. "The primary care physicians should not be
penalized."
http://www.shreveporttimes.com/article/20090529/NEWS01/905290322/1060
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Jeremy Alford
Capitol Correspondent
BATON ROUGE — A freshman lawmaker from Lafourche Parish
wants to simultaneously eliminate state jobs through an early-retirement
program and encourage more people to get involved in state government by scaling
back new financial-disclosure requirements.
The House and Governmental Affairs Committee oversaw a
major rewrite of the most-contentious bill and sent it to the full House for
further debate. Advanced by a 9-7 vote, Rep. Dee Richard’s House Bill 49 was
opposed by Gov. Bobby Jindal, who ushered in new
financial-disclosure laws during last year’s first special session.
As originally filed, the legislation sought to exclude
some officials from having to publicly report their spouses’ state retirement
payments in financial-disclosure forms. Richard, a Thibodaux legislator with no party
affiliation, said he wants to loosen the restrictions so more people can
serve on local-level boards and commissions.
“Some people are uncomfortable revealing information that
is only indirectly connected to them,” Richard said. “These are mostly
volunteer positions, and we want more people to step up.”
The latest version of the bill would allow board and
commission members who receive no per-meeting payments or compensation to
file less-detailed forms. Currently, people holding these positions must
report income, conflicts of interest and connections to nonprofits.
Under Richard’s bill, these officials would only be
required to disclose income from the state or gaming interests. Many city
councils and governing authorities that have districts representing fewer
than 5,000 people could likewise be placed in the lower tier.
Camille Conaway, Jindal’s policy
consultant, urged lawmakers not to pass the amended legislation. She said
many officials won’t have to file until next year under the current system
and it’s too early in the process to be making changes.
Richard’s House Bill 513 is pending action on the House
floor. It would create an early-retirement program for members of the
Louisiana State Employees’ Retirement System, known as LASERS.
But as the state faces a $1.3 billion shortfall, the most
relevant piece of Richard’s proposal calls for many of the positions vacated
through the program to be permanently abolished.
The legislation would impact state workers who have
attained age 50 and have at least 10 years of service credit. Those taking
part in the early-retirement program, however, would face a reduction of
benefits.
It would prohibit reestablishing, over a five-year period,
more than 10 percent of the positions that have become vacant. It also
prohibits each branch of government from opening more than one-third of any
positions abolished.
But there are a few
exceptions in the bill for agencies that will be protected from job cuts,
including the LSU Health Science Center in Shrevepor,
E.A. Conway Medical Center in Monroe, Huey P. Long Medical Center in
Pineville and the Department of Public Safety and Corrections.
http://www.dailycomet.com/article/20090528/ARTICLES/905289932?Title=Lawmaker-s-bills-include-jobs-ethics
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By MARSHA SHULER
Advocate Capitol News Bureau
TRAVIS SPRADLING/THE ADVOCATE
Health-care industry representatives outlined how
proposed cuts to the state’s budget would affect private hospitals and other
health-care providers at a State Capitol news conference Thursday. Dionne E.
Viator, of Baton Rouge General Medical Center, at podium, said the cuts could
force burn victims to seek treatment in other states. At left is Paul A. Salles, chief executive officer of Metropolitan
Hospital Council of New
Orleans, and Paul A. Matessino, center,
president of the Louisiana
Hospital Association.
At right rear is Patricia T. Jeter, senior vice president for the Louisiana Hospital Association.
Hospital and ambulance company interests decried Gov.
Bobby Jindal’s proposed budget cuts Thursday,
saying they would hurt health care for Louisiana
residents and trigger employee layoffs detrimental to the state economy.
“This is not the story of the boy who cried wolf,” said
John Matessino, president of the Louisiana Hospital
Association. “This is reality.”
Hospitals are facing $200 million in state budget cuts in
reimbursement for care they deliver to the state’s poor through the Medicaid
health insurance program.
And ambulance companies estimate a $3.6 million reduction
if cuts in Jindal’s $28 billion proposed state
budget for the fiscal year beginning July 1 go unchanged.
The health-care provider groups held a State Capitol news
conference to lay out their plight as the Senate Finance Committee continues
budget hearings.
The budget ax fell heaviest on health care and higher
education as the Jindal administration developed a
plan to finance state government operations with a $1.3 billion decline in
state revenue.
Matessino said the state
continues to expect hospitals to provide services 24-hours-a-day, seven days
a week and to be prepared for hurricanes and swine flu outbreaks. But the
proposed budget does not provide financial stability to do all that, he said.
The health-care industry is the largest employer in Louisiana with a $7.8
billion payroll and more than 250,000 employees, said Paul Salles, chief executive officer of the Metropolitan
Hospital Council of New Orleans.
Salles said the proposed cuts
will lead to the elimination of 3,700 hospital jobs alone across the state.
“This number only includes people related to hospitals, not ambulances,
nursing homes, home health agencies and other health-care providers,” he
said.
“There will be a substantial negative impact on the Louisiana economy,” Salles said.
Salles said hospitals are
already underpaid by $150 million on the health care they deliver today for
Medicaid patients. “The burden leads to high health-care costs for business
and individuals through cost-shifting” as those who have insurance pay more,
he said.
Dionne Viator, senior vice president of Baton Rouge General Medical
Center, said the
health-care cuts would have a $6 million impact on the General. She said
Lafayette General would take a $5 million hit and Christus
Schumpert in Shreveport
get an $8 million reduction.
“It scares me how hospitals will be able to respond and
cope,” Viator said.
Viator said the cuts could impact operations of the
General’s unit that treats burn victims to the point that patients may have
to go to other states for care.
Tyron Picard, executive vice president of Acadian
Ambulance, said the proposed 7 percent reduction proposed for ambulance
services will be “crippling to ambulance operations and ultimately to patient
care.”
Picard said a survey of ambulance companies in 58 out of
64 parishes found that the cut would lead to 110 lost jobs, longer response
times, loss of coverage in some areas, and “ultimately
impact patient care and patient outcomes.”
The cut has a compounding effect because ambulance
companies are already being reimbursed 6 percent below cost for Medicare
patient services, Picard said.
http://www.2theadvocate.com/news/46426392.html
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By Bill Barrow
Capital bureau
BATON ROUGE -- A coalition of medical providers, from
hospitals to ambulance firms, joined political forces Thursday to urge
lawmakers to reverse proposed budget cuts that the alliance said will yield
thousands of layoffs and a decline in patient services.
Led by the Louisiana Hospital Association, the group
implored Gov. Bobby Jindal and lawmakers to ease
the proposed cuts, which will reduce payments to health-care providers for
the services they render to Medicaid patients.
LHA President John Matessino did
not offer specific solutions, though he mentioned the balances of the state's
rainy day fund, the economic development mega-fund and a Medicaid trust fund,
none of which are usual sources for general fund operating expenses.
"There are funds out there" legislators could tap, he said.
Advertisement
State Health Secretary Alan Levine disputed the idea that
Medicaid beneficiaries will lose access to services, though he continues to
lament the long-term challenges facing the state's health-care delivery
system.
The back-and-forth comes as the Senate Finance Committee
mulls the $27.9 billion spending plan for fiscal 2010 that the House passed
earlier this month. The House restored about $130 million in health-care cuts
that Jindal proposed, but that leaves about $375
million in reductions that fall mostly on providers of Medicaid services.
Health care and higher education bear the brunt of cuts in
the downward swings of Louisiana's
budget cycles because they do not enjoy statutory protection
"We can't absorb this magnitude of cuts, not this
time," Matessino said.
Levine said he has tried to mitigate the reductions, and
he cautioned that they pale in comparison to what is ahead when federal
stimulus dollars and other "one-time" revenue sources run out.
He also cited $93 million in temporary financing that is
leveraging about four times that amount in federal money, much of it for
hospitals. But, Matessino said, a large portion of
that is intended to cover previous hurricane losses rather than future
operating expenses.
Paul Salles of the Metropolitan
Hospital Council cited a study that said 70 jobs, $2.8 million in personal
earnings and $7.2 million in overall business transactions would be lost for
every $1 million cut in state Medicaid financing.
Tyron Picard of the Louisiana Ambulance Alliance said a
statewide survey of ambulance providers found that 45 percent of the
responding providers plan layoffs and more than a quarter are likely to
reduce their service area.
The gathering marked the industry's most public effort
this session, in contrast to the frequent pleas from higher education
officials.
"The last thing we want to do is fight with higher
education for money," Matessino said.
"We're not going to do that."
http://www.nola.com/news/t-p/capital/index.ssf?/base/news-7/1243575098153670.xml&coll=1
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By Leslie Williams
Staff writer
The Orleans Parish Hospital Service District has entered
into an agreement that could result in reopening a hospital in eastern New Orleans by the end
of 2011, according to Frederick Young Jr., president of Methodist Health
System Foundation.
Young revealed the deal Thursday night at the State of the
East, an event organized by the New Orleans East Business Association. On May
21, the service district essentially put $2 million down to buy the
long-shuttered Methodist Hospital and other health care centers in eastern New Orleans from
Universal Health Services.
If the purchase goes through, hospital service would
return to an area that has made do with health clinics since Hurricane
Katrina. And it would end 30-minute drives to full-service hospitals.
"The purchase has been committed to by a $2 million
escrow agreement," Young said. "If the purchase is not signed by
the end of June, the service district will lose the $2 million."
The city of New
Orleans lent the money to the Hospital Service
District, he said.
The remaining money needed for the purchase is expected
from Community Development Block Grant funds, about $40 million.
Young expects the facility to be rebuilt by the end of
2011 if all goes well, or by mid-2012 if there are
complications. He said the new facility will be a "bread-and-butter,
acute-care hospital that initially will open with 80 beds."
The deal includes the Pendleton
Memorial Methodist
Hospital main campus on Read
Boulevard as well as the 29-acre Lakeland Medical Pavilion campus at 6000 Bullard Ave.
and the Lake Forest
Ambulatory Surgical
Center at 10545 Lake Forest Blvd.
City officials have been touting the idea of buying those
facilities since 2007, but the parties have not been able to craft an
agreement.
The service district operates like the east and West Jefferson hospital districts, which are
responsible for their own obligations and debts. Each hospital district is
governed by a board of directors.
City Councilwoman Cynthia Willard-Lewis declared that
"the hospital is the No. 1 priority of the community."
The resurrection of the hospital will enable the return of
doctors, nurses and other medical experts to eastern New Orleans, she said.
Another clinic also is on the way for eastern New Orleans.
Willard-Lewis announced Thursday that Mayor Ray Nagin had entered into a verbal agreement to build a $1.1
million, 5,000-square-foot outpatient clinic on Chef Menteur Highway.
http://www.nola.com/news/?/base/news-1/1243575171153670.xml&coll=1
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by Adam Duvernay, The Times-Picayune
Chris
Granger / The Times-Picayune
The Southeast Louisiana chapter of the American Red
Cross operated out of a north shore hotel for two months following Hurricane
Katrina, then in Metairie until its return
to 2640 Canal St.
After almost four years on the move, the American Red
Cross has returned to the heart of New
Orleans to renew its mission of relief and support
for the city.
The organization's Southeast
Louisiana chapter headquarters officially reopened its doors at 2640 Canal St.
Thursday during a ceremony at which the building was renamed for Robert
Merrick, a local businessman and former board chair of the chapter.
"This chapter has come a long, long way, " said Merrick.
"All I did was basically write a check. The
real meaning of the building is the amazing volunteers it houses."
Though Red Cross staff and volunteers have been working
alongside the building's construction since it began in April 2007, Thursday
marked the end of major reconstruction.
"It's a very tangible sign for the city to open our
doors on Canal Street,
especially after those doors saw 5 feet of floodwater,
" said Kay Wilkins, CEO of the chapter.
Damage to the 34,000-square-foot building forced the Red
Cross to evacuate to a north shore hotel for two months following the storm.
The organization then took up residence in Metairie.
While there, the Red Cross continued to work in New Orleans, but
staffers were physically detached from the community they were serving.
After $2.1 million of reconstruction plus more than
$700,000 in upgrades, Wilkins said the facility is better able to serve the
community than ever.
Though the staff has been reduced from pre-Katrina levels
-- from 50 paid staff members to 30, and from 1,700
volunteers to 700 -- Wilkins said the organization is growing.
The renovated facility now supports an emergency
operations center on the second floor: a 24-hour hub for disaster relief
services, with emergency generators and two staff showers.
The Merrick
Building now has four
extra classrooms for first aid, disaster training courses and a
disaster-preparedness store.
"It needed to be in the city,
" Merrick said. "It is the
Southeast Louisiana chapter, but New
Orleans is the hub. This is where the action is, and
this is where they should be."
As one of the country's first chapters, and one that sees
regular need for disaster relief, the local chapter has had an important hand
in teaching other Red Cross chapters about emergency preparedness and
response, said Jerry DeFrancisco, president of
humanitarian services for the Red Cross.
DeFrancisco said the chapter has
been a focus of discussion during the organization's national meetings and,
after Katrina, became one of the areas most nationally recognized as a place
for service.
Ruth Davis, community outreach manager for the chapter and
a Baltimore native, first came to the Gulf Coast
after the storm. After nearly four years here, she calls New Orleans home.
"There was a sense that things weren't done yet, and
the people I worked with felt the same, " Davis said.
Though she came here to work, Davis said she fell in love with the city's
culture.
Davis said the reopening of
the Merrick Building
was a nice change from the Metairie office,
but she didn't have the same emotional connection she saw in her coworkers
who worked there before Katrina.
"To me it's just a new building, but it's been fun
for me to be able to watch them come back to something they knew before, " Davis
said.
The building's dedication came just days before hurricane
season begins, and Red Cross officials sought to use the occasion to
emphasize storm readiness.
"You have to get as excited in Louisiana about emergency preparedness as
we are about out football and our food, " said
retired Gen. Russell Honore, who commanded armed forces
in the city after Katrina and has spent the past year raising money for the
Red Cross.
Honore said such excitement
could only come about through a cultural change in the city, but he added
that people are starting to get it.
"The only way we're going to make that cultural shift
is if we hold each person who hears the message responsible for paying it
forward, " Wilkins added.
http://www.nola.com/news/index.ssf/2009/05/american_red_cross_headquarter.html
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Susan Edwards / Eyewitness News
NEW ORLEANS
– Nathan Frazier helped open a little restaurant in New Orleans East six months
ago to help bring business back to the community. But the progress hasn't
been very pretty.
Video: Watch the Story
"Like everything else out here in the east, it's a
struggle," Frazier said.
By "everything else", Frazier means
still-standing dilapidated buildings, empty lots and shopping malls, and no
healthcare to speak of, nearly four years after the storm.
"Go anywhere else, things are happening, moving. But
come to New Orleans East, it's a halt," he said.
A group that calls itself the New Orleans East Business
Association hoped to change that mindset among New Orleans East residents and
business owners Thursday night by making announcements they say will be the
turning point for the community.
The New Orleans Regional Business Partners says it's in
talks with three to four major firms that "could create 800-900
jobs" if they locate to New Orleans East.
Another announcement: re-development of the old Methodist Hospital, which many residents say is
most critical to bringing the community back. It is estimated the new
hospital will be open and operating at the end of 2011,
or no later than mid-2012.
The acute-care hospital would open initially with 80 beds,
and funded with a mix of capital outlay funds, community development block
grant funds, FEMA hazard mitigation funds and debt funds.
With hundreds of residents searching for hope, and hoping
for change, each had their own take on the future of the east.
"I was very impressed with the fact they didn't bring
smoke and mirrors, but projections and a source of funding to get hospital
started," said resident and business owner Vincent Sylvain.
Others sat and listened in disappointment, worried that
there was little confirmation of such projects and plans, and too much
uncertainty ahead.
"If my son gets sick in the middle of the night, I
can't go three blocks. I have to drive to Tulane or Ochsner
or another hospital. There's no place to spend money on a mall, or go to a
movie," said Loretta Harrison, who lives in New Orleans East. " We knew it would take time but not this long."
http://www.wwltv.com/topstories/stories/wwl052809cbnoeast.279c100e.html
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Tommy Stryjewski
I have a question for Rep. Kevin Pearson, R-Slidell, and
the other representatives who supported HB687, the bill to ban the practice
of dentistry at schools: Where is Louisiana
going to be in 20 years?
Are we heading toward improvement? Are our people going to
be healthier and better educated?
Some people in government think that raising taxes on
gasoline is good for the environment because it is believed that people will
drive less. But the reality in fact is that people are still going to have to
get up in the morning for work, and because there is no public
transportation, they’ll pay whatever ridiculous price the gas costs, and the
health of the environment is going to be just as bad as when we started.
I haven’t spoken to the parents of these children, so I
don’t know why they are not being taken to the dentist. Maybe the parents are
broke. Maybe they’re too busy working multiple jobs. Maybe they’re just bad
parents and are lazy. But I am certain that if we ban dentists from schools,
things will just revert to as they were before, and the kids who weren’t
getting care in the first place will just continue to not get any.
To argue that this bill would prevent bad dental care is
laughable and a lie.
For one thing, it is cost-saving to society (and the
state’s Medicaid budget) to give preventive care. Secondly, it has been
well-documented in the medical literature that outcomes and quality are
consistently excellent in these kinds of “mobile clinics.” But that’s not
what this debate is really about, is it?
As a Baton Rouge native,
Catholic High and LSU alumnus, I hope to return to Louisiana one day to establish my own
medical career. But there is nothing more disheartening and discouraging than
hearing about such arrogance and insensitivity. It is an embarrassment and a
scandal that this bill was even introduced.
Tommy Stryjewski
Harvard medical student
Brighton,
Mass.
http://www.2theadvocate.com/opinion/46423657.html
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The Associated Press
(AP) — BATON ROUGE, La.
- A ban on mobile dental clinics in schools is stalled in the House, even
after lawmakers stripped parts of the bill and grandfathered in many of the
existing clinics.
The sponsor of the bill, Rep. Kevin Pearson, pulled it
from a vote Thursday after lawmakers continued to register complaints. The
bill already had failed passage once in the House.
House Speaker Jim Tucker, a co-sponsor, says the bill will
be reworked, likely to direct the Louisiana State Board of Dentistry to come
up with new regulations for the clinics.
Supporters of a ban say it is unsanitary and unsafe to
drill on children's teeth in school gyms, libraries and cafeterias. Opponents
say the mobile clinics bring care to poor children who otherwise would never
see a dentist, and they say no problems have been reported.
http://www.nola.com/newsflash/index.ssf?/base/national-20/1243562464117230.xml&storylist=louisiana
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Katie Moore / Eyewitness News
BATON ROUGE, La. – Just
this week, revenue estimates put Louisiana
$30 million deeper in the hole for next year's state budget. That means even
more cuts lawmakers will have to make.
Video: Watch the Story
It's why hundreds of people converged on the state capitol
on Thursday to beg the Senate to soften the blow to health care and higher education.
Political analysts say it's the first time in two decades
that Louisiana
has faced such drastic budget cuts – a 180 degree turn from last year's
massive budget surplus.
Now health care and higher education are desperate to stop
the bleeding from their state programs before the cuts even start, and
Thursday was their last chance to make their case to state lawmakers before
the end of the session.
There are new proposals working their way through the
state Senate that would restore some of the funding to higher education,
plans that the governor has threatened to veto, but now says he's
considering. Those big revenue debates are likely to heat up next week.
It started with hundreds of Louisianans with special needs
on the state capitol steps, urging the state Senate to stop the cuts to
health care programs they benefit from. It continued inside, where the real
action is: the Senate Finance Committee, which is changing the House's
version of the state budget.
Mental health advocates from New Orleans begged to keep one of the few
inpatient facilities in the city open.
"It completely eliminates the few
number of beds throughout the new orleans
area,” said Cecile Tebo, a New Orleans mental health advocate.
Health care is facing a $375 million dollar budget cut
next year – that's after the House restored $130 million from the governor's
proposal.
"Students will go where they're wanted. Students in Louisiana need to know
they're wanted,” said Allison Reynolds, a Louisiana Tech student.
Dr. Bruce Chaloux with the
Southern Regional Education Board said the cuts “will set us back a
decade."
And representatives from other southeastern states were
there as well to beg the Senate to restore some of the $219 million in cuts
higher education is facing. Some said the cuts are greater in Louisiana than they
are in bordering states.
The deep cuts would mean massive restructuring of Louisiana's
universities, so the higher education commissioner, Sally Clausen, asked to
restore some funds this year to give them time to plan more restructuring to
handle the cuts.
"You have to have the regents, the Board of Regents
study that change for a year,” Clausen said. “We’ve begun that process
already. But the immediate plan is right here. It’s
cuts that we were able to make in a hurry. They’re not necessarily the wisest
decisions, but they are the decisions that get us to a point where we have
been asked to get to.”
"For those of us who have been around a long time,
this is a familiar sight,” said Clancy DuBos, an
Eyewitness News political analyst. “It was like this all the time before
citizens passed the Stelly Plan. Once the Stelly Plan kicked in in ‘03,
the budget grew every year and so did the revenues. Now the legislature has
rolled back Stelly, the budget continues to grow,
but the revenues aren't growing. And when you combine that with oil prices
being down..."
DuBos said it's a double whammy
that the state hasn't seen in decades – the reason hundreds packed the
capitol to make their last pitch to the Senate Finance Committee before the
budget bill makes it to the floor for a final vote.
http://www.wwltv.com/topstories/stories/wwl052809cblxgrcuts.272c5233.html
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Advocate Opinion page staff
For the rank-and-file worker in state government, two
things have come along at one time, and the combination is disturbing.
One of them is the push by the state House to mandate
significant reductions in the state work force. The House-passed budget,
characteristically, orders someone else — the commissioner of administration
— to cut more than 2,000 state jobs. The budget also does away with “merit”
raises that are received annually by almost every state employee eligible for
them.
At the same time, legislators are urging change in Civil
Service. Among the proposals is doing away with the “bumping” privilege that
allows senior employees to take the jobs of junior staff in the event of layoffs.
Among the outcries: We’re going back to the days of the
deduct box!
The deduct box, as Louisianians
know, was Huey P. Long’s system of raking a percentage of state employees’
pay into his political coffers. The deduct box is symbolic of a return to
what the textbooks call the spoils system, with state political leaders
hiring and firing because of political connections.
All involved in this discussion should calm down. There
are tough issues here, but not ones that require a return to the evils of the
1930s in state government.
If anything, the idea of Civil Service reform draws upon
the contrast between today’s functions of government and those of the 1930s
or other eras before computers and the professionalization of the state work
force.
Many state workers are in hospitals or other direct
service-delivery types of jobs. Another whole cadre of workers, many of them
in Baton Rouge,
is in offices, working on computers and dealing with issues as credentialed
professionals, from lawyers to accountants to scientists and skilled
technicians.
Over time, the latter class is going to grow. There will
be more, and more highly paid, professionals and fewer people sorting forms
and stamping documents.
There’s a good argument — advanced by
Rep. Mike Danahay, D-Sulphur,
and Gov. Bobby Jindal among others — that a
Civil Service system with 1,400 job classifications is a relic that does not
reflect the realities of the work force, nor does it give the state the
flexibility to manage a new-technology work force.
As Danahay is among the first to
say, the Civil Service Commission has made significant strides in improving
the system. Still, more can be done.
A goal of reducing to 700 or so job classifications
doesn’t seem unreasonable. Nor is a hard look at bumping privileges and
linking “merit“ pay raises to realistic assessments
of employees’ performance.
The proposal by House Speaker Jim Tucker, R-Terrytown, for significant cuts in the state payroll has
caused alarm among state workers, but there again a thoughtful approach to
the state’s work force needs is forced upon the state because of declining
revenue.
We agree with Tucker in principle that state government is
“feather-bedded,” to use the old term for a bloated payroll. But staff
reductions have to be made carefully, and they require significant
investments in information technology. Simply spreading the cuts around —
basically, the current plan in the state budget — has a different effect from
targeting cuts to eliminate agencies that don’t perform or are obsolete.
Further, the reductions ought to be made with some
sensitivity to the fears of workers that politics, and not merit, will rule.
Tucker and Jindal could become the leading force
for unionization in the state government, if bumping privileges go away and
workers decide to organize rather than face a grievance process alone.
By and large, as Tucker also is among the first to say,
state employees are typically well-motivated and perform well. They also
understand state budget crises, and the serious impact of the recession on
state revenue.
Their concerns about change ought to be taken into
account. But we don’t see much in what Jindal and
others have proposed that is so radical that employees ought to drag out the
torches and pitchforks quite yet.
http://www.2theadvocate.com/opinion/46423837.html
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The New York Times | 05.28.09
By PAULINE W. CHEN, M.D.
Dana
Neely/Getty Images
I’ve spent a lot of time over the last few years thinking,
writing and speaking about end-of-life care, but this issue recently became
quite personal for me. My mother-in-law died two weeks ago.
A ringer in her youth for Donna Reed, with Rita Hayworth
legs, my mother-in-law possessed a dazzling memory and a designer’s flair,
and she loved to surround herself with family and friends (“where the action
is,” she used to say). She spent most of her 86 years following her husband
across the country, teaching art in the schools where he taught. But wherever
they landed, she managed always to make new friends. Lots of friends. When
one of her sons passed away, she and my father-in-law received more than six
hundred letters of condolence.
But by the time my mother-in-law died 14 days ago, her
social circle had shrunk considerably. She had been battling rheumatoid
arthritis for almost 50 years, a series of debilitating strokes for 10, and
the ulcers on her legs that would not heal would, in the final year of her
life, necessitate an above-the-knee amputation. Over the last few months,
unable to hold a pen to write and too weak to speak into a phone, my
mother-in-law saw her social life whither away. Her once expansive world was
reduced to the square footage accessible by wheelchair and amenable to the
trappings of all the medical equipment she needed.
In the days since her death, I have often thought about
the many conversations my mother-in-law and the family had with the doctors
and nurses about the dying process. There was the initial discussion over two
months ago that she was likely to die soon and would benefit from hospice,
and then there were also the many daily conversations about her comfort,
about what she wanted and what she did not.
While I have become over the last few years a voice in the
movement to improve end-of-life care in this country, these kinds of
conversations with patients and their families still hit hard. As a close
friend of mine once said, “One of the scariest things in the world is to look
someone in the eye and tell them they are dying.” But in my practice I do try
to tell patients they are dying because I believe in my heart that it is
worse when clinicians don’t.
Nonetheless, every doctor comes to these conversations
with some anxiety. It is hard not to feel as if you have failed your patients
and their families, to wonder if taking out an inch more of bowel when
removing the colon cancer, starting with a different antibiotic, or ordering
a different diagnostic test might have somehow changed the course of events.
And then there is the conversation itself. “Death” and
“dying” are words that can echo in a room long after they are said. Hopes can
be shattered in an instant. Patients and families may feel abandoned.
It is hard as a doctor not to wonder: Am I doing more harm
than good?
One particular study came back to me during these last few
weeks, a study that attempted to answer just this question. Published last
fall in The Journal of the American Medical Association, the study examined
how end-of-life care discussions with terminal patients affected their
quality of life and that of their caregivers.
Over the course of almost six years, Professor Holly Prigerson, director of the Center for Psycho-oncology and
Palliative Care Research at the Dana-Farber Cancer Institute in Boston, and her
colleagues interviewed more than 300 terminal patients, asking them if their
doctors had ever discussed care at the end of life. After these patients
died, the investigators analyzed the type of medical care received prior to
death, then interviewed the patients’ caregivers six months later to assess
how they were adjusting to their loss.
What Dr. Prigerson and her
co-investigators found was that those patients who had had discussions with
their physicians were more likely to have better quality of life at the end
of their lives. These patients were not more depressed or more worried as a
result of these discussions, and they tended to receive less aggressive
medical care and earlier hospice referrals. Moreover, their caregivers fared
better and suffered from significantly less depression six months after the
patient’s death than caregivers whose loved ones had received more aggressive
care.
I spoke to the lead author of the study and one of the
investigators, Dr. Alexi Wright, a medical oncologist at Dana-Farber.
“There is almost an assumption a priori that these
end-of-life discussions will cause harm, so doctors are afraid to have them,”
Dr. Wright said. “Patients then fail to realize that their time is limited,
and they don’t make the kind of choices they would if they did know.”
I asked Dr. Wright if telling patients that they were
dying might take away hope. “In trying to emphasize only the positive, we can
end up with a misguided sense of hope,” Dr. Wright responded. “I think it’s
really important to define hope more broadly. Hope is in the life we live, in
our families. When I meet patients with incurable cancer, I hope they live as
long as they can and with the best quality of life they can have. But I know
from the outset that they will die from their disease, so hope is helping
them to live as long as and the best that they can.”
Dr. Wright also emphasized the need to have several
discussions about end-of-life care choices. “These conversations are not a one
shot deal, but often need to happen repeatedly, as patient preferences about
end-of-life care change and their disease states can change,” she explained.
“It’s possible, too, that a patient might be in denial or may not be ready to
hear such news and wouldn’t remember a discussion. But at the end of the day
what’s important is what the patient remembers ”
Individuals can differ markedly in the amount of
information they want to know, and conversations should be tailored
accordingly. “About 20 percent of patients don’t want to know prognostic
information,” Dr. Wright said. “But if patients have feelings about the kind
of care they want, they should bring it up with their physicians. You want to
be treated by a physician who you feel really understands and respects your
values.”
That sense of understanding can have a cascading benefit
for survivors. “As doctors we tend to focus on the patient, the person
sitting before us. We need to think about the legacy of our treatments and
the potential to help families cope with inevitable loss.”
The loss of my mother-in-law hangs heavy in our house.
There are moments when my husband is silent and I know that he, like me, is
thinking about her life and her last days.
Those last days were not always perfect. There was the
clinician whose well-meaning but overly enthusiastic pronouncements that my
mother-in-law was “actively dying” left all of us more exasperated than
comforted. And she suffered for a few days from a side effect of morphine.
But in the end, the ongoing discussion and interactions with the doctors and
nurses about her desires and her dislikes gave my mother-in-law not only
comfort but also a sense of still being part of the conversation, part of
“the action,” part of life.
And those discussions also gave my husband and his sister
opportunities. They sat with their mother and read to her. They fed her when
she was hungry and put cool towels to her face when she was hot. My
sister-in-law even organized one last social event, a “Spring Fling,” for her
mother. The children, grandchildren and two great-grandchildren from across
the country filled the room with the kind of lively conversation and laughter
my mother-in-law had always loved.
I remember that she glowed that day. Her cheeks, once
pale, were flushed pink, and her voice, usually barely audible, rang clear.
She smiled, she laughed and she kissed all of us as we leaned over her bed.
After all the festivities had come to an end, my husband
and sister-in-law left the room to escort everyone out. I saw my
mother-in-law look up toward the sky after they left, opening her mouth as if
to speak. I walked closer and heard her say softly to herself,
“I am so happy.”
Join the discussion on the Well blog, “Redefining Hope at
Life’s End.
http://www.nytimes.com/2009/05/28/health/28chen.html?_r=1&ref=health
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The New York Times | 05.28.09
By NICHOLAS WADE
People have a deep desire to communicate with animals, as
is evident from the way they converse with their dogs, enjoy myths about
talking animals or devote lifetimes to teaching chimpanzees how to speak. A
delicate, if tiny, step has now been taken toward the real thing: the
creation of a mouse with a human gene for language.
The gene, FOXP2, was identified in 1998 as the cause of a
subtle speech defect in a large London
family, half of whose members have difficulties with articulation and
grammar. All those affected inherited a disrupted version of the gene from
one parent. FOXP2 quickly attracted the attention of evolutionary biologists
because other animals also possess the gene, and the human version differs
significantly in its DNA sequence from those of mice and chimpanzees, just as
might be expected for a gene sculpted by natural selection to play an
important role in language.
Researchers at the Max Planck Institute for Evolutionary
Anthropology in Leipzig, Germany, have now genetically
engineered a strain of mice whose FOXP2 gene has been swapped out for the
human version. Svante Paabo,
in whose laboratory the mouse was engineered, promised several years ago that
when the project was completed, “We will speak to the mouse.” He did not
promise that the mouse would say anything in reply, doubtless because a great
many genes must have undergone evolutionary change to endow people with the
faculty of language, and the new mouse was gaining only one of them. So it is
perhaps surprising that possession of the human version of FOXP2 does in fact
change the sounds that mice use to communicate with other mice, as well as
other aspects of brain function.
That is the result reported in the current issue of the
journal Cell by Wolfgang Enard, also of the Leipzig institute, and a
large team of German researchers who studied 300 features of the humanized
mice. FOXP2, a gene whose protein product switches on other genes, is
important during the embryo’s development and plays an active part in
constructing many tissues, including the lungs, stomach and brain. The gene
is so vital that mice in which both copies of the gene are disrupted die
after a few weeks.
Despite the mammalian body’s dependence on having its two
FOXP2 genes work just right, Dr. Enard’s team found
that the human version of FOXP2 seemed to substitute perfectly for the mouse
version in all the mouse’s tissues except for the brain.
In a region of the brain called the basal ganglia, known
in people to be involved in language, the humanized mice grew nerve cells
that had a more complex structure. Baby mice utter ultrasonic whistles when
removed from their mothers. The humanized baby mice, when isolated, made
whistles that had a slightly lower pitch, among other differences, Dr. Enard says. Dr. Enard argues
that putting significant human genes into mice is the only feasible way of
exploring the essential differences between people and chimps, our closest
living relatives.
There are about 20 million DNA differences between the
genomes of humans and chimps, but most make no physical difference. To
understand which DNA changes are important, the genes must be put into
another species. There is no good way of genetically engineering chimps, even
it were ethically acceptable, so the mouse is the
test of choice, in Dr. Enard’s view.
Dr. Joseph Buxbaum, an expert on
the molecular basis of psychiatric disease at Mount Sinai Medical
Center, said Dr. Enard’s team had taken a good first step toward
understanding the role of FOXP2 in the development of the brain. “The most
surprising finding, and cause for great optimism, is that the gene does seem
to have a great effect on pathways of neural development in mice,” he said.
Dr. Gary Marcus, who studies language acquisition at New York University, said the study showed lots
of small effects from the human FOXP2, which fit with the view that FOXP2
plays a vital role in language, probably with many other genes that remain to
be discovered. “People shouldn’t think of this as the one language gene but
as part of a broader cascade of genes,” he said. “It would have been truly
spectacular if they had wound up with a talking mouse.”
http://www.nytimes.com/2009/05/29/science/29mouse.html?ref=science
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