Why are several key figures saying that rebuilding a healthcare facility inside the existing Charity Hospital is "off the table"?

It's bunk. Charity is definitely not off the table. If anything, going back into Charity is now more likely than it has been for several years.  Why?  Because state and federal officials - though clearly not Mayor Landrieu - finally see that Fred Cerise's"self-supporting" UMC as proposed is entirely unsustainable and will saddle taxpayers with debt and subsidy costs for decades.  The mirage of inevitable "progress" in the Lower Mid-City site is fading.  And the Mayor knows it.  That's why he's holding a press conference on the UMC AND in support of the biomedical district - code for BioDistrict New Orleans/GNOBEDD - at 3 p.m. today at City Hall.  

The Mayor is also probably getting really nervous because the continued push for the New Orleans East hospital means that the bed count in the metro region will only increase, further reducing the overall need for hospital beds.  Listen to this excellent interview with State Treasurer John Kennedy on WWL with Garland Robinette.

He makes the Mayor's prouncement yesterday that any talk of going back into Charity is "bad"...look rather ridiculous and out of touch.  There's no reason it's off the table other than the Mayor's declaration that it is so.  Governor Jindal and other attendees at the Monday meeting in the state capitol indicated that all options need to be reviewed, that Kaufman-Hall should study all possible options.

But then you have the head of the UMC Board, Bobby Yarborough, saying Tuesday that going back into Charity is off the table.

Treasurer Kennedy has it right: all options MUST be on the table right now if we're going to avoid a boondoggle. That means the Kennedy/Vitter/Tucker plan and the FHL Charity plan, along with any other plans.

Here are the details on the press conference at City Hall today - go and tell the Mayor that Charity Hospital is not off the table.

Today, a resolution that requires the full Lousiana legislature to approve the business and plan and financing for the proposed UMC passed the House Appropriations Committee on a 12-11 vote.

Whew.  Score one for public oversight and accountability.  Given the lack of a business plan, the lack of over $400 million in financing, and the lack of a clear site, the UMC project is definitely in need of additional oversight.  And the legislature needs to exercise a higher degree of control over this project right now as laid out in House Concurrent Resolution 59 because better alternatives exist and they need to be fully explored.  Taxpayers shouldn't simply be stuck with a boondoggle because inertia demands it.

The measure now heads to the full House itself, as far as we can tell.  Tell your State Representatives to support this resolution!  It's crucial to ensuring that the UMC project is done right.

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Here's another interesting development from today: the trio of Senator David Vitter, Treasurer John Kennedy, and House Speaker Jim Tucker met with Governor Bobby Jindal, Secretary Greenstein, UMC Chair Bobby Yarborough, UMC board members, and Mayor Landrieu to discuss the UMC alternative proposed by the trio last week.

According to the Vitter press release that went out this afternoon, "“The discussion today in the governor’s office and the concrete outcome it led to were extremely productive. The governor is writing the full University Medical Center board and asking them to look at all options and possibilities – including other existing assets, partners and potential partners, ways to independently and efficiently manage the new facility, etc. – with the help of appropriate experts like Kaufman Hall. This is meant to empower the board to do its job independently and not rubber-stamp any LSU plan."

Interesting.  Take a look at that language: "look at all options and possibilities - including other existing assets"...so, reading the tea leaves, does that mean that the powers that be are considering the existing Charity Hospital building, which the state owns, and the multiple attendant buildings in its complex?  And the former VA Hospital building and its complex?  If not, it should.

Contact any person listed above and tell them: "REBUILD INSIDE CHARITY HOSPITAL!"

Here's why:

- It's less expensive than building new in the UMC Footprint; a retrofit for a modern facility in the existing limestone shell could be accomplished with the money the state already has onhand.

- It would take less time than continuing the death march through lawsuits, expropriations, and demolitions in the UMC Footprint.  If this was really about getting healthcare back online in New Orleans, we would have retrofitted Charity starting several years ago...and the full new hospital would have been back online for several years by now.

- The Kennedy-Tucker-Vitter alternate UMC proposal incorporates a 250-bed rebuild of a health facility inside of the existing Charity building as a priority.

The situation surrounding the UMC is as fluid as ever.  Help influence the outcome in a positive manner.  Start contacting state, city, and federal officials today to keep them on the right track.

Senator David Vitter, House Speaker Jim Tucker, Treasurer John Kennedy and state leaders sent a letter today - Thursday - June 9, 2011 -  to Governor Bobby Jindal envisioning an $800 million alternative for the new UMC Academic Medical Center that includes the potential of reconstituting a healthcare facility in the existing Charity Hospital shell.  [Read attached letter for details]

The much more fiscally responsible plan could entail using Charity Hospital as one of the entities that would make up the new University Medical Center.  Senator Vitter has been very vocal as of late in regards to his concerns that the 424 bed hospital proposed by LSU and the State is unsustainable over the long term.  Treasurer Kennedy, too, has long been a critic of the project, especially it's lack of a business plan.

Vitter's and Kennedy's concerns are supported by a report that was presented to the UMC Board at their last meting that was written by Kaufman-Hall - an independent and well-respected financial consulting firm out of Illinois who specialize in health care and who were hired by the UMC board to do the number crunching for the UMC's long awaited - and much needed - business plan. 

Kaufman-Hall - taking into consideration new factors and variables presented by LSU when they asked Kaufman-Hall to revise their report after they found the first draft that was leaked back in April - (not to their taste) -  estimated that the new Academic Medical Center, at best, could only support between 330-403 beds.  SaveCharityHospital.com reported on that presentation on June 4, 2011.

 In the new proposal presented today by Senator Vitter and other Republican lawmakers, in addition to the possibility of reusing the existing Charity Hospital building for a smaller hospital, is to make use of a Jefferson Parish hospital as well as buying a share of Tulane University's New Orleans Hospital.  The three combined would comprise the University Medical Center.

At a price of only $800 million dollars, the University Medical Center Management Corporation [UMCMC] would not only be able to afford the new hospital with the funds in hand, but it would also be able to employ the best construction materials, equipment, contractors and marketing firms that are necessary to attract the best doctors and medical staff in the world.

Two big things happened in the past week.

First, the City Council voted to revoke the public rights of way in the UMC Footprint.

Second, as if that move in and of itself wasn't reckless enough at this point, the Kaufman-Hall report on the feasibilty of the UMC was presented to the UMC Board.  AFTER the City Council voted to revoke.

Credit must be given to Kaufman-Hall for its presentation.  We did not see the "doctored" (pun intended) version of the financial feasibility report that we anticipated.  Instead, the numbers appeared to be rather independent and objective.

Why?  The report revealed what has been said for some time now: the 424-bed design is excessive when looking at patient projections for the coming years.  The UMC Hospital should be smaller - needing somewhere between 330-403 beds.  Gee, isn't it great that we've arrived at that revelation now that the 37-acre site, which was excessive for even the terrible 424-bed suburban design, has been largely destroyed through expropriation and demolition?  Isn't it great that we now see that there's additional uncertainty about what will actually be built (if anything) AFTER the city council has already cowed itself before the juvenile rage of an angry, red-faced, table-pounding Jerry Jones...and whimpered in submission as it gave up its last bit of leverage over this project.  They aided and abetted the fait accompli - so did the Mayor's office, which was pushing very hard to make this happen.

Several other interesting things emerged.  The Kaufman-Hall presentation revealed that the annual state subsidy for the UMC will likely be around $100 million - up from a present figure at about $20 million.  That shouldn't be a problem at all.  You know, the State of Louisiana is just flush with cash right now.  It certainly wouldn't contemplate cutting $800 million in healthcare spending around the state at other facilities.  I'm sure Representative Fannin will just waltz along with this and pony up the dough, a smile on his face.  Importantly, policy changes could skew the estimate.  Under one scenario presented by Kaufman-Hall, if certain reimbursement policies change in a certain way, the annual required state subsidy for operations could be as much as - gasp - $147 million (see page 42).  There's also the $300 million ramp up funding that the state needs to find somewhere in its gold-plated pockets.  And the prospect of legacy debts...something not accounted for in the Kaufman-Hall report.

Several boosters of the UMC spoke before the UMC Board meeting, prior to the Kaufman-Hall presentation, exclaiming "This is our Super Dome moment!"  Wow.  They better have some crow on hand in upcoming months because this thing ain't over, the uncertainty keeps rising...and they might need to eat it.

Oh yeah - there's also this.  The state and UMC are now saying that they will look at financing the $400 million + gap in funding for the complex on the private market...despite all sorts of smokescreen assertions otherwise along the way.

Senator David Vitter, when are we going to see a press release?

On Thursday, the UMC Board meets at 1 p.m. deep in the bowels of the LSU Medical School complex.

Here’s what our crystal ball shows: the UMC Board’s consultant, Kaufman-Hall, will unveil a “revised” report on the financial feasibility of the proposed UMC complex.  And unlike the earlier leaked draft of the Kaufman-Hall report, which said the current $1.2 billion, 424-bed model would be unsustainable…you can pretty much be certain that this new version of the report will tout the wonders of the UMC.  In this version of the report, now that the UMC Board has conveniently gone for two months without a meeting, you’ll see the numbers somehow supporting the feasibility of the proposed Megahospital.  You can almost smell the sleight of hand.

Will this report somehow constitute the business plan for the UMC?  We’re not sure.  But we are certain that there is still no UMC business plan at this point.

Go to the meeting on Thursday: LSU Health Sciences Center Lions Clinic Building, Isadore Cohn Learning Center, 6^th floor. And tell the UMC to stop blowing smoke.

And if you’re not at the UMC Board meeting, you can always head on over to the City Council meeting where it’s highly likely that the City Council will be considering the revocation of the streets in the UMC Footprint despite the fact that council member Head iterated at the Public Works "information only" hearing on May 23rd, that the item would probably not come up before the next full Council Meeting or the one after that.  [Audio blurb begins at 1:30:28]. While the meeting starts at 10 a.m., council meetings tend to drag on for hours.  Check the City Council website calendar on Wednesday.

Tell your city council members: do not revoke the UMC streets!  The City should not give up its last bit of leverage over the UMC Footprint.  We’ve already seen the VA Hospital destroy the street grid – killing off key thoroughfares like Banks Street.  Adding another “superblock” to the mix with the UMC would dramatically distort city traffic patterns.

Plus, as the blog Inside the Footprint noted a few weeks ago, it’s not clear that the State will even follow the terms of the renegotiated CEA that the city fought for to improve design.  Specifically, Jerry Jones told a state legislative committee that the state might not even build the second parking garage mandated in the CEA: “We don't think the other parking garage is absolutely necessary."

We haven’t seen any houses moving off the UMC site.  Nobody seems to know what’s going to happen with McDonogh No. 11 School.  And the Blood Center is still being forced from the site.  And there are hundreds of legal suits in progress as we speak.

There’s so much uncertainty clouding the UMC project that the streets should not be revoked!

It was unbelievable to see the difference between the way legislators treated the UMC presenters - including the mysterious "Dryades Street Public Policy Group" - and the way the legislators treated the Office of Community Development.  Skepticism applied to the second group; Senators emphasized "truth and reality" in leveling criticism.  But not to the first group, for some reason.

 In a email to his fellow members, a state legislator apparently had this to say yesterday as he and supporters of the proposed UMC hospital in Lower Mid-City shifted into damage control mode after the House Ways and Means Committee stripped $900 million in borrowing authority for the UMC from a budget bill:

"The biggest downside of the money being stripped is the image that it portrays to other regions of the State and nationally.  It is never good to have a regional delegation member being perceived as being against the UMC."

No, no it is not good.  While several people out there speculate that yesterday's move is merely a slap at the governor, which will soon be reversed, it's hard to deny that the move to strip the authority reinforces the chief problem with the UMC project: the continuing sense of serious uncertainty about whether it will ever be built.

There's still no business plan - this website sent out a letter to legislators in 2009 saying there was no business plan, so it's a chronic, ongoing problem with this whole venture - and the full funding necessary for construction of the hospital is not onhand.

Nevertheless, one legislator who supports the bill was doggedly trying to right the listing ship yesterday:

"As you all know, the news media has sezied [sic] upon this issue to suggest that there will be additional delays to the UMC project.  I would hope that in the future everyone will focus not only on supporting this important project, but would also consider the that our actions sometimes have unanticipated and unintended consequences, and we should always strive to think about the downside before taking action.

I thought it was important to share with you these details of this important project so that you can respond to constituent and media inquiries."

It's no wonder the media jumped on this matter.  Jerry Jones with the Office of Facilities and Planning Control hemmed and hawed, stating that the committee's move yesterday would cause serious delay for the project...and then reversing himself later in the day, telling the media that delays would not result - a sign of the Governor's office, no doubt, joining in the damage control fiesta.

Here's the deal.  The serious ongoing uncertainty that has plagued this project continues to beg the question: why does the state repeatedly refuse to go back into the existing Rev. Avery C. Alexander Charity Hospital?  MInus about $103 million in expenditures, the state has a little over $630 million on hand at this point - that we know of, excluding "potential" FEMA funds that the state continues to factor into its total - and that's enough to retrofit Charity Hospital.

Instead, the state has bulldozed forward like a drunken fool, spending over $55 million thus far to acquire and destroy property, hire professional legal services, and relocate masses of people and businesses.  Over a hundred properties are still in legal dispute, so the costs of going with the Mid-City site will increase.  The state did all that despite the fact that it has a perfectly usable building...that it owns!  The building would also meet the programmatic needs of the proposed UMC.  And building in the existing building would - gasp - still create thousands of jobs (medical and construction)!

Jerry Jones, even yesterday, continued the misleading refrain that any attempt to build in the old Charity building equates to creating something less than a fully modern, state-of-the-art academic medical center.  That's not true.  We believe that's a false choice driven by an obsession with the supposed "stigma" of the word "Charity" itself.  Rebuilding in Charity does not consign the UMC to be an indigent care facility alone.

That's the irony - supporters of the UMC will always say opponents lack vision.  But it's the supporters of the terribly designed replacement facility that can't seem to see a simple but powerful plan that's right for New Orleans.

As Dr. John once said: "If we can get Charity Hospital open faster and cheaper, how come we not doin' it?"

Today the House  Ways and Means Committee voted to strip the State and LSU of $900 Million dollars in borrowing authority for the new UMC Academic Medical Center.

This is a hugely important development.  Without backing from the State, Jerry Jones, State Facility Planning and Control Director, reports that construction for the Mega-Charity replacement hospital will be delayed for at least another year.   That means we will be looking at at least 11 years since the New Orleans Mid-City and downtown area has had a hospital.

At City Council's public works committee meeting earlier today  - [segment begins at about 15 minutes] -  SaveCharityHospital.com learned that the State are also absent other monies previously factored into the 1.2 billion dollar figure needed to support their 424 bed design.  According to Tom Rish, who was representing Jerry Jones and State Facility Planning and Control at the "information only" meeting,  $39 million of the 475 million dollars of FEMA money allocated to the project by an arbitration hearing created by Mary Landrieu can only be used for repairs to the current Charity Hospital building. 

We cannot afford to let healthcare be held hostage to bickering over dollars.  FEMA awarded New Orleans all the money we need to rebuild and retrofit Avery C. Alexander Charity Hospital.  Let's get it done.

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Note: You can watch today's Ways & Means video here:  Henry's amendment begins at approximtely 4:23:30.

In recent weeks, the chorus of skepticism and opposition to the state's proposed UMC "Taj Ma Hospital" has grown significantly.

While it's true that Senator David Vitter, State Rep. Jim Fannin, State Treasurer Kennedy, and even the BayouBuzz blog have suddenly crackled to life with criticism...we note that we and our allies have been making essentially similar arguments all along.

The leaked Kaufman Hall report certainly helped ram home the point that the proposed hospital -  weighing in at $1.2 billion instead of the less than $900 million cost for a Charity retrofit - is unsustainable.  The cost analysis lines up with the intuitive sense that it's smarter to reuse an existing building shell that meets all the programmatic needs...than to go through the trouble of destroying a historic neighborhood, displacing hundreds of people, and hurting scores of small businesses by forcing them to relocate.

Even the latest CityBusiness article, which, while it gives LSU's Larry Hollier a soapbox, can't ignore that the state, UMC, and LSU are "on the run" politically.  Things are not looking pretty.

While others remain under the illusion that the hospital is viable, Hollier himself sees the $300 million that the state has already allocated for the UMC project as potentially at risk:

"Hollier doesn’t share Greenstein’s unwavering confidence. He said the future of the hospital is 'tenuous' and fears the legislature will refuse to release a portion of the $300 million it has appropriated for the project, forcing the state to downsize the hospital."

In other words, it's not at all clear what size or type of hospital complex we'll actually see in the end.  That's important because the city council still has a chance to stop the public streets in the UMC Footprint from being revoked prematurely.  The council will likely consider the revocation in June, but the council's public works committee will ostensibly address the issue at a May 23 meeting at city hall (tentativley set for 1 pm in council chambers) - please go and object to revocation of the streets given all the uncertainty.  If the streets are revoked and torn out, it will mean the end of meaningful city influence over the project.

Hollier's comments on the ongoing problems with UMC funding also reveal his lack of vision:

"If that happens [funding revoked], the goal of building a modern academic medical center that will attract the best physicians and create a bio-medical corridor in downtown New Orleans will be dashed, leaving the city with nothing more than a shinier version of the old Charity Hospital, Hollier said."

Well, as we've said numerous times in the past, a revitalized Charity Hospital building could be the centerpiece of an academic medical center - one that is actually in the downtown.  And it would drive just as much economic and job development if located there.  Plus, revitalizing old buildings that are still structurally sounds is the smartest and most sustainable way to proceed.

Additionally, the proposed UMC hospital will not create a bio-medical corridor in downtown New Orleans.  It actually forces a bio-medical corridor OUT of the downtown by pushing into neighborhoods instead of revitalizing the Central Business District.  It's one of the first big steps in a "BioDistrict" march of development out into the historic neighborhoods of Mid-City.

Below are a number of key developments that have transpired lately - and some action steps that you can take to help drive for better outcomes:

1.  State and its chief contractor try to freeze out public input on Charity Hospital adaptive reuse.

The state is mandated to hold multiple public input meetings or forums regarding the adaptive reuse of Charity Hospital.  After a raucous meeting in the fall where the public made it clear that Charity should be retrofitted...it looks like the state took the cowardly and evasive path forward.  The state ostensibly held two "public" meetings in March of 2011, but did not notify any consulting parties directly - diverging from past practice - but instead merely put out a notice in the fine print in the back of the Times-Picayune.  This change in practice was clearly an attempt to cut out community voices that disagree with the state's way forward.  Or should we say...BioDistrict New Orleans' plans for Charity Hospital.  We continue to hear that the BioDistrict now has plans for using Charity Hospital.  That's interesting since the president of the BioDistrict was one of the only people in attendance at the two March "public" meetings on adaptive reuse.

Action Step: Contact the state's Office of Facilities and Planning Control.  Ask to speak with Mr. Jerry Jones.  Tell him that the state needs to hold a true public meeting where consulting parties - (public interest organizations) - are given actual notice of the public meetings in advance.  Here is the number to call: (225) 342-0820 begin_of_the_skype_highlighting            (225) 342-0820      end_of_the_skype_highlighting   or email:  http://doa.louisiana.gov/fpc/fpc.htm

2.  State legislature continues to express skepticism about UMC financing

The state legislature held a hearing one week ago where several members, including State Representative Jim Fannin, showed that they are worried about the many uncertainties that continue to plague the UMC project.  They are right to be worried!  Contact your state legislators and let them know that you don't support the boondoggle unfolding in Lower Mid-City.  Tell the legislators to support the alternative of rebuilding a 21st century, modern hospital in the existing Charity Hospital shell.  

Action Step: Contact your Louisiana state legislators and let them know how you feel.  Specifically, be sure to contact these representatives on the Appropriations Committee.

3.  Revocation of the streets in the UMC Footprint

Contact your city council person here in New Orleans to request a "NO" vote on any attempt to revoke the streets in the UMC Footprint.  This issue will likely be before the council in the next month or so.  It's inappropriate to give the streets to the state/LSU/UMC because the money is still not in hand.  Senator David Vitter has been ramming home the point that financing cannot support the current design.  And there is still no business plan in place.  

Action Step: Contact city council members here in New Orleans and request that they vote "NO" on the revocation of the UMC Footprint streets.  Once the city loses the streets, it has no more leverage over the UMC project:

Jackie Clarkson:             (504) 658-1070         jbclarkson@cityofno.com

Arnie Fielkow:             (504) 658-1060         afielkow@cityofno.com

Susan Guidry:             (504) 658-1010         sgguidry@cityofno.com

Kristin Palmer:             (504) 658-1030         kgpalmer@cityofno.com

Stacy Head: (504) 658 -1020   shead@cityofno.com

Cynthia Hedge-Morell:             (504) 658-1040        chmorrell@cityofno.com

Jon Johnson:             (504) 658-1050         jdjohnson@cityofno.com

The State of Louisiana continues to try to squirm out from under the many inconvenient facts that continue to present themselves.  Every time the hospital is shown to be too big or unsustainable or wholly inapporpriate for a residential neighborhood, the state finds another way to manipulate the facts to rationalize its way forward.

Enough is enough!