Health Care

New Orleans is in the midst of a troubling public health crisis. Charity Hospital has historically served New Orleans' most vulnerable citizens and its continued closure further jeopardizes the city's uninsured population, stretches limited government services to the their breaking point, and puts unnecessary strain on the region's private hospitals and care providers. The current LSU/VA plan condemns the residents of New Orleans to years of inadequate medical resources while their proposed facility is built. Since Charity Hospital can be renovated at least four and a half years faster than the LSU/VA proposal for a new medical complex, the work of attracting top flight medical personnel to provide critical public health services can begin sooner by rebuilding Charity.

Below you will find a collection of articles pertaining to the preservation issue:

As Expected, City Planning Commission Walks Away from its Responsibility

Yesterday, in what was correctly expected to be a rubber-stamp decision, the City Planning Commission voted to close public streets in the Lower Mid-City neighborhood surrendered for the LSU/VA. Though the CPC staff has stipulated that no roads can be closed while residents remain in their homes, access to individual street will be cut off as soon as those living on a specific block are kicked off of their properties. Residents who fight for their neighborhood, while permitted access to their own homes, would be slowly choked off from what was once their community. City Council will need to pass an ordinance to officially enact the recommendations adopted yesterday by the City Planning Commission. The move is reminiscent of the building moratorium imposed on the neighborhood by City Council in 2007. Lower Mid-City has been the only community in New Orleans officially barred from rebuilding.

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Courthouse calling! Show your support for Lower Mid-City residents!

At the Federal Courthouse on Wednesday, February 10th, the National Trust for Historic Preservation and residents of Lower Mid-City will hear a summary judgment after asking the court to speed up on issuing an opinion on its legal challenge. The National Trust, which filed the suit, alleges that FEMA and the VA violated federal environmental laws in evaluating the proposed LSU/VA in pieces instead of assessing the potential impacts of the entire development.

The practice of dividing unwieldy projects into "phases" became commonplace all over the country under the Bush administration as a means of shepherding development deals through longstanding environmental regulations. The purpose of 1979's National Environmental Policy Act, or NEPA, was to require federal agencies to consider and disclose the cumulative impact of a proposed development before site manipulation can begin. Under the previous administration at the Department of Veterans Affairs, officials splintered the proposed development to demolish Lower Mid-City into a separate "site selection" phase in order to skirt NEPA without evaluating the cumulative consequences of site selection, demolition, construction, and medical campus operations for nearby neighborhoods and the city at-large.

Though city and state officials continue to promote the current proposal to demolish Lower Mid-City and claim construction to be forthcoming, the last four years of obfuscation has not resulted in a rebuilt hospital infrastructure or new medical industry jobs. Instead, it has lead to ever increasing estimations of the total cost of the project, eroded public confidence in governmental processes, a ridiculously stubborn unwillingness to examine a faster, less expensive, and less destructive compromise plan, and a refusal to propose other workable alternatives.

Tomorrow's summary judgment could finally force federal, state, and city officials to begin examining more workable - and legal - plans for the restoration of emergency care, Veterans' care and biomedical jobs to downtown New Orleans.

For more information about the lawsuit and summary judgment, click here and here.

Show your support tomorrow and join us at 9AM the Federal Courthouse on the corner of Poydras and Camp. The proceedings will take place in Judge Fallon's courtroom on the 4th floor.

Special Commentary: Charity Hospital and the City Master Plan

The New Orleans City Planning Commission recently approved the final draft of the city's master plan.  The master plan includes two chapters, one on historic preservation and the other on environmental quality. The goals listed in the historic preservation chapter include "Encouraging adaptive-reuse of historic structures that contribute to overall neighborhood character and quality of life," and making New Orleans a model city of "sustainable historic preservation."  The goals listed in the environmental chapter include achieving Smart Growth patterns by encouraging mixed-use, walkable and "bikeable" neighborhoods; "renovating and reusing existing public facilities or other available buildings wherever possible" and "requiring all municipal facilities to adopt sustainable building practices."

New Orleans has always been the leader in historic preservation and sustainability.  New Orleans created the Vieux Carre' Commission in 1936, and was one of the first cities to recognize the importance of the tout ensemble of a neighborhood, that is that a collection of individual historic buildings, even buildings that would be of little significance on their own, are more worthy of preservation as a group.  This initiative has preserved the Vieux Carre' neighborhood that presently exists, and today the City of New Orleans, with its 18 National Register Districts and 13 local historic districts, has the largest number of historic districts than any other city in the United States.  The historic neighborhoods of New Orleans are often referenced and pictured in books and publication on the New Urbanism and Smart Growth, making New Orleans a leader in sustainability long before Make It Right and Global Green were established.

It is therefore discouraging to go further into the city's master plan and see that the land use plan for the area bounded by Canal Street, South Rocheblave Street, Banks Street, Tulane Avenue and Claiborne Avenue, the area known as the site of the proposed LSU/VA Hospitals, has been designated as "Mixed-Use Health/Life Sciences Neighborhood" when there is presently no such health facility located in this area.  I wonder how a proposal to build two large hospital facilities that requires eviction of residents and business owners, and the demolition and disposal of 24 city blocks of an established historic district, including the relocation of streets and infrastructure, fits into a master plan with goals of historic preservation and sustainability.  I also wonder how the abandonment of the existing Charity Hospital building, which is suitable for a complete renovation into a first class teaching hospital, and the further degradation of the current medical district into an urban ghetto of vacant buildings, fits into the master plan's goals of historic preservation and encouraging "renovating and reusing existing public facilities...wherever possible."  Some of the affected property owners repaired their Katrina damaged homes with Road Home grants, a complete waste of tax payer dollars if these same houses are to be demolished.

I cannot believe that the drafters of the master plan would have authored a master plan with goals that are contradictory to the proposed land use plan.  I can only conclude that the land use plan was purposely manipulated to suit the LSU and VA Hospital projects.  The process for establishing the land use in these blocks is vastly different than the process for establishing the land use everywhere else, which included lengthy planning sessions involving the input of residents.  In the footprint of the LSU and VA hospitals, the residents and business owners affected by the proposed hospitals have no say over the future development of their neighborhood.  It also sets up a dangerous precedent where a politically connected developer can have the master plan modified to conform to whatever the developer wishes to propose.

The City of New Orleans finds itself back where we started.

The next day I learn that a federal arbitration panel, swayed by testimony from biased architects and engineers who have a stake in the new hospital design in closed-door hearings, has awarded Louisiana $475 million dollars for the Katrina damages to Charity Hospital, and have concluded that the building was damaged beyond 50 percent.  This could have been received as great news, allowing the state to proceed with the conversion of old Charity Hospital into a first class teaching hospital, sparing the relocation of residents and businesses and the destruction of Mid City, and at little cost to the state.  Work could start immediately since the state already owns Charity and doesn't have to acquire any property.  What's more, the project could be completed in 3 years.  A study done by RMJM Hillier, a renowned architectural firm that specializes in both health care facilities and historic preservation, substantiates the claim that Charity can be renovated for less time and for less money, particularly since the building is presently closed, allowing for a single phase renovation rather than the costly multi-phased, piece-meal renovations that are typical of hospitals having to remain open during construction.  To renovate a closed hospital is a rare opportunity presented to Louisiana.  Preservationists trying to convince state and local officials to abandon the current plan in favor of renovating Charity Hospital are looked upon as "obstructionists" when in fact they are trying to encourage LSU to take the path of least resistance.

LSU and proponents of the new hospital claim that the only way to achieve a state-of-the-art teaching hospital is to build from the ground up, as if a complete gutting of Charity will only yield a hospital that is the equivalent of Pre-Katrina Charity.  If Charity were gutted in accordance with RMJM Hillier's recommendations, all that would remain is the brick and limestone exterior walls, and the concrete and steel building skeleton; everything else, the interiors, fixtures and equipment would be new and state-of-the art.  All the building's systems including HVAC, plumbing, electrical, medical gases, laboratory wastes, fire sprinkler systems, etc. would also be new and would be equivalent to new construction installations.

Unfortunately, LSU is proceeding with their original plans for construction of the new facility and the abandonment of the existing Charity Hospital facility.  The $475 million combined with $300 million still falls short of the estimated cost of $1.2 billion required for the facility, therefore requiring additional financing by the state.  The time estimate for the LSU Hospital is 7 years of construction following the time spent acquiring property, from an article in "Top Construction Projects 2009" a supplement of City Business, published in February of last year.

What is more unfortunate is that the proposed hospital design is deliberately suburban.  It could have been designed to fit on as little as four city blocks by stacking the patient bedroom floors on top of the diagnostic/treatment "podium," which is typical of urban hospitals; and stacking the physical plant and parking garages.  This would result in a hospital that is 12 to 14 stories tall, with a minimal footprint and less demolition of historic structures.  Instead, 12 blocks were assigned for the site, so the design response is a low rise facility with the patient bedroom floors connected to the diagnostic/treatment facility via pedestrian bridges.  To the east of the site, and providing a substantial buffer from the established medical district downtown, is a vast amount of surface parking that would rival in size the surface parking lots of the Esplanade Mall.

Instead of New Orleans moving forward to achieve goals of historic preservation and sustainability, we are moving backwards.

Michael Rouchell, architect

Move Over LSU: Make Room For Our Vets!

Perhaps you heard about an exciting new compromise proposal on the table in the long-standing controversy over the proposed LSU/VA medical center. The new idea would allow construction on a new VA Hospital to begin now without resolving the still simmering controversy over whether it is better to build a modern teaching hospital in the facade of historic Charity Hospital or seize private land to build a more expensive, sprawling campus.

Instead of forcing the VA to expropriate and destroy the tight-knit residential community north of Galvez St., the compromise would swap the VA into the less-populated land near I-10 and Claiborne Ave. that has been banked by LSU. The VA could finish building a new hospital to care for returning veterans sooner than if they were to continue struggling to untangle the complications inherent to land decisions that would destroy residential communities, a fate the Department of Veterans Affairs has heretofore been relegated by LSU's decision to reserve the most viable land for itself.

The new idea has been proposed in a radio ad purchased by Smart Growth Louisiana, which can be heard below.

The proposed development in Lower Mid-City has stalled because LSU does not have the money it needs to begin construction on its new teaching facility but has stuck the Department of Veterans Affairs, which does have the funding to get started, with a difficult and morally hazardous land acquisition process. LSU's proposal is also controversial because of evidence that they and the state have misrepresented damage incurred at Charity Hospital in the immediate aftermath of Hurricane Katrina in 2005 in an attempt to justify the expense of building an expensive new facility.

Recently, a federal arbitration panel finished hearing testimony from the state of Louisiana and FEMA and will soon settle the amount the state will be reimbursed for storm damage at Charity Hospital.

Yet, even if the state receives the maximum amount of funding possible under arbitration, over half a billion dollars, there will still be a shortfall of several hundred million dollars that will continue to stall construction.

LSU has proposed building a $1.2 billion campus between Claiborne Ave. and Galvez St. The state has allocated $300 million toward that cost and the most the federal arbitration will provide is $492 million. Even granting LSU's own cost estimates, over $400 million will need to be borrowed in an extremely volitle bond market. State Treasurer John Kennedy and others have repeatedly warned against betting on LSU's ability to raise so much money given the changes to healthcare financing promised under federal healthcare reform.

Advocates for Charity Hospital have pointed to a study by the internationally renown architecture firm RMJM that proposes reusing the historic facade of Charity Hospital and building a state-of-the-art facility inside. The RMJM plan would cost hundreds of millions of dollars less and could be finished in less time.

This compromise proposal would allow the VA to begin construction on the Claiborne Ave. to Galvez St. site while the residential neighborhood between Galvez St. and Rocheblave St. could be saved without forcing a definitive solution to the dispute over the merits of an expensive, sprawling medical campus compared to the RMJM plan to incorporate the facade of Charity Hospital.

Given President Obama's recent decision to commit more troops overseas in Afghanistan, it is more important than ever to allow the VA to build a hospital to care for returning veterans as quickly as possible. Will LSU and state officials accept a compromise that will allow them to do so?

 

Eli Ackerman: Real Stories of the Budget Patrol

For the last few weeks, I've been trying to stay apprised of the ongoing City Council hearings for the 2010 budget. Without going into the boring details, the city's budget approval process over the last few years has been extraordinarily confusing. I have been trying to identify whether or not the city is allocating additional money for unreported costs associated with the proposed LSU/VA project.

More specifically, I want to know whether or not the city is allocating money for other purposes with the intention of shifting funds to cover costs associated with the proposed LSU/VA medical center in a discretionary fashion outside of public purview and beyond the regular oversight capabilities of City Council.

On Monday, November 16th, we found a new agreement – signed by the Mayor – that obligates the City to this stalled project in new and important ways. I brought the document to the City Council budget hearings for answers and what we heard may surprise you.

I don’t usually write in the first person on the SaveCharityHospital.com blog. I do so here because there is no other account of these events. Read the whole post to hear about my experience at City Council on Monday and exciting news about the VA's possible willingness to relocate to another site in downtown New Orleans should it be offered to them.

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New CEA between City and State

The new Cooperative Endeavor Agreement by and between City of New Orleans and the State of Louisiana through the Division of Administration and Louisiana State University.

Letter: Use of eminent domain for LSU/VA immoral with reasonable alternatives available

Kit Senter sent in this Letter to the Editor to the Times-Picayune:

 

Yes, the government has the right of eminent domain. It can take people's property away from them against their will, but the reasons for the taking must be justifiable and the owner must be paid just compensation.

 

So what's wrong with the government taking the property of hundreds of people to use their land to build a medical complex?

First, there is alternative land that could be used for such a complex, and this lands is already owned by the government or are unoccupied.

The site of Big Charity and the 23 other buildings in the Charity complex are publicly owned and are the perfect place to build the new complex. The site of the Lindy Boggs Hospital and the acres adjacent to it would make a perfect site for the new VA hospital. Lindy Boggs is privately owned, but the site is unoccupied so using that land will leave no one dispossessed.

Second, people are not going to be paid just compensation for their property. After Katrina, Mayor Nagin encouraged New Orleanians to come home and rebuild their homes. Many did. Meanwhile, out of the spotlight, the mayor signed a memorandum of understanding in which he pledged to clear the area in Mid-City and buy the owners out. Then the city stopped issuing building permits in the area.

So we have had a couple of years of demolition by neglect, engineered by the government, which resulted in driving down property values. By the time the government gets around to buying landowners out, prices will have dropped so much that the homeowner or business owner will not be offered just compensation.

My conclusion is that the land grab may be legal, but it is unethical, immoral and perhaps downright criminal.

Kit Senter
New Orleans

 

 

We're glad the issue of homeowner compensation in Lower Mid-City is on people's minds. The building moratorium that has been in effect over the last few years has made any serious improvement to the by homeowners, residents, or investors impossible. This has unfairly suppressed the value of the neighborhood and will likely soon result in compensation offers below what they ordinarily would have been had the neighborhood been allowed to rebuild. It would be doubly immoral if the moratorium was put into place for the expressed purpose of limiting the compensation homeowners will receive for their properties.

Developers Eye "Completely Destroyed" Charity Hospital

Today, the Times-Picayune had a provocative and interesting article in which a developer proposes rehabilitating Charity Hospital into the new home of City Hall. At various points, downtown developers have floated all sorts of ideas to put Charity Hospital back into commerce – a medical supply showroom, condominiums, dorms – that all ultimately lead back to one lingering question:

If the building is able to be gutted and rebuilt into a state-of-the-art something, why shouldn't it be gutted and rebuilt into the state-of-the-art hospital this city needs so badly?

The question demands a real answer now more than ever given that plans to build a $1.2 billion medical campus in Lower Mid-City have stalled, putting the whole vision of a synergized biomedical corridor – the apparent rationale for keeping Charity Hospital closed in the first place – at risk.

The suggested reuse of Charity Hospital addresses the million square foot elephant in the room: What will become of downtown New Orleans? The article implicitly raises important questions about New Orleans' moribund downtown and whether or not it is wise to evacuate hospital infrastructure and associated economic development into Lower Mid-City's residential streets without any real plan for area to be abandoned.

These are the types of things everyone had hoped would be evaluated within the Goody Clancy master planning process. This is why a coalition of nearly 80 community groups, and this website, have spent months and months calling for the inclusion of real evaluation of the competing plans for new hospitals within the master plan process. Perhaps this is why disappointment with the product that the Goody Clancy team has produced is growing more widespread.

 

Analysis: Friday's Victory in Civil District Court

On Friday, a lawsuit on behalf of New Orleans taxpayers and Lower Mid-City residents against Mayor C. Ray Nagin took an important and exciting step forward. Judge Ethel Julien of Civil District Court ruled that the lawsuit can move forward, definitively squashing an attempt by the city to have the case thrown out.

The lawsuit challenges the legality of an agreement (a Memorandum of Understanding or MOU) made between the Mayor and the Department of Veterans Affairs in which Mr. Nagin agreed to surrender 34 acres of Lower Mid-City to the VA for a proposed new medical complex and exposed city taxpayers to financial penalties without seeking the approval of the City Planning Commission and the City Council as stipulated by the City Charter.

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This Friday: Support Lower Mid-City residents in Civil District Court

This Friday, Judge Ethel Julien of Orleans Parish Civil District Court will preside over a preliminary hearing in a civil lawsuit filed by lawyers representing residents of Lower Mid-City whose homes are slated for demolition under the proposed LSU/VA medical complex. The proceedings are expected to begin at 10:30 and are open to the public. We'll see you there!

This lawsuit challenges the legality of the document signed between Mayor Nagin and the Department of Veteran's Affairs in which he agreed to offer Lower Mid-City for expropriation and exposed the city to a signficant financial penalty without going through the processes established by the City Charter. Significant land agreements in which public streets are closed and financial obligations are set forth require public hearings and votes by the City Planning Commission and the City Council. Neither body held public hearings on the hospital matter, in violation of City Charter.

City Business has a good article in this week's edition summarizing the case.

SaveCharityHospital.com has covered this lawsuit extensively. This analysis compares how the normal processes were followed in this Spring's debate over whether or not to relocate City Hall but not in the case of the proposed LSU/VA medical center. This piece describes the potential financial penalties that city taxpayers face as a result of Mayor Nagin's unlawful agreement in greater detail. The petition filed by Lower Mid-City residents can be downloaded here.

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