New Orleans city officials are aggressively pushing back against a "devastating" proposed $15 million cut to inpatient mental health and substance abuse services now being offered at LSU Interim Hospital.
The cuts were included in Gov. Bobby Jindal's recent budget, and they are part of an effort to close a $251 million state budget shortfall this year. The plan includes a $34 million hit on hospitals statewide.
The proposed cuts at LSU's operations in New Orleans include:
• at least 110 employees,
• the hospital's twenty-bed, inpatient detox unit,
• nine of 38 beds in the psychiatric unit, and
• half of the 20 mental-health emergency room beds.
The Criminal Justice Committee of the City Council met Wed¬nesday afternoon to talk about the cuts and their potential impacts on New Orleans' most vulnerable populations, most of who are not criminals. But many mentally ill people end up in jail when services are slashed.
And a city in crisis "can't go forward" unless critical services kept in place, Councilwoman Susan Guidry said.
Speaking as part of a panel addressing the committee, Muni¬cipal Court Chief Judge Paul Sens said it was already "staggering, the amount of money that is being wasted by not giving these people the services they need."
Sens reported that over a recent 16-month period, he and his colleagues ordered 246 psychiatric evaluations for mentally ill people who came before the court.
"One hundred and sixty of those people were found to be incompetent," he said. "Normally in that situation, they are referred to University Hospital, they stay there three days, and are cycled back into the system."
Twenty-three of those 160, he said, "cycled back through the system 75 times."
"This system is never going to change," without inpatient clinical care, he said.
Paying for that care is another matter in an era of Medicaid cuts from Washington.
Dr. Roxanne Townsend, chief executive officer of LSU Interim Hospital, told the committee that the hospital has already seen its budget shrink by some $150 million since 2009, down from $955 million to $804 million.
"This is the first time we have had to touch behavioral-health services," she said. "We do anticipate that there will be an overflow into the emergency room."
Unfortunately, the emergency room is slated to lose four beds as well.
"These [proposed] cuts are happening to a system that has been on a road to improvement, but it is fragile," said New Orleans Health Commissioner Dr. Karen De¬Salvo.
She cited the "extremely short timeline and somewhat arbitrary nature of the cuts," and noted that the city does not "have room to absorb these cuts," given the various and ongoing post-traumatic disorders and social ills that continue to befall New Orleans.
The Jindal administration has maintained that it did not request or require any specific cuts to mental health or substance abuse programs at LSU Interim Hospital, a point echoed Wednesday by Dr. Tony Speier, an assistant secretary at the state Department of Health and Hospitals.
Speier defended Jindal, who he said heard the "cry for assistance for mental health services" coming out of New Orleans in 2008, and has worked with local mental-health providers to expand the service base for its citizens.
Jindal critics at the Advocates for Louisiana Public Healthcare maintain that the governor essentially raided $50 million in Medicaid money generated at LSU Interim and gave it to his Department of Health and Hospitals to shore up that department's $489 million shortfall.
Those critics argue that Jindal has consistently tipped the scales in favor of reimbursing private Medicaid providers over public and charity hospitals such as LSU Interim.
Councilman Jon Johnson said he invited Jindal to speak at the council's upcoming city Housing and Human Needs Committee meeting. Johnson said he'll urge Jindal to reconsider the cuts.
"This is nothing new for the state," he said. "The state administration has always looked at health care as an area that they will go into and cut because, frankly and honestly, it is one of the areas where the state has the latitude to go in and make cuts. It should not happen... Those mental health beds that were taken out of the city of New Orleans need to be returned to the city of New Orleans!"