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Louisiana Hospice

Bobby Jindal, Governor of Louisiana.

Bobby Jindal, Governor of Louisiana.

“You can judge the character of a man by how he treats those who can do nothing for him”.   Malcolm Forbes

The source of the above referenced quote is debatable and has been credited to Ann Landers, Goethe, and numerous others.  It really doesn’t matter.   I cannot think of a single decent person who has not treated those who can nothing for him with respect and dignity.

Louisiana, known for food, fun, Mardi Gras and large close knit families has been let down by our Governor and the Department of Health and Hospitals.  I am deeply saddened and ashamed by our elected governor and his appointed head of DHH, Bruce Greenstein.

Effective February 1, 2013, Louisiana Medicaid will no longer pay for hospice.  Patients with Medicare will continue to receive benefits but those who depend upon Medicaid alone will no longer receive care in their homes or hospice care delivered as an adjunct in a nursing home at the end of their life.

Those individuals that rely on Medicaid for hospice care as the sole payor source for their healthcare will be forced to choose between dying at home with loved ones ill equipped to manage their care or go to a sterile institution and be cared for by strangers.

Consider who these people are.  Gay men dying of HIV, IV drug users with failing livers and those people who haven’t been able to find or hold onto a job with benefits will suffer disproportionately.  Most addicts who have terminal illness have an underlying psychiatric disorder either diagnosed or undiscovered.  Society’s undesirables, the forgotten, and those who are financially burdensome because they don’t pay taxes will be overlooked by the state of Louisiana.

Lucky for the Governor, they will not be able to vote once they are dead.  They will not speak out because they can’t.  If they have families, they will be too exhausted from caring for a dying loved one to worry about politics.  In some ways, this was a politically savvy move for the governor.

What Jindal overlooked is that these financial burdens to society have value other than financial.  Of course, Jindal doesn’t recognize their contributions to society because they can do nothing for him.  The gay man with end stage HIV may have a family who loves him.  The IV drug abuser may be all that their spouse has.  The unemployed may have children who are losing a parent.  The disproportionate number of patients with mental  illness will hardly notice the absence of benefits.  They have long since been overlooked by the Jindal administration.

He drove home the cruelty of his decision by insisting that that the home health care benefit remained in effect for Medicaid patients.  Essentially this translates into home health care agencies taking on even more underpaid and unpaid care.  The 50 visits a year Medicaid paid at a rate of half of what Medicare pays allows for home health is often insufficient for non terminal patients.  The quota for a terminal patient can be exhausted in a month or less if the patient receives quality care.

Many agencies will provide the care at a sharp loss while Medicaid RACs scrutinize every visit note for an opportunity to take back the scant amount of money paid.

But these guys – the gays, the junkies and the bums who don’t work obviously do not merit good care in Jindal’s opinion. They can do nothing for him.

If you agree with Jindal, I respect your right to your opinion but I do not care to hear it.  If you think that the state of Louisiana has implemented a reduction in Medicaid Benefits that is the equivalent of spitting in the faces of the needy and poor, please take the time out of your day to let The Secretary of DHH our governor know.

Bruce Greenstein, Secretary of Louisiana Department of Health and Hospitals is at:

Department of Health and Hospitals
P.O. Box 629
Baton Rouge, LA 70821-0629

The ‘contact us’ page on the Governor’s website has a variety of ways to contact him.  See below.  If you are a hospice or hospice association and are holding a public event soon, please consider asking B0bby to attend.

Choose one of the links below to interact with Governor Bobby Jindal:

    1. Email the Governor
    2. Request the Governor Attend an Event
    3. Request a Meeting with the Governor
    4. Request the Governor for a Photo
    5. Request a Proclamation from the Governor
    6. Request an Official Statement or Certificate from the Governor
    7. Apply to serve on a Board or Commission
    8. Nominate someone for the Governor’s Spirit of Louisiana Award

Medicaid Change in the Air

The Jindal administration is proposing far reaching changes to the way in which Medicaid operates in the state of Louisiana.  For our clients, the change is long in coming.  However, what the changes will entail is not yet clear or determined.

Louisiana DHH has issued a fact sheet and a white paper on the proposed changes.  A link to the papers is included to your left.  I encourage all readers to study these documents and send any comments or suggestions to DHH.  I cannot think of anyone better equipped to guide our state government on Medicaid Health Services than Medicaid providers.

Also, Michelle Breaux Perry, Legislative Liason at Louisiana Department of Health and Hospitals advises that an open meeting will be held to discuss these proposed changes.  Please, please attend.  It is our chance to be heard before decisions are made.  Too many times we are taken by surprise when new mandates affecting our industry show up unannounced.  Details of the meeting are as follows:

Event:   LHF Medicaid Reform Advisory Group Meeting
Topic:   Louisiana Health First Medicaid Reform Concept
Date:    Tuesday November 18, 2008
Time:    1:00 p.m. – 5:00 p.m.
Location:  Poydras Building – 1st Floor Hearing Room
1702 North 3rd Street, Baton Rouge, LA  70802

If I am fortunate enough to have no surveys or other pressing matters, I plan on attending.  My calandar is marked.  What about yours?

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