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Program J: Charity Hospital and Medical Center of Louisiana at New Orleans

Program Authorization: R.S. 36:251-259; 1-15 and Act 3 of 1997

PROGRAM DESCRIPTION

The mission of Medical Center of Louisiana at New Orleans and University Hospital is to provide quality patient-centered care in a teaching setting to all people and maintain a special concern for the medically under served and indigent of the State of Louisiana. Medical Center of Louisiana and University Hospital, which are separate charity hospital facilities, are both located in New Orleans.

The goal of Medical Center of Louisiana at New Orleans (MCLNO) and University Hospital is to ensure that quality health care is provided to the community in the most effective and efficient manner possible.

Medical Center of Louisiana is New Orleans’ major health care system, serving the Greater New Orleans Area, including Jefferson, Orleans, Plaquemines, St. Bernard, St. Charles-East Bank, St. John the Baptist, and St. Tammany parishes with quality health programs at its two campuses. University Hospital was added to the system when it was purchased by the State in 1992. Charity Hospital is one of the most historic of the nation’s hospitals. It was established in 1736 with the bequest from a French seaman and merchant, and has been in continuous operation ever since. The hospital is the forerunner of today’s system of safety net public hospitals stretching across Louisiana.

The Charity campus of the Medical Center of Louisiana has, as a major center of excellence, the finest trauma center in the State of Louisiana, designated by the Orleans Parish health Department as the official trauma center for the parish. In addition, Charity Hospital is the home of the Gulf Coast Research Center, staffed by physician from the renowned Louisiana State University and Tulane Medical Schools, where state-of-the-art medicine is practiced under ideal staffing and physical circumstances with total access to research studies and systems from both institutions. The facilities provide acute general medical and specialty services and critical care to the indigent, uninsured, Medicare, and Medicaid patients of the hospital’s service area.

The hospital provides additional support functions such as pharmacy; blood bank; respiratory therapy; anesthesiology; and various diagnostic services and other support functions of a non-medical nature, such as administration; maintenance; housekeeping; mail service; purchasing; accounting; and admissions and registration. The facility also maintains a stipend program for medical residents and contracts for physician and anatomical services and works cooperatively with medical schools and other health education institutions to broaden the opportunity for clinical training in the hospital.

The facilities deliver a comprehensive range of quality health care to any Louisiana resident, especially to the medically indigent or anyone needing emergency care. The Medical Center provides services without regard to race, creed, color, national origin or ability to pay, and serves as the tertiary referral center for the charity hospital system and as a resource to other hospitals and medical care providers. The primary service area includes Orleans, Jefferson, Plaquemine, St. Bernard, St. Charles and St. John the Baptist parishes. The Charity Hospital and Medical Center of Louisiana serves as an educational center of the LSU Medical School and the Tulane University School of Medicine that fosters excellence in training, education and research, and maintains an environment where patients and staff are treated with dignity, compassion and respect. The hospitals are currently staffed for 693 beds.

 

OBJECTIVES AND PERFORMANCE INDICATORS

Unless otherwise indicated, all objectives are to be accomplished during or by the end of FY 1999-2000. Performance indicators are made up of two parts: name and value. The indicator name describes what is being measured. The indicator value is the numeric value or level achieved within a given measurement period. For budgeting purposes, performance indicator values are shown for the prior fiscal year, the current fiscal year, and alternative funding scenarios (continuation budget level and Executive Budget recommendation level) for the ensuing fiscal year (the fiscal year of the budget document).

 

 

 

 

RESOURCE ALLOCATION FOR THE PROGRAM

SOURCE OF FUNDING

This program is funded with Interagency Transfers, Self-generated Revenue and Federal Funds. The Interagency Transfers represent Title XIX reimbursement from the Medicaid program for services provided to Medicaid eligible and "free care" patients. The Self-generated Revenue represents insurance and self pay revenues for services provided to patients who are not eligible for "free care". The Federal Funds are derived from Title XVIII, Medicare payments for services provided to Medicare eligible patients.

ANALYSIS OF RECOMMENDATION

GENERAL FUND

TOTAL

T.O.

DESCRIPTION

 

 

 

 

 

$600,000

$388,687,666

0

 

ACT 19 FISCAL YEAR 1998-1999

 

 

 

 

 

 

 

 

 

BA-7 TRANSACTIONS:

$0

$0

0

 

None

 

 

 

 

 

$600,000

$388,687,666

0

 

EXISTING OPERATING BUDGET – November 20, 1998

 

 

 

 

 

$0

$2,610,000

0

 

Annualization of FY 1998-1999 Classified State Employees Merit Increase

$0

$2,666,665

0

 

Classified State Employees Merit Increases for FY 1999-2000

$0

$4,891,159

0

 

Risk Management Adjustment

$0

$3,886,000

0

 

Acquisitions and Major Repairs

$0

$3,565,000

0

 

Nonrecurring Acquisitions and Major Repairs

$0

$4,277

0

 

Legislative Auditor Fees

$0

$5,167

0

 

UPS Fees

$0

$1,771,266

0

 

Salary Base Adjustment

$0

($5,432,557)

0

 

Attrition Adjustment

$0

($987,754)

(30)

 

Personnel Reductions

$0

$26,496

0

 

Civil Service Fees

($600,000)

($600,000)

0

 

Other Nonrecurring Adjustments – Nonrecurring of funding for New Orleans Health Corporation

$0

$636,920

0

 

Other Adjustments - Fund equipment maintenance contracts

$0

$173,384

0

 

Other Adjustments – 1% House Officer Stipend increase to the Southern Regional Average for public hospitals

$0

$3,986,350

0

 

Other Adjustments - Increase transfer in Ryan White Federal Funds from the Office of Public Health for HIV medications

$0

$0

4,581

 

Other Technical Adjustments – Transfer positions from Administration to reflect appropriate T.O. by hospital

$0

($969,878)

0

 

Other Technical Adjustments - Transfer funding to E.A. Conway Medical Center for additional primary care services

 

 

 

 

 

$0

$388,007,843

4,551

 

TOTAL RECOMMENDED

         

($600,000)

($679,823)

4,551

 

DIFFERENCE (TOTAL RECOMMENDATION AND EXISTING OPERATING BUDGET)

The total means of financing for this program is recommended at 99.8% of the existing operating budget. It represents 87.4% of the total request ($443,838,151) for this program. The overall net decrease is a result of the transfer of funds to E.A. Conway Medical Center for additional primary care services, nonrecurring funding for the New Orleans Health Corporation, and a reduction of 30 vacant positions. These reductions are offset by a significant increase in Risk Management premiums and an increase in the transfer of Ryan White Federal Funds from the Office of Public Health for HIV medications. These changes are not anticipated to significantly impact the delivery of services.

PROFESSIONAL SERVICES

$8,759,712

 

Tulane University Medical Center for House Officers

$6,700,000

 

Tulane University Medical Center for resident supervision and physician services

$2,799,016

 

Tulane University Medical Center for medical direction services

$823,500

 

Tulane University Medical Center for providing physician services to the hospital's trauma services

$623,653

 

Tulane University Medical Center for HIV in-patient and outpatient services

$200,000

 

Tulane University Medical Center for diagnostic services

$150,000

 

Tulane University Medical Center for radiation oncology physician services

$11,787

 

Tulane University Medical Center for specialized clinical services

$6,421,412

 

Van Meter & Associates for management of Emergency Medical Services and physician clinical care coverage to patients in the Emergency Department

$3,433,832

 

CHNO Independent Staff for physicians

$300,017

 

Total Blood Management for Perfusionist services

$120,990

 

Xavier University of LA for clinical pharmacist services

$5,000

 

Richard Cales for technical network consulting services

$75,000

 

Physical therapy services

$7,500

 

Mike Diaz for occupational therapy services

$35,000

 

Orleans Parish Medical Society for providing data collection and documentation services

$10,000

 

S. Longo and Associates for Joint Commission on the Accreditation of Healthcare Organizations consultation

$7,000

 

Deaf Action Center of Greater New Orleans for sign language interpreter services

$3,700

 

Golastien, Inc. for mechanical and electrical design

$45,000

 

Gregory Meier for Revenue enhancement accounting services

$71,867

 

NO/AIDS Task Force for health education (HIV)

$4,800

 

Eppling and Associates for real estate appraising services

$49,800

 

Financial Improvement Technologies for providing consulting and staffing services related to modification of the patient accounting system

$9,750

 

Patrick Marion for Medicare collection consultation

$77,000

 

Various ministers for chaplain services

$9,000

 

American Appraisal for fixed asset accounting

$12,500

 

Michael Palumbo for photographic services

$8,000

 

Professional Security Training, Inc. for firearms training

$7,500

 

Bartels & Company for providing graphic artist services for the design and typesetting of newspaper advertisements

$223,341

 

Northeast Louisiana University for clinical pharmacy services

$263,756

 

Servicemaster Management Service for biomedical engineering

$40,000

 

Charbonnet Transportation for professional mortuary services

$9,910

 

Elevator Technical Services for elevator inspection

$49,899

 

Boyce and Associates for revenue enhancement consulting services

$46,000

 

George Whetsell for patient care system redesign

 

 

 

$31,415,242

 

TOTAL PROFESSIONAL SERVICES

OTHER CHARGES

$137,863

 

Legislative Auditor expenses

$357,260

 

Costs associated with medical stipends and scholarships for Allied Health students in return for pledged services after graduation.

$400,000

 

Costs associated with Federal HIV funds for early intervention program

$306,070

 

Costs associated with HIV funds from the City of New Orleans for early intervention program

 

 

 

$1,201,193

 

TOTAL OTHER CHARGES

 

 

 

 

 

Interagency Transfers:

$6,000,000

 

Payments with LPFA for bonded indebtedness on University Hospital

$28,312,645

 

Payments to LSU Medical Center for physician services, and supervision

$16,673,531

 

Payments to LSU Medical Center for house officer salaries

$3,697,325

 

Payments to LSU Medical Center for HIV outpatient clinic services

$630,000

 

Payments to LSU Medical Center for dental clinic services

$100,000

 

Payments to LSU Medical Center for Telemedicine

$57,971

 

Payments to LSU Medical Center for renal transplant services

$10,925,000

 

Payments to the Office of Mental Health for operation and management of the acute psychiatric inpatient unit

$430,494

 

Payments to the Department of Civil Service

$134,254

 

Payments for Uniform Payroll System expenses

$39,142

 

Payments to the Comprehensive Public Training Program

$10,145

 

Payments to the Treasury Department for bank service charges

 

 

 

$67,010,507

 

TOTAL INTERAGENCY TRANSFERS

ACQUISITIONS AND MAJOR REPAIRS

$3,886,000

 

Funding for replacement of inoperable and obsolete equipment

 

 

 

$3,886,000

 

TOTAL ACQUISITIONS AND MAJOR REPAIRS


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