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Program A: Louisiana State University Medical Center

Program Authorization: Constitution of 1974, Article VIII; Section 7; R.S. 17:3215, 3351

PROGRAM DESCRIPTION

The mission of the LSU Medical Center is two-fold: (1) Assure the availability of acute and primary health care services to the uninsured, the under insured, and to others with problems of access to medical care. (2) Serve as the principal sites for the clinical education of future doctors and other health care professionals.

The goals of the LSU Medical Center are:

1. Educate health professional and scientists at all levels through the advancement and dissemination of knowledge in medicine, dentistry, nursing, allied health, public health, and basic sciences.

2. Conduct statewide programs of clinical and basic health science research resulting in publications, technology transfers, and related economic enhancements to meet the changing needs of the state of Louisiana and the nation.

3. Provide health care coordination and referral services coordination, and public information.

4. Improve through oversight of operations of Area Health Education Centers (AHEC'S), the number and distribution of healthcare providers in rural and underserved areas of Louisiana and support existing health care providers through continuing education programs.

The Louisiana State University Medical Center is a multi-unit academic health science center providing interdependent instruction, research, and public service in health-related fields.

The Louisiana State University Medical Center in New Orleans comprises six professional schools: Dentistry, Graduate Studies, Allied Health Professions, Nursing, and Medicine in New Orleans with Lions-LSU Clinics, and the School of Medicine in Shreveport, with its University Hospital. LSU Medical Center is Louisiana's only comprehensive facility for the professional education of health care providers. The LSU Medical Center also has a major role in public service through direct patient care, especially for a majority of the state's indigent citizens. This program consists of the following activities: Formula Funding, and Non-Formula Funding.

OBJECTIVES AND PERFORMANCE INDICATORS

1. The LSU Medical Center will provide education, research, patient care services and community outreach in FY 1998-99.

RESOURCE ALLOCATION FOR THE PROGRAM

SOURCE OF FUNDING

The sources of funding for this program are the general fund, interagency transfers, fees and self-generated revenues, and federal funds. Interagency transfers include funds from: (1) the Department of Health and Hospitals for (a) Title XIX (Medicaid) reimbursements at the Louisiana State University Medical Center - Shreveport campus, and (b) outpatient early intervention services with respect to Human Immuno-deficiency Virus (HIV) disease at the Louisiana State University Medical Center; and (2) the Louisiana State University Medical Center, Health Care Services Division for charity hospital contracts for residency training and medical services at the Louisiana State University Medical Center's New Orleans and Shreveport campuses. Fees and self-generated revenues are from: (1) student fees, such as (a) general registration fees, (b) nonresident fees, and (c) other fees; (2) sales and services of educational activities; and (3) other revenues, including (a) commercial health insurance and self-pay revenues (at the Louisiana State University Medical Center - Shreveport campus), (b) hospital restricted revenues (at the Louisiana State University Medical Center), and (c) miscellaneous fees. Federal funds are from Medicare reimbursements at the Louisiana State University Medical Center - Shreveport campus.

ANALYSIS OF RECOMMENDATION

GENERAL FUND

TOTAL

T.O.

 

DESCRIPTION

 

 

 

 

 

$97,479,964

     $347,292,822

0

 

ACT 18 FISCAL YEAR 1997-1998

 

 

 

 

 

 

 

 

 

BA-7 TRANSACTIONS:

$0

$0

0

 

None

 

 

 

 

 

$97,479,964

$347,292,822

0

 

EXISTING OPERATING BUDGET - December 10, 1997

 

 

 

 

 

($10,000)

($10,000)

0

 

Non-Recurring Adjustment(s) - Louisiana Library Network installation

$0

$0

0

 

Equipment/Major Repairs Adjustment(s) (Non-recurring: -$1,215,437; Replacement/New: +$1,215,437)

$1,805,642

$1,805,642

0

 

Annualization of 1997 -'98 Merit Pay Adjustment(s)

$2,043,461

$2,043,461

0

 

1998 -'99 Merit Pay Adjustment(s)

($487,487)

($487,487)

0

 

Retirement Rate Adjustment(s)

$18,663

$18,663

0

 

Adjustment(s) for Civil Service, Training and Other Statewide Interagency Transfer Activities

($109,822)

($109,822)

0

 

Reductions in various Expenditure Categories; Including Reductions to fully fund Salaries

$7,805,954

$7,805,954

0

 

Risk Management Adjustment(s)

$34,942

$34,942

0

 

Legislative Auditor Fees

$4,367,777

$0

0

 

Means of Financing Substitution - Replace Fees and Self-generated revenues (which currently finance recurring expenditures with non-recurring revenues from restricted fund balances) with State General Fund (Direct)

$0

$6,017,030

0

 

Increase in Interagency Transfers from the Louisiana State University Medical Center Health Care Services Division for charity hospital contracts for residency training and medical services

 

 

 

 

 

$112,949,094

$364,411,205

0

 

TOTAL RECOMMENDED

 

 

 

 

 

$15,469,130

$17,118,383

0

 

DIFFERENCE (TOTAL RECOMMENDED AND EXISTING OPERATING BUDGET)

The total means of financing for this program is recommended at 104.9% of the existing operating budget. It represents 93.8% of the total request ($388,590,797) for this program. The major reasons for the increase from the existing operating budget are due to: (1) the risk management adjustment ($7,805,954); (2) merit increases ($3,849,103); and (3) an increase in interagency transfers ($ 6,017,030), which is attributable to an increase in the agency's contracts with the Health Care Services Division's charity hospitals for residency training and medical services at the Louisiana State University Medical Center's New Orleans and Shreveport campuses. Another significant adjustment is due to a $4,367,777 means of financing substitution. This adjustment replaces fees and self-generated revenues with general fund to finance recurring expenditures currently funded with non-recurring revenues from restricted ("off-budget") balances. This substitution is recommended because LSUMC non longer has any excess restricted funds available to be used for general support of its "on-budget" activities. For the last several years, non-recurring Title XIX (Medicaid) "disproportionate share" revenues generated by LSUMC appropriations have had as much as $47.7 million in general fund replaced with off-budget disproportionate share Medicaid funds (budgetarily considered to be self-generated revenues). In FY 1997-98, $28.6 million in general fund and $14.8 million in interagency transfers (Title XIX [Medicaid]) replaced $43.3 million in fees and self-generated revenues derived from "off-budget" sources. The recommended $4.4 million substitution represents the final phase of restoring LSUMC's general fund appropriation to its original $47.7 million (pre-"disproportionate share") level. LSUMC no longer has any disproportionate share funds in its restricted fund balances to support the operation of its medical school, hospital or research functions. A large portion of its remaining restricted funds are stringently earmarked for: (1) clinical faculty compensation; (2) support for certain activities and departments that are vital to LSUMC's academic mission; and (3) faculty research projects and support for LSUMC's research infrastructure.

PROFESSIONAL SERVICES

This program does not have a specific allocation for Professional Services for Fiscal Year 1998-1999.

OTHER CHARGES

This program does not have a specific allocation for Other Charges for Fiscal Year 1998-1999.

ACQUISITIONS AND MAJOR REPAIRS

This program does not have funding for Acquisitions and Major Repairs for Fiscal Year 1998-1999.


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