Hospital headache: More questions than answers still plague LSU, VA

New Orleans CityBusiness, Apr 10, 2008 by Richard A Webster

A state Senate panel convened a hearing March 25 to clarify the status of Louisiana State University's proposed $1.2-billion, 484- bed teaching hospital. But the meeting raised just as many questions as it answered.

Department of Health and Hospitals Secretary Alan Levine expressed concerns about the cost and the size of the hospital and said he will need up to three months to study the business plan.

State Sen. Julie Quinn, R-Metairie, went so far as to question the very need for a new facility as opposed to renovating the old Charity Hospital building, a point that left state Sen. Cheryl Gray, D-New Orleans, "troubled."

"I can appreciate the debate about size. But to the extent people are saying we don't know if we need a new hospital for the future, that concerns me," said Gray, who worries any uncertainty could have a negative impact on plans for a new downtown Veterans Administration Hospital.

"I think we need to be concerned that we are not sending a message that suggests we're backing off from the hospital," she said. "Everyone seems to think the VA is on track but clearly if they start getting the sense there's a problem, I think they will look for other alternatives."

LSU and the VA have partnered to build a joint medical center in downtown New Orleans for more than $2 billion in state and federal funds. The proposed site is bordered by South Rocheblave and Canal streets and North Claiborne and Tulane avenues. The complex will replace Charity Hospital and the VA Hospital, both closed since Hurricane Katrina, and serve as a teaching facility for local medical schools.

Dr. Fred Cerise, LSU's vice chancellor of health affairs and medical education, echoed Gray's concerns that increased delays that call into question the state and city's commitment to the LSU hospital will threaten the VA project as well.

"The VA has made it very clear they're committed to this, that the preferred location is downtown and they want to do something in conjunction with LSU," Cerise said. "But at some point if it appears the state is not going to proceed in this direction, it would influence the VA's decision. And if at some point the VA were to get the message that we're not moving ahead or we changed our minds, then I think all bets are off."

Dr. James Moises, a longtime opponent of the LSU plan, said he has heard behind the scenes that the VA has already made a decision to abandon the downtown site in favor of a location on Jefferson Highway across from Ochsner Health System.

"From what I've heard the VA and LSU joint venture has been off for a long time," Moises said. "I think the VA is in bed with Ochsner and they're going there. But LSU will keep pushing that if they don't get what they need, the joint venture with the VA will be off. It's a bargaining tool now. The VA says it's still committed to being in the New Orleans metropolitan area but not specifically downtown."

Ochsner spokeswoman Katherine Voss said hospital officials were not available for comment.

Julie Catellier, director of the Southeast Louisiana Veterans Health Care System, said the VA remains committed to building a state-of-the-art facility in metropolitan New Orleans and said the "preferred site" is the 34-acre downtown quadrant between Canal and Tulane designated by James Peake, secretary of Department of Veterans Affairs.

"The funding to accomplish this critical goal is secure and we are making substantial progress on the replacement hospital project," Catellier said. "It's important that our veterans know and understand that VA will have a medical center here for them."

Tulane Medical Center has long supported LSU's proposed hospital but during the Senate hearing, Dr. Benjamin Sachs, head of the Tulane University's School of Medicine, gave LSU the impression Tulane's support has wavered.

When asked whether he believes 484 beds are required in the new facility, Sachs said, "With new innovations in the way medicine is being provided, you won't need as many beds as you need today."

Cerise said Sachs' suggestion that perhaps the hospital didn't need to be as big as proposed took him off guard.

"Tulane has been involved in discussions with LSU and the VA from the beginning," Cerise said, "There has been a large amount of mutual planning and at this stage to suggest a substantially different model is something that I think creates a problem for this project. We are depending upon two years of planning and analytical work done by independent experts. It's not unusual to get questions but we have done an extensive amount of mutual planning, so yes, it was unexpected to hear a suggestion that it could be smaller."

Sachs said he is fully supportive of a new teaching hospital and never intended to question its viability.

"I'm only four months into living in New Orleans and people who have been here have studied this a lot longer than I have. I don't claim to be an expert on what is needed at this time," Sachs said.

However, it is important to consider technological advances in the past 10 years that have decreased the length of hospital stays and what could occur in the seven years it is expected to take to build the 484-bed hospital, Sachs said.