Too many unknowns: Gov. John Bel Edwards not yet ready to commit to specific north Baton Rouge ER proposal _lowres

Advocate staff photo by TRAVIS SPRADLING -- Exterior of Champion Medical Center, April 28, 2016. Chauna Banks-Daniel and her north Baton Rouge blue ribbon commission are hosting a meeting on Thursday evening at Champion Medical Center in Howell Place where they'll discuss opening an emergency room in north BR.

A proposal to build an emergency room in north Baton Rouge has too many unknowns, Gov. John Bel Edwards said Tuesday, and he wants to ensure that improving health care access in the area is done right before committing to funding or a specific plan.

Some local officials have advocated for an emergency room to be added at Champion Medical Center, a specialty surgical hospital near Baton Rouge Metropolitan Airport. But the for-profit company that owns the hospital would require more than $7 million in subsidies over the next two years, while state government is still struggling to fund its existing hospitals.

Meanwhile, Our Lady of the Lake Regional Medical Center recently submitted a draft plan to the state’s Department of Health showing how it could expand emergency services at its north Baton Rouge urgent care centers. It’s unclear whether those services would cost the state more money than the hospital already receives as part of its public-private partnership to serve the poor.

Edwards said in late March he was “working very hard to get an emergency room back open in north Baton Rouge.” He reiterated his pledge Tuesday, though legislators said he told them Monday the state lacks the money for the Champion emergency room subsidy.

“… There are questions surrounding the proposal,” the governor said in a statement about Champion. “This project is a priority, and I want to ensure that we not only get it done but that we get it done right. … I’m asking the area’s delegation to work with me as we move forward.”

Edwards’ spokesman Richard Carbo said one of the problems with Champion’s proposal is that it does not have approval yet from the Centers for Medicare and Medicaid Services, a designation that ensures facilities meet the minimum safety standards necessary to be considered a provider.

“We don’t have full proposals from either yet,” Carbo said about Champion and Our Lady of the Lake. “But we are in conversations. We don’t have a preference for one over the other at this point.”

The Department of Health also released a statement saying it recognizes “the need for greater access to appropriate health care services in north Baton Rouge” and that it will study and provide information about the best path forward.

North Baton Rouge has lacked an emergency room for more than a year, with the closures of Baton Rouge General’s Mid City ER on Florida Boulevard in 2015 and the state’s Earl K. Long hospital in 2013.

The gap in emergency services has sparked heated political battles about the kind of health care that residents in north Baton Rouge most need. The proposed free-standing emergency room at Champion Medical Center would require a build out of the facility, which focuses on personalized, boutique-style health care and specialty surgeries. Champion’s promise of a quick timeline, saying it could be open and offering services by 2017, has excited some of their backers.

The East Baton Rouge Parish Metro Council passed a resolution at the end of May to encourage local hospitals to discuss potential agreements with Champion to take in patients who need additional care after a few days at Champion.

Our Lady of the Lake spokeswoman Kelly Zimmerman said Tuesday that CEO Scott Wester sent the Department of Health a draft of a plan for expanded services in north Baton Rouge “in anticipation of discussions.”

The Lake’s proposal is for an “advanced care center” at its extensive urgent care facility on Airline Highway, which the proposal says it would replicate on Florida Boulevard. The Lake would add 24/7 emergency physicians, expand lab services and participate in a pilot program in which ambulances could bring patients not in need of an emergency room to its urgent care clinic instead.

“We continue to work with (Department of Health) to explore the issue,” Zimmerman said.

Political leaders had mixed reactions to Edwards’ lack of immediate action on the proposal for Champion.

State Rep. Edmond Jordan, D-Baton Rouge, said he was disappointed Champion will not receive the funding it has asked for, but he said he’s glad Edwards has reaffirmed his commitment to north Baton Rouge.

Jordan said he wants the best for north Baton Rouge, regardless of whether the services come from Champion or Our Lady of the Lake. But he said Our Lady of the Lake’s past comments about north Baton Rouge not needing an emergency room give him pause about its proposal.

“I just find it a little bit curious that now that Champion is at the table, now all of the sudden the Lake is interested in potential ER services,” Jordan said.

State Sen. Regina Barrow, D-Baton Rouge, said she is disappointed in the lack of funding this year, but she’s been happy to see the Department of Health take an interest in north Baton Rouge.

“I understand the dynamics of where we are; I know money is tight,” Barrow said. “But I was hoping we could get the ball rolling.”

State Rep. Ted James, D-Baton Rouge, called Champion’s proposal a “starting point,” and he applauded the facility for bringing other parties to the table. James said he is less concerned with the time frame and who is behind the health care proposals and more concerned with making sure north Baton Rouge receives the right fit.

“The people there don’t deserve something that is not sustainable,” James said.

But Gary Chambers, a member of the #NBRNOW Blue Ribbon Commission pushing for the Champion ER, lashed out at Our Lady of the Lake’s plan.

“This is about funding and controlling the health care market, not about helping the people of north Baton Rouge for them,” Chambers said. “It’s disgraceful they would do this at the last hour to attempt to stop progress for north Baton Rouge.”

State Sen. Bodi White, R-Central, said it was late in the game for those pushing the Champion emergency room to request money. The state’s regular legislative session ended Monday, with a special session to raise revenue — in part for hospitals — that started later Monday.

“With the shape of our budget and trying to fund our hospital partners across the state … this is a tough year to try to do it, to try to start it,” White said. “It may be different next year.”

Meanwhile, White had authored a bill in the regular legislative session to create a pilot program for ambulances to take patients not in need of emergency services to other health care centers. The legislation, which passed and is awaiting Edwards’ signature, outlines urgent care centers, mental health centers, detoxification centers and other health care facilities as places where ambulances could transfer certain patients. He created the bill with the goal of alleviating overcrowding in emergency rooms and to give Emergency Medical Services more flexibility.

Despite different proposals for emergency services in north Baton Rouge, stand-alone ERs are controversial trends. Our Lady of the Lake opened the first one in the state in 2012 in Livingston Parish.

Proponents argue they expand access to health services, but critics say they are generally glorified urgent care centers that can charge patients more. The annual subsidy Champion is requesting, at $3.8 million a year, also is almost as much as the $4 million a year subsidy the city of New Orleans is giving to its full-service New Orleans East Hospital.

The Louisiana Emergency Response Network has said standalone emergency rooms are usually not equipped to help trauma patients. Those who have been in serious automobile wrecks, people who have fallen great distances and victims of gunshot wounds are almost always routed to a trauma center — at Our Lady of the Lake on Essen Lane in Baton Rouge, for instance — instead of the nearest hospital.

New Orleans state Rep. Walt Leger also expressed concerns about free-standing emergency departments. During the regular legislative session, the Democratic representative passed a resolution asking the Louisiana Department of Health to reject licenses for these types of facilities.

Leger said in Texas, hundreds of these for-profit ventures pop up near legitimate emergency rooms but are not equipped to treat serious emergency conditions like heart attacks and strokes. He said people who go to them often have to be transferred to legitimate hospital emergency rooms, thereby wasting precious time.

But Leger did add an amendment to his resolution, with north Baton Rouge in mind, that the directive would not apply to rural and urban communities with a “critical shortage of health care professionals and facilities.”

Barrow also authored a resolution to urge and request the Department of Health to make a recommendation regarding free-standing emergency departments in north Baton Rouge.