After meeting with hospital officials, emergency room physicians, paramedics and community leaders, Health Secretary Kathy Kliebert said she is confident other facilities can handle the added load when Baton Rouge General Medical Center-Mid City closes its emergency room March 31.
“What happens next? That’s the big question,” Kliebert said Tuesday during a community meeting at Star Hill Baptist Church. Roughly 150 people were present.
The short answer is a lot of education and outreach efforts. Kliebert said the state Department of Health and Hospitals will need help from everybody, including the state Department of Education and the East Baton Rouge Parish school system, to get out the word on where and how to access health care.
The last thing anyone wants to happen is for April 1 to dawn with people unsure what to do in case of emergencies or where to go for primary care, specialty or urgent care clinics, she said.
DHH plans to get that information into as many hands as possible, and as quickly, Kliebert said.
The long-term solution will involve changing the way people use ERs, and a brochure with guidelines on when to go to the ER or a clinic won’t do that, she said.
The state closed Earl K. Long Medical Center in April 2013. Although those patients had access to free care at Our Lady of the Lake Regional Medical Center, and at LSU Health Baton Rouge clinics, many, particularly those from the central and northern parts of the city, chose to go to the Mid City ER instead. Saddled with the costs of treating more uninsured and underinsured patients, the Mid City ER losses reached $2 million per month.
Many patients used the ER as their source of primary care. This kind of improper ER use is an entrenched, national problem, Kliebert said, and it will take years to alter patient behavior, but the change is necessary.
DHH figures show that of the 45,000 Mid City ER visits last year, only 20 percent involved life-threatening issues.
It may take a similar time period for anger to fade over the Mid City ER’s closure. Moderator John Spain, executive vice president of the Baton Rouge Area Foundation, told attendees the discussion would be limited to making sure community members know how to get adequate health care.
The conversation about why and how it happened is for another day, he said.
But the Rev. Richard Andrus, pastor at St. Paul the Apostle Catholic Church, was one of several speakers who weren’t satisfied with the health care community’s solution.
This decision was immoral and unjust, Andrus said. Everything that matters to the Mid City community doesn’t seem to matter to the people who made the decision. There has to be a way to fund emergency care in this community, he said.
Dr. Luther Stewart said if a similar decision — made behind closed doors, with no community input — affected the General’s Bluebonnet campus, or Our Lady of the Lake Regional Medical Center, or Woman’s Hospital, the surrounding communities would rise up in protest.
The closure would never happen, he said.
David Hood, former DHH secretary, said the plans DHH and other health care officials have made should be applauded. But the Mid City ER could stay open if the state expanded Medicaid. The state could collect $18 billion in federal funding over 10 years and care for 240,000 additional people, he said.
Gov. Bobby Jindal has said expanding Medicaid would cost the state close to $2 billion, money Louisiana doesn’t have, over that period.
Meanwhile, Kliebert said there has been some progress in changing patients’ ER habits.
More patients visited LSU Health Baton Rouge’s Mid City urgent care clinic in the year ending in April than went to Earl K. Long’s ER in the 12 months before the hospital closed.
DHH also thinks it may have found a solution to finding transportation for the uninsured. One common complaint is that poor people don’t have a way to get to the Lake, which is located on Essen Lane.
However, DHH is working with CATS, now a non-emergency transportation provider for Medicaid, to take uninsured patients to LSU clinics, Kliebert said. An arrangement between CATS and Our Lady of the Lake may allow DHH to fund that transportation using federal health care dollars.
Kliebert said the state could leverage existing dollars for transportation, so no additional state funds would be needed.
Meanwhile, Baton Rouge General officials said only a few services, such as cath lab procedures for emergency heart care, will shift to the Bluebonnet campus. The services and facilities that will remain at Mid City include Pennington Cancer Center, the regional burn center, advanced wound care and hyperbarics, Behavioral Wellness Center, geriatric psychiatric care, surgery, rehabilitation, medical acute care, skilled care, intensive care, dialysis, long- term acute care, hospice, and lab and imaging services. Mid City also will serve as a satellite campus for Tulane School of Medicine, house internal medicine and family medicine residency programs and the General’s schools of nursing and radiologic technology.
Last month, DHH announced plans to expand LSU Health clinics to help offset the ER closing. Those steps include:
Expanding LSU Health’s Mid City urgent care clinic hours to 9 a.m. to 9 p.m. seven days a week as of March 23. The clinic on North Foster Drive, 1.5 miles from the Mid City ER, is now open 3 p.m. to 11 p.m. Monday to Friday, and 9 a.m. to 9 p.m. Saturday and Sunday.
Expanding the hours at LSU Health’s 24-hour North Campus Urgent Care Clinic on Airline Highway for advanced diagnostic services such as CT scans and MRIs.
Our Lady of the Lake Regional Medical Center also plans to expand pediatric staff at North Campus Urgent Care, add more evening hours and same-day appointments for pediatric practices at its Goodwood clinic, and look at ways to increase seniors’ services.
Seniors made up roughly 25 percent of the ER visits at Mid City while children accounted for 13 percent.
Follow Ted Griggs on Twitter, @tedgriggsbr.