Two of the three issues surrounding Our Lady of the Lake Medical Center becoming home to LSU medical education and hospital operations remain unresolved.

But LSU’s system vice president in charge of health care, Fred Cerise, said progress is being made although it’s been slow going since the deal with the Lake was struck in early 2010.

One issue left to tackle is how to handle prisoner care that has been done at LSU’s Earl K. Long Medical Center, which will close by the end of 2013.

Prisoner care is not part of the deal with the Lake.

The other issue involves the licensing of LSU clinics now attached to the north Baton Rouge-based EKL. The licensing issue is key to being able to access federal dollars for care of the uninsured.

Previously, Cerise called the two issues among three “hanging concerns” related to the cooperative endeavor agreement with the Lake.

LSU resolved the third issue involving obstetrics and gynecological services by entering into an agreement with Woman’s Hospital in fall 2009 to house its medical training program and in-patient care.

The Lake pact excluded those services.

Within the next month, Cerise said a request for proposal will be issued seeking a hospital willing to accept the prisoner patients. EKL runs a prisoner patient census of about seven a day, Cerise said.

Cerise said LSU earlier put out a feeler to gauge hospital interest in the program.

“We have had inquiries from a few places,” Cerise said, including Baton Rouge General Medical Center and a hospital in St. Francisville.

The questions the hospitals raised help officials draft the request for proposal that will be sent out, Cerise said. “That does not mean they want to do it,” he said.

“If we don’t get the response we are looking for, there are other things we can consider such as seeking a company that would do the whole thing. They would take on the responsibility for finding hospitals and doctors,” Cerise said. “But we want to see first off if there’s a hospital interested in doing it.”

Meanwhile, Cerise said, the state Department of Health and Hospitals is working with LSU trying to resolve the issue of federal health-care financing related to EKL’s clinics.

Cerise said DHH has submitted a Medicaid state plan amendment to the federal Center for Medicare and Medicaid Services.

State Medicaid director Don Gregory said the state is proposing a rule to allow the clinics to become arms of LSU’s University Medical Center in Lafayette, which would allow preservation of the financing stream.

Under Medicaid rules, the hospital to which clinics would be linked has to be within a 35 mile radius of the hospital, DHH Undersecretary Jerry Phillips said.

Phillips said the new rule would expand that to a hospital within 50 miles and provide for an exception to 100 miles in the event of the closure of a state-owned hospital. The rule is specifically written for the EKL situation, he said.

If patients need hospitalization, they could go to the Lafayette hospital but more likely would be referred to the care of LSU physicians at the Lake, Phillips said.

CMS seems willing to go along, Gregory said. “They understand the need,” he said.

Meanwhile, LSU’s Health Care Services Division along with Community Health Care Services are seeking federal approval to make the Mid-City Clinic — located at 1401 North Foster Drive — a “Federally Qualified Health Clinic Look-alike,” LSU Health Care Services Division executive officer Roxane Townsend said.

Such entities get enhanced Medicaid reimbursement for care delivered, she said.