LSU wants to close Earl K. Long Medical Center in mid-April, but key approvals have not yet been granted as patients and medical education programs are scheduled to move to Our Lady of the Lake Regional Medical Center.

Contract details are not completed with the Lake on a deal LSU entered into with a cooperative endeavor agreement nearly three years ago.

The state Department of Health and Hospitals has not yet sought federal approval for the financial arrangement included in the Lake deal.

LSU has not yet submitted a layoff plan to state Civil Service for the 834 state employees whose jobs will be eliminated at Earl K. Long and its medical clinics.

Neither have officials figured out what happens when a much-praised mental health emergency unit on the property closes as the hospital is vacated.

“They don’t have anything finished. Nothing is complete. Nothing is absolute,” said state Rep. Regina Barrow, D-Baton Rouge, in whose district the Airline Drive hospital sits.

LSU System Executive Vice President Frank Opelka said he is confident the pieces will come together in time. He said it is essential to move on an accelerated basis because of the numbers of people leaving hospital employment and a need to stabilize the workforce.

The hospital closure had been planned for November.

The LSU Board of Supervisors is scheduled to consider a revision to the existing memorandum of understanding with the Lake on Friday. According to LSU officials, the final documents are in negotiation, which will expand the Lake’s role to cover LSU-operated clinics.

The clinics must be attached to a hospital for the funding stream to flow to cover outpatient care. Originally, LSU proposed having them operate as an arm of its University Medical Center in Lafayette after Earl K. Long closed. The federal Centers for Medicare and Medicaid Services nixed the idea.

“There are numerous discussions about the overall operations and timeline that include the teaching programs as well as the hospital and clinic patient care,” said the Lake’s communications executive, Catherine Harrell. “No final agreement has been reached, but the state and LSU have asked how we can offer our expertise to help address the new circumstances.”

The original agreement called for the Lake to get 100 percent reimbursement for uncompensated care and 95 percent of costs for those enrolled in Medicaid. That financial arrangement needs the approval of CMS.

DHH Secretary Bruce Greenstein said that instead of getting a lump sum for uninsured care, as LSU has, there will be a rate established for the care delivery.

DHH has not yet filed for the “state plan amendment” with the mid-April closing date looming.

“It takes 90 days to 120 days,” DHH Undersecretary Jerry Phillips said. “But it’s retroactive if it’s going to cost the federal government less.”

Phillips said DHH tries to time the approvals to when the agreements would be effective.

He said DHH likely would file the request for approval once an agreement is reached on how the outpatient clinic piece of the deal with the Lake is structured. “That will have to be picked up,” he said.

“It’s a very doable time line,” Phillips said.

Phillips said LSU still would maintain management of the clinics. “If the Lake agrees to take on the clinics, their licensing and certification would be under the Lake’s hospital,” he said.

As the hospital closes, 834 employees of the Earl K. Long center and its clinics will lose state jobs, according to the LSU Health Care Services Division.

“The layoff plan cannot be submitted to Civil Service until we have an official effective date, which is supposed to be in the signed MOU,” HCSD spokesman Marvin McGraw said in an email response to questions. The memorandum of understanding is an extension of the cooperative endeavor agreement between the state, LSU and the Lake.

Civil Service must approve the layoff. Opelka said he will go before the Civil Service Commission on March 6 to discuss plans.

Opelka said the Lake is interested in hiring former Earl K. Long facility employees.

Capital Area Human Services District executive director Jan Kasofsky said a group of people is working on finding a place to continue providing emergency care for those in mental health crisis and considered a danger to themselves or others.

The Mental Health Emergency Room Extension on EKL’s property will have to close because there will no longer be utility services to the unit, Kasofsky said. The unit has relieved area private hospitals of having those with mental problems taking up emergency room beds.

“We don’t have a solution yet,” she said.

By March 20, Kasofsky said, the unit is expected to have a new license that does not require proximity to a hospital.