Legislators are feeling left out these days as Gov. Bobby Jindal moves forward aggressively with activity affecting the future of the state’s public hospital system.

Jindal and his top aides talk a lot about public-private partnerships and “changing the model” that the LSU hospitals provide services under.

But exactly what that means for Louisiana’s unique charity hospital system is far from clear, beyond Jindal’s push for private sector operations in other areas.

“I’m not sure which way they are going and why they are going,” said state Senate Finance Committee Chairman Jack Donahue, R-Mandeville. He said he is not alone among legislators.

“I have not had that conversation with them. What their plan is or what the intent is,” said House Appropriations Committee Chairman Jim Fannin, D-Jonesboro.

Legislators say they have been left on the sidelines as Jindal set about administratively making changes in the LSU hospital system via budget cuts and upheaval in top management.

Those changes could have immediate as well as long-ranging effects on the course of a system that long has delivered health care for the poor and served as the training ground for the state’s future physicians.

“I don’t have any more information today,” said House Speaker Chuck Kleckley, who is keenly interested in what’s happening in his own backyard with W.O. Moss Medical Center in Lake Charles.

Moss has been a target for closure in the past but survived.

“I wish I knew,” said state Senate President Pro Tempore Sharon Broome, D-Baton Rouge. “My colleagues and I are trying to find out what they have in mind ... and what it could mean for their constituents.”

Administration talk about public-private partnerships moved to the forefront in the wake of a sudden drop in federal Medicaid dollars coming to the state. Commissioner of Administration Paul Rainwater and state Department of Health and Hospitals Secretary Bruce Greenstein began the push to make changes now.

Their message was delivered as the administration stripped more than $320 million in funding from LSU’s 10-hospital system. “This is an opportunity to reform and modernize,” said Greenstein.

Thereafter, the Jindal-controlled LSU Board of Supervisors ordered development of a plan which called for a 34.5 percent cut that didn’t close hospitals or emergency rooms.

Those standards kept any cut plan outside legislative bounds.

Under state law, legislators must approve reductions of 35 percent or more as well as the closure of hospitals or emergency rooms.

Legislators inserted those provisions in law because they wanted say-so over the future of the LSU hospital system. But the administration didn’t want to go there.

Neither public-private partnerships nor the type of nebulous “reform” the administration envisioned could surface overnight, so LSU and the administration came up with some one-time money to cushion cuts but still require employee layoffs and service reductions.

Just this week the prospect of more cuts prompted LSU’s new health-care leadership to resurrect the 34.5 percent cut, 10-bed per hospital scenario. Once again, the action remained outside legislative bounds of authority.

“There’s a lot happening as it relates to health care in Louisiana, and I think that we as legislators owe our constituents as much information and insight as possible because at the end of the day they are the ones that are being impacted the most,” said Broome.

“We are absolutely being kept in the dark,” said Broome.

And so is the public.

Marsha Shuler covers health care policies for The Advocate Capitol news bureau. Her email address is mshuler@theadvocate.com.