Zydekitten
03-09-2007, 07:41 PM
Sigh.
__________________________________________________ _____________
Caught in red tape, FEMA health clinic trailers sit idle
Double-wides arrived in N.O. last summer
Friday, March 09, 2007
By Jan Moller
Capital bureau
BATON ROUGE -- In a hurricane-ravaged city desperately lacking health services for the poor, the primary-care clinics that arrived in New Orleans last summer looked to be just what the doctor ordered.
The six double-wide trailers from FEMA, each equipped with eight exam rooms, were supposed to be strategically deployed around the city and provide checkups and other nonemergency health services for the city's poor and uninsured.
But nearly nine months after they were first delivered, the trailers are still in the parking lot of University Hospital waiting to be deployed, and Louisiana State University officials are angrily asking how the seemingly simple process of bringing them into service got delayed by red tape and political foot-dragging.
"It looks like the city's own bureaucratic roadblocks have prevented health care from being delivered," Ben Mount, a member of the LSU Board of Supervisors, said Thursday. "It's shameful, and it's scandalous," said Jim Roy, another member of the board.
Charles Zewe, communications director for the LSU System, said university officials are investigating the matter, combing through records and trying to figure out exactly what went wrong.
"It is inexcusable to LSU that there has been such a lengthy delay in delivering health care to people, and we are trying to move as quickly as possible to apply for the permits and get the clinics in place," Zewe said. "We're not yet sure where the responsibility lies for such an intolerable situation."
Meetings, e-mails
This much is clear, according to a detailed timeline, e-mails and other documents supplied by the university in response to a public records request: LSU hospital officials began planning for a temporary network of neighborhood clinics in early November 2005, barely two months after Hurricane Katrina knocked Charity Hospital out of commission and threw health-care services for many of the city's uninsured into disarray.
Eight months later, in late June and early July, FEMA delivered the trailers to New Orleans, with the $761,000 bill picked up by the federal government.
It wasn't until last week that the New Orleans City Council agreed to temporarily waive the city's zoning code to allow the trailers to be located at six schools around the city -- three on the east bank and three in Algiers -- for two years.
In between fell more than 100 meetings and dozens of e-mails about the issue involving LSU executives and officials at the city, state and federal levels. And the journey is not over. The zoning waivers still need approval from Mayor Ray Nagin, which cannot occur until next week at the earliest, as well as permits from the city that could take up to six months to acquire.
Donald Smithburg, who heads LSU's hospitals division, said university officials have stood ready to operate the clinics -- each of which require one doctor, two nurses and administrative staff -- since last summer, which is when LSU officials first approached the City Council about a zoning change for the clinics.
He said he was flummoxed by the continued delays. "It's been a procedural mystery as to how we get these trailers placed," Smithburg said.
Tons of zoning laws
City Council President Oliver Thomas said he was enthusiastic about the proposed clinics when the idea was floated to him by university officials last August. But as is customary with zoning issues, Thomas said he directed LSU officials to discuss the clinic sites with the council members whose districts would be affected.
"I don't know what's transpired since then," Thomas said.
The clinics are slated to be located at Behrman Elementary School, 715 Opelousas Ave., Algiers; Henderson Middle School, 1912 L.B. Landry Ave., Algiers; Walker High School, 2832 Gen. Meyer Ave., Algiers; Douglass High School, 3820 St. Claude Ave.; Drew Elementary School, 3819 St. Claude; and McDonogh No. 28 Junior High School, 2733 Esplanade Ave.
Councilman James Carter, whose district would house five of the clinics, attributed the delay to "a lot of research in dealing with the zoning laws that we have." Since current law does not allow for health clinics to be located on school property, which is zoned residential, Carter at first thought the city might have to change its zoning law, a process that can take up to a year.
Carter said it wasn't until January when the city Planning Commission suggested granting a temporary waiver while the city decides whether to permanently change the code. "My office has been working very hard this entire time to get this thing done," Carter said.
Even before Katrina, LSU officials saw neighborhood clinics as the future of the state's health-care safety net for the poor.
For years, the state has drawn criticism for steering uninsured patients into a network of 10 charity hospitals, resulting in long travel times for those who don't live near a hospital and lengthy emergency room waits for patients who arrived in need of routine medical treatment.
Murky trails ahead
LSU's initial plan, developed long before the trailers arrived, was to locate the clinics at FEMA trailer parks around the city. But when plans for the trailer parks were scrapped last spring, university officials began looking at school-based clinics.
First, however, they needed approval from the Recovery School District, which they outlined in a letter to the Superintendent Robin Jarvis in late June. Once that permission was granted, which took less than a week, LSU took its case to city officials.
Records show that LSU officials were notified on July 11 by a New Orleans zoning official that the clinic sites would require approval from the mayor and City Council. Less than a month later, on Aug. 9, the process got under way when Dr. Dwayne Thomas, the chief executive at LSU's Medical Center of Louisiana at New Orleans, wrote to Oliver Thomas requesting a variance.
After that the trail gets murky.
Oliver Thomas wrote back on Aug. 29, expressing support for the project and letting Dwayne Thomas know that his letter had been forward to City Council members Carter and Cynthia Willard-Lewis.
According to the timeline, "multiple calls to Councilman Carter and Councilwoman Willard-Lewis regarding the ordinance" were placed between August and November. "Unable to get a firm commitment to pursue ordinance change," the timeline reads.
The city's main concern, Dwayne Thomas said, was that changing the zoning code -- instead of simply approving a temporary change -- could produce unintended consequences by potentially opening up whole swaths of residential property to commercial development.
Frustrated enough?
In mid-November, state officials were concerned enough about the delays that Maureen Daly, director of the adolescent school health program for the state Department of Health and Hospitals, sent out an e-mail to Health and Hospitals Secretary Fred Cerise asking that both he and Gov. Kathleen Blanco contact the City Council about the issue.
By mid-January, LSU officials had grown frustrated enough by the lack of cooperation from the city that they were considering buying or leasing land for the clinics.
"We do have the zoning maps and know which properties we can pursue that are zoned appropriately," Dwayne Thomas wrote in a Jan. 8 e-mail to Dr. Michael Butler, LSU's medical director. "However . . . we felt it wise to give the N.O. City Council another shot at this."
The breakthrough, according to the timeline, occurred three days later, at a Jan. 11 meeting involving Carter, LSU officials, a representative from the city Planning Commission and nonprofit clinics. On Jan. 30, university officials sent a formal request to Carter asking for a zoning variance, and laying out detailed plans of how the clinics would operate.
Two weeks later -- on Feb. 15 -- the ordinances were finally introduced to the council. Carter said it was never his intention to slow things down. "Certainly the issue of health care and school-based clinics is something that made a lot of sense to us," he said.
. . . . . . .
Jan Moller can be reached at jmoller@timespicayune.com or (225) 342-5207.
__________________________________________________ _____________
Caught in red tape, FEMA health clinic trailers sit idle
Double-wides arrived in N.O. last summer
Friday, March 09, 2007
By Jan Moller
Capital bureau
BATON ROUGE -- In a hurricane-ravaged city desperately lacking health services for the poor, the primary-care clinics that arrived in New Orleans last summer looked to be just what the doctor ordered.
The six double-wide trailers from FEMA, each equipped with eight exam rooms, were supposed to be strategically deployed around the city and provide checkups and other nonemergency health services for the city's poor and uninsured.
But nearly nine months after they were first delivered, the trailers are still in the parking lot of University Hospital waiting to be deployed, and Louisiana State University officials are angrily asking how the seemingly simple process of bringing them into service got delayed by red tape and political foot-dragging.
"It looks like the city's own bureaucratic roadblocks have prevented health care from being delivered," Ben Mount, a member of the LSU Board of Supervisors, said Thursday. "It's shameful, and it's scandalous," said Jim Roy, another member of the board.
Charles Zewe, communications director for the LSU System, said university officials are investigating the matter, combing through records and trying to figure out exactly what went wrong.
"It is inexcusable to LSU that there has been such a lengthy delay in delivering health care to people, and we are trying to move as quickly as possible to apply for the permits and get the clinics in place," Zewe said. "We're not yet sure where the responsibility lies for such an intolerable situation."
Meetings, e-mails
This much is clear, according to a detailed timeline, e-mails and other documents supplied by the university in response to a public records request: LSU hospital officials began planning for a temporary network of neighborhood clinics in early November 2005, barely two months after Hurricane Katrina knocked Charity Hospital out of commission and threw health-care services for many of the city's uninsured into disarray.
Eight months later, in late June and early July, FEMA delivered the trailers to New Orleans, with the $761,000 bill picked up by the federal government.
It wasn't until last week that the New Orleans City Council agreed to temporarily waive the city's zoning code to allow the trailers to be located at six schools around the city -- three on the east bank and three in Algiers -- for two years.
In between fell more than 100 meetings and dozens of e-mails about the issue involving LSU executives and officials at the city, state and federal levels. And the journey is not over. The zoning waivers still need approval from Mayor Ray Nagin, which cannot occur until next week at the earliest, as well as permits from the city that could take up to six months to acquire.
Donald Smithburg, who heads LSU's hospitals division, said university officials have stood ready to operate the clinics -- each of which require one doctor, two nurses and administrative staff -- since last summer, which is when LSU officials first approached the City Council about a zoning change for the clinics.
He said he was flummoxed by the continued delays. "It's been a procedural mystery as to how we get these trailers placed," Smithburg said.
Tons of zoning laws
City Council President Oliver Thomas said he was enthusiastic about the proposed clinics when the idea was floated to him by university officials last August. But as is customary with zoning issues, Thomas said he directed LSU officials to discuss the clinic sites with the council members whose districts would be affected.
"I don't know what's transpired since then," Thomas said.
The clinics are slated to be located at Behrman Elementary School, 715 Opelousas Ave., Algiers; Henderson Middle School, 1912 L.B. Landry Ave., Algiers; Walker High School, 2832 Gen. Meyer Ave., Algiers; Douglass High School, 3820 St. Claude Ave.; Drew Elementary School, 3819 St. Claude; and McDonogh No. 28 Junior High School, 2733 Esplanade Ave.
Councilman James Carter, whose district would house five of the clinics, attributed the delay to "a lot of research in dealing with the zoning laws that we have." Since current law does not allow for health clinics to be located on school property, which is zoned residential, Carter at first thought the city might have to change its zoning law, a process that can take up to a year.
Carter said it wasn't until January when the city Planning Commission suggested granting a temporary waiver while the city decides whether to permanently change the code. "My office has been working very hard this entire time to get this thing done," Carter said.
Even before Katrina, LSU officials saw neighborhood clinics as the future of the state's health-care safety net for the poor.
For years, the state has drawn criticism for steering uninsured patients into a network of 10 charity hospitals, resulting in long travel times for those who don't live near a hospital and lengthy emergency room waits for patients who arrived in need of routine medical treatment.
Murky trails ahead
LSU's initial plan, developed long before the trailers arrived, was to locate the clinics at FEMA trailer parks around the city. But when plans for the trailer parks were scrapped last spring, university officials began looking at school-based clinics.
First, however, they needed approval from the Recovery School District, which they outlined in a letter to the Superintendent Robin Jarvis in late June. Once that permission was granted, which took less than a week, LSU took its case to city officials.
Records show that LSU officials were notified on July 11 by a New Orleans zoning official that the clinic sites would require approval from the mayor and City Council. Less than a month later, on Aug. 9, the process got under way when Dr. Dwayne Thomas, the chief executive at LSU's Medical Center of Louisiana at New Orleans, wrote to Oliver Thomas requesting a variance.
After that the trail gets murky.
Oliver Thomas wrote back on Aug. 29, expressing support for the project and letting Dwayne Thomas know that his letter had been forward to City Council members Carter and Cynthia Willard-Lewis.
According to the timeline, "multiple calls to Councilman Carter and Councilwoman Willard-Lewis regarding the ordinance" were placed between August and November. "Unable to get a firm commitment to pursue ordinance change," the timeline reads.
The city's main concern, Dwayne Thomas said, was that changing the zoning code -- instead of simply approving a temporary change -- could produce unintended consequences by potentially opening up whole swaths of residential property to commercial development.
Frustrated enough?
In mid-November, state officials were concerned enough about the delays that Maureen Daly, director of the adolescent school health program for the state Department of Health and Hospitals, sent out an e-mail to Health and Hospitals Secretary Fred Cerise asking that both he and Gov. Kathleen Blanco contact the City Council about the issue.
By mid-January, LSU officials had grown frustrated enough by the lack of cooperation from the city that they were considering buying or leasing land for the clinics.
"We do have the zoning maps and know which properties we can pursue that are zoned appropriately," Dwayne Thomas wrote in a Jan. 8 e-mail to Dr. Michael Butler, LSU's medical director. "However . . . we felt it wise to give the N.O. City Council another shot at this."
The breakthrough, according to the timeline, occurred three days later, at a Jan. 11 meeting involving Carter, LSU officials, a representative from the city Planning Commission and nonprofit clinics. On Jan. 30, university officials sent a formal request to Carter asking for a zoning variance, and laying out detailed plans of how the clinics would operate.
Two weeks later -- on Feb. 15 -- the ordinances were finally introduced to the council. Carter said it was never his intention to slow things down. "Certainly the issue of health care and school-based clinics is something that made a lot of sense to us," he said.
. . . . . . .
Jan Moller can be reached at jmoller@timespicayune.com or (225) 342-5207.