Friday, February 13, 2009

Jindal Tip-Toes Around Hospital Plans

It's been a pretty interesting 48 hours or so in the ongoing debate over whether to build a new LSU/VA super complex or to rehabilitate Charity. Let's review, shall we?

We shall.

On Wednesday, and Adrastros has a good political take on this, righty pundit John Maginnis wrote a column taking Governor Bobby Jindal to task for his poor leadership, citing a pattern of political cowardice. He sneaks in the LSU/VA controversy as exhibit C toward the bottom of the article:

Jindal also supports LSU's plan for a new teaching hospital in New Orleans, but you wouldn't know it from his silence while preservationists accuse state health-care officials of plotting to destroy a neighborhood alleged to be historic.

Maybe I'm nitpicking, but the neighborhood is not "alleged to be historic." It's a nationally registered historic district as part of the Mid City Historic District. This isn't something that preservationists are just making up or alleging to suit the needs to their argument; the Mid City Historic District was designated way back in 1993. The hospital proposal threatens 145 historic buildings. It's a fact. But either way, it rhetorically reduces the argument against the LSU/VA complex to the aesthetic complaints of those nerdy historians when, in actuality, the opponents of the LSU plan center their arguments on things like fiscal responsibility, transparency, and the city's public health emergency.

Coincidentally or not, Jindal turned around and within 24 hours, was on the tv 'reaffirming his support' for the LSU/VA.

But where some saw certainty, there's actually some surprising equivocation:

He said that renovating Charity is out of the picture.

“My commitment hasn’t changed. Our support hasn’t changed,” Jindal said, adding the only way they'd renovate is “if LSU were all of a sudden to come back and say, ‘you know what, we’ve talked to engineers, we’ve talked to architects, we think we can build a great, modern hospital within the old footprint.’”

“My point is this: I continue to support the fact that we need a modern hospital that is connected to the VA, that’s a home for not only patient care – which is absolutely critical – but graduate medical education and cutting-edge research,” Jindal said.

How very interesting. Jindal reaffirms his support for a robust biomedical district anchored by a modern teaching hospital and pledges his support for the LSU plan. But he does not explicitly rule out the rebuilding of a hospital in Charity. He just says that the decision is up to LSU.

Now why would he say something like that? Why would he even create that daylight?

In fact, world-renown architects and engineers have already evaluated the Charity footprint. RMJM Hillier, the world's 6th largest architecture and design firm, found that the old limestone shell of Charity remains not just structurally sound, but ideal for a "great, modern hospital."

In fact, an objective side-by-side comparison of the LSU proposal and the RMJM Hillier proposal yields a clear conclusion.

New Orleans can have a state-of-the-art biomedical development corridor faster, cheaper, and better based on the Hillier model. By building a state of the art facility in the Charity shell, New Orleans can attract economic development, restore public health infrastructure, and make the Central Business District more robust, all while avoiding the demolition of a historic residential neighborhood.


LSU has argued that their teaching hospital needs to be connected to the VA. Why? Why do the hospitals need to be connected? Are they sharing facilities?

Not really. In fact, there is no compelling reason why these hospitals need to be directly adjacent instead of two blocks away.

What is it about the Charity building that makes it incongruous with a modern facility?

Nothing. In fact, the RMJM Hillier plan does not plan to preserve Charity's interior or anything about the outdated ward layout. They propose preserving the solid limestone exterior while building an entirely brand-new facility inside.

LSU has never taken the time to properly evaluate the structure of Charity. One of their major claims by LSU is that Charity is unsound structurally because of rusted connectors in the limestone shell of the building.

In fact, RMJM Hillier took a thermal image of the building and found that the building wasn't even constructed with connectors.

And so on and so forth.


The LSU/VA project will not go forward as currently proposed.

Residents, public health advocates, smart growth planners, preservationists, and civil rights activists will fight this every single step of the way.

LSU does not have the money, LSU does not have the argument, and LSU does not have the right.

And our city doesn't have the time. We can't afford for them to cling to their disproved model when everybody else is willing to compromise with this alternative proposal. We could start building next year instead of next century.

If LSU would just take an honest look at RMJM Hillier's plan or even bother to show up at one of the countless public forums that have been held on the matter to defend their plan, they might have some credibility. But they haven't and they don't.

We can have a state-of-the-art hospital district sometime before the end of next decade if LSU would just reevaluate Charity and admit that rebuilding on that site is the smarter, better, cheaper, and faster way to bring back medical care to New Orleans.

And to me, it looks like Bobby Jindal is willing to support that compromise as soon as LSU gets its own head out of the sand.


So you tell me who's the obstructionist here?

Is it the diverse partnerships that have already rallied around a compromise proposal?

Or is it really just LSU that can't get its sh*t together?


G Bitch said...

Good work, E.

I have relatives and acquaintances who were in the Charity system for many, many years and LSU's desire for a brand-new hospital is not new and the flooding gave LSU what it saw as a chance to demand a new hospital. Opposition was not expected. The connection to VA is about "sharing" costs with VA, something I do not see VA or the feds doing. And LSU raised money for a new hospital years ago. That money is gone. Where? Someone knows. The facts are being ignored because the facts are inconvenient.

Jindal reaffirms his support for a robust biomedical district anchored by a modern teaching hospital and pledges his support for the LSU plan. But he does not explicitly rule out the rebuilding of a hospital in Charity. He just says that the decision is up to LSU.Now why would he say something like that?

Doesn't this sound like the yes-no crap he tried to pull with the state legislator raises? He said that was the decision of legislators, that the pay raises were up to them, not him. It's his way of getting something without sticking his neck out or taking any kind of risk that might hamper or slow down his national ambitions. Yet with the pay raise issue, he made a total fool out of himself, and nationally at that, and then changed his "mind." He thinks he can get the glory and leave the blame for others. I hope this backfires on his ass, too.

Puddinhead said...

Jesus. Perfect, logical solution...LSU goes ahead and moves the school to BR, and donates the old Charity shell to some preservation group. Then the patients can bus up to BR to get medical care, and the preservationist can hug their 70-year-old building that seems to be more important than the actual issue of medical care is...

E said...

Right because they wouldn't have to worry about selecting a site, drawing up specs, or acquiring land if they up and moved to Baton Rouge?

They wouldn't have to face down neighborhoods in Baton Rouge?

They wouldn't have to face down all of their allies on the DDD and the GNOBEDD?

They wouldn't have to go back through the state legislature or renegotiate the VA?

Face it, Puddinhead. The best and fastest way to build new medical facilities in New Orleans is to adopt the RMJM Hillier compromise proposal. Even if EVERYBODY that was displeased with the LSU/VA just capitulated tomorrow morning, it would still be years YEARS! before LSU would have it together to start construction.

That's why they need to get with the program and get with the people that have come up with this sustainable compromise.

Cheaper, faster, better.

Ella said...

I had some reservations about all this, but I also didn't realize they had 12'6" ceilings on all floors. Hospitals need large ceiling space, and therefore are a pain to retrofit. Sure it was a hospital before, but getting it back in order would require a lot of code updates- and the codes have changed a lot since the late 40's!

RMJM is a large firm, and while they have a sincere sounding corporate responsibility policy, they still aren't going to rock the (seaworthy) boat. And 12'6" ceilings are awesome. With a good hospital speciality design firm on the team they should be able to make that work no problem.

No matter what one's opinions are on the new vs. renovate issue, the current plan is just bad. It is a unintelligent use of space and money. It draws on the same ill-informed urban renewal ideas that lead the destruction of a substantial part of Treme to create to Armstrong Park.

Puddinhead said...

Jesus, you ever been to Baton Rouge for any length of time? Say "It's for LSU" and they'll gladly give you their first born son. There's mile after mile of open prime development space within Baton Rouge, and nobody gives a rat's patootie about urban vs. suburban design. If LSU ever gets fed up and even floats a hint that they might consider a move from NOLA to BR, the citizenry of BR will welcome them with big wet sloppy kisses while the state Legislators won't be able to keep from falling over each other to be the ones to find ways to supply the necessary financing. "Allies" in NOLA business community? They're "useful" now...and will have absolutely no use if the overall calculations begin to produce answers of "BR" rather than "NOLA". LSU and State government will leave the NO contingent standing with their thumbs up their collective tookises. The VA has stated they're ready to go ahead with their project on the riverside part of the parcel whether the State's involved or not. The VA will likely be built in Lower Mid-City either way...even after the Legislature and BR government get to feed their fetish for huge new shiny things in the city of Baton Rouge for LSU.

As far as State government is concerned, NOLA is the ne'er-do-well son who the "adults" in the state (who they see as all being in State government, of course) have been trying to "straighten out" for years. Some of those knuckleheads get off on feeling like they're dealing a little "tough love" to anyone. Another significant portion feels like they can't go wrong as far as their constituency is concerned with being seen as "punishing" NOLA. A REALLY big contingent spends so much time (and for so many years, for a large number of them) in Baton Rouge that they see BR as their REAL constituency, rather than whatever part of the State they actually represent.

Richard P. said...

Some very valid points. Absolutely, if LSU ever starts hinting at moving the medical school B.R. people will be all over it. They've been chomping at the bit since 2005 to state their case of their superiority to N.O. No matter what everyone needs to come together to start moving forward in earnest on this project and stop fiddling around, for the interests of the city and region.

Also, as regards the renovation what does not seem to have been brought up yet is that LSU had no choice but to purchase Hotel Dieu years ago. Charity Hospital was *condemned* for use as a hospital because of fire safety and was not going to keep its accreditation. Even in the era between then and immediately prior to 8/29/2005 whenever there had to be surgeries for trauma patients such patients might have been kept at Charity for maybe a day or so and then moved as soon as convenient to Tulane or University Hospital. Most of the building was either offices or clinics. Thus, it's still hard, as well meaning as I have no doubt that many of the supporters of Charity Hospital are, to find their renovation proposal quite credible in the cold light of reality.

bayoustjohndavid said...

Richard P. and Puddinhead are basically correct. Notice that the resolution by a representative from Morgan City was cosponsored by a senator from St. Tammany. Opposition from people and neighborhood groups in Baton Rouge? Not gonna happen. People in B.R. have complained about congestion and other byproducts of growth for at least twenty years, but they're mostly Sun Belt conservatives to whom growth is an absolute and the free market is part of God's plan. If I can add a personal observation, I looked at the Baton Rouge version of City Business in the waiting room of my doctor's office (temporarily in B.R. post-K) a few times late 2005/ early 2006, they seemed to think that the B.R. area had permanently become the financial and population center of the state. They'd gladly sacrifice a neighborhood and put up with traffic snarls to maintain that status.

You can argue to what degree the threat of losing the medical school warrants rolling over for the LSU board, but don't dismiss the threat.

Finally, preservationists should certainly make use of the RMJM Hillier report, but I think LSU opponents are relying it on a little too much If the report should be discredited, or even called into serious question, it will knock the legs out from under the opposition.

bayoustjohndavid said...

That should read:

"but they're mostly Sun Belt conservatives to whom growth is an absolute good and the free market"

E said...

Well maybe it is true that Baton Rouge would roll out the red carpet, but I don't think we're being reasonable about the extent to which the relocation of the hospital away from New Orleans would cause political mayhem. It won't be easy to just relocate. There will be a great deal of political and technocratic resistance before anything like that can happen. And it will mean that LSU will not have a hospital built for several more years.

And since so many components of the biomedical district that LSU wants to be a part of are already right here in sunny New Orleans, they'd basically be admitting that their precious economic development model was a load of crap if they decided to relocate to BR.

Anonymous said...

Richard, Puddinhead, and David are right that Baton Rouge would welcome the move, but they're wrong that its a credible threat. LSU officials themselves knocked this one at the testimony - the LSU Health Sciences division is not just the medical school but dentistry, mental health, I think there are 7 divisions. So they said there is no way, they are not even contemplating moving the entire health sciences division out of new orleans.

second, i'm sick of people talking about well the building was rough before so it can't be renovated. First, don't you guys remember the American Can building before Pres re-did it? Second, don't you understand that LSU was willfully neglecting Charity to argue for a new hospital? Third, if you read up the FHL/Hillier/Lower Mid-City /Appropriations Committee responses you would QUICKLY realize that the Hillier report is not in danger of becoming discredited because some people poo-pooed it such as you guys here, but rather it is strengthened by close examination. Our state "leaders" are bombastic miscreants clearly promoting an agenda and willing to outright lie about it. See the issue of the "metal connectors." The state facilities director, a real prize of a man, Jerry Jones, attempted to discredit the Hillier report by saying that they neglected to include the fact that in order to restore Charity, each piece of the stone shell would have to be removed in order to repair the rusted metal anchors that attach them. Every single one, to the tune of untold lots of dollars. Some of the Legislators parroted this back as fact. This exchange is in the testimony. Well guess what?!?!?! Hillier's experts did thermal imaging and selective probes, and there are no damn metal anchors. That shell is done by the art of MASONRY.

Every single item LSU puts forth crumbles under scrutiny such as this. How about the fact that they can't or won't name what interest rate they need their theoretical future bond to yield to finance their proposal? Disgusting.

Puddinhead said...

Oh, for crying out's a good thing the old Charity structure wasn't built complete with vaginas.

This is like discussion with fundagelicals, so thoroughly convinced they have a monopoly on the moral high ground. Of course, that's pretty much with ANY topic...

Richard said...

The Charity Hospital building got to be a mess well before LSU took it over as part of the state hospital network. Again, I'm saying that the issue is that *as a fully-functioning, modern hospital* the building was deemed not fit for use. For offices and clinics, another story. But somehow a renovation could bring a 70-year-old structure up to speed on all of the necessary safety features for in-patient care? Another question is this: since people seem to be wont to question LSU's motives (why wouldn't LSU want to have as good a facility as they could get?), OK, the Foundation for Historical Louisiana is a private foundation, right? Who's paying, then, for their big media campaign on this? LSU has handled this poorly, yes, but they do seem to be well bent to a new facility. Both the concept of somehow renovating the 70-year-old building to make it just as good as any other facility in the country and the chance of pushing LSU to change their mind that seems to be well set on what they want seem to me to be very, very far fetched (unless they change their mind to relocate to B.R. as no doubt many in B.R. would dearly love to see them do and stick it to N.O. and as discussed where there will be zero opposition). I want what's best for the city's and the region's economic and health care and medical education interests, period and I am having a harder and harder time, despite how LSU has handled this, seeing as how the opposition to this project is taking that same kind of perspective.

Richard said...

and to add, this was in 1992 that Charity was deemed unfit and on the verge of losing accreditation.

E said...


Hillier is not proposing a rennovation. Instead, they are building an entirely new hospital facility within the limestone shell of original Charity.

They're talking about doing a total gut-job.

The original ceiling heights are ideal for a modern hospital. Nothing else would really remain.

Richard said...

OK, call it what you want. However, it sounds like it would be a massive project. I'd think that logically with that old of a building it would have to be. You're talking about, again, a 70-year-old structure (when safety and building codes and building mechanical systems were no doubt entirely different than now, not to say that the building itself is not super strong and tough...I'm sure that it is) that back in 1992 was about to lose accreditation if LSU had not acquired Hotel Dieu and merged the facilities that's supposedly going to be made up-to-date. And this would be as good of a hospital as there is anywhere? A genuine asset to the community and to the medical schools? And all of this could be accomplished in less time and at a lower cost than building from scratch? Please pardon for being skeptical. I'm not against historical projects. I love history, to the contrary. But the jobs and the region's economic needs and the medical schools' needs have to count first.

swampwoman said...

The main reason Charity was not approved for fire safety was because only 2 of the wings had external fire escapes - the third external fire escape was built and eventually the building was compliant with the fire code. It was a temporary situation resulting in the purchase of UH.

The sad thing was, as soon as UH was bought, the big Charity building, along with all the employees there immediately became the "red-headed step children" and UH was immediately transformed into the LSU darling. You can guess who got all the funding, it sure wasn't the building at 1532 Tulane.

There was also some shady things happening with Entergy - rumor had it that Entergy was operating a substation somewhere atop the new parking lot behind the LSU medican school, with massive tonnage of A/C and power, yet big Charity never had adequate air conditioning, and power outages occurred more frequently than normal.

swampwoman said...

If you plug in 1528 Perdido St, New Orleans, LA, United States to Google Maps, and turn the screen around, you can see the street view of the newer external fire escape.

Oddly enough there is no street view on Google of the 1500 and 1600 blocks of Gravier St. I wonder if those picture views of the back of Charity were blocked from being taken...

Richard said...

What concerns me is that LSU has made it pretty clear what they want to do. What's the actual chance of getting them to 1.) change their mind and 2.) change their thinking and do exactly what the preservationist contingent wants them to do? Suppose they say "OK, we won't do this...but we'll go to the suburbs" or "relocate to Baton Rouge." LSU obviously does want any part of trying to go with a renovation of the historic building for use as a hospital. Why do people seem to believe that they could be persuaded to do that, then? I feel positive that the other options would easily come fruition long before LSU would decide to go back to Big Charity. What people, I suspect, are not taking into consideration at all is the anti-New Orleans sentiment that there is around the state and in the capital and would have some pull with the LSU leadership. If LSU has this proposal that would be a definite plus for New Orleans if it goes forward then by all means let's move forward with and not continue to fiddle around. What is beyond dispute is how many parties that there are who are just flat-out against almost anything that is good for New Orleans. If this never gets built then I can very easily see parties in Baton Rouge applauding that outcome and also looking to spark the talk of moving everything to there (where, for sure, there will be no preservationist contingent to throw any roadblocks). Why do we seem to want take the risk that New Orleans might never see any progress on this project at all?

swampwoman said...

It is crystal clear that the state of Louisiana and the Mississippi gulf coast has always had contempt for New Orleans. I don't think anyone in this city is that much in denial about their palpable aversion to this metropolitan area.

What is more disconcerting is how can an entity such as LSU become the bellwether for events happening 60 miles south? It is CRIMINAL what LSU is doing, manipulating the governor, the legislature, and all parts in between, into abandoning the poor of this state. This was NEVER the case when DHH and LHCA ran the Charity System. There are people DYING due to LSU's apathy in rebuilding a hospital in New Orleans.

Some may cloak abandoning rebuilding Charity in New Orleans, in the shroud of a business decision, but in reality it is, plain and simple, dealing with the devil. Last I checked, contempt isn't a Christian value. Perhaps LSU should be reminded of that.

Richard said...

Swampwoman, you are full of it. LSU would *love* to relocate everything to Red Stick and is looking for any excuse to do so and leave N.O. grasping at straws. Why can't you and others understand that fact?

Richard said...

Let's look at the different possible scenario's and consider the realistic likelihood of each one coming to fruition. 1.) LSU and VA build their new buildings in New Orleans as planned. 2) LSU builds a new building in the suburbs. 3.) LSU relocates the whole medical complex to B.R. (where a replacement for Earl K. Long charity hospital has to be built, too) 4.) LSU goes back to Charity Hospital. 5.) nothing happens and the medical schools make-do as they have and continue to use University Hospital indefinitely. Scenario no. 1 is the clearest economic benefit to New Orleans and most benefit to the medical schools and medical district and is the best scenario in terms of New Orleans being able to compete with what other cities have, which is the topic needs to be. Do people even begin to realize how much New Orleans has fallen behind in this aspect -- and this is and has to be a key part of our economy? If people keep on being more or less obstructionist and the nothing- happens scenario comes to pass there's no way that that is a positive for our area. LSU has said what they want to do but until it's finished I don't see where there is anything compelling them to the point that they *have* to do something. I fear that all this carrying on will ultimately lead to no progress at all (exactly what the New Orleans haters and opponents of this projects, i.e. private hospitals and politico's representing those interests, want).

swampwoman said...

To reiterate - my post concurs with your assertion that LSU would pull out of New Orleans in a heartbeat, yet you chose to pull in an insult, telling me I am full of it - tsk, tsk, tsk. Tell us Rich, have you ever set foot inside any of the buildings located at or around 1532 Tulane Avenue? Armchair quarterbacking, pontificating from the ivory tower up in BR, clueless as to what actually happens here.

The BEST thing LSU could do is take an example from Obama - admit they were wrong, relinquish control of the Charity system and give it back to either DHH, LHCA, or some other entity that isn't clouded by delusions of power, greed and authority. Then maybe the CITIZENS of the state would get what their tax monies pay for; instead of a bunch of overpaid blowhards dictating policy with their own selfish political motives, effective health care that reaches across all class and party lines.

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