Monday, March 02, 2009

Charity Cha Cha

During Mardi Gras, City Business publisher Mark Singletary took time out from parading to write a factually deficient manifesto in support of the unfunded LSU/VA megahospital even though a new Charity would be a faster, cheaper, and more progressive way to restore a world-class medical facility to the metro area.

The piece is particularly horrendous because his argument is essentially that the new project is a done deal and must go forward because he says it's a done deal and must go forward. He doesn't actively refute any of the major concerns related to cost estimates, conflicts of interest, or community justice. He just says it must be so. See for yourself:

Here’s the deal. The new Louisiana State University teaching/charity/trauma/learning center in downtown New Orleans is going to be at the lower end of Mid-City between Tulane Avenue and Canal Boulevard next to the equally new Veterans Administration hospital.

Period, end of story.

That is unless we don’t get close to $500 million from FEMA.

All LSU needs is $492 million it wants from FEMA, not to complete the project, but to start it. So far FEMA’s offer is somewhere just short of $150 million. The $350 million gap is based on a FEMA assessment of the old Charity building and how much damage was sustained during Hurricane Katrina.

When finished, the entire complex will cost somewhere close to $800 million, plus or minus $100 million. The FEMA money is critical.

LSU thinks the Charity building is completely damaged and FEMA thinks not - at least for now.

If FEMA drops our ball, refuses to pay up and otherwise gets in the way of the state’s best-laid plans, there won’t be a new LSU teaching hospital. Also, end of story.

Or, if old-time Louisiana politics mess things up so much and nothing happens in New Orleans, we end up losing everything - medical center, medical school and thousands of high paying jobs.

There has also been a lot talk about using the old Charity Hospital facility on Tulane Avenue. That talk is a feint. Public hearings have been held, consultants have conspired, the Legislature has convened and decisions have been made to go forward. New hospital wins.

End of story! Done deal! New hospital wins!

Because Stone Cold Mark Singletary Said So!

I love that last paragraph especially. Public hearings have been held? Not one ever at City Council or in front of the City Planning Commission. Consultants have conspired? Um, I think that's precisely what we're saying.

But let's go back and look at the whole. Singletary says the only thing standing in the way of the destruction of Lower Mid City is the $492 million (pocket change I know, "all LSU needs") it will take to "not to complete the project, but to start it."

I don't think he meant to write a pro-Charity column but it would sort of seem like it based on the silliness of his argument. At any rate, he seems to think its a foregone conclusion that FEMA reimburses LSU to the tune of the rest of that $492 million.

That's a pretty bold assumption don't ya think?

But not just because I say so/end of story/done deal/temper tantrum...

Let's actually examine at some like, you know, evidence.

The quotes that follow come from the February 04. 2009 version of the FEMA Project Worksheet Report on Charity Hospital. The emphasis is always mine. (I'll try to get this doc online for you as soon as I can.)

In the middle of December, Governor Bobby Jindal rejected FEMA's offer to reimburse the state $150 million for Katrina-related damages. This was a new high offer from FEMA, put forth in the closing days of the Bush administration, up from $23 million.

Let's take a look at how FEMA came up with that $150 million figure.

Again, the original assessment was roughly $23 million. From there, the feds added tens of millions of dollars because "FEMA also recognizes the likelihood of additional damages that would be discovered through exploratory work, testing, and construction. It is further understood that in the months immediately following the hurricanes Katrina and Rita, certain mechanical and electrical components within the facility would have started to deteriorate to the point of disrepair."

But that wasn't all. An extra $51 million got tacked on by FEMA and the Department of Homeland Security for reasons independent from estimates of actual damage to the building:

This determination was based on (1) the magnitude of the impact of the disaster, (2) recognition that the actual cause of much post-storm damage could not conclusively be determined, and (3) the desire to accelerate the recovery of the healthcare system in New Orleans.

In other words, in response to heavy political pressure, FEMA basically tacked on a gift $51 million outside their evaluation of actual storm damage to Charity in order to help Louisiana expedite the restoration of medical care to New Orleans (which by default means the LSU/VA project).

How likely is it now that another few hundred million dollars will be forthcoming?

Well, if you look at the most recent project worksheet report, it wouldn't seem as though FEMA is particularly enchanted with the state of Louisiana's penchant for intentional neglect. More specifically, FEMA seems to think that a lot of the damage has been inflected upon the building by LSU itself due to its failure to properly secure the hospital for years after Katrina. The following selections have been lifted from FEMA's project worksheet report on Charity from early February:

Through 2008, FEMA conducted additional assessments of Charity Hospital to validate additional damages presented by the applicant. During these assessments, FEMA observed deteriorating conditions at Charity Hospital resulting in the continuation of damages. The observed damages consisted of (1) Preventable damages, such as humidity damage and mold damage, and (2) Damage due to lack of use and deferred maintenance.

Here is the chronology of warnings from FEMA to the state of Louisiana regarding the protection of the Charity facility from further damages.

In an April 16, 2007 letter, Jim Start, Director of the Louisiana Transitional Recovery Office, advised the State of Louisiana that, "it is imperative that the applicants are aware of the requirements related to protecting facilities from further deterioration and the implications of neglecting to do so. Moreover, it should be noted that a significant number of these degrading facilities are state-owned. Examples of these facilities include Charity Hospital and RSD (Recovery School District). Avoidable damages linked to an applicant not taking proper measures to protect its facilities will not be eligible for reimbursement through the FEMA PA Program..."

In a follow-up May 5, 2008 letter, Jim Stark advised the State of Louisiana that "now, over a year since my first letter and nearing three years since the storm event, it is alarming that applicants continue to allow their facilities to deteriorate. A significant number of these degraded facilities are owned by the Facility, Planning, and Control Department. Charity Hospital, the Dibert Building and the L&M Building, all facilities in the LSU MCLNO Network, are examples of such facilities... Avoidable damages linked to an applicant not taking proper measures to protect its facilities will not be eligible for reimbursement through the FEMA PA Program..."

Naturally, LSU has acted with all deliberate speed to secure the property after Jim Stark warned them that they were risking reimbursement eligibility.

July 12, 2007, the architect developed a scope of work to suspend continuing damages related to Hurricane Katrina and minimize the immediate vulnerability of the facility. This scope of work has since been submitted to FEMA and was addressed in Version 2 of this project worksheet, which was obligated November 13, 2008. At the writing of this project worksheet, FEMA has observed that none of this work has been initiated.

So is Barack Obama's FEMA now going to "earmark" another 300 or so million dollars for this LSU/VA "pork" project when Charity could be rebuild faster and cheaper without destroying a residential neighborhood? Is Barack Obama's FEMA suddenly going to reward LSU for their own failure to properly secure the facility over the course of three and a half years?

Bobby Jindal is threatening to turn down tens of millions of dollars in federal aid for Louisiana's recession victims but he's simultaneously asking for hundreds of millions of dollars in gift money from FEMA to fill a funding shortfall in a sprawling hospital project that still won't see its first shovels for several more years?

Janet Napolitano, the new head of the Department of Homeland Security will be down here in New Orleans this week to take a look. Something tells me she won't find the blank check being requested by Bobby Jindal and LSU to be particularly prudent.

Mark Singletary's little 'done deal' if is actually a LARGELY UNLIKELY IF.

This story ain't even close to its conclusion, kiddos. Pay attention to the news this week.

We'd have a done deal on our hands if LSU would come around to support the Hillier compromise proposal backed by a diverse coalition of New Orleanians.


jeffrey said...

Here's the problem I see with what you've written here. You're basically refuting Singletary's "Because I said so" with a separate "because I said so" from the discredited New Orleans office of a federal agency notorious for lowballing disaster estimates. You've got two questionable actors fighting it out here in LSU and FEMA and you've chosen to stand in FEMA's corner. That can't feel very comfortable.

But placing all that aside, I think Singletary is closer to making a valid point than you give him credit for. What he's saying is the new hospital will be built in Mid-City or not at all... not because Mark Singletary says so but because LSU says so and shows no sign of moving from that point.

Given LSU's stubborn position (whatever you may think of it) it is the reality. They may not be doing what you believe to be the optimal thing, but they are driving the bus. Therefore here are your choices

a) A charity hospital in Mid-City which comes at the expense of the neighborhood... and yes that's bad but does restore a much needed public health facility to New Orleans as well as it revitalizes medical education and research and all that good stuff proponents of the hospital keep harping on.

b) No charity hospital in New Orleans. LSU takes its ball and goes home to Baton Rouge. The empty charity building sits and rots. A huge chunk of what's left of the local economy outside of tourism is destroyed. Health services for the poor and uninsured in New Orleans are greatly diminished. Oschner ends up controlling health care delivery for the most part.

Keeping in mind that scenario b is sort of an elite Uptown New Orleans aristocrat's wet dream second only to... say the demolition of all viable public housing, I have to ask again how comfortable you are taking FEMA's side in this argument at this point.

Anonymous said...

Looks like Jim Stark is getting hung out to dry by Cao's office...wonder why?

E said...

Well Singletary cites no documents nor does he attempt to refute any of the points made in the Hillier alternative.

I on the other hand provide FEMA's assessment to contrast Singletary's totally baseless assessment that all of a sudden another several hundred million dollars is just going to be handed to LSU on a silver platter.

It's fine if you think FEMA's lacks credibility because the crux of the matter does not depend on sanctity of FEMA's word. All you have to do is drive down Tulane Avenue to Charity Hospital to witness LSU's negligence for yourself. The building has not been secured and I don't think a responsible FEMA is going to want to endorse that kind of state behavior no matter what goes on in terms of leadership turnover.

I also don't buy the two choices premise.

For one, whether LSU gets their malibu dream hospital or pulls the plug on New Orleans entirely, Charity will remain abandoned and unused. Everybody wins with the compromise proposal except those that have staked their political and professional reputations on hammering home a more wasteful and costly project.

For two, we already don't have a Charity Hospital in New Orleans. We already have a soft economy and we already lack health services for the poor. This is why we should be examining the Hillier compromise, which promises to bring back a biomedical economy and world class healthcare services FASTER AND CHEAPER than LSU.

Nobody on LSU's side has effectively refuted any of Hillier's claims about the feasibility of rebuilding at Charity or their estimates for cost and time frame.

It's because Hillier is the world-class architecture firm.

Meanwhile, LSU's architect got so involved with interlocking subcontractors that the plan fell apart as soon a real firm got a hold of it. (check my post on donald smithburg, adams, and phase II)


To follow up on anon, I agree that the inquiry into FEMA's office in NOLA might not be quite so cut and dry when you consider political context.

Anonymous said...

I would love a cheaper and more effective proposal, so show me one.

Take a look at the proposals on the table and when you add in all of the costs that Hillier left out, the proposals come out about two to four percent different. This assumes that all of Hillier's assumptions are correct and that there are no foundation or structure problems.

As for faster. And assuming a normal design, demolition, and construction period on a very restricted site. There is no way that it will be any faster. Remember, Hillier's plan is to strip the building to its frame both the interior and exterior.

Finally, Charity was opened in 1939 and no matter what the video says, 12'6" floor to floor heights are not acceptable for a hospital, 13'6" minimum for patient care floors and 16' for surgical and diagnostic floors, I believe those are the current AIA guidelines.

Let's stick to fact not fantasy and have an honest and open debate about the future of New Orleans, Medical Care, and Medical Education.

I know this would be a new path for New Orleans but one that should be tried.

jeffrey said...

e, I've read all of your posts on this matter and I'm more or less in agreement with you except for a few things. 1) I don't have as much faith in the Hillier report and 2) I take LSU's threat to leave very seriously.

I think there comes a point where you have to ask yourself whose agenda you're ultimately aiding. I look at what's likely to happen if LSU doesn't get to build where it wants to build and it looks an awful lot like what the Uptown "shrink-the-footprint" crowd has wanted since... well before "shrink-the-footprint" was even a term.