New Orleans Times-Pacayune
Friday, January 18, 2008
By Kate Moran
Seven uninsured patients filed a lawsuit Thursday in an attempt to force the state to reopen Charity Hospital or make other provisions for thousands of people whose health has deteriorated without ready access to free medical care.
The patients say Louisiana State University ran afoul of state law by closing Charity two months after Hurricane Katrina without a vote of the Legislature. What’s more, the plaintiffs say the university flouted the wishes of lawmakers by refusing to allow independent inspectors into the hospital to determine whether it might be salvaged.
“The unlawful closure of Big Charity has had a devastating impact on the greater New Orleans area,” the lawsuit says. “Among other things, thousands of residents lack basic health care, the chronically ill go untreated, and critical specialty care is either delayed or unavailable.”
Unlike the city’s decision to close four major housing projects, the demise of Charity never provoked a massive hue and cry among advocates for the poor. The lawsuit grew out of the efforts of a handful of activists, including James Moises, the former director of Charity’s emergency room, and Brad Ott, a graduate student and former patient, who kept the issue aflame with a few protests in front of the forlorn hospital.
They assembled a legal team comprising local attorneys such as Tracie Washington, Bill Quigley and Calvin Johnson, the newly retired judge who founded the city’s mental health court. They also brought on attorneys Stephen Rosenfeld of Boston, Steven Berman of Seattle and Leonard Aragon of Phoenix, all of whom agreed to work pro bono.
Aiming for class action
The attorneys hope the lawsuit will be certified as a class action. They worked for months to unearth seven former Charity patients who could embody the hardships faced by thousands and finally filed suit Thursday morning in the Civil District Court in New Orleans.
“We’ve done something this morning that I would suggest is monumental to the city — to the region,” Johnson said Thursday.
The lawsuit describes how patients such as Lucille Moore of New Orleans, who suffers from thyroidism, an enlarged heart and blurry vision in her left eye, have had to travel several hours to safety-net hospitals in other parts of the state since Charity closed. Moore needs surgery to restore her vision, and the closest hospital that will perform it is in Bogalusa.
Because the surgery takes place over three days and the hospital will not keep her overnight, Moore will have to pay for a hotel. She also will have to pay a cab or find someone to drive her there because there is no public transit between New Orleans and Bogalusa.
“Because of the distance and cost of treatment, Ms. Moore has postponed the surgery twice despite the fact that she has no vision in her left eye and is therefore unable to work,” the lawsuit says.
Onus on private hospitals
Patients who cannot make the trip to far-flung public hospitals have washed up in the emergency rooms of private hospitals in the area, where they rack up bills they cannot pay. The flood of indigent patients also has caused a hardship for doctors. In April, doctors at West Jefferson Medical Center sued the state for failing to pay them for taking care of thousands of patients who used to go to Charity.
Charity Hospital is not a standalone institution. It is one of several components, along with University Hospital and dozens of affiliated clinics, that make up the Medical Center of Louisiana at New Orleans. The state reopened University a year after the storm, and 35 of the specialty clinics are now up and running.
The plaintiffs say that is not enough. The Medical Center of Louisiana had a total of 550 staffed beds when Charity was still open, including 98 beds for mental patients. It now has fewer than 200 beds: 171 at University and 25 psychiatric beds at the former DePaul Hospital near Audubon Park.
The lawsuit urges the court to consider reopening Charity, but the plaintiffs say they are not wedded to the building: an Art Deco landmark that flooded during the storm but was mucked out weeks afterward by doctors, including Moises, and military personnel. They say they simply want the state to restore the full complement of services that were offered in New Orleans before the storm.
“This is not a lawsuit about reopening a building,” Johnson said.
LSU defends strategy
Fred Cerise, vice president for health affairs and medical education at LSU, said Charity was an obsolete and inadequate facility before the storm, so much so that the university risked losing accreditation for the teaching programs it ran at the hospital. He denied allegations in the lawsuit that LSU circumvented the Legislature and closed the hospital after the storm without proper approval.
The state did not decide to close Charity, he said. Katrina decided that for that state.
Though the lawsuit names only LSU and its leadership as defendants, Cerise says the university did not make a unilateral decision to mothball the hospital. He said the state Office of Facility Planning, which manages the disposition of all public buildings, sent inspectors into the building and determined that repairing it would be too expensive.
LSU plans to build a new academic medical center in downtown New Orleans to replace Charity, but the project will not be completed until at least 2012. Cerise said the state has provided for uninsured patients in the meantime by bulking up services at safety-net hospitals in Bogalusa, Houma and other parts of the state and by directing millions of dollars to private hospitals in the New Orleans area — if not to the doctors who work in them — to treat former Charity patients.
Supporters of the lawsuit disagree.
“This suit is about time,” Councilwoman Shelley Midura said at a Thursday news conference. “There will be a new hospital built, but even the most optimistic estimates put that at a minimum of five to 10 years. Tell me, what do we do in the interim?”
New Orleans activists demand Charity Hospital be partially reopened now, as the healthcare crisis worsens particularly for mental health. A former Charity doctor charges that Charity Hospital remains completely closed to justify building a new hospital in 7-10 years with more private patients. He will be one of several speakers at an American Public Health Association talk this November on the dire effects of closing Charity and other public hospitals and clinics.
On Sept 3, community activists gathered at dormant Charity Hospital, demanding at least a partial re-opening of the facility that once served as New Orleans’ refuge for uninsured patients. They maintain that three floors of Charity were cleaned and decontaminated and could have been opened as early as October 2005, relieving the dire shortage of mental health services. The demonstration included groups also pushing to reopen public housing and members of the Gulf Coast Civic Works Project, which demands a New Deal-style Katrina recovery program hiring 100,000 residents in rebuilding jobs.
Meanwhile, James Moises, a former Charity Hospital ER doctor charges that Louisiana State University Systems Office in Baton Rouge, which operates Charity, has kept Charity closed to justify a 7-10 year project to completely rebuild Charity Hospital into a facility more oriented to private patients to offset the hospital’s operating costs. Keeping Charity Hospital closed has greatly reduced the number of badly-needed acute psych beds. The result is that Emergency Rooms are so overcrowded that suicidal patients are often untreated, and desperate family members call the Parish prison trying to get their mentally ill loved ones into a small program in the jail. You can hear an Aug 29 NPR piece describing the New Orleans mental health situation and why Charity Hospital remains completely closed.
For an NPR interview on this click on: