Category: QCCT Trust

Final Meeting of UofL Ad Hoc Hospital Operations Review Committee

Presentation to Hospital Employees and the Public

Ad Hoc Committee Members on Stage

Because the presentation was essentially identical to that of May 9th, I refer you to my discussion of that meeting which is still on point, and to my final comments in that article which I still hold true.

This final presentation was held in the auditorium of the hospital. The room was appropriately well filled with hospital employees. These were the people who worked with and were interviewed by the consultants, Dixon Hughes Goodman. (DHG). I can’t say there were many members of the general public, if at all. I recognized two other members of the press.  A handout with most the slides used is available on the KHPI website (4.8 MB). Some slides, including financial trend information, were used in the presentation but not included in the handout and are available here. An earlier slide comparing University Hospital market share with that of other Louisville hospitals was not presented at all. Continue reading “Final Meeting of UofL Ad Hoc Hospital Operations Review Committee”

UofL President Ramsey’s Request for the QCCT Audit

I was able to obtain a copy of the communication sent by UofL President James Ramsey to State Auditor Adam Edelen that the University believes initiated the Auditor’s review of the University’s use of the QCCT supporting indigent care at University Hospital. Some of us believe that this audit was inevitable and that the University simply wanted to put their best face on a potentially threatening situation. Why stand in front of a freight train? [Of course, this analogy seems not to work with respect to the University’s claims that its Hospital, various boards, foundations, and other units are private!] Here follows the text of the facsimile sent to Frankfort. Continue reading “UofL President Ramsey’s Request for the QCCT Audit”

Kentucky State Auditor’s Report Critical of UofL Management of QCCT Fund for Indigent Care.

University of Louisville tried to pretend they liked this report!
I could weep.

Two days ago, Kentucky’s Auditor of State Accounts Adam Edelen released a long-awaited audit of the University of Louisville’s handling of the QCCT fund. The Quality Community and Charitable Trust is funded by both state and local governments and is used by University Hospital to provide medical care to people who do not have any form of health insurance or the resources to pay out-of-pocket. The report was highly critical of the University and the QCCT Board that is controlled by the University. Despite a valiant effort by University officials to put a positive spin on the audit, every news outlet I have seen that reported on the matter emphasized the negative aspects of the report. In my opinion, the University did not help its own case in this regard.

Also two days ago, the University’s own consultants gave their final report on the hospital’s performance, and yesterday Louisville’s Mayor Fisher released his FY 2013 Budget including city funding for the QCCT fund. It has been a lot to digest all at once. Yesterday I finally had a chance to read the full text of the audit and I was stunned. The press release describing it was bad enough. The report itself is a devastating indictment of the failure of University responsibility for these public monies. Read the full report for yourself and form your own opinions. I could not believe what I was reading and that this behavior could have been allowed to go on so long. There is much accountability blame to go around. Continue reading “Kentucky State Auditor’s Report Critical of UofL Management of QCCT Fund for Indigent Care.”

Louisville Mayor Fischer’s Budget Recommends Renewal of QCCT Funding.

The funding is less, but the same!

Just minutes ago, the mayor released his budget to the Metro Council and the rest of us.  Relevant to recent discussions on these pages, Mayor Greg Fischer recommended funding the Quality and Community Care Trust for 2012-2013 at $7.0 million which actually keeps it at the 2012 level.  Here is what the Mayor had to say about the QCCT:

“This budget continues to fund external charitable agencies at the same rate I proposed last year and the same rate since merger and continues to fund, also at the same level, indigent healthcare at University Hospital. We are committed to indigent care and to being an active participantin finding solutions to the long term needs of indigent care and the challenges that University Hospital faces.”

This may appear to be a decrease, but in prior years, the University was returning $2.6 million of a larger budgeted amount of $9.6 million.  This is not a decrease in the net amount provided to University Hospital for care of those it deems eligible.  Rather it provides a more honest accounting and avoids the dysfunctional and vaguely dishonest appearance of the earlier shell game.  I think the State Auditor’s recent audit would favor this accounting change and I commend the Mayor.

What remains to be seen is how the Kentucky State Legislature will view this honest accounting.  Some in the legislature have promised that if Metro Government reduces its contribution to the QCCT fund,  that they would push for the state to reduce its own contribution dollar-for-dollar.  The Mayor’s budget does not change the net amount contributed and should not be used as an excuse to reduce the states share.  Indeed, the report from Auditor Edelen’s office tells us that the Commonwealth has been playing a little $5 million shell game of its own with the University.

None of these necessary budgetary preparations alter the demands of these pages that before additional public money is poured into the improperly managed and overpriced creature that the QCCT has become, that the University of Louisville abandon its claim that University Hospital is a private entity, that the University abandon its secret-books policies, and that we stop thinking as if the QCCT fund and University Hospital represent the total solution to our shared responsibility of financing and providing medical care to the disadvantaged.  By way of perspective, the Mayor’s budget allots $1.88 million to the city’s Family Health Centers.  I would say, why so little?  To rebut my question is to open the doors to the conversation we should be having now, not next budget time, about how to fund indigent care in Louisville and Kentucky.

Peter Hasselbacher, MD
24 May 2012