Category: QCCT Trust

More Bad Press For the University of Louisville. A QCCT Scandal?

One of my favorite lines from old movies is: “The Devil can quote scripture to his own purpose.” So have various parties seen different things in the Dranove opinion of the recent partially released documents related to the acquisition that would have included the University of Louisville Hospital. The University itself focused on a line forecasting “dire effects” if the University was not permitted to proceed with its plans to hand over control of its clinical activities to another organization. My attention was focused on the lack of specific detail in the report. One of the items that must have captured the attention of County Attorney O’Connell who commissioned the report, was the suggestion that a body independent of the University oversee any future use of the Quality and Community Care Trust (QCCT) through which millions of state and local government funds are funneled to the University.

When the County Attorney asked for minutes of the University Board supposedly overseeing the funds, he was astonished to find that the legally required documents were not available, or worse, that there was no official documentation that the Board had met since 2007. Such a failure echoes the recent complaint of the Louisville Metro Council that the University had not produced information requested of it by the Council. Notwithstanding, the Council voted to continue the QCCT funding anyway. The University has now shared a little of its own increasingly tarnished reputation with an overly tolerant Council.

County Attorney O’Connell has called for a new Board, completely independent of the University, to oversee any future use of a public QCCT funding mechanism. He wanted to insure that “money did not come before mission” with respect to the University. I recently called for a State Audit of the QCCT, and questioned whether this almost 30-year-old partial solution to funding indigent care in Louisville is still appropriate. After all, Louisville’s governance has merged, the needs of the pubic have evolved, the health care system of Jefferson County has been drastically reorganized, and alas, the University of Louisville has also changed.

Would a lack of the required accountability from the QCCT Board simply represent a failure of University management? Is this part of a pattern of the University attempting to circumnavigate the law? I cannot help but be reminded of the recent Passport Scandal in which the University and its internal organizations harvested money intended for medical care of the needy and used it for other purposes. In my opinion, what we have been seeing unfold is a failure of leadership at the highest levels of the University of Louisville. The University of Louisville has lost its way.  It needs our help now, not enabling responses from the public to which it is accountable.

Peter Hasselbacher, MD

A PDF version of this entry can be obtained here.

Dust-Up Over Disbursement of QCCT Funding to University Hospital

There was a little excitement this week in the Louisville Metro Council over whether or not to continue the next installment of the $7 million indigent care payments to University of Louisville Hospital from the QCCT funds. The City of Louisville and Kentucky provide many millions of dollars annually against which University Hospital can bill for eligible indigent patients.

There were a number of issues that caused the Budget Committee to put the brakes on the city’s payments as of January 1. One was that that in the post-Passport scandal era the Hospital had not provided the requested and expected accountability. It is puzzling to me that the Council expressed the same transparency concerns last July but had still not been satisfied. Is the council giving too much deference to the university?  The procedural move also signaled that there are deep concerns about the proposed acquisition of University of Louisville Hospital by the hospital chain Catholic Health Initiatives out of Denver. Would the same services be provided, and would it even be legal to give public funds to a private religious organization.

Two days later the Council as a whole voted to release additional installments of the remaining $4.8 million funding until March, pending the apparently delinquent reports by the Hospital. Councilman Downard said that, “the hammer is still there” concerning their demands for information, but I thought the hammer had already been cocked! So much for transparency from this self-declared private institution. Amendments were offered to make the continuation dependent on providing the same range of services after as before any take-over but they were defeated. The protest of the committee hold was overridden, but its point was made. The University of Louisville made some of its documents available publicly the very next day. The University seems to realize that it has lost its public relations war against the citizens of Louisville. I sent the Council an open letter the day of their main meeting. It gives additional details and outlines my thoughts about whether the QCCT mechanism is still an appropriate way to fund indigent care in our city, or whether it has had unexpected and undesirable consequences. What do you think?

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