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37–470 2008

THE FUTURE OF THE U.S. DEPARTMENT 

OF VETERANS AFFAIRS HEALTHCARE 

IN SOUTH LOUISIANA 

FIELD HEARING 

BEFORE THE

COMMITTEE ON VETERANS’ AFFAIRS 

U.S. HOUSE OF REPRESENTATIVES 

ONE HUNDRED TENTH CONGRESS 

FIRST SESSION 

JULY 9, 2007 

HEARING HELD IN NEW ORLEANS, LA 

Serial No. 110–32 

Printed for the use of the Committee on Veterans’ Affairs 

( 


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COMMITTEE ON VETERANS’ AFFAIRS 

BOB FILNER, California, Chairman 

CORRINE BROWN, Florida 

VIC SNYDER, Arkansas 

MICHAEL H. MICHAUD, Maine 

STEPHANIE HERSETH SANDLIN, South 

Dakota 

HARRY E. MITCHELL, Arizona 

JOHN J. HALL, New York 

PHIL HARE, Illinois 

MICHAEL F. DOYLE, Pennsylvania 

SHELLEY BERKLEY, Nevada 

JOHN T. SALAZAR, Colorado 

CIRO D. RODRIGUEZ, Texas 

JOE DONNELLY, Indiana 

JERRY MCNERNEY, California 

ZACHARY T. SPACE, Ohio 

TIMOTHY J. WALZ, Minnesota 

STEVE BUYER, Indiana, Ranking 

CLIFF STEARNS, Florida 

JERRY MORAN, Kansas 

RICHARD H. BAKER, Louisiana 

HENRY E. BROWN, JR., South Carolina 

JEFF MILLER, Florida 

JOHN BOOZMAN, Arkansas 

GINNY BROWN-WAITE, Florida 

MICHAEL R. TURNER, Ohio 

BRIAN P. BILBRAY, California 

DOUG LAMBORN, Colorado 

GUS M. BILIRAKIS, Florida 

VERN BUCHANAN, Florida 

Malcom A. Shorter, Staff Director 

Pursuant to clause 2(e)(4) of Rule XI of the Rules of the House, public hearing records 

of the Committee on Veterans’ Affairs are also published in electronic form. The printed 

hearing record remains the official version. Because electronic submissions are used to 

prepare both printed and electronic versions of the hearing record, the process of converting 

between various electronic formats may introduce unintentional errors or omissions. Such occurrences are inherent in the current publication process and should diminish as the process 

is further refined. 


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C O N T E N T S 

July 9, 2007 

Page 

The Future of the U.S. Department of Veterans Affairs Healthcare in South 

Louisiana .............................................................................................................. 1 

OPENING STATEMENTS 

Chairman Bob Filner ............................................................................................... 1 

Prepared statement of Chairman Filner ........................................................ 62 

Hon. Michael H. Michaud, Chairman, Subcommittee on Health ........................ 6 

Prepared statement of Congressman Michaud .............................................. 62 

Hon. Jeff Miller, Ranking Republican Member, Subcommittee on Health ......... 5 

Prepared statement of Congressman Miller ................................................... 63 

Hon. Richard H. Baker ............................................................................................ 2 

Hon. William J. Jefferson ....................................................................................... 3 

WITNESSES 

U.S. Department of Veterans Affairs, Rica Lewis-Payton, FACHE, Deputy 

Director, Veterans Integrated Service Network 16, Veterans Health Administration ................................................................................................................. 48 

Prepared statement of Ms. Lewis-Payton ....................................................... 81 

American Legion, William M. ‘‘Bill’’ Detweiler, Past National Commander ...... 37 

Prepared statement of Mr. Detweiler ............................................................. 73 

Disabled American Veterans, Chuck Trenchard, Adjutant, Department of Louisiana ..................................................................................................................... 36 

Prepared statement of Mr. Trenchard ............................................................ 72 

Louisiana Department of Health and Hospitals, Frederick P. Cerise, M.D., 

M.P.H., Secretary ................................................................................................. 9 

Prepared statement of Dr. Cerise ................................................................... 66 

Louisiana State University Healthcare Services Division, New Orleans, LA, 

Michael Kaiser, M.D., Acting Chief Medical Officer ......................................... 10 

Prepared statement of Dr. Kaiser ................................................................... 65 

Military Order of the Purple Heart, Henry J. Cook, III, National Senior 

Vice Commander .................................................................................................. 33 

Prepared statement of Mr. Cook ..................................................................... 71 

New Orleans, LA, City of, Hon. C. Ray Nagin, Mayor ......................................... 7 

Prepared statement of Mayor Nagin .............................................................. 63 

Penn, Bill, M.D. Baton Rouge, LA ......................................................................... 38 

Prepared statement of Dr. Penn ..................................................................... 80 

Tulane University, New Orleans, LA, Alan M. Miller, Ph.D., M.D., Interim 

Senior Vice President for Health Sciences ......................................................... 13 

Prepared statement of Dr. Miller .................................................................... 69 

SUBMISSIONS FOR THE RECORD 

Ochsner Health System, New Orleans, LA, Patrick J. Quinlan, M.D., Chief 

Executive Officer, statement ............................................................................... 85 

Veterans of Foreign Wars of the United States, Clayton P. ‘‘Sonny’’ Degrees, 

Jr., State Commander, Department of Louisiana, statement .......................... 86 


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iv 

MATERIAL SUBMITTED FOR THE RECORD 

Charts: 

Southeast Louisiana Veterans Healthcare System, Map Showing the 23 Parishes with Clinics Serving Veterans in: New Orleans, Baton Rouge, Hammond, St. John Parish, Slidell, and Houma ....................................................... 83 

Southeast Louisiana Veterans Healthcare System, Individual Patients Treated FY 2005–FY 2007 ............................................................................................ 84 

Southeast Louisiana Veterans Healthcare System, FY 2007 Patients by Parish .......................................................................................................................... 84 


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THE FUTURE OF THE U.S. DEPARTMENT 

OF VETERANS AFFAIRS HEALTHCARE 

IN SOUTH LOUISIANA 

MONDAY, JULY 9, 2007 

U. S. HOUSE OF REPRESENTATIVES, 

COMMITTEE ON VETERANS’ AFFAIRS, 

Washington, DC. 

The Committee met, pursuant to notice, at at 9:30 a.m., in the 

Supreme Court Building, 400 Royal Street, 4th Floor Courtroom, 

New Orleans, Louisiana, Honorable Bob Filner [Chairman of the 

Committee] presiding. 

Present: Representatives Filner, Michaud, Miller, and Baker. 

Also Present: Representative Jefferson. 

OPENING STATEMENT OF CHAIRMAN FILNER 

The CHAIRMAN. Good morning. The field hearing for the House 

Committee on Veterans’ Affairs is called to order. 

We thank you for your attendance, and thank all the Members 

for being here. I’m the Chairman of the Committee. My name is 

Bob Filner. I’m from San Diego, California. Mr. Baker is from 

Baton Rouge; is that correct? 

Mr. BAKER. (Nods head affirmatively). 

The CHAIRMAN. Mr. Miller from Florida, thank you for coming; 

Mr. Michaud from Maine, Mr. Jefferson from New Orleans. 

I do have to ask unanimous consent that Mr. Jefferson be invited 

to sit in for this hearing today. Hearing no objection, that is ordered. 

And we also ask unanimous consent that all Members have five 

legislative days in which to revise or extend remarks and presenting statements be made part of the record. And hearing no objection, that is ordered too. 

We are here, as you know, to explore the challenges faced by the 

U.S. Department of Veterans Affairs (VA) and other healthcare facilities to provide high quality safe healthcare to veterans and citizens of this area. 

We know what happened in August of 2005 causing obviously 

significant damage to an incredible large area in the southeastern 

United States. 

In the three-State area of Louisiana, Mississippi and Alabama, 

the VA facilities affected included the Gulfport, Mississippi and 

New Orleans medical centers; New Orleans regional benefits office; 


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and five community based outpatient clinics along the Gulf Coast; 

and Biloxi VA National Cemetery. 

The VA has tried to respond to these challenges. In many cases, 

they have done well, but we still do not have a VA hospital that’s 

on the books for planning or that’s on the—that’s ready for construction. We have to meet this challenge. 

I noticed in all the testimony that I read beforehand there is incredible unanimity on the fact that, given this great difficulty that 

was faced, there is an opportunity to rebuild in a different, maybe 

more responsive, more collaborative way and I was extremely interested in the fact that everybody was so optimistic even given the 

bureaucratic challenges. We have appropriated as a Congress $625 million and we have— and this Committee has urged the Secretary of the VA to make the 

decision about this without any further delay, so we are here. 

It’s a standard joke, ‘‘we’re the Federal Government, we’re here 

to help,’’ but we are here to help. I don’t think the Nation responded as it should have quickly enough to the situation after 

Hurricane Katrina. We have a long way to go on that. 

This is, I think, the first hearing from a Committee to Congress 

here. We are going to have several other hearings with different 

Committees of the Congress. All the chairmen had met and said we 

are going to, as a group, make sure we understand what’s going on 

in New Orleans and the surrounding area and do what we can to 

speed things up in terms of rebuilding. 

We have two local Members from the—from the Louisiana delegation here with us. Mr. Baker has been a hard-working Member 

of this Committee. He never lets a hearing or a time go by without 

saying we have got to do something for New Orleans and for Louisiana. He’s in there fighting all the time and we appreciate Mr. 

Baker’s contribution to the Committee. 

And, of course, Mr. Jefferson, as the representative here, never 

lets me pass anywhere in Congress without saying when are we 

going to get the hospital, when are we going to rebuild the facilities, so you have—and the rest of the delegation for Louisiana are 

very hard working and they are trying to do the job for you and 

we have to support them. 

Mr. Baker, thank you for inviting us today and we are looking 

forward to your opening statement and your expertise on this 

issue. 

[The prepared statement of Chairman Filner appears on p. 62.] 

OPENING STATEMENT OF HON. RICHARD H. BAKER 

Mr. BAKER. Thank you, Mr. Chairman. I am most appreciative 

of your courtesies and all the effort made to facilitate this hearing, 

and I also appreciate very much your courtesy in describing my activities on the Committee. I had thought you would characterize 

them quite differently, so I am very—I am very appreciative of 

your kind remarks of my contributions to the Committee’s action. 

Let me also add my appreciation to those Members who have 

traveled great distance to be here today. Mr. Michaud, the Chairman of the Subcommittee on this matter, as well as Mr. Miller 

from Florida, who was overseas on congressional business and 


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came back for this hearing, to both of you gentlemen, I certainly 

am appreciative of the difficulty it is in traveling, particularly to 

get back to the City of New Orleans and curtail your own personal 

travel arrangements. 

And Mr. Jefferson and I, of course, have worked together for 

many years in the Congress and I have come to great appreciation 

for his intellect and knowledge on these matters. 

I need to make several things very clear about my motivations 

and intense interest in the subject matter, and I am extremely 

pleased to see the number of veterans we have here in attendance 

this morning. 

This is about you. It is about the healthcare to which you are entitled. It is about the service you have given to this country and 

your undying devotion to meet your obligations as they were given 

to you. 

I find it inexcusable that two years after Katrina we are now debating how. It’s not a question of what or who’s going to build it 

or where is it going to be located. These are unacceptable circumstances. 

I do not care where this facility is built, and I want to put it on 

the record because some are running rampant ‘‘Baker wants to 

build this thing in Baton Rouge.’’ I do not. What I care about, I 

care about getting this facility built in as quick a period of time as 

is humanly practicable understanding the Chairman and Members 

of this Committee’s desire to have the taxpayers’ interest protected 

at all costs. 

Now, there are questions I’m going to ask that some people may 

not want to talk about. You deserve those answers and taxpayers 

do as well. It’s my job as a representative of veterans on the Veterans’ Affairs Committee in the United States Congress not to 

leave a stone unturned or a leaf not examined in the course of this 

progress and I fully intend to do that. But I want you as veterans 

to understand what I’m doing is exclusively what I believe to be in 

your best interest. There is no other motive. 

If we can build it where it’s now proposed and get the doors open 

in 24 months, hey, I’m ready to go. But if we can’t, we owe it to 

you to tell you why not and what are our options. 

And, Mr. Chairman, I just can’t express to you enough my appreciation for you and the Committee Members for coming here today 

to give us the opportunity to hear our expert witnesses talk about 

this subject matter and hopefully facilitate coming to a conclusion 

and a decision that’s in the best interest of the United States veterans and taxpayers as well. I yield back my time. 

The CHAIRMAN. Thank you, Mr. Baker. 

As I said, Mr. Jefferson doesn’t let me ever go by, pass him in 

the hall or on the Florida house without him saying let’s get that 

built, let’s get that VA facility built. 

Mr. Jefferson, thank you for your very aggressive representation 

of your district. 

OPENING STATEMENT OF HON. WILLIAM J. JEFFERSON 

Mr. JEFFERSON. Thank you, Mr. Chairman. I would also like to 

thank the Members of Congress who traveled here, to welcome 

them to my district and to our region. 


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I’d like to thank the Chairman for his attention and commitment 

to this issue. He’s been unwavering in his support for us and we 

really appreciate the many times he’s called the Committee together formally to talk about this and the time we’ve talked informally. I thank Richard Baker for the help and support he’s given 

us over the years and that he continues to give for our recovery. 

Mr. Chairman, I’d like to thank you for this opportunity to speak 

with the Committee today to address the state of our VA system 

in south Louisiana. We all appreciate that the VA has committed 

to a building a new hospital for our veterans and our veterans in 

the greater New Orleans area. They deserve nothing less than top 

notch facilities and treatment, and we are doing all we can to keep 

our promises to them. 

The proposed partnership between the VA and the Louisiana 

State University (LSU) Medical Center represents what is in the 

best interest of our veterans, the healthcare profession of the area, 

and the citizens of south Louisiana. A combined facility located 

downtown will enable LSU Medical Center to continue providing 

its services to the VA, it will lower operating costs for both facilities, and will be a tremendous boost to our local economy and to 

our recovery from the devastation of 2005. 

The VA Center in New Orleans has always been a reasonable facility, one that has drawn from veterans living along the entire 

Gulf Coast. While the population of the City of New Orleans itself 

may be down, most displaced veterans are in the outlying parishes. 

It would be a tremendous disservice to them and to other veterans 

of the region to use such misleading numbers about our people 

back home to relocate this hospital in some other place. 

Both the Louisiana Recovery Authority and the Regional Planning Commission have declared their support for the downtown location of the VA hospital. Since the downtown hospital has remained closed, the VA has done an admirable job of ensuring that 

immediate healthcare needs of our veterans are met. The network 

of local clinics and quick deportment of mobile clinics have gone a 

long way to create the capacity to meet outpatient needs; however, 

if a veteran requires a procedure that can only be performed in a 

full hospital, he or she must still travel to Houston or Jackson or 

some other place. To force the veterans to make long trips at times 

of sickness is an unacceptable standards for our Nation. It’s imperative that we move quickly to resolve this problem. Our veterans 

have waited long enough for this matter to be well on the way toward being solved. 

To establish the VA Medical Center as a proposed downtown site 

is vital to us in our restoration. Along with Tulane Medical Center, 

Xavier, and Delgado, the joint facility would become a part of the 

biomedical corridor that exists in downtown New Orleans. 

Prior to the storm, nearly 10,000 jobs were located in the medical 

district. The proposed joint VA–LSU center would add another 

3,400 jobs to that total. Construction of the new facility alone is estimated to create an additional 19,000 jobs. Once the facility begins 

operations, the capital investment area will soon follow. 

In adding in fiscal year 2005 to this hospital’s restoration, the 

National Institutes of Health (NIH) has sent about $130,000 in 

grants to our area. We must ensure that this engine of economic 


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recovery continues to be in place and we respect support from NIH 

and other support to follow it. 

From a practical point of view, it simply makes sense to share— for the VA and LSU to share facilities. By sharing lavatories, 

housekeeping, rehabilitation, radiological facilities, these costs, 

these overhead costs are consolidated between these two hospitals. 

Money would be saved in the short and long run and efficiencies 

would be realized. In so many ways, this is the next logical step 

to the partnership that already has existed over years past between 

LSU and the VA hospital. 

I deeply support that our local and State authorities are well 

along the way to having done their part to provide support for the 

required—for this required endeavor. We provided a business plan 

and I think a sound business plan and approved the initial land 

acquisition funding of $74 million to the Legislature. We must now 

follow up these steps with action. 

The VA has committed to building a new hospital in the New Orleans area and we are grateful for that, but we must take this opportunity to build for the future and create a state-of-the-art hospital that integrates seamlessly within the established medical 

downtown district. Our veterans should not have to wait a day 

longer while we debate this policy and while this policy remains 

unsettled. 

I, unlike Mr. Baker, have a parochial interest and a parochial 

stake in this and I want to see the hospital built in the area that 

it was built in before. I think that makes the most sense. We are 

here, as he said however, to support our veterans in any way that 

we possibly can; and we appreciate your service and we think now 

it’s time for us to serve you better. 

So thank you Mr. Chairman. I really appreciate this chance to 

be a part of this Committee this morning. Thank you. 

The CHAIRMAN. Thank you, Mr. Jefferson. 

Mr. Miller, thank you for coming from your home district and 

being here with us this morning. 

OPENING STATEMENT OF HON. JEFF MILLER 

Mr. MILLER OF FLORIDA. Thank you very much, Mr. Chairman. 

I know that many in this room share my concerns about the topic 

of today’s hearing, and I’m grateful that you and this Committee 

are holding this meeting to exercise our duty of assuring that the 

actions of the VA are for the benefit of all our Nation’s veterans. 

As has already been stated here this morning, nearly two years 

after Hurricane Katrina, there is still not a clear consensus plan 

on how veterans’ healthcare needs will be addressed in this region, 

and I am troubled by some of those proposals. 

The proposal receiving the most attention has cost estimates approaching $1.2 billion, yet there is very little certainty about where 

the facility is going to be located. Taxpayers and veterans both can 

better be served if VA would take a more fiscally responsible approach and situate a facility that won’t be subject to a repeat of 

what happened to the old hospital. 

With a declining population of veterans in the area prior to 

Katrina, a medical center where veterans are actually located 

would provide a quicker path to delivering healthcare to those in 


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need. Furthermore, new hospitals are going up all over this country 

at one third the cost that is being estimated. 

Veterans in southeast Louisiana deserve timely access to healthcare just as veterans throughout the rest of the Nation do. That is 

never in question. However, I question the proposed joint venture, 

and the significant amount of time that has lapsed with very little 

progress and that makes me question the plan even more. 

Putting a replacement facility in a flood prone area looks like no 

lesson was learned from the past, and putting the replacement facility back in the same area after years of population shifts looks 

like VA isn’t looking clearly toward the future. 

I look forward to today’s testimony and hopefully constructive 

ideas on how veterans in this are can receive timely access to 

healthcare at a cost that best serves the interest of the veteran and 

the taxpayer. 

I yield back. 

[The prepared statement of Congressman Miller appears on p. 

63.] 

The CHAIRMAN. Thank you, Mr. Miller. 

Mr. Michaud is the Chairman of our Health Subcommittee on 

this Committee and he’s come all the way from Maine for today. 

OPENING STATEMENT OF HON. MICHAEL H. MICHAUD 

Mr. MICHAUD. Thank you very much, Mr. Chairman. And I can 

assure you that the weather in Maine is much cooler than it is 

down here today. I also would like to thank Mr. Baker and Mr. Jefferson for your advocacy for veterans in trying to get this hospital 

built as soon as possible, but I also, Mr. Chairman, want to express 

my thanks to you for holding this hearing today. 

This is an important issue for veterans of Louisiana and for our 

VA system. Veterans in southern Louisiana have waited too long 

for a decision to be made on the future of healthcare delivery in 

this area. 

VA has an opportunity to be creative and to benefit the community. The decisions need to be made quickly and wisely and with 

good, effective use of taxpayers dollars. 

We must always remember that our responsibility here is to our 

veterans. They deserve to have access to the best possible care and 

they must be the guiding principal as far as where this facility 

goes; and hopefully it will be built sooner rather than later. 

And with that, I look forward to hearing our witnesses this 

morning and look forward to having a dialog on this very important 

issue for veterans in southern Louisiana. 

So once again, Mr. Chairman, thank you very much and I yield 

back the balance of my time. 

The CHAIRMAN. Thank you, Mr. Michaud. I thank you. 

[The prepared statement of Congressman Michaud appears on p. 

62.] 

The CHAIRMAN. Just to tell you our procedure, we’ll have three 

panels of witnesses. There will be testimony of the whole panel. 

Hopefully they will each limit their oral testimony to five minutes 

with their full written statement made a part of our record. The 

Committee will have a chance to ask questions of the panel after 

all the testimony and then we’ll proceed through the three panels. 


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Mayor Nagin, welcome. 

Mr. NAGIN. Thank you. 

The CHAIRMAN. I think we all feel we know you as America’s 

Mayor watching you for so many weeks on television. We appreciate your leadership, we appreciate the strong force you were to 

the city. I think the test of your leadership came in by the voters. 

Mr. NAGIN. Yeah. It continues to be tested every day. 

The CHAIRMAN. And I must say, Mayor Nagin, I don’t think the 

Federal Government as a whole has responded in a rapid enough 

way and in a comprehensive enough way to the terrible tragedy 

that you had to be part of. It’s our responsibility as a nation to see 

New Orleans as a vital dynamic place again and we are going to 

do whatever we can on this Committee. 

Before you came in, I think I mentioned that various Committees 

of the Congress are going to be here in the next few months to try 

to make sure that the plan that the President put forward in that 

evening newscast almost two years ago is actually carried out. We 

have not done the job that you and your constituents deserve and 

we’ll continue to work with you and appreciate your leadership, 

and the floor is yours, sir. 

STATEMENTS OF HON. C. RAY NAGIN, MAYOR, CITY OF NEW 

ORLEANS, LA; FREDERICK P. CERISE, M.D., M.P.H., SECRETARY, LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALS, ACCOMPANIED BY MIKE ROMANO, SENIOR CONSULTANT, PHASE 2 CONSULTING; MICHAEL KAISER, M.D., 

ACTING CHIEF MEDICAL OFFICER, LOUISIANA STATE UNIVERSITY HEALTHCARE SERVICES DIVISION, NEW ORLEANS, 

LA; AND ALAN M. MILLER, PH.D., M.D., INTERIM SENIOR VICE 

PRESIDENT FOR HEALTH SCIENCES, TULANE UNIVERSITY, 

NEW ORLEANS, LA 

STATEMENT OF HON. C. RAY NAGIN 

Mr. NAGIN. Good morning, ladies and gentlemen. I am C. Ray 

Nagin, Mayor of the City of New Orleans, one of America’s most 

beloved and culturally distinctive cities, a city that’s in full recovery, a city that has spent 23 months putting itself back together, 

both our infrastructure and our people. 

We are a city that is about 64 percent of its pre-Katrina population. The metropolitan area stands at about 92 to about 93 percent of its pre-Katrina population, but more importantly, some 

studies that have been done, the remaining residents who are not 

back in our city, about 70 percent of them are planning to come 

back into this region. 

So we are planning for a full recovery. We are building much 

smarter than we were pre-Katrina. We are building higher and better and we also have the Federal Government, who I thank you for 

the investments that have been made. 

The Corps of Engineers has been doing some pretty significant 

work investing billions and billions of dollars. That’s an investment 

that I think is wise. 

If you look around the world, other areas that have challenges 

with floods have been able to protect themselves better. And if it 

wasn’t for some flaws in the design of the federally-built levee sysVerDate Aug 31 2005 20:55 Jun 13, 2008 Jkt 037470 PO 00000 Frm 00011 Fmt 6633 Sfmt 6633 E:\HR\OC\37470.XXX 37470

hsrobinson on PROD1PC76 with HEARING
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tems here in New Orleans, we wouldn’t be here talking about these 

critical issues. 

So to the Chairman, Congressman Filner, to the Ranking Member and Congressman Buyer, to Congressmen Jefferson, Baker, and 

all the other Members of this Committee, I’m not going to read my 

full report, but I do want to highlight a couple of things and you 

can take a look at the report a little bit later. 

This VA hospital is critical to our future. It’s nestled in the middle of a medical—a legislatively creative medical district that encompasses more than 30 public, private, and nonprofit organizations including several colleges and universities, including LSU, 

Tulane, Xavier, and Delgado. Several hospitals are involved to 

medical schools, nursing schools, medical-related offices and businesses, and associated biotech companies. 

The presence of the VA hospital in this districts creates critical 

synergies and leveraging ability that clustering of these medical facilities achieve. The VA hospital is also critical because of its economic development. It will be an economic development engine for 

this entire region. And I know you talked about the dollars associated with rebuilding this facility, and all that can be achieved if 

its done in conjunction with LSU. 

Recognizing the importance of this development, the City of New 

Orleans along with a coalition of regional partners have come together and we all are in full support of them. A unanimous resolution was approved by our regional partners as it relates to this. 

In addition, the Louisiana Chapter of the American Legion with 

more than a thousand delegates in attendance at its annual meeting last month also unanimously supported the rebuilding of the 

VA hospital in this region. 

The city and its partners have the financial means to expeditiously acquire the necessary land, and we are very confident that 

we can do that within the 18-month designed timeframe that the 

VA has for reconstructing this hospital. 

In closing, Mr. Chairman and Members of this Committee, I 

would like to once again thank you for the opportunity to discuss 

our plans and hopes for the re-establishment of these very critical 

healthcare institutions in a post Katrina environment. We thank 

you for all of your support. 

I want to make sure that you understand that everything we are 

doing going forward is in full recognition of the learning that we 

have from Katrina. We will not have a repeat of that particular 

episode. We are building smarter and better in this city and we 

need the Federal Government’s support as it relates to making 

sure that, as our population comes back, that we have a critical 

healthcare system in place and VA is a big part of that. Thank you. 

[The prepared statement of Mayor Nagin appears on p. 63.] 

The CHAIRMAN. Thank you, Mayor Nagin. 

From the Secretary of the Louisiana Department of Health and 

Hospitals, Dr. Frederick Cerise, accompanied by senior consultant 

for Phase Two Consulting, Mr. Michael Romano. Thank you, Mr. 

Secretary. 


hsrobinson on PROD1PC76 with HEARING
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STATEMENT OF FREDERICK P. CERISE, M.D., M.P.H. 

Dr. CERISE. Thank you, Mr. Chairman and Members of the Committee. Thanks for the opportunity to testify today on the future of 

the veterans’ healthcare in south Louisiana, and let me add my 

thanks to those of the Committee and the veterans here today for 

their service to our country. 

I’m Fred Cerise, Secretary of the Louisiana Department of 

Health and Hospitals, a Louisiana State agency for healthcare in 

Louisiana. 

Louisiana and the Department of Veterans Affairs have had a 

successful relationship for many years as demonstrated by collaboration among the VA, Tulane University and Louisiana State University. 

Further, the LSU Sciences Center Healthcare Services Division, 

which operates the system of public hospitals and clinics in Louisiana, and the VA have similar missions to provide primary and 

specialty care and other related medical services to their populations. 

The two systems have much in common: Both are public healthcare systems, both provide a high volume of outpatient care, and 

both have healthcare practices that include management for individuals with chronic diseases. Additionally, physicians from Tulane 

and LSU regularly rotate between the two systems. 

After Hurricane Katrina, Louisiana Healthcare Redesign Collaborative was created through a legislative resolution to respond 

to healthcare issues in the New Orleans region. The backbone of 

the redesigned system of care put forward by that collaborative is 

the ‘‘medical home’’ along with—consistent with recommendations 

for improved systems of care put forth by a number of professional 

societies. This model is very similar to the VA’s current operation. 

Louisiana is moving forward with its redesign work in the area 

of healthcare. In the recent legislative session, funding was allocated to pilot the medical home system of care, health information 

technology, and quality initiatives. 

The VA had been recognized for its work for a number of years. 

In July of 2007, Business Week magazine called the VA healthcare 

the best medical care in the U.S. In 2004, an article in the American Journal of Managed Care stated that, ‘‘today, the VA is recognized for leadership in clinical informatics and performance improvement, cares for more patients with proportionally fewer resources, and sets national benchmarks in patient satisfaction.’’

The VA also provides an avenue for healthcare research. In New 

Orleans alone, the VA has 29 active research projects and is home 

to the Mental Illness Research, Education and Clinical Center. 

Given the similar mission and goals between the State and the 

VA, a joint partnership between the two entities makes sense. 

What’s been proposed is to move from three separate patient facilities that existed in New Orleans prior to Katrina to a single shared 

VA–LSU inpatient facility with a more dispersed network of clinics. 

Sharing of common physical plant requirements, certain high-end 

clinical services will create hundreds of billions of dollars in operating efficiently for our taxpayers and improved health benefits for 

all those who have served. 


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The State’s commitment to this partnership has been unwavering. On February 23rd, 2006, Governor Blanco was present as Jonathan Perlin, the VA Secretary at the time, and LSU President Lee 

Jenkins signed an LOU allowing LSU and the VA to enter into negotiations to jointly plan and build a shared hospital in New Orleans. Extensive detailed planning ensued. 

But in a particular area, the U.S. Department of Housing and 

Urban Development (HUD) approval for spending Community Development Block Grant (CDBG) dollars may delay the rebuilding. 

Governor Blanco proposed self financing the State’s share to ensure 

that the State can continue to meet the extra high costs. The funding was approved by the State legislative. 

Governor Blanco recently signed Act 203 which allocates an ini- tial $74 million for land acquisition, acquisition of land. The Legislature also will provide the $226 million downpayment for the new 

academic medical center in downtown New Orleans to replace the 

old Charity Hospital, and the remainder of the project will be financed through general revenue bonds. 

In addition to these investments, the State’s also committed $38 

million to a cancer research institute which will be established in 

downtown New Orleans. The presence of the existing LSU and 

Tulane Health Sciences Center combined with the VA and the new 

cancer center will create a medical district that not only will provide state-of-the-art healthcare to our citizens but also will drive 

economic development in New Orleans. 

There is widespread support for this endeavor including the Regional Planning Commission for Jefferson, Orleans, Plaquemines, 

St. Bernard, and St. Tammany Parishes, the Downtown Development District of New Orleans, the Unified New Orleans Plan, the 

Louisiana Recovery Plan and the Louisiana State Legislature. 

Hurricane Katrina was a tragedy for the New Orleans region and 

for our country. Together, we have the opportunity to create something new and innovative in the wake of this terrible disaster. 

A shared inpatient facility with a dispersed network of clinics organized to better serve our citizens is not a simple rebuilding of our 

old systems but a creation of a new model that makes sense for 

those receiving care and responds with clinical and financial accountability to the taxpayers supporting this care. 

I urge you to recognize the opportunity to do something truly innovative for our citizens in supporting this endeavor. 

Thank you for the opportunity to testify this morning. 

[The prepared statement of Dr. Cerise appears on p. 66.] 

The CHAIRMAN. Mr. Romano, you have a statement or——

Mr. ROMANO. No, sir. 

The CHAIRMAN. Thank you very much. 

Dr. Michael Kaiser is the Acting Chief Medical Officer of the 

LSU Healthcare Services Divisions. We welcome you and thank 

you for your collaboration with VA in the past and look forward to 

it in the future. 

STATEMENT OF MICHAEL KAISER, M.D. 

Dr. KAISER. Thank you. Good morning, Mr. Chairman and Members of the Committee. My name is Michael Kaiser. I’m a pediatrician and Acting Chief Medical Officer of the LSU Healthcare ServVerDate Aug 31 2005 20:55 Jun 13, 2008 Jkt 037470 PO 00000 Frm 00014 Fmt 6633 Sfmt 6633 E:\HR\OC\37470.XXX 37470

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ices Division which consists of seven acute care hospitals and extensive outpatient clinics operated by the State of Louisiana. These 

include our rebuilt LSU Interim Hospital campus in New Orleans, 

which was effectively destroyed by Hurricane Katrina. 

Similar to other local public hospitals across the country, this facility functioned as the core of the safety net for the uninsured and 

was the predominant site for the clinical training of physicians and 

other healthcare professionals. 

The now-closed Charity Hospital sits across the street from the 

VA Hospital, which also suffered catastrophic damage in the storm. 

Following Katrina, nothing has occupied our time and attention 

more fully than the restoration of a public hospital and its clinics 

to serve the people of this region and the future healthcare professionals who train there. 

Of necessity, LSU has focused on both the present and the future. In the nearly two years since Katrina, we have moved from 

emergency facilitates in tents to the opening of a small, interim 

hospital and a growing number of primary and specialty care clinics in several locations. Our capacity is not yet up to the level of 

need in the region, particularly in the availability of psychiatric 

services, some medical specialties and dispersed primary care clinics, but we have made significant progress. Other major additional 

steps will be taken in the months ahead. 

As we continue to work—as we continue work to address the immediate and critical needs of our community, LSU has kept a 

steady focus on the longer term. The region desperately needs not 

only additional healthcare resources but also ways to develop and 

deploy those assets through a better and more efficient system 

than was possible before the storm. 

LSU has long worked toward fundamental improvements in its 

delivery system, such as through its award-winning disease management program, but the convergence of the need to rebuild and 

the heightened support today for both a reformed delivery model 

for care to the uninsured and for the financial and reimbursement 

reform necessary to make that new model possible present realistic 

opportunities for our long-term agenda for change. 

The potential collaboration between the VA and Louisiana’s 

State public hospital system is one propelled by unintended opportunity, but it is a core part of our strategic vision. We have a 

chance to jointly design and cooperatively operate a new facility 

that meets the needs of both institutions and the patients they 

serve while at the same time achieving significantly enhanced efficiency, cost savings and quality healthcare. 

The proposed collaboration is a logical step for reasons that extend beyond the destruction of Katrina. The adjacent VA and Louisiana-operated public hospitals have a long history of working together. Prior to the storm, the New Orleans VA purchased over $3 

million of clinical and other services from LSU. Many physicians 

worked at both the VA and the Medical Center of Louisiana at 

New Orleans facilities and many medical residents, both from LSU 

and Tulane, rotated to both hospitals. 

For the past 18 months, I have chaired the planning efforts with 

the VA. First, the Collaborative Opportunities Study Group, cochaired with Mr. Michael Moreland, Director of the VA Hospital in 


hsrobinson on PROD1PC76 with HEARING
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Pittsburgh, looked at the possibility of a feasibility of building together and sharing services. Once proved feasible, the Collaborative Opportunities Planning Group (COPG), co-chaired with Mr. 

Ed Tucker, Director of the DeBakey VA Hospital, has been studying what services should be shared and the details of building together. The COPG continues to meet weekly in order to present a 

final report to the Secretary by the end of September 2007. 

The creation of a VA–LSU campus in downtown New Orleans 

will create benefits for both partners that exceed what either can 

accomplish separately in different locations. We have a rare opportunity to develop a whole that is greater than the sum of its parts. 

There are enormous benefits to the community of a downtown medical complex. It is a synergy created by working together that will 

enhance the services available to all our patients. 

The Louisiana Legislature in its just completed 2007 Regular Session approved outlaying of $1.2 million for the new academic 

medical center which matches the cost estimate for the facility contained in the business plan completed by the Adams Group, a national hospital consulting firm, and overwhelmingly approved by 

both houses of the Louisiana Legislature. 

The construction of the new academic medical center is being 

managed by the Office of Facilities Planning and Control which is 

an agency within the executive branch of Louisiana government. 

Acquisition of land identified for the new medical center and the 

VA facility is already underway with contracts having been issued 

to complete title and appraisal work. Once the VA firmly commits 

to building of the downtown site, the City of New Orleans and the 

State of Louisiana are prepared to immediately proceed with land 

acquisition for the VA. 

From this point forward and given the preparation of both partners, the process of building a new hospital complex together can 

proceed as quickly as choosing to build separately. Significant 

groundwork has been laid for long-term mutually beneficial collaboration and we are poised to see it through to completion. 

Thank you for your interest and for the opportunity to share 

LSU’s perspective on these critical matters. Far from being an obstacle to healthcare reform as some have feared, the creation of a 

revitalized academic medical center complex in the city will be a 

catalyst for that reform. Particularly if LSU and the VA work together, it will also sustain a reformed system in the long run by 

supporting a viable, mission-driven system dedicated to improved 

access, the highest quality medical care and innovative healthcare 

education in a rebuilt community. 

[The prepared statement of Dr. Kaiser appears on p. 65.] 

The CHAIRMAN. Thank you, Dr. Kaiser. 

I think, for the record, you meant $1.2 billion with the same Legislature. I heard million, but I assume you meant billion. 

Dr. KAISER. I sure did. 

The CHAIRMAN. I thought we were getting away cheap. 

Dr. Alan Miller is the Interim Senior Vice President for Health 

Sciences at Tulane University. Welcome, Dr. Miller. I just would 

say that your testimony would have been far more compelling had 

you included San Diego as a bioscience giant. 

Dr. MILLER. I have to talk to my consultants. 


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STATEMENT OF ALAN M. MILLER, PH.D., M.D. 

Dr. MILLER. Mr. Chairman and Members of the Committee, 

thank you for the opportunity to speak to you about the importance 

of fully restoring accessible healthcare to our region’s veterans and 

about Tulane’s historic and present role. 

Almost 23 months have passed since Hurricane Katrina. We 

have seen enormous progress in some areas; in other areas 

progress has come at a distressingly slow pace. Our primary focus 

now is the timely re-establishment of the highest quality care for 

our veterans. 

The VA has been a valued Tulane partner for nearly 40 years 

and during that time our faculty, residents, and medical students 

have worked side by side with the VA providing patient care, educating future physicians, and performing cutting edge medical research. 

I’d like to focus my comments on three areas: Provision of care 

before Katrina, the VA’s and Tulane’s roles in re-establishing medical care post Katrina, and the importance of the VA in medical research and the future of biosciences. 

Prior to Katrina, Tulane provided approximately 70 percent of 

the patient care at the VA with more than 75 faculty serving joint 

appointments. Well-educated and trained physicians are essential 

in assuring access to quality healthcare. 

Tulane’s mission of healthcare medical education, and research is 

intimately intertwined with that of the VA. 

Before August 2005, the VA Medical Center provided training for 

approximately 140 residents. 120 of them were from Tulane. 

The VA’s integration with the health science centers at Tulane 

and LSU provided a critical synergy that was a key strength in the 

region’s overall healthcare and a vibrant environment for bioscience research. 

The VA’s swift response after Katrina allowed for a successful 

and safe evacuation of hundreds of patients and employees. Tulane 

faculty, residents, and staff were integral to the evacuation and in 

re-establishing a presence in the community immediately following 

the storm. 

The VA’s outpatient clinics have reopened and visits are up to 75 

percent of its pre-storm. Through its partnership with Tulane, the 

VA is now providing new patient care at Tulane University Hospital and Clinic as it strives to keep up with the rapidly expanding 

population. Over 40 Tulane physicians and 26 residents are currently providing services and training at various VA locations in 

the area. Tulane is actively recruiting new physicians to accommodate the increasing need in the area, many specifically to support 

the VA’s clinical mission. 

As we look down the road, 5, 10, 20 years or longer, it’s clear 

that the VA will be a cornerstone for healthcare, research and the 

biosciences industry in our region. Over 8,000 people are currently 

employed in bioscience and healthcare related fields. Although New 

Orleans ranks behind bioscience giants like San Francisco, Boston, 

San Diego, and the Research Triangle, we outrank other up-andcoming centers including Nashville, Birmingham, and Louisville. In fiscal year 2005, New Orleans accounted for more than $130 

million in NIH awards representing 82 percent of all NIH funding 


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in the Gulf coast region. That includes New Orleans, the Mississippi and Alabama coasts, and the Florida panhandle. Tulane 

itself accounted for 46 percent of all NIH awards in that region. 

Prior to Katrina, the New Orleans bioscience district was actively 

building a framework for entrepreneurial success. Key pieces included critical Tulane, LSU, State of Louisiana partnerships. Construction will begin this fall in the downtown bioscience district on 

an $86 million cancer research facility and a $60 million BioInnovation Center. 

The synergy generated by those projects and collaborations, each 

within a few blocks of each other, will create a rich, dynamic teaching and research environment that will rival any in the country. A 

strong VA Medical Center is a crucial component of this burgeoning bioscience hub. It is hard to imagine the district without 

the VA and the VA being built anywhere but in the district. 

I want to thank each of you and your colleagues in Congress for 

demonstrating a strong commitment to the region’s veterans by appropriating more than $600 million for a new state-of-the-art VA 

Medical Center. The State too has now done its part in providing 

funding for a public hospital to be built in tandem with the VA. 

This leverages the Federal investment providing substantial cost 

savings and demonstrating good stewardship of taxpayer dollars. 

In addition, the investments by the city, State, and other institutions in the emerging bioscience district provide unique opportunities to create a vibrant and inter-reliant collaboration. 

It is our hope that the VA and the City of New Orleans move 

quickly to begin the process of land acquisition, planning and construction so that we may re-establish the full spectrum of care for 

our veteran population. 

Once again, I thank you for allowing me to speak to Members of 

this Committee. With your help, we will continue to bring back 

healthcare in our city and region not just back to where it was but 

to an even better future. 

[The prepared statement of Dr. Miller appears on p. 69.] 

The CHAIRMAN. Thank you, and I thank all of you for your commitment to the healthcare of this area. I’m going to just ask one 

question of you before my colleagues, if I can, in order to give you 

a chance to go further than your statement. 

Virtually everybody who has testified in written testimony thinks 

that the hospital should be relocated where it is, where it was. I’m 

sure you heard Congressman Miller, who will have his very penetrating questions in a few minutes, but he represents a train of 

thought in the Congress that says why put it right back where it 

was. 

You said we are building smarter, better. Can you just give us 

the arguments that we need, as a Congress, to make sure that we 

can answer those questions? 

Mr. NAGIN. Well, the best way I can explain this is, when 

Katrina hit us, the storm surge overwhelmed the levees because 

they were poorly designed. All of those design flaws, as best I can 

determine being a nonengineer, have been corrected and there have 

been other enhancements that have been put in place to make sure 

that if another Katrina came this way we wouldn’t have the cataVerDate Aug 31 2005 20:55 Jun 13, 2008 Jkt 037470 PO 00000 Frm 00018 Fmt 6633 Sfmt 6633 E:\HR\OC\37470.XXX 37470

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strophic flooding that we’ve had during Katrina. That’s the first 

point. 

The second point is that every citizen that is getting a building 

permit and every business that is asking for a building permit 

post-Katrina, if they had at least 51 percent damage, they have to 

elevate their foundations to take into account the new Federal 

Emergency Management Agency (FEMA) flood plain maps that are 

in place. 

So that’s probably the biggest arguments that I will make; and 

then we’ve had several teams from around the world, the Netherlands, and to look at exactly what’s happening in other parts of the 

world that are even more vulnerable from a standpoint that they 

are even further below sea level than we are and their techniques 

and engineering that can ensure that New Orleans and this region 

is safe going forward. 

The CHAIRMAN. Thank you, Mayor. I just wanted you to get 

ready for the——

Mr. NAGIN. Oh, I understand. 

The CHAIRMAN. For the questions that Mr. Miller is going to 

have. 

Mr. NAGIN. Where is Mr. Miller from? 

The CHAIRMAN. Florida. 

Mr. NAGIN. Florida. Okay. Good. Let’s talk. 

The CHAIRMAN. All right. Mr. Baker, you have the floor, and I 

look forward to your questions. 

Mr. BAKER. Thank you, Mr. Chairman. 

Dr. Cerise, I’d like to just start with the questionnaire that was 

forwarded to the Governor by Secretary Jackson sometime back 

which outlined about two pages of questions which were pertinent 

to the financial capability of the State to engage in this project. 

I did not speak to the Governor about the report and response. 

These are press attributions only, so I say that in this context. It 

appeared that the response was we are just going to go ahead on 

our own. I was not clear as to what we are going to go ahead on 

our own really means. Does that mean the LSU-Charity replacement facility will be constructed with total State dollars and that 

they would move ahead in that fashion or can you clarify for me 

what that intent was in response to the question? 

Dr. CERISE. I think the—the Governor’s concern was that, as we 

are hearing today, the concern over the claim for getting this 

project accomplished, so a great desire to make this partnership 

work because——

Mr. BAKER. Let me interject there. The time would be extended 

by entering the questionnaire? I’m trying to get to the reason for 

not responding and then saying we are going to go ahead on our 

own any way. 

Dr. CERISE. I think the—in fact, I know the responses have been 

drafted and the Governor will respond to that questionnaire; however, there is a concern. 

We have been in conversation, or the State, not me personally, 

been in conversation with HUD on these Community Development 

Block Grant dollars and the ability to commit those dollars to this 

project and that process has proved to be a prolonged process. 


hsrobinson on PROD1PC76 with HEARING
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And so what the Governor was saying is look, I don’t want this 

prolonged process to have a negative effect on the state and the VA 

discussions so that this hospital formation can go forward; and so 

I’m committed and the Legislature approved that the ability of the 

State to go this without the HUD dollars, not ignoring the HUD 

questions, not—because she fully feels and we fully feel we can answer those questions adequately and, as I said, they are drafted 

and put forward, but the State cannot afford—we don’t know how 

long that would play out, this discussion with HUD. 

And so for that purpose, she opted to make a commitment from 

the State for the funds for the academic medical center because 

there’s broad support for this academic medical center. 

Mr. BAKER. Let’s stop there for a moment. That’s presuming 

there is a definitive decision by someone that the VA facility will 

be built as a collaborative because, otherwise, you are going to construct two State facilities with State money while waiting on the 

VA-State relationship to be ironed out or the CDBG money to be 

ironed out. 

Isn’t that somewhat of a risk that you would invest State dollars 

in—up front unless you have absolute assurances the funding 

stream will be available to you at a date certain? 

Dr. CERISE. Sir, when you say two State facilities with State dollars——

Mr. BAKER. The LSU–VA hospital facility and the replacement, 

whatever it may be called, for the Charity system, that are to be 

on the collaborative campus with the VA facility which you are now 

saying you are going to go ahead without. 

Dr. CERISE. What the Governor is committing to is a single replacement facility hopefully in conjunction with the VA because we 

think it makes great sense long-term; but if not in conjunction with 

the VA——

Mr. BAKER. Well, that gets me back to my point. How do you design that collaborative facility without a collaborator? 

Dr. CERISE. The collaborative work is ongoing right now. What 

she was trying to answer is a concern that the State was going to—

was moving too slowly to keep up with the VA’s timeframe. 

Mr. BAKER. Okay. I’ll give up and let me go to timeframe. 

As originally reported by the collaborative group, there was a 

study, a report that was issued in which the timeline for commencing architectural services was in mid 2006. That timeline carried on for an operational opening of end of 2011, 2012, basically 

a six-year clock. 

As I view it now, we—we don’t now have an architectural firm 

appointed for the three collaborative interests because we don’t 

have a collaboration. 

I would assume that with the announcement by the VA that the 

original site of some 30 plus acres is now insufficient and additional acreage will have to be acquired and that that would push 

back that timeline of a commencement date to at least, let’s say, 

the beginning of 2008. 

Is that an unreasonable assumption based on where we were 

today in the uncertainties of funding? 


hsrobinson on PROD1PC76 with HEARING
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Dr. CERISE. I’m going to ask Dr. Kaiser, who has been working 

on that collaborative who has more detailed knowledge to address 

that. 

Dr. KAISER. Mr. Baker, both the Department of Veterans Affairs 

and the State of Louisiana have selected architects. They have not 

been announced just because of your questions exactly, so it’s unclear if we’re building collaboratively with the VA or if we are 

building separately. 

As soon as the Department of Veterans Affairs makes their decision about the location, then the architects have been selected, 

could be announced, and could go to work. 

Mr. BAKER. So we could assume if everything went swimmingly 

that by September we could have architects at work designing a facility? 

Dr. KAISER. Yes, sir. 

Mr. BAKER. Okay. Well, that would mean we would then be 2012, 

2013. I think this is the point that has not been made clearly to 

the veterans. 

Some have assumed that if we don’t take the deal as it’s outlined, where it’s proposed, in the terms in which it’s proposed that 

they are going to be without healthcare. Even if you take it the 

way it’s been prescribed, you are without healthcare for the next 

six to seven years any way. Now, is that an acceptable time window? 

I look up, drive up and down the interstate between Baton Rouge 

and New Orleans and see hospitals and healthcare facilities being 

built all the time in tow or three years or less. I have not yet had 

an adequate explanation from HUD, the VA, or anybody else why 

this process is so doggedly long. 

There are extraordinary uncertainties about how we are going to 

go forward. And I again make the point to veterans: If you are worried about healthcare, the collaboration makes it extraordinarily 

more complicated to get the facility opened and operational for your 

purposes. 

And my question will be of a lot of the veterans who are here 

today: How long is long enough? Is it five years; is it six years; is 

it seven years? When does it get to be too long? I think it’s too long 

right now, but let me move on. 

Mr. Chairman, my time has long since expired. I am more than 

willing to yield to other Members and come back for additional 

rounds, but I’m at your direction, sir. 

The CHAIRMAN. We will come back to you, Mr. Baker. Mr. Jefferson. 

Mr. JEFFERSON. Thank you, Mr. Chairman. I really have lots of 

questions to be answered that cannot be answered by you at the 

table. 

I think you tried to make the point and I want to ask, maybe 

help you make the point that our State has done all that it can, 

that it has been asked to do any way, to position itself in the event 

this collaborative is struck, this agreement is struck between LSU, 

Tulane, and the VA. Is that not what you have been discussing 

with us this morning? 

Dr. CERISE. That’s correct. 


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Mr. JEFFERSON. And the criticism that was coming forth from 

some Members of Congress was that the State had not itself made 

a sufficient commitment and that it would not make a sufficient 

commitment to be a good partner; and this has been cleared up, 

has it not. 

Dr. CERISE. That’s correct. 

Mr. JEFFERSON. One of the questions for a detailed budget, a detailed plan, has that been delivered through the legislative process 

and through administrative action. 

Dr. CERISE. The Legislature has made the commitment of three issues: The $74 million for land acquisition and planning, $225 million or $226 million, which is the balance of the downpayment for 

the State’s portion of this, essentially making the State commitment to build the State’s share of this center in New Orleans. And 

so the commitment to acquire the land and to build the State facility there in conjunction with the VA. 

Mr. JEFFERSON. I want to make it clear. It won’t be the State’s 

responsibility to build this facility all by itself, and there has to be 

some planning, some cooperation here. But the deadline, the 

timeline for building it——

When I went to a meeting in Mr. Filner’s office and the Members 

of the Committee and others, we were all fussing about how long 

it might take to get this done, but they told us there was no way 

to quicken the process, that for most VA hospitals that are being 

built it take’s this sort of period of time: The five, six, seven years. 

And that entirely is not the fault of the State or legislative process; 

isn’t that correct? 

Dr. CERISE. It’s my understanding that to do this separately or 

together at this point is—will—to do this with the State, it will not 

delay the VA as opposed to doing it separately from—— Mr. JEFFERSON. So it isn’t the idea of the collaboration itself that 

brings up the time issues in place. It’s just a matter of how physically one can build a hospital in this period of time. It just takes 

that much time to do it is what we’ve been told; is that correct? 

Dr. CERISE. That’s correct. 

Mr. JEFFERSON. But the things that will come out of this process, 

this collaborative process, I think can be a model for what might 

happen in other places. 

As the Mayor stated—and I may ask him this. I don’t know. As 

the Mayor stated, had it not been for the faulty levees, we would 

not be discussing our recovery, at least not today in these terms. 

And the State has undergone some process where it has established a strong building code across the State, in particular down 

here, to do what it can in the event of another such catastrophe 

to at least elevate so that there wouldn’t be such a tremendous 

record loss. 

Some of us used to think that it was better to have records in 

the basement or the lower levels of Charity Hospital or to have 

them some other place than now, but a lot has been learned from 

that. 

Can you maybe—I want to ask the Mayor. I’ll ask you this. Can 

you talk about the way we planned for the future with hospitals, 

with our record keeping restoration, with making the facilities 

available at the time of the storm and that sort of thing so that 


hsrobinson on PROD1PC76 with HEARING
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we might provide some assurance to Members of the Congress, others around the country that we made good plans to deal with these 

questions? 

Mr. ROMANO. Mr. Jefferson, I think I might be able to help respond to that. 

Part of—the question was asked earlier about the cost of the facility, the $1.2 billion, and that cost really comes from three main 

areas. 

The first really has to do with the planning for a university type 

medical center. In order to be able to teach in a facility, it’s basically required, and so forth. 

It also talks about additional technology that’s required for some 

of the record keeping that you are describing to become electronic 

as opposed to paper based and making the storage of those records 

much more disaster proof for the future. 

And then, finally, when you talk about hurricane hardening, the 

way the facility is being planned, it is essentially to put the essential services above the flood plain; and so a lot of the cost has to 

do with ramps and everything that will create an emergency room 

that’s 22 or 26 feet above sea level at the required spot. And so the 

lower levels would be more for retail type things, clinics and such 

space that would, if something disastrous were to happen again, 

would not be essential services on those lower levels. 

And so those are just some examples of how planning is going 

forward to address some of those issues for the hospitals. 

Mr. JEFFERSON. On Tulane’s part, you have anything to add to 

that, sir? 

Dr. MILLER. Certainly not in terms of—facilities is not my thing, 

but there’s other costs, Mr. Jefferson, that—that can’t be measured 

in terms of the construction costs. Those are the cost benefits or 

some of the synergies that are created by having LSU, Tulane in 

close proximity to both hospitals, the State hospital and the VA 

hospital. 

The fact that our physicians can provide services there, it takes 

less total full-time equivalents (FTEs) to be able to provide the 

same type of services as opposed to the VA that is built basically 

isolated from the universities. So there’s tremendous benefits to the 

synergy created by the location. 

Mr. JEFFERSON. Thank you, Mr. Chairman for the—my time has 

expired. I appreciate that. 

The CHAIRMAN. Thank you, Mr. Jefferson. Mr. Miller? 

Mr. MILLER OF FLORIDA. Thank you, Mr. Chairman. Following 

up my colleague’s question in regard to the cost of the facility, Dr. 

Cerise or Mr. Romano, can you explain, other than ramps to get 

out of the flooding area, how the cost has escalated from $630 million, which was the estimate I think in the fall of just last year, 

to $1.2 billion today; and what assurances do we have today that 

that number won’t continue to escalate. 

Mr. ROMANO. I think the best answer to the question is that the 

initial estimates that were provided were based on a facility sizing 

that, again, at that point was an estimate that didn’t have any real 

science behind it. And as the estimates have become refined and 

the business plan has evolved, the size of the facility has grown, 


hsrobinson on PROD1PC76 with HEARING
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first of all; and so that is the biggest impact that accounted for the 

change from the $650 million to the $1.2 billion. 

Mr. MILLER OF FLORIDA. So it has doubled in size? 

Mr. ROMANO. Excuse me? 

Mr. MILLER OF FLORIDA. So it has doubled in size? 

Mr. ROMANO. No. And then that’s not the only factor. 

In addition to that, the cost estimates became what we would 

call fully loaded in terms of including all of the financing costs and 

interim financing costs associated with the facilities incorporating 

all of the various outpatient components that would have to go 

with it. Again, as the business plan evolved, those things become 

clearer and the estimates became sharper. 

Mr. MILLER OF FLORIDA. If I can interrupt. Do we assume that 

the business plan will continue to evolve and costs will continue to 

escalate? 

Mr. ROMANO. There’s no assurance that the costs couldn’t escalate for other reasons, but the business plan has been brought forth 

reasonably and in its final form. 

Mr. MILLER OF FLORIDA. Dr. Cerise, my colleague, Mr. Baker, 

was asking you about Secretary Jackson’s letter to Governor Blanco. I didn’t get a decent response from you as well in regard to why 

the answers haven’t been given to HUD. 

You said we are working on it, when will they will be provided. 

When will they be provided? Also I would like to request that a 

copy of those answers be provided to this Committee for the record 

today. Can you elaborate just a little bit? 

[The information was not provided to the Committee.] 

Dr. CERISE. Sure. I think, again, the concern of—we have been 

in negotiations or discussions with HUD for a period of many 

months now regarding the $300 million and Community Block 

Grant (CBG) and——

Mr. MILLER OF FLORIDA. I’m still—I apologize. You’re filibustering me. I want to know when? You’ve got to know in your mind 

when that questionnaire is going to be answered. 

Dr. CERISE. I think that——

Mr. MILLER OF FLORIDA. The letter was June 21st. 

Dr. CERISE. And I imagine—like I said, I know that there’s a 

draft of responses posed, so I think it’s reasonable to think within 

a week or so that could be finalized. 

Mr. MILLER OF FLORIDA. It had $74 million attached to it? 

Dr. CERISE. Excuse me. 

Mr. MILLER OF FLORIDA. It had $74 million attached to it. Isn’t 

that a pretty good incentive to get those questions answered? 

Dr. CERISE. Again, when the Governor prioritized, she made our 

priority a commitment of the funds to demonstrate that the State 

was willing to commit funds to make this happen. That was a priority above responding to the questions and getting that final form 

back. 

Those questions can be answered I think—again, I’m speaking 

for the Governor now, but within a week or so I think is reasonable. 

Mr. MILLER OF FLORIDA. Thank you. That’s what I needed, a 

week or so. We’ll be awaiting your response. 


hsrobinson on PROD1PC76 with HEARING
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Can you tell me what the $74 million in Community Block Grant 

(CBG) funds are going to be used for and are those the same funds 

that the Governor is saying that the State is allocating for acquisition of the lands? 

Dr. CERISE. That’s right. The State has made a commitment to put forth $74 million. 

Mr. MILLER OF FLORIDA. Is that the same money that’s coming 

from HUD? 

Dr. CERISE. No, sir. 

Mr. MILLER OF FLORIDA. What will the HUD money be used for, 

because I understand these funds will enable the State of Louisiana to acquire land and continue design work for a new academic medical center in downtown New Orleans. That is not the 

same money? 

Dr. CERISE. That’s right. 

Mr. MILLER OF FLORIDA. It just happens to be the exact same 

number, $74 million? 

Dr. CERISE. What the Governor did and the Legislature did was 

put forth State funds to make sure that this project would move 

along as opposed to HUD dollars. 

Mr. MILLER OF FLORIDA. That money is for what? 

Dr. CERISE. For land acquisition and planning and design. 

Mr. MILLER OF FLORIDA. And the CBG funds are for what? 

Dr. CERISE. The use, I do not know. 

Mr. MILLER OF FLORIDA. It says land acquisition and design 

work. It appears to be the exact same thing. I just want to make 

sure that everybody’s up front and honest who is providing money 

and where, is it coming from the Federal Government or is the 

State Government providing it? 

Dr. CERISE. The State is relying on those Federal dollars to replace—to go toward replacement of this facility; and that process 

has turned out to be a very prolonged protracted process and the 

State did say we’re going to put forward State dollars to make sure 

this happens, to make sure the State does not delay this, and use 

those Federal dollars in appropriate places elsewhere. 

Mr. MILLER OF FLORIDA. Those appropriate places are to acquire 

land and continue design work for an academic medical center. 

Dr. CERISE. That was the plan for those funds up until—— Mr. MILLER OF FLORIDA. I’m sorry, my time has run out. I apologize. I’ll get you in the next round. 

Dr. CERISE. We will not be spending those dollars in two places. 

They are being deployed——

Mr. MILLER OF FLORIDA. I’ll get you in the next round; and, 

Mayor, I’ll see you in the next round too. Thank you, Mr. Chairman. 

The CHAIRMAN. Thank you, Mr. Miller. Mr Michaud? 

Mr. MICHAUD. Thank you very much, Mr. Chairman. I have a 

couple of questions for Dr. Kaiser. 

There’s been a lot of discussion about the facility here in downtown. How difficult would it be to maintain that current relationship with some of your other facilities? You mentioned in your 

opening comment you have seven acute care hospitals and extensive outpatient clinics, so my first question is: Could you still have 

that relationship in one of these other facilities that might not be 


hsrobinson on PROD1PC76 with HEARING
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downtown? And my second question is: Since you’re asking for the 

Federal Government to have a strong partnership with LSU to 

take care of our veterans and since you have so many acute care 

hospitals, do you provide a TRICARE—do you accept TRICARE in 

your hospitals? 

Dr. KAISER. The—the seven hospitals run by the healthcare services division are scattered across the State. The one here in New 

Orleans formally known as Medical Center of Louisiana in New Orleans, now an interim hospital, well, those seven hospitals continue 

to work together. We have many programs. I’m the Director of 

those seven hospitals. 

For—the collaboration with the VA is critically important here in 

New Orleans because of the synergies that will be created by putting the facilities next to each other, their operational savings, but 

it doesn’t really have an influence on what’s going to happen 

around the rest of the State. Have I answered your question, sir? 

Mr. MICHAUD. Could you—does the facility have to be in downtown? Could it be five, ten miles out of the city? Does it have to 

be downtown to still have that collaborative effort. 

Dr. KAISER. The State of Louisiana, LSU and our partners have 

all agreed that the replacement hospital, the replacement State 

hospital should be in downtown New Orleans and will be. 

Mr. MICHAUD. But does LSU, do you feel that collaboration can 

be elsewhere? I know you talked about the collaborative effort with 

all three. In your opinion, can LSU do it elsewhere? 

Dr. KAISER. With the VA, no, sir. 

Mr. MICHAUD. Okay. And what about TRICARE; do you accept 

those. 

Dr. KAISER. The hospitals around the State all have collaborative 

relationships with the Department of Veterans Affairs and provide 

services as needed for veterans when they are not available 

through the veterans system. 

Mr. MICHAUD. So does—the seven acute hospitals I assume then 

do take TRICARE. 

Dr. KAISER. I’m not positive. I’m not positive really. 

Mr. MICHAUD. You don’t know. Okay. 

My question, Mr. Mayor, you had mentioned about you’re building smarter and I can appreciate that, but it’s my understanding 

that the levee has not been fixed; is that correct? 

And what are you doing as far as a possible terrorist attack? I’m 

sure it’s being taken care of as far as hurricanes or tornados, but 

can you elaborate a little more? Because as the Chairman mentioned, that’s going to be a big issue for those of us who try to, you 

know, use Federal dollars wisely is to build in an area where it 

would be safer. 

Mr. NAGIN. Well, most of the areas that had breached preKatrina or during—right when Katrina hit have been repaired to 

the new standards that the Corps of Engineers has designed. The 

entire system of levee protection that encompasses the entire metropolitan area of the New Orleans region has not been completed, 

and the Corps of Engineers gives us estimates that by 2010 or possibly 2011 the entire system will be complete, so—— And we are pretty comfortable that the new design builds the 

levees much higher, they’re re-enforced, they are armored, and 


hsrobinson on PROD1PC76 with HEARING
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there also is a gated system that protects us against storm surges 

at the lake, which we didn’t have prior to Katrina. 

As far as terrorist attacks are concerned, we work with the Federal Government on a number of different initiatives. Particularly 

the target area that seems to generate the most concerns is our 

port; and our port has invested a significant amount of dollars with 

various technologies that allow us to scan, you know, cargo that 

comes off the ships themselves and we work with the Office of 

Homeland Security on a regular basis to assess threats. 

With what happened recently in London, we were on conference 

calls on almost a realtime basis to make sure that there weren’t 

any collateral threats to the City of New Orleans, and we were 

given the clear light that we weren’t. 

Mr. MICHAUD. Thank you. Thank you, Mr. Chairman. 

The CHAIRMAN. I appreciate your testimony on building smarter 

and the hardening. What do you call it, hurricane hardening? 

Mr. NAGIN. Hardening, yeah. 

The CHAIRMAN. And I certainly have the confidence that that is 

going in the right direction, so thank you for that. 

As I read the testimony from all of you looking at the opportunities for the future, I mean taking the tragedy and saying now we 

can rebuild and, in fact, put new models and even better collaboration, one thing that I saw was missing, at least in the written testimony, was—you can tell me in actual fact—is the issue of mental 

health for not only our older veterans but those coming back from 

Iraq and Afghanistan. 

This Congress, in the wake of what I call the Katrina of the U.S. 

Department of Defense health system; that is, the Walter Reed 

scandal, because it deserves a silver lining and we were able to get 

tremendous new resources for the VA, in fact, $13 billion over last 

year, almost a 30-percent increase, unprecedented in our history, 

and much of that is in the area of mental health, post traumatic 

stress disorder (PTSD), traumatic brain injury, and I would just, I 

guess, advise that as you go forward with planning, these injuries 

are going to be more and more prevalent in the population, in those 

returning from Iraq. And I think you would do well to anticipate 

that need and look forward and look further in new ways of dealing 

with these injuries, many of them hit at least at the beginning of 

their—their effect. 

I guess that’s just off the top. If there’s any response, I’d be 

grateful. 

Dr. Miller? 

Dr. MILLER. Yes. Mr. Filner, one of the advantages of building 

the VA downtown is that both of our medical schools have outstanding departments of psychiatry with experts who have a lot of 

experience in the area of post traumatic stress disorder and have 

already begun working with the area’s veterans now in the postKatrina period, so it would be a very important part of our missions to continue that and expand that as we regrow the medical 

facilities. 

The CHAIRMAN. Would these—a lot of these veterans are falling 

through the cracks when they return to their home areas. There’s 

not only the resources in place, so as we are building, we need to 

have those firmly in place. Dr. Kaiser, you want to answer that? 


hsrobinson on PROD1PC76 with HEARING
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Dr. KAISER. Ms. Catellier when she testifies I’m sure can talk 

about the plans for the VA, but in the plans for both LSU and the 

VA are mental health services. They are built—they are both built 

in. 

The CHAIRMAN. I think we really need some creative mechanism 

especially for those who come back from Iraq, to have ways of dealing with these issues with their peers with whatever techniques, 

you know, to expand on those and research on those because we 

have not done this right. 

We failed, I think, our veterans from Vietnam. 200,000 homeless 

veterans on the streets tonight are Vietnam vets. That’s a terrible 

tragedy this government allowed to happen, and we haven’t given 

up on those yet. 

And I will tell you a startling statistic that seems to have credence: As many Vietnam vets have now died from suicide as from 

the original battles, I mean, from the original war. And that’s a 

testimony to how we need these mental health services and begin 

to make sure these tough marines and soldiers and sailors know 

that, you know, it’s okay to admit this and get it done because it 

could be more tragic than any original wound that they had. 

Mr. Baker, we will have another round of questions. 

Mr. BAKER. Thank you, Mr. Chairman. 

Dr. Cerise, I’m going to move past the earlier line of questions 

to a subject which other Members have brought up; and that is, the 

replacement structure as envisioned in the initial collaborative report that was made to Congress which included the original 

timeline, so that’s the frame of reference from which I’m making 

my questions. 

That was the plan that was to have begun mid-year 2006 with 

a completion late 2011, 2012, so we are talking about the same 

general outline. I have not seen any other study released or recommendations for construction. 

At the site which is now proposed, there would be a defendant 

place philosophy which would require certain assets being deployed 

at the site, meaning if there were to be a recurrence of a flooding 

event, you could successfully take care of and administer to those 

who were on the site for a period of eight days. 

The first question would be: How long did it take the Corps to 

pump the water out the last time? It’s longer than eight days. 

Mr. NAGIN. Yeah. It’s 22 days. 

Mr. BAKER. My point is, if we are going to do this defend-inplace, we need to have the capacity to have cookies and soft drinks 

and bathroom facilities. It also goes to the cost estimate of $1.2 billion. In this same description of the project site, it requires the elevation of the perimeter of site to repel post-Katrina flood levels, 

current elevation assumption is 15 feet above sea level. Now, I’m 

a Congressman. I’m not sure what that means. I think that sounds 

like a levee. 

Was it the intent in this report to levee the VA site from the potential of a recurring flood event? 

Dr. CERISE. Yeah. I’m going to—I’ll defer to those that are more 

familiar with the actual construction and business plan. I will say 

that it’s not uncommon—in fact, when we looked around the counVerDate Aug 31 2005 20:55 Jun 13, 2008 Jkt 037470 PO 00000 Frm 00028 Fmt 6633 Sfmt 6633 E:\HR\OC\37470.XXX 37470

hsrobinson on PROD1PC76 with HEARING
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try after—immediately after Katrina to see that particular philosophy of protecting——

Mr. BAKER. Oh, I understand it’s not avid, but I’m just—I’m trying to make clear are we leveeing the site or are we not? 

Mr. ROMANO. I think the direct answer to your question is no, 

but at the same time to again design—and, again, I was—performed the business plan portion. The financial portion was not 

my——

Mr. BAKER. Well, let me just read to you again from the report. 

Elevation of the perimeter of site to repel post-Katrina flood levels, 

current elevation assumption is 15 feet above sea level. Now, I 

don’t know how you get that done without some—something stopping the water, a wall of some sort, a retainer. 

The next question would then be, since the modification of the 

proposal, which was originally 35 acres, we are now in the 70-acre 

plus site. I’m understanding the leveeing criteria was a concern of 

the VA, to protect their assets. It may not have been the criteria 

the State was looking at. 

Would we now just levee off the VA facilities or would we levee 

off the entire 70 acres? Has the leveeing cost been included in the 

$1.2 billion projection? 

Mr. ROMANO. Well, again, the $1.2 billion projection includes the 

cost for the LSU site—the site and it includes building the facility 

to such a height that it would be able to——

Mr. BAKER. Oh, I’m not missing that point. In the same document, it says the first 15 feet of vertical elevation will not be utilized for any purpose whatsoever. Homeland Security won’t let you 

use it as a garage, the VA won’t let me use it as a hospital, so this 

thing is going to be on 15-foot piers surrounded by a levee. 

Dr. KAISER. No, sir. The hospital will be elevated, the critical 

services will be elevated at this point probably 25 feet and there 

can be service underneath. It just will be not critical medical services for both the LSU portion I believe and that’s also planned for 

the VA portion. 

Mr. BAKER. Well, if you would review the portion of the report 

which says elevation of the perimeter of the site to repel postKatrina flood levels and explain that to me in writing at a later 

time. 

[The information was not provided to the Committee.] 

Further, vehicular ingress and egress ramps for emergency access to State or Federal highway system elevated above the hundred-year flood plain. Now, has the cost of elevating the roadways 

in and out of the facility been included in the $1.2 billion or whose 

cost is that? 

Mr. ROMANO. Yes, it has. 

Mr. BAKER. Amazing. I’d like to see those numbers. 

Are you going to elevate a State or Federal—I assume it only 

means one roadway in and out above the hundred-year flood plain, 

which I assume has got to be 14 or 15 feet above mean sea level. 

Mr. ROMANO. And, again, I believe as Dr. Kaiser referenced, 

that’s the 24 foot number for the essential services that the 

project’s been working with. 


hsrobinson on PROD1PC76 with HEARING
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Mr. BAKER. And this also means we have to have a self-generating independent power source that’s also 15 or 25 feet above the 

mean elevation of the building site? 

Mr. ROMANO. Yes, sir. 

Mr. BAKER. Okay. That will run at least eight days we hope? 

Mr. ROMANO. Yes, sir. 

Mr. BAKER. Okay. Great. I’d like to see those numbers too. 

Mr. Chairman, I’ve got 11 seconds and I don’t want to get into 

my financing questions because they certainly are going to take me 

more than 12 seconds. And I hate to suggest it, but I’m going to 

withhold for another round, unless you want me to go ahead. 

The CHAIRMAN. Yeah. To get to the rest of the panels in a reasonable time, I think this will be the last round, but I’ll give you 

a couple minutes to ask some more questions. 

Mr. BAKER. Mr. Cerise, the project is proposed to be funded by 

revenue bonds. What have private hospitals done post Katrina with 

regard to the number of beds being provided? Have they expanded 

the number of beds within the Orleans market? 

Dr. CERISE. No, sir. There are fewer beds in the Orleans market 

now than before Katrina. 

Mr. BAKER. And is that—that’s the private market decision? 

Dr. CERISE. That’s correct. 

Mr. BAKER. And the public market decision with this project is 

to increase the number of beds in the public facility over what was 

pre-Katrina? 

Dr. CERISE. No, sir. 

Mr. BAKER. So the number of beds provided will be the same or 

less or——

Dr. CERISE. That’s correct. It’s a smaller overall bed. Dr. Kaiser 

can tell you——

Mr. BAKER. That’s okay, because I want to get to the concerns 

of funding this project. 

You are going to go to Wall Street and ask people to buy bonds 

issued by the State for the purposes of financing this project of at 

least $900 million. The financials that I saw had a 30-year rate estimated at 4.85 percent for the feasibility of the project. Is that 

what your belief is today? 

Mr. ROMANO. Yes, sir. 

Mr. BAKER. Okay. Well, morning rate for treasuries had a yield 

of 5.1. You are not suggesting that revenue bonds issued by a 

project which has revenues a little bit not clear are going to beat 

the market rate for U.S. Treasuries. 

Mr. ROMANO. No. That’s understood, sir. We’ve done some subsequent sensitivity analyses because that was one of the questions by 

the HUD Secretary. And even if the rate were to go up by as much 

as a half a point, it would not significantly effect the financing. 

Mr. BAKER. So we’ve got a tenth of a point margin from today. 

We are at 5.1, the projection was 4.85. Technically, I’m wrong. It 

was 5.204 this morning, so we are at about four and a half points 

of your five-point limit this morning. 

Secondly, the effect of the issuance of $900 million of revenue 

bonds on the State’s general obligation capacity, you are suggesting, I think LSU has I believe suggested, that the issuance of 


hsrobinson on PROD1PC76 with HEARING
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the revenue bonds would have no impairment on the State’s general obligation capacity? 

Mr. ROMANO. I’m not certain one way or the other, but I do believe that the figure that we’ve been working with as what’s being borrowed at $800 million, so $1.2 billion less $400 million from 

other sources. 

Mr. BAKER. That’s a new figure. I’ve seen $900 million. But my 

point for asking is the Time program, which none of you have any 

reason to be familiar with, is a program funded by revenue bonds 

secured by the gasoline taxes on gasoline sold at the pump. That 

is a very clearly identifiable steady source of revenue from which 

a person holding the obligation has a fairly sophisticated analysis 

of the likelihood of return and the security of that transaction. 

In the case of the Time program, those revenue bonds did adversely impact the State’s general obligation abilities. We are sit- ting today at a capacity of about $300 million in annual general obligation bonds that could not be sold into the market. 

I haven’t seen anything in the literature which discusses indepth the financial implications of going to a market for nine—your $800 million worth of revenue bonds for a proposal that does not 

make clear the source of the revenue for repayment nor have I seen 

a statement from, let’s say, the State treasurer or the rating agencies or anyone else that it will not have an adverse effect on the 

State’s general obligation bonding capacity. 

Can—may I request that that information be provided to the 

Committee? 

[The information was not provided to the Committee.] 

Mr. ROMANO. Certainly. And I believe that those pieces are in 

process as sort of the next step now that the business plan has 

been completed. 

For ten seconds worth of a comment as far as the identifiable 

revenue sources, again, the business plan tries to speak to the patient revenues and where those would come from in terms of where 

those bonds would be repaid. 

Mr. BAKER. Mr. Chairman, not to impose on the Committee, I 

know we have other panels to come. There are innumerable more 

questions that I would like to ask. I’ll pose in writing and submit 

them to you, Mr. Chairman, perhaps for follow up from this panel. 

[The Committee did not receive a copy of the questions, nor responses from the witnesses.] 

This is the best panel we’ve got to answer the specific operational 

questions about this proposal. I thank you, Mr. Chairman. 

The CHAIRMAN. Thank you, and we will submit those questions 

on behalf of the Committee. 

Mr. BAKER. Thank you, Mr. Chairman. 

The CHAIRMAN. Mr. Jefferson? 

Mr. JEFFERSON. I’m reluctant to wait until Mr. Baker’s financial 

questions, so I’m going to start anyhow. 

More than 20 years ago—you may or may not know this—the 

State created a Time program to which Mr. Baker referred. It’s 

been a long, long time ago when Mr. Romer was Governor. And 

when it did that, it also put some limits on this general revenue 

bond obligations voluntarily. They weren’t imposed or required by 

an outside authority. I don’t know if you know this or not. I’m just 


hsrobinson on PROD1PC76 with HEARING
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asking if you do, but it now has a limitation which it puts on itself 

to only do so much. In the old days, we didn’t stop there. We put 

more and more bond time. 

Is it your understanding that the—if you can answer this—that 

the limitation that the State has, it’s operating under is a self-imposed limitation and that if the State—no one knows what the 

State’s full capacity for general obligation bonds because it hasn’t 

explored it for many, many years. Are you familiar with this at all? 

Dr. CERISE. No, sir, I’m not. I can tell you this project has been 

discussed and approved by a joint budget Committee of the State 

Legislature and certainly bond commission and——

Mr. JEFFERSON. So the State has made a judgment it has no effect on this other than it’s not detrimental; is that correct. 

Dr. CERISE. The State——

Mr. JEFFERSON [continuing]. Has made a decision that it doesn’t 

detrimentally effect this. 

Dr. CERISE. That it can do this. 

Mr. JEFFERSON. So we needn’t worry about that on our end of it. 

The State has to kind of make that judgment about it. 

I want to talk about something we need to worry about and Mr. 

Baker has raised another question, which is the one about the 

raised—the 15-foot security against flooding above sea level I think 

is how it was described. 

Now, if one understands the State—I just do this for the benefit 

of the people, the Members who aren’t from here, coming from the 

river—which we can see, it’s out this way (indicating) a little bit—

to the lake, the city goes down a little dip then—It’s higher on 

this—toward the river than any other place in town, and so the 

flooding that took place up around here was far less than what 

took place on the lake and would be the case in any event of a 

flood. So the need to raise the area is really going well beyond what 

you need to do in order to protect yourselves from what happened 

before. 

I’d like to ask you. How much flooding was there; what was the 

level of flooding in the Charity Hospital system? How many feet of 

water was in the Charity system? 

Dr. CERISE. The basement was full up to the first floor. At the 

street level, it was about at mid thigh, maybe a little bit higher 

than mid thigh at the street level, in that area. 

Mr. NAGIN. Yeah, two to three feet. 

Mr. JEFFERSON. Two to three feet. So what’s happening here, 

with the worst flooding one could imagine and with the city under 

water, you had two to three feet of water there, which means that 

to raise it 15 feet above sea level is to go to extraordinary lengths 

to give assurances that nothing else can happen that would be totaled. But even with the worse we can imagine, which that was the 

worst, the city became part of Lake Pontchartrain, that’s what happened there. So I suggest that you’ve gone well beyond the need 

to assure to talk about 15 feet. 

Now, someone mentioned that Mayor Nagin went to the Netherlands sometime ago, I guess almost a year and a half ago now. 

Where most of it is 15 to 20 feet below sea level, I should tell the 

Committee that it’s been for I guess the last 30 years fairly well 


hsrobinson on PROD1PC76 with HEARING
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safe of the sea storms that have come because they have taken protections that have worked well. 

We call it leveeing here. They have breakers out in the sea. They 

have the same sort of designs we are talking about now with our 

partners and have discussed with honoring the levees and all the 

rest with dikes and dunes and all and the protection against 

surges. That’s all technologically possible; we know that. 

In fact, a lot of the consulting done with the folks in the Netherlands was done by our own Corps of Engineers. We have known for 

20 years how to prevent the flooding here. We just haven’t put it 

in place because there wasn’t the urgency to fund it. 

So I want to make sure that the Committee understands and the 

Members of Congress understand that this is a doable and possible 

situation without going to the extraordinary lengths you are going 

to. I commend you for what you’ve done to go this far, but frankly, 

when you look at it, it’s probably more assurance than is needed. 

Now, the last thing is on the acreage for the site. There was 

some talk about not being enough space for it. Can you tell us— maybe Mr. Mayor and someone else—I only have a few minutes 

here, a few seconds—it has been taken under eminent domain. 

Most of the land, as I appreciate it, is nonresidential and not occupied. 

Mr. NAGIN. Yes. 

Mr. JEFFERSON. Tell us how you can meet this footprint requirement that the VA has—and maybe someone from the State—how 

quickly this can be done and how efficiently this can be done. 

Mr. NAGIN. We have identified a large enough site to accommodate anything that the VA could build both now and in the future, 

and there are two specific areas. 

The first site that we have identified is very near the LSU—well, 

all of them are very near where LSU has planned to build their facility. 

The second that the Congressman mentioned, there’s not a lot of 

residential people there and we can accumulate that very quickly. 

We have signed a cooperative endeavor agreement with the State, 

we’ve identified the funds, we are going to use our quick-take authority both at the State level and the local level so we can do this 

fairly quickly. 

Just to give you some perspective, quick-take expropriation at 

the city level takes anywhere from 45 to 60 days max; so we feel 

very comfortable—the State’s Legislature is much stronger than 

ours, so we feel as though we can move a lot quicker. 

In addition to that, there’s another parcel of land that’s next to 

the targeted area that we have. That is more residential, but it’s 

rental; and we feel as though if we needed to expand the footprint 

that we have today and identify it that we could do that fairly 

quickly also, so I don’t think footprint is going to be an issue. 

Mr. JEFFERSON. Thank you, Mr. Chairman. 

The CHAIRMAN. Thank you, Mr. Jefferson. Mr. Miller? 

Mr. MILLER OF FLORIDA. Thank you, Mr. Chairman. If I could 

yield to my colleague, Mr. Baker, for questioning. 

Mr. BAKER. I thank you gentlemen, and just a brief comment on 

this bond obligation authority. It really goes to the State’s revenue 

stream. We are at a $30 million budget this year. I don’t know 


hsrobinson on PROD1PC76 with HEARING
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what the prognostications are. Some of the market may feel that 

the State revenues may be done as the Katrina effect tails off from 

the Federal revenue streams and other sources of one-time revenue, but it is a very slippery slope. 

It is a market-driven decision and it’s not a self-imposed decision 

and it’s what the market is willing to let us borrow their money 

for given our ability to repay it; and that is clearly driven by our 

net balance sheet as a State entity. And so there are a lot of significant concerns about the $800 or $900 million of revenue. 

I thank you all. I yield. 

Mr. MILLER OF FLORIDA. Strike that. I yield to the gentleman for 

the State, Baker. He is eminently clear always. 

Dr. Miller, you talked about former collaborative efforts. If I understood Dr. Kaiser correctly, he said that LSU and the VA could 

not continue collaboratively and I will ask you to clarify your answer. 

If it was, if the VA hospital were not built adjacent, do you see 

an opportunity for the VA and Tulane to continue a collaborative 

research effort even if the VA decides not to build the medical center adjacent to the Tulane campus? 

Dr. MILLER. The collaborative, the downtown collaboration is 

more than just hospitals. It’s about research, education, and patient care and the proximity to the medical schools is evaluated in 

that. 

After 40 years of partnership, we certainly wouldn’t want to walk 

away from the VA, but it would definitely be more difficult for us 

to carry on all of our missions if the VA were not proximate to 

where our medical schools and our other teaching hospitals are; 

and that would effect the clinical service where it undoubtedly 

would take more FTEs to provide the same amount of clinical care 

and it would be a different type of clinical care than could be afforded when one has teaching faculty who are every day involved 

with the patient care at the VA. 

All the VAs I’ve been associated with during my career, including 

Miami, Gainesville, and New Orleans, have had close proximity to 

the medical schools and so that’s the model that I know. 

Research would become more difficult because you lose the synergy of being next to the research labs of others doing similar research, so you don’t have that every day, day-to-day collaboration 

to the same extent that you had. 

And, finally, education becomes more difficult for the residents 

and medical students who have to go back and forth to be able to 

attend their lectures, to use the libraries, and have direct contact 

with the faculty. So would we continue, yes, we would; would it be 

to the same extent and to the same benefit we had before, I don’t 

think we could. 

Mr. MILLER OF FLORIDA. Dr. Kaiser? 

Dr. KAISER. I think it was said well by Dr. Miller. 

I certainly didn’t mean to imply that we wouldn’t be able to collaborate with the VA should they choose another location. We will 

work with them. Our faculty, our residents, our education has been 

done conjointly with the VA for many years, but there are huge opportunities of working together in the synergy if you put the facilities next to each other. 


hsrobinson on PROD1PC76 with HEARING
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Mr. MILLER OF FLORIDA. Thank you. I appreciate your clarification. Mayor Nagin? 

Mr. NAGIN. Sir? 

Mr. MILLER OF FLORIDA. Nice to see you again, sir, and congratulations on your reelection. There is all kind of talk out on the 

streets today that there may be another type of announcement 

coming sometime soon. Can you elaborate, sir? 

Mr. NAGIN. No, I won’t elaborate on any of that. You know, I 

guess a lot of those races are getting pretty boring and they are 

looking for a little spark, so we’ll see what happens in the future. 

Mr. MILLER OF FLORIDA. Can you tell me about the new site? 

How many residential units are in the new speculative site? 

Mr. NAGIN. Yes. Most of the—most of the structures in the targeted site are commercial, and there’s very few residential in the 

initial first phase site. And if there are, they are rental units that 

we feel pretty comfortable that we could go in and quick-take. And 

when we quick-take, we have to basically compensate the owners 

for fair market value, so we don’t see a big issue there. 

We do have some community groups that we have talked to and 

worked through some issues with, but we think we can still get it 

done pretty quickly. 

Mr. MILLER OF FLORIDA. Quick-take, is that another word for 

eminent domain? 

Mr. NAGIN. Yes. It’s a piece of legislation. 

Mr. MILLER OF FLORIDA. Let me just assure everybody on the 

panel that even though some of our questions appear to be rather 

blunt and argumentative, nobody here wants to cast aspersions on 

anything that the medical centers do, that the city wants to do. 

The President has made it very clear. 

From where I come from, I have the largest veteran population 

in the country out of the congressional districts and I do not have 

a VA medical center. However, it would surprise you to know that 

a recent study that was just given to this Committee by the Veterans Administration, we can solve the issue that is before us in 

northwest Florida for less than the CBG block grant that HUD just 

gave Louisiana. 

So, for anybody that may be here today thinking that I want to 

stop a hospital from being built here, that is not at all what my 

desire is to do. 

I have heard, although we are talking about teaching and students and you are talking about research, my concern is for the 

veterans. The veterans that are sitting here that have served our 

Nation. They need a veterans hospital, and it may not be that it 

needs to be downtown collaboratively with LSU or Tulane. 

That’s what this Committee is trying to decide today. So, Dr. Cerise, any of the questions that have been asked today are specifically to get answers to the questions, so I appreciate your patience. 

Mr. NAGIN. We understand that, Congressman. And, you know, 

you have our full commitment if you need a VA hospital in Florida, 

we will lobby with you to make sure it gets done after this one is 

done. 

The CHAIRMAN. Thank you, Mr. Miller. 

Mr. NAGIN. Mr. Chairman, I have a noon flight to catch, so if it’s 

okay with this Committee, I’d love to be excused. 


hsrobinson on PROD1PC76 with HEARING
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I’m going up to Washington D.C. to testify in front of the Homeland Security Subcommittee on FEMA, so if I could be excused, I 

appreciate it. Thank you. 

The CHAIRMAN. Thank you. I appreciate your leadership. 

Again, Dr. Miller, once again you gave a list of close proximity 

of hospitals and the VA Center and you missed San Diego. We are 

going to have to get you out there. 

Dr. MILLER. Sir, I haven’t had the pleasure of working at the San 

Diego facility. I was talking about those that I had experience at, 

but certainly I’ll come out and do a couple of months. 

The CHAIRMAN. We welcome you. Mr. Michaud? 

Mr. MICHAUD. Thank you very much, Mr. Chairman. Just one 

quick followup question and it deals with the levee, if anyone can 

answer it. 

The Mayor had mentioned about 65 percent or 64 percent of the 

people are coming back. My concern is well, how many of those are 

actually going to be veterans? Will there be the need—this might 

be a better question for the VA—for a full-fledged hospital, whether 

it’s here in New Orleans or somewhere, but by the time——

My question is: The Mayor had mentioned that the levee will be 

taken care of by I think it was 2010 or 2011, so at the time that 

you’re—if this hospital is to be built downtown New Orleans, 

what’s the timeframe of the hospital being built or the VA facility 

being built and the levee system? Is it pretty much on the same 

timeframe if you are able to start? 

Dr. CERISE. That’s my understanding, but I’m not as familiar 

with the timeline for the levee system. 

Mr. ROMANO. Again, I’m not sure about the levees, but the hospital on both sides still plans to be open in 2012, so it seems like 

that planning jives with what the Mayor was talking about. 

Mr. MICHAUD. And my last question, Mr. Chairman, goes to Dr. 

Kaiser. Because when I asked a question about a TRICARE since, 

you know, $1.2 billion is a lot of money and I notice I saw some 

veterans in the back shaking their heads as far as whether you 

would accept TRICARE. 

If this joint venture moves forward with LSU and if LSU, the 

hospitals that you represent, do not accept TRICARE, would you be 

opposed if it was part of the agreement that you do accept 

TRICARE patients with such a large amount of money? 

Dr. KAISER. There would be no problem, but it’s important to emphasize that the planned facility downtown looks at the existing 

VA sharing responsibilities and looks at how services can be shared 

back and forth between LSU and the VA, and there’s a great benefit to both my patient populations for the quality of care that we 

can offer. 

There’s great expertise, rehab services in the VA that we’ll be 

able to offer to some of our citizens. We have some specialties that 

the VA doesn’t currently have that we’ll be able to offer back to the 

veterans. And so the synergy—we talk about medical education, we 

talk about research, but we also need to talk about quality of services for both populations. Thank you. 

Mr. MICHAUD. Thank you. Thank you, Mr. Chairman. I yield my 

time. 


hsrobinson on PROD1PC76 with HEARING
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The CHAIRMAN. We thank you all, we thank the panel. We’ve 

been here for a long stretch this morning. We thank you for your 

information, for your commitment to healthcare. And we’ll excuse 

Panel One, and Panel Two will consist of representatives and independent veterans to testify. 

The CHAIRMAN. Again, thank you for being with us, for helping 

us deal with this critical issue. 

We hear first from Henry Cook, the III, the National Senior Vice 

Commander for the Military Order of the Purple Heart. And as I 

was talking with him earlier, he had close association with a legend in your area former Chairman of this Committee, Sonny Montgomery; and we welcome you here and welcome you in honor of 

Sonny also. 

STATEMENTS OF HENRY J. COOK, III, NATIONAL SENIOR VICE 

COMMANDER, MILITARY ORDER OF THE PURPLE HEART; 

CHUCK TRENCHARD, ADJUTANT, DEPARTMENT OF LOUISIANA, DISABLED AMERICAN VETERANS; WILLIAM M. 

‘‘BILL’’ DETWEILER, PAST NATIONAL COMMANDER, AMERICAN LEGION; AND BILL PENN, M.D., BATON ROUGE, LA 

(INDEPENDENT VETERAN) 

STATEMENT OF HENRY J. COOK, III 

Mr. COOK. Thank you very much, Mr. Chairman. Chairman Filner, Members of the Committee, ladies and gentlemen, I am Henry 

J. Cook, the III, National Senior Vice Commander of the Military 

Order of the Purple Heart (MOPH). 

It is my honor today to appear before this Committee which is 

of such great importance to all veterans. And please keep that in 

mind during this hearing: The importance of our veterans. 

I heard a lot of testimony today about Tulane, about LSU, about 

public hospitals, about bureaucrats, but I didn’t hear much about 

veterans; and this is where we have to keep the focus of this hearing. Please do that. 

I’m accompanied here by fellow members of the Military Order 

of the Purple Heart, and I will remind you that these are veterans 

who have shed blood on the battlefields of this country; and for 

that, they were awarded the purple heart meal. 

I’m also accompanied today by the State officers for both the 

States of Louisiana and Mississippi, and also present are members 

of our ladies auxiliary. 

I would like to preface my remarks today with a statement of 

thanks first to the Department of Veterans Affairs in both Louisiana and Mississippi for the way they reacted and took care of 

veterans when Hurricanes Katrina and Rita struck. Almost all our 

government agencies at both State and Federal levels were overwhelmed by the sheer magnitude and consequences. However, the 

Department of Veterans Affairs and the regional office in both Louisiana and Mississippi maintained their focus on care for veterans 

during this trying and challenging time. The services to the veterans provided by them—were without equal and, in some cases, 

heroic. 

I know of cases where nurses from the ICU stuck by their patients while they transferred them all the way to Washington, D.C. 


hsrobinson on PROD1PC76 with HEARING
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without giving a thought to their own home that they knew was 

destroyed. That is dedication to veterans. I ask that you commend 

the Department of Veterans Affairs by the way they continue to 

care for veterans in the aftermath of those catastrophic events. 

Your Committee and the Department of Veterans Affairs Medical 

Center in New Orleans are both very important to the members of 

my organization and all veterans for both Louisiana and Mississippi who were served by that facility. As we sit here today, your 

Committee is here in town but our VA is gone. It’s gone, and we 

have veterans, World War II veterans, who are dying at the rate 

of 1,300 a day nationally and they can’t wait until 2011, 2012, 

2013. They need care today, and I respectively present that to you. 

From our perspective, the Department of Veterans Affairs medical system in New Orleans and on the Mississippi Gulf Coast, 

those two were very intertwined. They are struggling to deliver at 

best fragmented services. 

We are looking for your Committee to restore the New Orleans 

Veterans’ Affairs Medical Center as a badly needed service provider 

to our members and all veterans in the area. This should be done 

as soon as possible so as to prevent the further loss of services and 

to provide full restoration of earned entitlements that these veterans have earned. 

To better explain what I meant by saying fragmented, I’m going 

to tell you that while the Department of Veterans Affairs in New 

Orleans is, in fact, providing service for veterans, many of them 

have to go to other locations for their care and think again of the 

World War II veteran, quite elderly. 

Now, in my particular situation, I received, prior to Katrina, my 

orthopedic care, here in New Orleans at the VA. Now, I either have 

to go to Pensacola or Mobile. Fortunately, I am physically able and 

financially able to do that. A lot of veterans cannot. They can’t get 

someone to—they can’t drive, they can’t get someone to drive them, 

so what do they do? They go without care. We need to fix that. We 

need to fix it now. 

Now, the VA, of course, will tell you, along with some other agencies, that they sort of fixed this by the fact that when they ask a 

veteran to travel more than 28 miles from their home to a VA facility for treatment or even a private facility that they send them to, 

as they are doing now, they pay them for their travel. You may be 

shocked to know that they reimburse veterans for travel at a rate 

of 11 cents per mile when the Federal rate is 47 and a half cents 

per mile. The IRS approved rate is 47 and a half cents a mile. We 

pay the veteran, we reimburse him 11 cents a mile to travel and 

we also subtract a deductible. He has to pay a deductible if he uses 

it for the first three times of the month. If he has to travel four 

times in a month, he gets to keep the whole 11 cents of the mile. 

Something else that needs fixing, gentlemen. Gas is over $3.00 a 

gallon. If a veteran needs someone to take them to the hospital, 

they do ask for gas money. We can’t even give that to veterans. 

We in the MOPH have members now who routinely travel to Mobile, to Jackson, to Pensacola and as far as Houston for care from 

the VA Medical Affairs system. The system of healthcare for the 

veteran in this area is very fragmented by every definition of the 

word. Please return to the veterans here a world class medical faVerDate Aug 31 2005 20:55 Jun 13, 2008 Jkt 037470 PO 00000 Frm 00038 Fmt 6633 Sfmt 6633 E:\HR\OC\37470.XXX 37470

hsrobinson on PROD1PC76 with HEARING
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cility for veterans that can serve our membership and all veterans 

at one location and as soon as possible. 

There is one other problem area relative to veterans care, members of the veterans regional offices that were disturbed here in 

Louisiana. This involves a loss of ability of veterans to pursue 

claims that they had pending before the Department of Veterans 

Affairs. 

The Director of the State Veterans’ Affairs Claim Division for the 

State of Mississippi at the time Katrina struck informed me that 

many veterans, most of the veterans that were having their claims 

processed in the New Orleans regional office when they lost that, 

those claims were then moved to Jackson. Well, it wasn’t easy and 

it’s still not easy, again, for those veterans, many of them World 

War II, to go to Florida to meet with a case officer, to go to Jackson 

to meet with a case officer to talk about their claim, to go to doctor’s appointments in Jackson, Houston, Pensacola to support their 

claims. We need to bring it all back here, gentlemen, and we need 

to bring it back now. 

The transfer in those claims has created a terrible burden not 

only on the VA system as it exists and is operating fragmented, but 

on the also neighboring regional office in Mississippi. I do not know 

the status of the backlog now on the claims, but it exists and it’s 

still nasty. 

We know that—in summary, we know that Katrina’s has a devastating effect on the Department of Veterans Affairs medical care 

system. We should all know that what is most important now is 

full restoration of all veterans’ medical care. And this is not about 

jobs, it’s not about downtown, it’s not about Tulane, it’s not about 

LSU, it’s not about public hospitals, it’s about veterans. 

One person mentioned, and I was glad, about the PTSD, the 

added mental services that we are seeing now that the VA has to 

pick up. The VA is doing the very best they can now, but I can tell 

you again they are fragmented. 

Just recently on the Mississippi Gulf Coast, we had a soldier recently return from Iraq whose mother was a VA employee. He tried 

to get a PTSD appointment because he was having bad psychiatric 

flashbacks. He was given an appointment in six weeks. He committed suicide in the time he was waiting. We can’t afford another 

death like that, we really can’t. 

And I’m going to go back and mention, when I schedule an appointment now to go to Mobile for orthopedic care, it’s a six-month 

wait for my next appointment. That’s totally unacceptable. 

I thank you for allowing me to appear before this Committee on 

behalf of the Military Order of the Purple Heart. We have a lot of 

supporters here today from the Military Order of Purple Heart, and 

I now stand ready to take your questions. 

[The prepared statement of Mr. Cook appears on p. 71.] 

The CHAIRMAN. Thank you, Mr. Cook. 

I will say, by the way, that this Committee and Congress and the 

House did up that mileage rate to the Federal rate. That has not 

gone through the Senate yet or has been finally passed, but we 

have done our job in relationship to that. Just that little thing 

there. 

Mr. COOK. Thank you very much for that. 


hsrobinson on PROD1PC76 with HEARING
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The CHAIRMAN. Okay. Chuck Trenchard is the adjutant for the 

Department of the Louisiana Disabled American Veterans. Thank 

you very much for being here with us. 

STATEMENT OF CHUCK TRENCHARD 

Mr. TRENCHARD. Thank you, sir. Mr. Chairman and Members of 

the Committee, thank you for the opportunity you have afforded 

me to come speak to you today on behalf of the Disabled American 

Veterans. 

The loss of the VA Medical Center in New Orleans has had a 

profound impact on both the quality and availability of appropriate 

healthcare for thousands of Louisiana and Mississippi veterans as 

well as veterans from both Alabama and the Florida panhandle. It 

is essentially that a new medical facility be constructed as soon as 

possible to ensure the well-being of these veterans. 

The primary focus of this facility should be the care and treatment of America’s veterans. Any other economic and political considerations in regard to the location of the facility are secondary 

and should be fulfilled only as a by-product. 

This facility needs to be solely for the benefit of veterans and 

should be located in an easily accessible location safe from hurricanes and flooding. It should be placed in a location that will benefit the greatest number of veterans. It should be a dedicated facility not incorporated with any other programs. 

Whether we like it or not, this is a time of war and America’s 

military are putting their lives on the line to keep our country safe 

as they have for over 200 years. As an instrument of national 

power, the military is trained to do what they are told to do, how 

they are told to do it, and when they are told to do it. 

Veterans are a unique group of people. They don’t have to ask 

what they can do for their country. They know what to do and they 

do it well without regard for the risk. They have never kept their 

country waiting. 

Throughout the Spanish-American world, World War I, World 

War II, Korea, Vietnam, Panama, Kuwait, Afghanistan and now 

Iraq, veterans met the call to arms and successfully served to defend our Nation against all enemies. They have never kept America 

waiting. We owe it to our veterans to properly care for them now 

and not keep them waiting. 

As time goes by, the healthcare situation will get worse not better and America’s veterans will suffer. We need to put politics and 

bureaucracy aside and do the right thing: Take care of our veterans 

now. After all, haven’t they earned it? Thank you. 

[The prepared statement of Mr. Trenchard appears on p. 72.] 

The CHAIRMAN. Thank you. 

Bill Detweiler is Past National Commander of the American Legion, and just let me remind you we have your full statement for 

the record and we hope you can summarize that in about five minutes. 


hsrobinson on PROD1PC76 with HEARING
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STATEMENT OF WILLIAM M. ‘‘BILL’’ DETWEILER 

Mr. DETWEILER. Will do. Thank you very much, Mr. Chairman. 

The American Legion appreciates the opportunity to come before 

this Committee this morning to discuss the status of veterans’ medical care here in the city, in the New Orleans area. 

Despite the heroic efforts of Mr. John Church, Director of the 

VAMC in New Orleans at the time of Hurricane Katrina and its 

aftermath, it was quickly determined following the flooding that 

the hospital was beyond repair and would have to be replaced. 

That is why we are all here. 

The veterans that are treated for outpatient treatment here at 

the clinic are well taken care of; however, those veterans that require hospitalization and cannot be treated in the immediate area, 

as some of my colleagues have indicated, must be sent to other facilities where beds can be found, including but not limited to, 

Shreveport, Alexandria, Jackson, and other places. Unfortunately, 

the American Legion does not see an early end to this manner of 

care for the veterans of this area. 

As an example, if a veteran is diagnosed at the VAMC here in 

the outpatient clinic with a psychological problem that requires 

hospitalization, it takes some 10 to 12 hours from diagnosis to admittance in a hospital where a bed can be found. Such a long, tedious process causes extreme stress to the veteran and his family, 

further aggravating the veteran’s medical condition. 

We suggest, Mr. Chairman, that the PTSD problems and other 

brain injury conditions evidenced in our returning servicemen and 

women from the chronic conflicts will only increase, placing a 

greater burden on an already depleted system. A new VAMC in 

New Orleans is urgently needed now. 

The American Legion suggests that you might consider a couple 

of recommendations. First, we believe that the association with the 

medical schools in the downtown area benefits the patients at the 

VAMC. The partnerships and long associations with LSU and 

Tulane Medical School, since it was established have been for the 

benefit of the veterans as well as to the community. 

The VAMC of New Orleans serves the medical community of this 

area as a teaching and research hospital, Just as the other veterans hospitals do throughout the VA medical system. Our veterans, like those in other parts of the United States, benefit from 

these associations because the hospitals in the VA system need the 

interns, residents, and doctors from the schools to augment the VA 

hospital staffs. 

Each year Tulane and LSU Medical Schools rotate over a hundred each of interns and other medical personnel through the 

VAMC. They provide the veterans of this area the best of care 

based on the latest discoveries in medical science. 

Currently, we have a shortage in medical professions in southeast Louisiana and the greater New Orleans area. Many of our doctors, nurses, and other medical professions have left the area after 

Katrina and have not returned. Thus, the medical schools provide 

the additional staff that is critical to the successful operation of the 

VAMC. In addition, the research that continues is also beneficial 

to the VAMC. 


hsrobinson on PROD1PC76 with HEARING
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As an example, while we sit here this morning, Dr. Paul Harch, 

a physician specializing in Hyperbaric Medicine at LSU Medical 

School is in Washington with his fellow colleagues of that particular specialty working to encourage Congress to make the necessary appropriation for a pilot project that will treat traumatic 

brain injuries in a little different manner. An appropriation request 

is before Congress to fund the scientific study that will be overseen 

by the Samueli Institute in Washington D.C., with Dr. Harch serving as the physician in charge here in New Orleans. And the proposal is for the LSU teaching hospital to serve as the primary site 

in a multi-center study that will include the VAMC New Orleans; 

Dr. John Mendoza, a neuropsychologist with the VA; and Dr. Tim 

Duncan of the VA staff who are currently working with Dr. Harch 

on this project. This is just one example of the close working relationship that exists between the hospital and the medical schools. 

I also suggest to you that transportation is an issue. The veterans that use the VAMC New Orleans are generally veterans who 

do not have medical and healthcare insurance. Many are on fixed 

incomes, no place else to seek their medical care. The relocation of 

the VAMC to downtown New Orleans will provide a hospital that 

is convenient, by public as well as private transportation, and is 

easily accessible by our veterans population, the hospital staff, and 

the many volunteers who help take care of these men and women 

on a daily basis. 

I would leave you just with one comment. We are very fortunate 

in this city to have a young lady who has been recently appointed 

as the director of VAMC, and you will hear from her shortly. She 

made a comment in a quote that appeared in the American Legion 

Magazine in the November 2006 issue. She said: It’s the VA’s desire to be the engine that drives healthcare in the City of New Orleans and the metropolitan area. We want to be leaders. We want 

to provide a futuristic, high-tech, high-touch institution for veterans, in collaboration with our affiliated partners.’’ We believe that her vision is the proper vision and is in the best 

interest of the veterans of this area. Thank you. 

[The prepared statement of Mr. Detweiler appears on p. 73.] 

The CHAIRMAN. Thank you very much. 

Finally on this panel, we have Dr. Bill Penn, who wants to be 

known as an independent veteran. Welcome, Doctor. 

STATEMENT OF BILL PENN, M.D. 

Dr. PENN. Thank you. I’m Billy Penn from Baton Rouge, Louisiana. 

Chairman Filner, Members of the Committee, thank you very 

much for allowing me, an independent veteran, the opportunity to 

present my views to you on rebuilding a veterans hospital. 

This is an issue that is a personal one for me and, as a veteran, 

it causes me great concern. Let me thank you for holding this hearing. As Members of the Veterans’ Affairs Committee, you have an 

opportunity to assist the veterans in Louisiana to bring more 

awareness to the problems we have faced since Hurricane Katrina. 

It is my hope that today’s hearing will highlight the opportunities 

we have to move forward to help bring the dream of a new veterans hospital to reality. 


hsrobinson on PROD1PC76 with HEARING
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As I mentioned earlier, I come to the Committee today as an 

independent veteran. I do not represent a particular organization, 

though I am a member of many. What I wish to convey to you is 

my assessment of the situation in which we find ourselves and the 

opportunities that we have now for moving forward with the VA 

Hospital. 

It is my understanding that Congress has already appropriated over $600 million to rebuild the VA hospital, but the VA has yet 

to make firm plans for rebuilding this facility. I ask the Committee 

and audience Members to consider today why? 

Why, when veterans need this hospital now more than ever as 

our veterans population is aging and as more men and women are 

returning from Iraq and Afghanistan, why does the VA continue to 

wait to build this hospital? Our veterans have sacrificed too much 

and have given so much for this country and this government to 

ask us to wait any longer. 

I commend the doctors, nurses, and other staff for operating 

under the worst of circumstances. Their efforts and accomplishments in preparing for Katrina and the actions in its wake were 

heroic and are to be commended. I only ask that those in the decision-making capacity make decisions and make them swiftly. 

Veterans, since Katrina, have been asked to travel hours for 

some of their healthcare needs. For example, veterans needing 

prosthesis for limb losses are on a waiting list and are transferred 

to another facility in other States. And unfortunately, in our State 

here, we are at least four hours from Shreveport, three hours from 

Alabama, six hours to Houston, four hours to Jackson, Mississippi, 

eight hours plus to Dallas. 

The VA hospital must be focused on the needs of veterans with 

post traumatic stress syndrome. As a personal example, I went for 

testing and examinations by a psychologist to try to help my post 

traumatic stress syndrome which I have experienced nightly for 54 

years. The treatment for the post traumatic stress syndrome now 

since Katrina requires a seven week stay in Little Rock, Arkansas, 

for a program which I’m just becoming familiar. 

I give these examples just to illustrate what one goes through 

and why we need a VA hospital in south Louisiana as soon as possible, with beds for psychiatric use and ample space for veterans 

including parking and seating in waiting rooms. 

In my estimation, it’s unacceptable for the VA to ask our veterans to wait any longer than they already have for this care to 

be restored in south Louisiana. 

I do not claim to have solutions on where this hospital should be 

or how big it should be. I only request that the healthcare needs 

of the veterans drive these decisions. We have an opportunity to 

show veterans and our men and women currently in uniform that 

we in the country are putting their interest first and not the interest of other groups. 

I urge Secretary Nicholson and the VA to work quickly to restore 

this very important facility with the healthcare need of our veterans on focus. Our veterans deserve no less. When the time came, 

we served our country. Please now respect us in our needs today. 

Thank you for the allowing me this opportunity. I will be answering any questions that you have. 


hsrobinson on PROD1PC76 with HEARING
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I am thankful for Mr. Filner for mentioning—was it $13 billion 

or $13 million for services with mental health for veterans. As a 

POW of Korea, I not only never received healthcare but we still 

cannot ever speak about it any more because it might hurt other 

POWs still over there. It’s way overdue, this post traumatic stress 

syndrome. 

I keep trying to put two and two together. We keep wanting to 

build this hospital where the other one was built. When the original Charity Hospital was built, it took 13 100-foot pilings on top 

of each other driven down before it hit any kind of solid ground. 

And with this city six feet below sea level, why are we so hasty to 

build in the same place? It would be like throwing good money out 

to bad. I don’t know. 

Anyway, as I mentioned, I’m open for any questions you may 

have. 

[The prepared statement of Dr. Penn appears on p. 80.] 

The CHAIRMAN. Thank you, Doctor. 

Mr. Baker, the floor is yours. 

Mr. BAKER. Thank you, Mr. Chairman. Dr. Penn, if I may ask 

you a question not directly on your subject matter. Was your practice in obstetrics? 

Dr. PENN. Yes, obstetrics-gynecology. 

Mr. BAKER. Is your middle name Rivers? 

Dr. PENN. Yes. 

Mr. BAKER. You delivered my wife’s first baby 37 years ago. I 

can’t believe it’s been 36 years since I last saw you and I believe 

I paid my bill, so I think I’m good. 

Dr. PENN. I’ll check. 

Mr. BAKER. Both of my children are doing quite well and got off 

to a very good start thanks to your kind leadership there, so thank 

you for the service to my family. 

Dr. PENN. Any time somebody asks me that, told me I delivered 

their baby, my first answer is how did they do in school. 

Mr. BAKER. They both did—well, they accounted for themselves 

satisfactorily. I’ll put it that way. Thank you, sir. 

I noted that each of you made a comment about the urge and necessity for replacement of services; and, Mr. Detweiler, I wanted to 

ask you that particular question. 

Your testimony indicates a strong support for the downtown location. That is notwithstanding how long the time it may take or is 

there a time limit that would bracket your intended support for 

that approach? 

Mr. DETWEILER. Well, you said, sir, that you drive up and down 

the highway and you see hospitals being built in two or three 

years. I’m for your two or three years. I don’t know why there’s so 

much bureaucracy involved in this hospital. I have no idea. There 

are a couple of hospitals that are sitting vacant now. Maybe they 

are destroyed beyond repair, I don’t know, but those hospitals are 

sitting vacant. Well, I’m wondering about—you know, I initially 

thought maybe they could do something to bring the current VA 

hospital back. I’m assured that that’s not possible. 

Mr. BAKER. Yeah. That was an interesting point; because when 

I heard the Mayor talk about the water at the site, he said the 

basement was full and there was about mid thigh level water on 


hsrobinson on PROD1PC76 with HEARING
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the street and then he said two to three feet. Well, how does two 

to three feet of water take an entire facility out of service? 

Mr. DETWEILER. I don’t know, sir. I live in the lowest part of the 

city in uptown area adjacent to the Tulane campus. I’m within a 

couple of blocks of the bottom of the saucer. I had about four feet, 

maybe four and a half, but that was it and I was back—you know, 

sure, we had to have the whole thing gutted and do what you got 

to do to fix it up, but I don’t know what the problem is as to why 

it would take so long. 

Mr. BAKER. Well, let me propose something to you then that 

might make sense from your organizational perspective. Let’s get 

all this planning business concluded 30, 60 days, let’s get the Secretary to make some decision, but the organization would support 

whatever gets restoration of care in the shortest time. 

Mr. DETWEILER. That’s all we are interested in. 

Mr. BAKER. Bingo. 

Mr. DETWEILER. That’s all we are really interested in. 

Mr. BAKER. Well, that’s all I was interested in. I wanted—— Mr. DETWEILER. I understood that these people are working 

closely together. I’ve seen reports as far as the sites are concerned 

in the downtown area where their aren’t that many problems. As 

far as property is concerned, there are very few, if any. I think 

there were like 35 or less properties that had homestead exemptions on them meaning that there are no real residences down 

there. So I think there are good things that can come, but let’s just 

stop talking and let’s build it. 

Mr. BAKER. Well, coming at it from a general perspective, we’re 

on the same page, getting restoration of healthcare services, number one. If we can do it in the city with the proposal that is before 

us, fine, but somebody’s got to explain to this Committee, I hope, 

why it’s going to take until 2013 to get the doors open. And if there 

is an alternative—if there’s an alternative out to be seriously examined and told to you why it will or why it won’t work. We just got 

to get on with it. 

And I want to express to each of you my appreciation for you 

coming here today. These Members have traveled a long way. And 

I would take more time. We have another panel to come, but I 

don’t want to be appearing to be dismissive of your appearance 

here today. 

I want to specifically say thank you, one, for your service to the 

country; and thank you, two, for coming here today; and, three, I 

got the message: We want this thing now, not later, and I am committed to get that as fast as we can. Thank you. 

The CHAIRMAN. Thank you, Mr. Baker. Mr. Jefferson? 

Mr. JEFFERSON. Thank you, Mr. Chairman. In line with what 

Mr. Baker said, I think everyone here in this audience and outside 

of this audience and on this Committee wants to see this facility 

built as quickly as possible. There’s no benefit to delay it for anyone. Even these collateral things that we talk about as benefits 

don’t occur unless the facility is put in place quickly, so that’s everyone’s commitment. 

As I appreciate it, it isn’t a problem in the State of Louisiana nor 

LSU or Tulane nor the collaborative nor the planning process. It’s 

probably what the VA’s told us: It takes this long to build this facilVerDate Aug 31 2005 20:55 Jun 13, 2008 Jkt 037470 PO 00000 Frm 00045 Fmt 6633 Sfmt 6633 E:\HR\OC\37470.XXX 37470

hsrobinson on PROD1PC76 with HEARING
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ity. Now, it’s incumbent upon us then to impress to the VA as 

much as we can to get this done. And I suspect if the trouble is 

building a hospital out of that time frame, it will take that timeframe wherever it builds it. So our job is to make sure it gets cut 

down and then answer our questions why it takes so long, so that’s 

where I think we all are. 

I want to just ask, let me see, ask Mr. Detweiler. When your organization was meeting and considering this whole matter, where 

the hospital should be built and how it should be built and that 

sort of thing and you looked at the issues of Tulane and LSU and 

in terms of teaching, as you’ve explained it, and someone was suggesting a minute ago that there hadn’t been maybe enough talk 

about veterans as talk about other things. Wasn’t the view of your 

organization to talk about the collaboration, the availability of 

medical facilities, and of common use of the latest technology, 

wasn’t that talking about those things the same—the whole matter 

of talking about patient care of veterans? 

Mr. DETWEILER. Well, you can’t have one without the other. I 

mean, sure, veterans—the care of the veteran is the thing that’s 

uppermost in our mind. The question is: How do you render the 

best care? And if you have the research facilities attached and you 

have those staffs available and so forth, then you have the better 

chance for better care. 

And there have been a lot of things, just as I mentioned this particular doctor from LSU, things of that nature, have been through 

research between the hospitals, between the VA, between Tulane 

and LSU and other schools and schools around the country with 

the VA. The veteran gets the better care. 

Mr. JEFFERSON. Thank you very much. Mr. Trenchard, good to 

see you, sir. You say the facility should be solely for the benefit of 

veterans and should be located in an easily accessible location safe 

from hurricanes and flooding. Could you explain a little bit more 

exactly what you are looking for in a facility? Do you mean just for 

veterans and no one else or do you mean that—do you feel if 

there’s a collaborative that somehow veterans’ issues will be submerged in other considerations? 

Mr. TRENCHARD. I think once you mingle this with any other programs, it’s going to detract from the quality healthcare that veterans are going to receive. I really believe that. I think it needs to 

be a dedicated facility for veterans. You start bringing in the Charity Hospital system or anything else into that, it’s just going to 

muddy the water. You are not going to get the quality you need. 

The other thing, as far as location, I’m not an expert. I’m not 

going to tell you that I know the best place to build this, but it 

doesn’t make too much sense to me to put it back down here where 

it’s going to flood. 

You know, New Orleans was pretty lucky. Believe it or not, they 

were. They didn’t get into the northeast quadrant of that hurricane. If that thing had come in around Grand Isle and it would 

have been hit by the northeast quadrant, I don’t know think there’s 

a levee around here or anything else that could have really protected this city. You take a look at what happened to Mississippi. 

New Orleans got it bad, but you take a look at Mississippi. There’s 

nothing left standing up there. 


hsrobinson on PROD1PC76 with HEARING
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Mr. JEFFERSON. So all along the Gulf Coast is a threat that hurricanes can happen; is that right? 

Mr. TRENCHARD. That’s right. And New Orleans has been very 

fortunate not to have been hit by one. Excuse me. 

Mr. JEFFERSON. Go ahead. 

Mr. TRENCHARD. I was born here in 1950, and over the last 57 

years, they’ve been pretty lucky. You know, Betsy was about the 

worst thing they had that came through here. And, you know, the 

law of averages being what it is, they are ripe for another one the 

way I see it. And I think if we rebuild down here in New Orleans, 

we got a good chance that we’re going to have to turn around and 

rebuild that thing again. 

The other thing: They brought up that it was going to take like 

until 2010, 2011 to construct this elaborate levee system and everything else. Our guys can’t wait that long. We need to build it some 

place we can build it now and not have to do all this extra construction and everything and don’t have to worry about anything, 

knocking it down or anything. 

Mr. JEFFERSON. I know you aren’t familiar with the levee planning in any detail and are picking up about what the Mayor said 

about the homes being completed down the line——

Mr. TRENCHARD. Yeah. 

Mr. JEFFERSON [continuing]. But the things that broke here, they 

have been fixed now and have been fixed over the last 18 months, 

the raising of the levees where the breaches took place, all those 

sorts of things, which is the notion that—which was done first so 

the city could come back and start restructuring and stuff. 

But the levee system goes all the way, as you know, well down 

to Plaquemine. That part is down the road and will be built later. 

The point of it is here, anywhere on the Gulf Coast—are you saying 

it shouldn’t be built anywhere along the Gulf Coast at all? 

Mr. TRENCHARD. No. I’m advocating that it would be better located further inland, and I’m not saying all the way in Baton 

Rouge. Some places that it can be built, just an example, maybe 

over by Hammond, maybe by Gonzales, further inland right off the 

interstate where it’s readily accessible to veterans. 

You know, it’s not just the New Orleans veterans. It’s for guys 

coming from Mississippi, Alabama, and even the panhandle of Florida. They don’t have a hospital yet and they are not liable to get 

one for a while either, although I’m sure they would like it. 

But, you know, the thing is, you know, I listen to them talk 

about these defective levees and this defective engineering and everything, but you know, at the time when those levees were constructed and all, I remember that, when all these levees were being 

built and they put those flood gates in and everything. You know, 

that was—they assured us that that was going to take care of the 

situation and that was based on the best knowledge they had at 

the time. Well, they found out from this major hurricane, which 

didn’t hit at the worst point but it hit bad enough, that it didn’t 

work. So how are they going to estimate—I’m kind of curious to see 

how they’re estimating that one, say, does hit west of here in the 

northeast quadrant hits New Orleans dead on, how do they estimate what forces it’s going to be able to withstand? I think that’s 

kind of hard to calculate myself. 


hsrobinson on PROD1PC76 with HEARING
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Mr. JEFFERSON. I can have a response to it, but, you know, it’s 

from living with the Corps for the last two years as to understand 

what they’re doing, but I’ll yield back my opportunity. I thank you 

for your testimony. 

The CHAIRMAN. Thank you, Mr. Jefferson. Thank you. Mr. Miller. 

Mr. MILLER OF FLORIDA. Mr. Cook, I appreciate the description 

of where I come from. I don’t believe I’ve ever been described as 

coming from the far flung area of Pensacola, but thank you, and 

I understand the distance that the veterans are having to drive 

right now in need of a veteran hospital and where you’re having 

to go to get your care. 

Mr. Detweiler, you said the American Legion passed a unanimous resolution endorsement of rebuilding of the medical center 

with the development of the biomedical district to the downtown 

New Orleans area. Now, why—why was it so specific to that site 

and not just what you just said a few minutes ago to Mr. Baker? 

Mr. DETWEILER. Because we thought that it would be better to 

be able to bring those facilities back together. 

I’ve lived with this, been involved with veterans’ benefits and involved with the American Legion for over 40 years and I’ve worked 

with the hospital, met with those people and listened to the work 

that has gone back and forth between the Tulane and LSU and VA 

system. And having had the opportunity to visit many VA facilities 

around the country as a national commander watching what other 

hospitals enjoy with the relationship of medical schools, I think the 

average veteran gets better care. 

Mr. MILLER OF FLORIDA. So you are saying that a veteran in a 

medical center that has no medical school attached to it is receiving substandard care? 

Mr. DETWEILER. No, sir, I’m not saying that. I am saying I think 

that they would get better care, I think the opportunity for more 

personnel is there. I’m not saying, because I don’t know what specific facility you may be referring to, that they would get less care. 

I’m saying that the opportunity for better care and the availability 

of current research is there. 

And we—you know, for example, we keep talking about PTSD. 

PTSD is a real serious problem. Finding a bed site in this area is 

almost impossible. That was my example about having to take 10 

to 12 hours from diagnosis here to get into a bed somewhere in the 

northern part of the State or Houston or Jackson, Mississippi, or 

somewhere else. That’s going to continue to grow. 

I think what we are saying, that some four out of ten or six out 

of ten servicemen and women that come back from Iraq and Afghanistan are likely to be subjected or in some part of their life suffer from PTSD or some sort of brain injury, and this is a real concern. So all I’m saying is, it seems to me now we are for building 

a hospital as quickly as possible. 

Now, again, if Mr. Baker says and he knows of somebody that 

can build a hospital within two or three years, we are for that, 

okay? And I don’t know why that somebody that can build a hospital within two or three years somewhere up the highway can’t 

put that hospital back in the area that we discussed. 

Mr. MILLER OF FLORIDA. I would say in defense of Mr. Baker and 

in defense of your other colleagues that are here——


hsrobinson on PROD1PC76 with HEARING
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Mr. BAKER. Please get this on the record: He’s defending Baker. 

Mr. DETWEILER. I know that. 

Mr. MILLER OF FLORIDA. You appear to be the only person at the 

table that is defending going back into the same place to repeat 

Mr. Nagin’s—— Mr. DETWEILER. Maybe. 

Mr. MILLER OF FLORIDA. You are. On the record, you are. 

Mr. DETWEILER. Right. 

Mr. MILLER OF FLORIDA. I can’t quite figure out the intensity 

that you have to go back downtown. Maybe there is a reason, 

maybe there’s not. I don’t know. 

Mr. DETWEILER. There’s no reason other than the fact that——

Mr. MILLER OF FLORIDA. My time is running out. It appears that, 

I don’t know if you read this or not in your comment, you talk 

about the New Orleans Medical District initiative. Did you read 

this out of your statement that you’ve entered into the record, that 

the American Legion endorses such a joint facility, with the proviso, let me finish the question—with the proviso that the veterans 

will be treated in a separate hospital building and not mingled 

with other patients. You read that——

Mr. DETWEILER. Yes, sir. I wrote that, yes, sir. 

Mr. MILLER OF FLORIDA. No. Did you read that out loud? 

Mr. DETWEILER. No, sir, I didn’t. I was under the gun. 

Mr. MILLER OF FLORIDA. Okay. That was in the middle of your— I just saw—— Mr. DETWEILER. No, sir, I did not read. I took different paragraphs to try to cover different issues and not say the same thing 

as some of my other people here have said. 

Mr. MILLER OF FLORIDA. So, a totally separate VA facility with 

no co-mingling of any patients. Do you understand that that is the 

way the project is moving forward today? 

Mr. DETWEILER. I understand that there are two concepts, okay. 

Mr. MILLER OF FLORIDA. That’s probably the reason that we got 

the delay that we’ve got today. Two years later, we have two concepts; tomorrow, it will be three concepts. 

Mr. DETWEILER. Well, let’s say this. Let me just say this. If the 

VA wants to move forward, let’s move forward then, forgot about 

the State. 

Mr. MILLER OF FLORIDA. I think you are hearing that today. 

Mr. DETWEILER. No. I heard that before. I heard that long ago. 

If the VA wanted to build a—rebuild that hospital some place within the downtown area or wherever, it would have moved forward. 

I don’t understand why the VA has not moved forward. 

Mr. MILLER OF FLORIDA. Because there are organizations like 

yours that are telling the VA that you want to rebuild downtown 

as a collaborative effort. 

Mr. DETWEILER. This was not something that we—this is something that came about because of the fact that the VA and the 

State got together and we thought it was in the best interest to do 

this. Now, if the VA doesn’t think that’s in the best interest to get 

the healthcare back and move forward, then build the hospital. 

Don’t worry about the State. Forget all of that. But why hasn’t the 

VA moved forward? The VA is an independent agency. It could 

surely move forward if it wanted to. 


hsrobinson on PROD1PC76 with HEARING
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Mr. MILLER OF FLORIDA. I think that Ms. Catellier, who you referenced and I’ve had an opportunity to work with her as well, will 

probably answer that question in the next round. Thank you, Mr. 

Chairman. 

The CHAIRMAN. Thank you, gentlemen. Mr. Michaud. 

Mr. MICHAUD. Thank you very much, Mr. Chairman. Just a couple of quick questions. 

We had a field hearing a couple of years ago in South Carolina 

talking about a collaborative effort in South Carolina with the VA 

and private industries, and there is an ongoing collaborative study 

group looking at the feasibility of building this facility. The report’s 

due at the end of this September for the Louisiana area. 

One of the things we found in the South Carolina situation was 

the fact that veteran service organizations (VSOs) were not at that 

time involved in the process, so I guess my first question would be 

just a simple yes or no answer for each of the VSOs. Have you been 

involved in the collaborative study group effort that is supposed to 

report back this September? 

Mr. COOK. No, not for the Military Order of Purple Hearts. 

Mr. TRENCHARD. Not at all. 

Mr. MICHAUD. No for the Purple Hearts, no for the DAV. 

Mr. DETWEILER. American Legion has taken it upon itself to 

meet with the VA, to meet with the staffs here. We’ve had two national commanders over the last two years come down and visit. 

They sat sit down and listen and were briefed on it. And the American Legion has an ongoing study that has been—I guess it’s about 

five years, four or five years, ‘‘A System Worth Saving.’’ And they 

have come down and they have looked at this, at the plans and so 

forth, and felt very comfortable with that project. 

Mr. MICHAUD. Thank you. And that is a good report the American Legion puts out, ‘‘A System Worth Saving.’’ I appreciate it. 

Mr. DETWEILER. Worth Saving. I think we are on our third or 

fourth year on that, yes. 

Mr. MICHAUD. Dr. Penn, have you been involved in that collaborative study group effort that’s supposed to report back this September? 

Dr. PENN. No, not at all. I just—well, I mentioned a while ago 

I’m an independent. I belong to a lot of service organizations such 

as the ex-POW, American ex-POW, and the Marine Corp League; 

and everybody’s quite concerned why is it going to take seven to 

eight years to build this hospital. It just is taking too long. 

And the last national geological survey facts I read were talking 

about the way we are losing so much marshland here in Louisiana 

that New Orleans would be a coastal city in 15, 20 years. So it 

looks like it’s going to be a lot of water here in New Orleans for 

a long time. 

Mr. MICHAUD. My second question for the VSOs. The Mayor 

mentioned that a lot of folks are coming back to the New Orleans 

region. Have you seen an increase or have your memberships come 

back or are they still out in other parts of the country? We’ll start 

with Mr. Cook. 

Mr. COOK. We still have members who have departed the area. 

Some have returned, some are planning to return, and some are 

not returning. We have them go as far away as Denver, Salt Lake 


hsrobinson on PROD1PC76 with HEARING
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City, Birmingham, Alabama. We have—we are scattered from the 

inner New Orleans area and from the Mississippi Gulf Coast area. 

And no, sir, they are not all back; no, sir, they are not all coming 

back. We hope to see most of them back, but we don’t—you know, 

we haven’t done any studies or anything, but we do know that 

some will not come back. 

Mr. TRENCHARD. I’ve seen a lot of these people coming in from 

Lafayette, Baton Rouge, Houston; and if they are not back by now, 

I seriously doubt they have any great plans on coming back. I think 

the bulk of the people are back that are going to come back the 

way things are set up. 

I just think the whole—there’s been a major shift of the amount 

of veterans right down here in New Orleans and I don’t think you 

are going to see that many of them come back. We lost a number 

of chapters in this area that have never come back, and so that 

would be my view on it. 

Mr. DETWEILER. We have veterans that have left and veterans 

that have come back. I can’t say they are all back, I can’t say that 

they are not coming back, but Katrina did cause the whole population to—you know, to scatter. There’s no question about that. 

I think the best person to answer the question as to the effect 

upon the hospital is to ask Ms. Catellier when she speaks. 

Dr. PENN. Now, you know, it’s been estimated over 4,000 doctors 

have left Louisiana, left New Orleans rather. I know in Baton 

Rouge every day there’s a notice in the paper there’s a new attorney, new physician, new dentist setting up office in Baton Rouge, 

so I don’t know how many of these people will come back. 

I was in a meeting the other day with some young people down 

here my daughter’s age, 40 something years old, and they are all 

leaving New Orleans and they are not coming back. 

Mr. DETWEILER. My son came back. He’s in that age group. 

Mr. MICHAUD. Thank you, Mr. Chairman. 

The CHAIRMAN. We thank the panel. We thank you for being 

with us today and thank you for your service to our Nation’s veterans that you do every day. Thank you so much. 

Mr. DETWEILER. Thank you, Mr. Chairman. 

The CHAIRMAN. You will be excused and the last panel we will 

hear from is from Department of Veterans Affairs officials who are 

here. 

The CHAIRMAN. If everyone will come to order, we have Ms. Rica 

Lewis-Payton, Deputy Director of Network 16 of the Department of 

the VA. With her is Julie Catellier; is that right, Acting Director 

of the Southeast Louisiana Veterans Healthcare System. You’ve 

had some good press on the way here, Ms. Catellier, so welcome 

and we look forward to your testimony. 

Ms. LEWIS-PAYTON. Actually, Mr. Chairman, because of that good 

press and the outstanding job, she’s been permanently assigned to 

this position. 

The CHAIRMAN. Okay. 

Ms. LEWIS-PAYTON. It’s now a part of the record. 

The CHAIRMAN. Congratulations, I guess. 


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STATEMENT OF RICA LEWIS-PAYTON, FACHE, DEPUTY DIRECTOR, VETERANS INTEGRATED SERVICE NETWORK 16, VETERANS HEALTH ADMINISTRATION, U.S. DEPARTMENT OF 

VETERANS AFFAIRS, ACCOMPANIED BY JULIE CATELLIER, 

DIRECTOR, SOUTHEAST LOUISIANA VETERANS HEALTHCARE SYSTEM, VETERANS HEALTH ADMINISTRATION, U.S. 

DEPARTMENT OF VETERANS AFFAIRS 

Ms. LEWIS-PAYTON. Mr. Chairman, Members of the Committee 

and Members of the Louisiana delegation, thank you for the continued support that Congress has given the Department of Veterans 

Affairs in our rebuilding and recovery efforts not only in southeastern Louisiana but also the entire Gulf region. 

Today, I will describe our ongoing healthcare restoration efforts 

in New Orleans and the current status of plans to rebuild our VA 

Medical Center. 

The Southeast Louisiana Veterans Healthcare System has made 

significant progress in meeting the healthcare needs of veterans in 

the greater New Orleans area. With the support of Congress, VA 

accelerated the activation of Community Based Outpatient Clinics 

(CBOCs) in the areas proposed under the care’s program. New 

CBOCs are now open in Slidell, Hammond, and St. John’s Parish. 

Currently, southeast Louisiana is served by six permanent CBOCs. 

Primary care and general mental health services are offered at 

each of these locations. Specialized mental health programs are 

currently provided and we are acquiring additional space and significantly expanding services. 

Plans are progressing to lease space for additional specialty care 

and ambulatory procedures. Patients requiring highly complex care 

are referred to other VISN facilities or care is obtained within the 

New Orleans community. Outpatient pharmacy services currently 

exist at all of our CBOCs and a $31⁄2 million project to establish 

a new and enhanced pharmacy in New Orleans will be completed 

in November 2007. A newly constructed diagnostic imaging center 

will open on the New Orleans campus in September 2007 providing 

the full range of general radiology, CT and MRI capability. Dental 

services are provided in both Baton Rouge and Mandeville, and 

currently we have no patients on the waiting list in dental. 

In addition, in keeping with the national initiative to provide patient care in the least restrictive environment, southeast Louisiana 

has tripled the size of its community base—community—and homebased programs. 

In June of 2007, VA entered into an agreement with its affiliate, 

the Tulane University Hospital and Clinic to allow VA physicians 

to admit and manage the care of veterans in the Tulane Hospital. 

Veterans have responded favorably to this ‘‘virtual VA inpatient’’ 

program because it allows them to remain near their families and 

support systems while being treated by their own familiar team of 

VA physicians and social workers. 

The Southeast Louisiana Veterans Healthcare System has served 

almost 30,000 unique veterans through May 2007. On average, 

1,000 outpatients are seen in the CBOCs per day. It is projected 

that by year end more than 35,000 unique veterans will have been 

treated. This is nearly 90 percent of the pre-Katrina level. 


hsrobinson on PROD1PC76 with HEARING
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There are currently 76 medical residents compared to 120 before 

Hurricane Katrina. VISN 16 is working with its academic affiliates, 

the Tulane Medical School, and the LSU Medical School to place 

VA residents in medical facilities throughout VISN 16 until such 

time as full clinical programs return to the Southeast Louisiana 

Veterans Healthcare System. 

VA has always been committed to building a new medical center 

in the greater New Orleans area. The space planning process has 

been initiated and in preparation for construction. The analysis of 

an architectural-engineering (AE) firm to design the new facility is 

complete and the announcement of the selection will take place 

soon. The replacement medical center is expected to provide acute 

medical, surgical, mental health, and tertiary care services as well 

as long-term care. 

VA and LSU have signed a Memorandum of Understanding 

agreeing to jointly study state-of-the-art healthcare delivery options 

in New Orleans. VA is pleased to learn of the State of Louisiana’s 

commitment of State funds for this project, and we will make a decision regarding the extent of its future collaboration with LSU 

after the report is completed. 

While VA remains committed to exploring this partnership with 

LSU, delays have arisen. To ensure these delays did not impact our 

ability to reconstruct the VA Medical Center in a timely manner, 

VA initiated a search to identify alternative building locations. This 

search resulted in two responsive offers. An initial market survey 

of the two sites has been conducted an further analyses are 

planned. VA looks forward to completing this process and will 

make a decision on this site in the near future. 

Thank you for the opportunity to be here today, and Ms. 

Catellier and I will be pleased to answer any questions that you 

may have. 

[The prepared statement of Ms. Lewis-Payton appears on p. 81.] 

The CHAIRMAN. Thank you very much. Thank you for your service to our veterans. So everything is going fine. 

You know, Mr. Detweiler, I guess he said—you know, he said 

why hasn’t the VA moved forward? I think that’s the right quote. 

Now you are saying everything is moving forward. The perception 

is we are not. I mean why the—the disconnect, and do we have any 

dates that you could give us? 

Ms. LEWIS-PAYTON. A couple of comments, sir. In terms of moving forward, we have worked diligently to ensure that we continue 

to provide quality healthcare services in the City of New Orleans. 

While it is not ideal, I can assure you that from the time we deployed mobile clinics a week after Hurricane Katrina until now, 

there’s not a day that passes that we aren’t discussing and developing and implementing plans to ensure veterans get care. 

As it relates to the construction, as you heard from panel Members here today, there are compelling arguments and divergent 

opinions about where that site should be. We have an obligation— we have an obligation to ensure that we do our due diligence in 

analyzing those options, but let me be extremely clear: At the forefront of all of those discussions and at the forefront of our decision 

is what’s in the best interest of the veterans we have the privilege 

to serve. 


hsrobinson on PROD1PC76 with HEARING
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The CHAIRMAN. Thank you. Mr. Baker. 

Mr. BAKER. Thank you, Mr. Chairman. Let me follow up on the 

Chairman’s general line of questions. 

With regard to the issuance of a report which will precede your 

decision-making window, is there an expected report deadline or is 

that indeterminate yet? 

Ms. LEWIS-PAYTON. There is expected report deadlines. As I indicated earlier, the initial analysis of the two sites has been completed. What we are in the process of doing now, and that should 

occur within the next two to three weeks, is the cost analysis associated with those two sites. 

As was also discussed here, there are costs associated with building downtown. We have to clearly understand what that means before we make those decisions. And based on that cost analysis, then 

a decision will be made whether or not we will do an environmental assessment of one site or two sites, and that will take a few 

months. 

Mr. BAKER. So it would not be unreasonable to expect the preliminary report and findings within 45 days and then another three 

months for environmental assessments? 

Ms. LEWIS-PAYTON. It would not be unreasonable to assume that. 

Mr. BAKER. So that we would likely be close to the first of next 

year when we would be in a position to make the final, final decision? 

Ms. LEWIS-PAYTON. Well, I would leave the actual date decision 

to the Secretary, but we should be in good position over the next 

couple of months to have done the analysis necessary on which that 

decision will be made. 

Mr. BAKER. And are you at liberty to disclose where the sites are 

that are under consideration? 

Ms. LEWIS-PAYTON. The two sites that are under consideration, 

of course, is the downtown site which is adjacent to the site identified by LSU; the second site is across from the Ochsner Hospital 

and it’s a 28-acre tract. 

Mr. BAKER. And how far is the Ochsner site from the downtown 

location? 

Ms. LEWIS-PAYTON. Approximately 4.5 miles. 

Mr. BAKER. 4.5 miles? 

Ms. LEWIS-PAYTON. Yes. 

Mr. BAKER. In earlier questions, I had asked the State officials 

and they were not clear as to elements of the construction requirements for the downtown site. One of those requirements, as I read 

their report, was securing the perimeter from the potential of a recurring flood event. I translated that as a levee. Do you understand 

whether that is correct? Will the downtown site as it is currently 

defined require leveeing in addition to the elevation of the principal 

building, 15 feet? 

Ms. LEWIS-PAYTON. Ms. Catellier? 

Ms. CATELLIER. Good afternoon, Congressman Baker. Good to see 

you again. 

Mr. BAKER. Thank you. 

Ms. CATELLIER. Actually, there has never been any discussion 

about a levee around the site. Earlier in the study report, which 


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you referred to, consideration was given to building a 15-foot berm, 

so putting the hospital up. 

The current discussions are about doing pilings and putting the 

first floor of services at 25 feet, essentially the same thing. 

Mr. BAKER. So initially two stories? 

Ms. CATELLIER. Yes, sir, that’s correct. 

Mr. BAKER. And what about the elevation of ramps and roadways to access that site? 

Ms. CATELLIER. There would have to be elevated ramps for sure. 

Mr. BAKER. And are those costs, as far as you are conversant 

with the project, already determined and in the cost of the project 

or is that yet to be defined? 

Ms. CATELLIER. Those are being studied now as referenced by 

Ms. Lewis-Payton. 

Mr. BAKER. And the defend-in-place position of eight days, should 

that be extended to the operative period for when the last event occurred that it took us the time to get the water out so that we 

know we have a reasonable certainty that we are capable of operating for the time of the crisis? 

Ms. CATELLIER. The best advice we’ve received from Homeland 

Security consultants and our own engineering staff is an eight-day 

defend-in-place strategy is adequate. 

Mr. BAKER. With regard to the choices of veterans, has the agency conducted a survey of veterans to determine if they have a preference in the matter; and if so, what is the scope of that survey? 

Ms. CATELLIER. Not to my knowledge. 

Mr. BAKER. I’ve just been presented with a copy of the survey 

conducted and albeit by a competitor in the process, by Ochsner, 

indicating that in a survey of 600 veterans, some—half of which 

are former patients, half of which are prospective patients, that 7.6 

out of 10 would prefer the Ochsner site. Now, I don’t know whether 

that’s a valid survey. I don’t want to place any particular credibility with it. 

Would it be unreasonable or is it out of common business practice—I don’t know—for the VA to engage in a survey of the veterans in the 25-parish area that is likely to be served by this facility to get their opinions about this; and second part, is the time 

constraint to build a major factor in your ultimate or the Secretary’s ultimate decision? 

If one project can be built in, say, two or three years less than 

another project, would that be a factor in determining which site 

would be selected? 

Ms. LEWIS-PAYTON. As I mentioned earlier, all of these compelling arguments, including what the timelines will be, what veteran 

preferences are, all of those arguments, all of those opinions about 

what we should do will be taken into consideration as the Secretary decides his—makes a decision regarding this. 

Mr. BAKER. So if I were to ensure that there would be a survey, 

I should just address those concerns to the Secretary and he would 

decide whether that action is appropriate; is that the process? 

Ms. LEWIS-PAYTON. Yes, sir. 

Mr. BAKER. Thank you very much. Mr. Chairman, I’m way over 

time. 

The CHAIRMAN. Thank you, Mr. Baker. Mr. Jefferson? 


hsrobinson on PROD1PC76 with HEARING
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Mr. JEFFERSON. Thank you, Mr. Chairman. 

Ms. Lewis-Payton—I want to ask you a question first. You’re saying the cost analysis comes later—what—if I understood you correctly. What was the first—what was the initial analysis? What did 

that involve with respect to these two sites, if it didn’t involve any 

concern about cost? 

Ms. LEWIS-PAYTON. And we will get you the specifics as part of 

the record, but the initial analysis included things around egress 

to the site, the adequacy of the sites, how easy transportation 

methods were to the sites, some of those issues; and Ms. Catellier 

may want to add other considerations because I think you had 

members on the site evaluation teams. 

Ms. CATELLIER. Ms. Lewis-Payton is accurate. In addition, environmental concerns above sea level, below sea level, road egress, 

restaurants, hotels, proximity to the medical schools. Each of the 

criteria was given a weighted value and a team of experts, including architects, attorneys, and engineers toured in detail both sites 

and rated and ranked those sites. 

Mr. JEFFERSON. Now, of course, the Ochsner site and the site 

downtown, both are susceptible to being hit by a storm, are they 

not, it just depends on where the storm hits? 

Ms. CATELLIER. Yes. 

Mr. JEFFERSON. So what happened in New Orleans was the 

flooding that actually did the damage here; and what we have 

heard is that there’s been some efforts made we all believe that 

will make that problem—that goes away. Some 300 years, it never 

happened until the levees failed. 

Now, so with respect to both sites, the issue of whether it can 

be a hurricane that hits it, it just depends on the path that the 

hurricane takes; isn’t that true? And so that’s—in other words, 

that’s not an eliminating factor. In both cases, there’s a problem. 

In your experience, Ms. Catellier, have you—are you familiar 

with the time it takes to build VA facilities in other places that 

you’ve seen recently built? 

Ms. CATELLIER. Yes. 

Mr. JEFFERSON. What is the average time it takes to build a VA 

hospital? And I know it’s a big question, but——

Ms. CATELLIER. Well, if I might qualify, just it really depends on 

the size and complexity of the facility. 

Mr. JEFFERSON. Well, give me a range kind of like, you know——

Ms. CATELLIER. As a rule, a very large hospital like the one we 

are building, about a million square feet, requires an 18-month design period, clinical experts and experts on our staff working with 

the architects. Once the design is completed, it’s about a three-year 

construction project process. 

Once the construction is completed, it takes about six months to 

do what we call activation, which means get the furniture in, get 

all the finishing touches, and begin to admit patients, so a good 

round number is five years. 

Mr. JEFFERSON. So no matter where this hospital is built, it’s 

going to take five years under the current way that things go? 

Ms. CATELLIER. That’s what my experts tell me. 


hsrobinson on PROD1PC76 with HEARING
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Mr. JEFFERSON. All right. Now, is there any way that this can 

be shortened and this can be done more quickly that your experts 

are looking at to figure this out? 

Ms. CATELLIER. I’m not an engineer, sir. I’m a nurse. 

Mr. JEFFERSON. That’s a good thing. 

Ms. CATELLIER. Those are the best timelines that I’ve been provided with by people who ought to know. 

Mr. JEFFERSON. So for those who say you have to build it right 

now today and in the morning, it can’t happen no matter where it’s 

built; it’s going to take this period of time to get this done? 

Ms. CATELLIER. We begin with the design of the hospital. That 

begins the clock. 

Mr. JEFFERSON. Now, the design, where are we within the design 

phase of it now; do we know? 

Ms. LEWIS-PAYTON. The initial space planning has been completed, the analysis of the AE firms has been completed as well. 

Mr. JEFFERSON. Now, with respect to either site here, if you can 

say so now, if the design were finished, let’s say we are finished 

now just as a hypothetical, and could you complete the hospital facility in either place in that three-year construction timeframe? 

Ms. LEWIS-PAYTON. That’s based on the information we have. 

Mr. JEFFERSON. Okay. And could you then have it open and 

ready for patient support in another—it seems like I just saw the 

six months it seemed like. That would all work out on the timeline 

you are talking about? 

[Ms. Lewis-Paton nods head affirmatively]. 

Mr. JEFFERSON. So with all of the collateral issues that everyone 

has been discussing today—and they really aren’t collateral, they 

all evolve around patient care—the issue of LSU and Tulane and 

the teaching facilities and medical, education, and research capacities, all these things are weighed into your decisionmaking? Are 

these a part of your decisionmaking as well? 

Ms. LEWIS-PAYTON. Yes, sir. 

Mr. JEFFERSON. The provision of these services to veterans? 

Ms. LEWIS-PAYTON. Yes, sir. 

Mr. JEFFERSON. Have you measured whether these same—these 

same benefits can be derived if the hospital is in Ochsner, where 

Ochsner is located as opposed to downtown with respect to these 

schools and things to the process of veterans care? 

Ms. LEWIS-PAYTON. That’s part of the analysis that has been 

mentioned on a number of occasions here. The close proximity——

Mr. JEFFERSON. Is that a possibility? 

Ms. LEWIS-PAYTON [continuing]. Is a part of the evaluation. It is 

not the sole determining factor, but it is a component of the evaluation. 

Mr. JEFFERSON. It’s an important part of the evaluation? 

Ms. LEWIS-PAYTON. Yes, sir. 

Mr. JEFFERSON. Okay. Is the VA—when we first talked, Mr. 

Chairman, back in your office a long time ago, we were all concerned about the VA making a decision to build a hospital in our 

general area and then we kind of get narrowed down to downtown 

New Orleans in a minute. 

So the decision has been made by the VA, and the VA will reassure you, that we aren’t talking about some other places along the 


hsrobinson on PROD1PC76 with HEARING
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Gulf Coast or in the southeastern United States. We are down to 

these two facilities where we are going to build; that’s about it? 

Ms. LEWIS-PAYTON. That’s correct. 

Mr. JEFFERSON. That’s it? 

Ms. LEWIS-PAYTON. We were always committed to the greater 

New Orleans area. 

Mr. JEFFERSON. So the advertising, that was just done to make 

sure you had options in the event that it turned out that way, so 

we don’t need to worry about that? 

Ms. LEWIS-PAYTON. That’s correct. 

Mr. JEFFERSON. Okay. I don’t have any other questions. 

The CHAIRMAN. Thank you, Mr. Jefferson. Mr. Miller? 

Mr. MILLER OF FLORIDA. If I could ask, as I understand it, between the two sites, one of the sites is going to have to go through 

a condemnation process or eminent domain, their title is not clear, 

we don’t know the timeframe. The Ochsner site has clear title and 

that’s not an issue. Do we have any idea of the amount of time difference between the two sites that that would take, that having to 

go through the process of acquiring the land that it would take? 

Ms. LEWIS-PAYTON. I heard the Mayor indicate during his testimony about the timelines and I think that may be in the information from LSU as well. I can’t remember the specifics in terms of 

the eminent domain process. Do you, Ms. Catellier? 

Ms. CATELLIER. Inclusive of eminent domain, we have delineated 

an 18-month access timeframe. We would need to have clear title 

to the land in 18 months, and the Mayor has guaranteed that he 

could deliver that. 

Mr. MILLER OF FLORIDA. So it would take 18 months to get title 

to the land? 

Ms. CATELLIER. It may not, Congressman Miller. It may take 

less. Our outside boundary is 18 months. 

Mr. MILLER OF FLORIDA. The Ochsner is zero because it’s clear 

title, correct? 

Ms. CATELLIER. Yes. 

Mr. MILLER OF FLORIDA. Did the Ochsner site flood? 

Ms. CATELLIER. No. 

Mr. MILLER OF FLORIDA. It did not flood? 

Ms. CATELLIER. To the best of my knowledge, it did not. 

Mr. MILLER OF FLORIDA. What is the reason for not demolishing 

the existing facility and rebuilding exactly where it stands today? 

Ms. CATELLIER. The existing facility sits on about six and a half 

acres of land, which would have been insufficient in the minds of 

the construction engineers. The studies have been commissioned to 

actually assess the market feasibility of the current land in the 

current site. 

Mr. MILLER OF FLORIDA. Is the building being—I mean I know 

there’s a CBOC in it, but we talked about a pharmacy and imaging. 

We are not putting them in that building, are we? 

Ms. LEWIS-PAYTON. No, sir. 

Mr. MILLER OF FLORIDA. So the real estate would be available 

then for sale potentially to somebody else? 

Ms. LEWIS-PAYTON. As I said, the market feasibility should be released soon in its final form and the Secretary will likely make a 

decision about disposal. 


hsrobinson on PROD1PC76 with HEARING
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Mr. MILLER OF FLORIDA. In February, I think it was in February, 

we passed the—the supplemental with $600 million in it. 

What exactly has VA been doing since February in regards to 

this issue, and I think I hear you saying we are dual tracked. We 

are going down one road as if we are not going to do the collaborative effort and we are going down the other road as if we were. 

We are not sitting still spinning our wheels, I hope? 

Ms. LEWIS-PAYTON. That’s absolutely correct, Congressman Miller. 

As I indicated earlier, significant effort and plans have been developed and in some cases implemented related to this. We have 

completed the analysis of the AE firm. That is ready for announcement. We have continued the work with LSU in terms of planning 

for a joint cooperative effort. Prior to that, we had a study group 

that assessed the feasibility of it. The two sites have been—the initial evaluations have been complete. 

So to answer your question, we have been very busy in those periods of time and have not been sitting just waiting for something 

to occur. 

Mr. MILLER OF FLORIDA. If there was never a New Orleans VA 

Medical Center, would we be looking at building one here today? 

Do the numbers currently justify building a medical center? 

Ms. LEWIS-PAYTON. Yes, sir, we believe they do. 

Mr. MILLER OF FLORIDA. Would we be looking at building it 

downtown in a flood prone area if it had not been there originally? 

Ms. LEWIS-PAYTON. When we look at the analysis of where our 

veterans are located, New Orleans really is central to that; and I 

yield to Ms. Catellier to better explain that. 

Ms. CATELLIER. Well, ours is a very regional healthcare system. 

One of the charts that I put up to better illustrate that for folks 

who may not know Louisiana or southeast Louisiana, you can see 

where the names of our clinics are. We kind of go in a circle around 

the lake. Currently with the location of our clinics, 80 percent of 

our patients—— Mr. MILLER OF FLORIDA. I’m just talking about between the two 

sites—— Ms. CATELLIER. Okay. 

Mr. MILLER OF FLORIDA [continuing]. Of downtown and the 

Ochsner site, which are the two sites that VA is currently looking 

at. 

Ms. CATELLIER. Each site would provide access to the patients 

who use us. Eighty percent of those people would be within an 

hour, so either site would work. 

Mr. MILLER OF FLORIDA. Either site would work, but given that 

there wasn’t a facility there and we are looking to put one today 

and you have a flood plain area and a non-flood plain area, you 

would still weight the flood plain area the same? 

Ms. CATELLIER. No. The flood plain area is one of the criteria, 

but it’s not the only criteria and it wasn’t weighted heavier than 

other criteria because you can mitigate for the flood plain. 

Mr. MILLER OF FLORIDA. With money—— Ms. CATELLIER. Yes, sir. 

Mr. MILLER OF FLORIDA [continuing]. That can be used for other 

veterans’ healthcare needs throughout the rest of the country. So 


hsrobinson on PROD1PC76 with HEARING
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you are taking dollars away from other veterans around the Nation 

just to rebuild a facility in a flood plain. It doesn’t make sense. 

Ms. LEWIS-PAYTON. Congressman Miller, I would like to add as 

well. You also—in this way, there’s really difficulty in making 

these analyses and really coming up with what’s the right decision 

in this case. 

You have the construction issues associated with those dollars, 

but there are also operational dollars that would far exceed what 

the construction costs are; and those types of operational assessments include the workload—I’m sorry, the lost productivity associated with travel. So all of those things have to be considered as 

well because we also share faculty between our medical affiliates, 

they are going back and forth between the sites. So all of these are 

considerations as well from an operational perspective. 

Mr. MILLER OF FLORIDA. I’m way over time also. Can you provide 

that information to this Committee, that in that decisionmaking 

process the difference between construction costs and offset? This 

Committee needs to understand that. 

[The information from VA follows:] 

Comparison of construction cost vs. operational cost of a hospital. 

The FY 2009 budget, Volume 4, Construction and Five Year Capital Plan 

identifies on page 6–10, the present facility operating costs is $189 million, 

the projected operating costs of the new facility, including non-recurring 

and recurring is $413.7 million and the total estimated project construction 

cost is $625 million. 

Response: Depending on the location, size, scope, and budget of the 

project, construction costs and operating costs vary. The general definition 

of construction costs are expenses incurred in the design (structure), overhead (services), and implementation of a project. Operating costs generally 

are the annual costs to sustain processes. Operational costs are both recurring and non-recurring. Recurring costs are typically utilities, electricity, 

staffing, and equipment maintenance. Non-recurring costs include equipment purchase (i.e. MRI, CT scan), and infrastructure maintenance. It is 

important to note the design of VA facilities is governed by many regulations and technical requirements. (VHA cleared—April 28, 2008) 

Mr. MILLER OF FLORIDA. With the time running out, let me also 

say that southeast Louisiana with Ms. Catellier is in very good 

hands. If it can be done, she will get it done. I know because I’ve 

worked with her in the past on projects in my district and she’ll 

do a wonderful job. 

Ms. LEWIS-PAYTON. We absolutely agree. 

The CHAIRMAN. Thank you. Mr. Michaud? 

Mr. MICHAUD. Thank you very much, Mr. Chairman. Mr. Miller 

asked most of my questions, but you had mentioned in your statement, and I quote, that what is in the best interest of the veterans 

we serve is what you do. 

I guess my concern is: During the previous panel, three out of 

the four individuals when I asked whether they were involved in 

the ongoing collaborative study group efforts, they said no. So my 

concern is how well are you really working with the veteran service 

organizations in this area and I would encourage you to work closely with them. It’s to your benefit as well as the veterans, and I’m 

just surprised that three out of four said that they weren’t involved 

in that collaborative study. 

So hopefully you will allow VSOs to be involved in the process. 

It doesn’t mean that you agree with them, but that they should 


hsrobinson on PROD1PC76 with HEARING
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definitely be involved in the process because I think both will benefit by that. 

Ms. LEWIS-PAYTON. We absolutely agree. They are not members 

on the study group, but as part of our communication plan, that 

is definitely a component of that. And, Ms. Catellier, do you want 

to add to that? 

Mr. MICHAUD. And hopefully that communication plan is not oneway communication? 

Ms. LEWIS-PAYTON. It’s not, sir. 

Ms. CATELLIER. And, Congressman, that is very much a part of 

my role is to be the advocate for all veterans and all VSOs. I meet 

with these folks on a weekly and monthly basis formally and daily, 

informally and bring their concerns and their thoughts to the Committee. 

Mr. MICHAUD. So why did three out of four say they were not involved in the process? 

Ms. CATELLIER. I suspect because they are not at the table for 

the specific deliberations and that I’m acting as their agent to 

bring their concerns to the group. 

Mr. MICHAUD. Okay. My next question is—and you mentioned 

that 90 percent of the veterans pre-Katrina level are back. That’s 

not counting the actual increase in workload. I know other VISNs 

have seen because of Iraq, Afghanistan, what have you. 

My question is—and I know they are being taken care of in 

CBOCs and what have you, but have you seen an increase in feefor-service or contracting out to rural hospitals and/or hospitals in 

general and what has that increase been since Katrina? 

Ms. CATELLIER. We purchase much of our care that we’d like to 

keep in the local community for the convenience of our veterans, 

so for those services we can buy, we do. And we’ll spend about $30 

million this year on purchased care. 

For complex care, especially cancer care and cardiac care and inpatient psychiatric care, which is not available in the local community, we refer our patients to our sister VA facilities within VISN 

16 and we provide the transportation for the care. 

Mr. MICHAUD. How does that increase before Katrina? Is it——

Ms. CATELLIER. For purchased care, the year before Katrina, it’s 

about 10 times more. 

Mr. MICHAUD. Okay. Since Katrina—and we’ve heard that some 

veterans are coming back—has the VA looked at exactly how many 

veterans are coming back, the demographic disbursement of the 

veterans, how many are coming back and where are they coming 

back to. 

And do you have any information, if not available today, that you 

can provide the Committee? 

Ms. CATELLIER. I do. Let me just give you just a snapshot because I know time is short, and I’ve asked my assistant to just put 

up a chart to sort of show it. 

Our patients predominantly come from six parishes around the 

city. And as I said, we are a regional healthcare system, so whereas the population in Orleans Parish, which is the City of Orleans, 

is not as robust as we had seen, we are seeing that made up for—

throughout the other parishes so that, as Ms. Lewis-Payton said, 


hsrobinson on PROD1PC76 with HEARING
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we are this year at about 90 percent. We’ll hit our pre-Katrina 

workload by next year, we believe. 

So this chart shows you that for the three parishes in and 

around Orleans Parish, so Jefferson Parish, Orleans Parish, and 

St. Tammany Parish where we have our clinics, about 40 percent 

of our patients live there. About another 25 percent live up in the 

Baton Rouge area and then the rest is disbursed around southeast 

Louisiana. But what we are seeing is that, even though the city is 

not coming back to the same rate, the region is. 

One other fact that I find very interesting as a newcomer to the 

city is that we have a huge market penetration of veterans in our 

veteran population, more than any VA I’ve worked at. Fifty percent 

of veterans who live in Orleans Parish use the VA, they are enrolled for care; and in the other six predominant parishes, about 30 

percent market penetration, which is very high in the VA. 

Mr. MICHAUD. Thank you. And, Mr. Chairman, if they could provide the charts for the Committee, it would be helpful. Thank you 

very much, Mr. Chairman. Thank you. 

[The charts, Southeast Louisiana Veterans Healthcare System, 

Map Showing the 23 Parishes with Clinics Serving Veterans in: 

New Orleans, Baton Rouge, Hammond, St. John Parish, Slidell, 

and Houma, Southeast Louisiana Veterans Healthcare System, Individual Patients Treated FY 2005–FY 2007, and Southeast Louisiana Veterans Healthcare System, FY 2007 Patients by Parish, 

appear on pages 83 and 84.] 

The CHAIRMAN. Thank you. Thank you all for giving us this information and making sure that we and the VA focus on these 

issues. We thank the Supreme Court of the State of Louisiana, by 

the way, for hosting us. 

I would like to give Mr. Baker and Mr. Jefferson a couple of minutes each to just summarize their—their impressions of this hearing and where we go from here. 

Mr. BAKER. Mr. Chairman, first, let me again express appreciation to you and others Members who have taken time from their 

schedule to be here today. I’m most appreciative. Most members of 

the audience attending would not know this is a very well-attended 

field hearing for events such as this, so it indicates the significant 

level of interest by the Committee in making the right decision 

here. 

I am also very encouraged by the representatives of the VA here 

in the last panel testifying today as to their process going forward. 

Certainly, I would like to see it expedited more quickly. And I only 

have one minor element to add to the list of already required elements for consideration, not that it would be determinative but 

that it would be another element on the long list, to include some 

sort of statistically significant sampling of the veterans as to their 

preferences for location. 

Outside of that, I think all the operational and construction elements that you have outlined are at the heart of this consideration 

are certainly appropriate and I think will yield the best decision 

possible and I’m going to support the agencies determinations as 

they go forward. 

I hope, however, that once these considerations are finalized that 

we can find a way; and if there is anything that the agency can 


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bring to my attention that would be helpful in the expediting of the 

construction process, I certainly hope that more thought will be 

given to that. 

It does appear to be a little longer time than a market driven approach to a similar complex project; and if there are rules or requirements that simply obfuscate the goal and are not benefiting 

to the public interest, we should review those and try to be helpful 

to you. 

I certainly don’t want to leave today without making the point 

that I am here to hopefully get the restoration of veteran services 

as quickly as possible. Wherever that decision is made, I’m for it. 

I just want it a little more quickly than we appear to be able to 

get it. 

I thank you. I yield back, Mr. Chairman: 

The CHAIRMAN. Thank you. Mr. Jefferson? 

Mr. JEFFERSON. Thank you, Mr. Chairman. And I would like to 

thank you and the Committee for coming down here today and 

spending the time with us and committing yourself as you have, 

each of you, to restoring our veterans’ benefits in our area. And I 

thank you for the particular attention you paid to my comments to 

you as we have talked on these issues. 

I want to thank the dean of our delegation in Washington, Richard Baker, which has also been a steadfast supporter of our recovery here completely and totally; and I appreciate that from someone who’s from Baton Rouge who has spent a lot of time with our 

efforts here and I know it’s important to him. 

I started out in this building, so I have a few feelings about it. 

Thirty-five years ago, I was a law clerk here and now—the Supreme Court wasn’t here then. It was a Federal District Court, and 

right up here where we are, we actually literally came upstairs if 

you had a problem at the District Court level because the Appeals 

Court was upstairs from where we were. And this building has 

been redone, and it was a Wildlife and Fisheries building redone 

as a Federal court building now redone as a State Supreme Court 

facility. It is magnificent and I’m glad you had a chance to see it, 

see what’s happening to make this transition and to restore this 

beautiful old building. 

I want to say, though, to the particular issues today that we are 

talking about, I think it’s been a very important hearing. And the 

folks you’ve heard from have been absolutely wonderful witnesses. 

I think the point we made is that our State and local people are 

trying to bear up to their end of responsibility, both with respect 

to funding for the restoration of a hospital here and for coming together in a collaborative sense with those who can provide care for 

the veterans. 

There was some questions early on about our State’s commitment. I think those questions are answered or have been answered 

by this Legislature’s actions in this particular session which just 

ended a few days ago. 

I think the issue of site selection that we’ve talked so much 

about, I first started out, I represented the area as a parochial advocate for it, but I think there are many arguments that have been 

made today that I think make this one that I can make on an obVerDate Aug 31 2005 20:55 Jun 13, 2008 Jkt 037470 PO 00000 Frm 00063 Fmt 6633 Sfmt 6602 E:\HR\OC\37470.XXX 37470

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jective basis if I had to, and I think that the issue is all around 

patient care. 

I think the veterans are right when they insist upon it, I think 

those at LSU are right when they talk about that as a core of our 

issue, and the Members here are right when they say that’s really 

the issue we are talking about. 

When the place is constructed, wherever it’s constructed, it will 

be a facility that will be able to serve veterans, but the real issue 

is going to be what happens once it is constructed and what facilities are going to be brought to bear to give patient’s care, day in 

and day out. 

I think the argument for—that has been made here, no matter 

how one starts out about site, is that there will be better patient 

care for veterans if you have the collaborative efforts that we’ve 

talked about here, that we see in so many other places, between 

LSU and Tulane and other features of our healthcare system that 

are located in this medical corridor. 

And in each case, the population is going to have access, as the 

map shows from the six-parish area, they can make access to either 

site, but the issue of the care of the patient and the research and 

all the rest of it all tie to patient care I think and argues more for 

the location here and I hope that that will be taken into account. 

The issue of population, you’ve answered that I think quite adequately. I was concerned earlier about whether enough people are 

back or are coming back. And I said in the opening and it’s been 

supported here, that even though they aren’t back literally in the 

City of New Orleans, it’s up to 65 percent of our population, they 

are around and about the city for the most part in other parishes 

that aren’t a part of Orleans proper. 

So I would urge this Committee to keep looking at this area and 

to understand how important it is since we get past the most important question, the issue of veteran care, patient care, then look 

at how important it is to our recovery in the second place, how essential it is to bringing the city back and making it whole again 

and how much of a responsibility, last, for the Federal Government 

to get that done. 

I have said often and I don’t want to keep sounding like a broken 

record, but the Mayor said it and I said it, others have said it. If 

the Federal Government had met its responsibility with respect to 

the design, construction, and maintenance of our levee system, we 

would not have had the flooding of the occasion, the destruction 

that took place here including the destruction of our medical 

healthcare facilities. 

So there is a unique Federal responsibility here we think to help 

to restore our city. So we argue for patient care in the first place; 

but the second place, if it weren’t for the efforts of this community 

and others to help to restore our city because it was a Federal—

the action or inaction, if you will, of the Federal Government that 

caused the flooding of our city’s facilities in the first place. 

So I thank the Committee for coming here. I hope you can take 

these arguments back to our colleagues in the Congress and look 

forward to getting this done as quickly as we can, to restoring the 

VA facilities in our area. Thank you very much, thank all of you. 


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The CHAIRMAN. Thank you. I want to thank all the Members of 

our Committee, the Committee staff. The Committee was very 

much engaged in this. I think we learned a great deal that we will 

bring back to Washington, DC, and we have focused our attention 

on the veterans, we have focused our attention on the speed at 

which the Federal Government can act to remedy the situation. 

We thank all of you for being here, we thank our last panel, and 

this hearing is adjourned. 

[Whereupon, at 12:44 p.m., the Committee was adjourned.] 


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A P P E N D I X 

Prepared Statement of Hon. Bob Filner 

Chairman, Full Committee on Veterans’ Affairs 

Thank you, everyone, for coming today. This is a very important hearing on the 

future of VA healthcare in South Louisiana. 

We are here today to explore the challenges faced by VA and other healthcare facilities to provide high quality, safe healthcare to veterans and other citizens of this 

area. 

On the morning of August 29, 2005, Hurricane Katrina made landfall near the 

Louisiana-Mississippi border, causing significant destruction to a 90,000 square mile 

area of the Southeastern United States. 

In the three-state area of Louisiana, Mississippi and Alabama, VA facilities affected included the Gulfport, Mississippi and New Orleans medical centers; New Orleans regional benefits office; five community based outpatient clinics along the Gulf 

Coast; and the Biloxi VA National Cemetery. 

The VA’s response to the hurricane and the safety of its patients has been recognized on numerous occasions as being outstanding. 

The hurricane had a major impact on the overall healthcare delivery system in 

Southeastern Louisiana and today, nearly two years later, the delivery of healthcare 

remains in flux as leaders struggle to come to some agreement on both the best location and the best partnerships to forge in order to provide timely, safe, high-quality 

healthcare to veterans and others. 

Today, veterans are seen at several different locations. Through the eight outpatient clinic locations throughout Southeastern Louisiana they are able to receive 

services that do include mental healthcare. 

Prior to Katrina, the New Orleans VA medical center had a longstanding partnership with Louisiana State University in New Orleans, Tulane University Schools of 

Medicine, and many allied health profession programs. It was also a primary teaching facility in the area. 

Congress appropriated $625 million, through two emergency supplemental appropriations, to move forward on building a new facility. On April 10, 2007, the Committee sent a letter to the Secretary urging VA to make their own decision without 

further delay. 

Today, we will hear from a number of interested stakeholders on the planning and 

future of VA healthcare in Southeastern Louisiana. 

We should keep in mind that moving ahead expeditiously to provide healthcare 

to veterans in the area is a top priority. 

Anything less than that, does a disservice to those who have served their country. 

Thank you all for attending the hearing today. 

f 

Prepared Statement of Hon. Michael H. Michaud 

Chairman, Subcommittee on Health 

I would like to express my thanks to the Chairman for holding this hearing today. 

This is an important issue for the veterans of Louisiana and for our VA system. 

Veterans in south Louisiana have waited too long for a decision to be made on 

the future of healthcare delivery in this area. 

VA has the opportunity to be creative and to benefit from community assistance 

and input. 

I feel it is of the utmost importance to hear from the local leadership and stakeholders about the situation here and how best to resolve it. 

The decision needs to be made quickly, wisely and with effective use of tax dollars. 


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And we must always remember that our responsibility here is to the veteran. 

They deserve to have access to the best possible care. That must be our guiding 

principle. 

With that, I look forward to hearing from the Members of the panels. 

f 

Prepared Statement of Hon. Jeff Miller 

Ranking Republican Member, Subcommittee on Health 

Thank you, Mr. Chairman. 

Many share my concerns about the topic of today’s hearing, and I am grateful that 

this Committee is meeting to exercise its duty of ensuring that actions taken by VA 

are for the benefit of our nation’s veterans. 

Nearly two years after Hurricane Katrina, there is still not a clear plan on how 

veterans’ healthcare needs will be addressed in the region, and I am troubled by 

many of the proposals. The proposal receiving the most attention has cost estimates 

approaching $1.2 billion, yet there is very little certainty about where this facility 

will be located. 

Taxpayers and veterans both can be better served if VA would look take a more 

fiscally responsible approach and situate a facility that won’t be subject to a repeat 

of what happened to the old hospital. With a declining population of veterans in the 

area prior to Katrina, a medical center where veterans are actually located would 

provide a quicker path to delivering healthcare to those in need. Furthermore, new 

hospitals are going up all around our country at a third of the estimated cost. 

Veterans in Southeast Louisiana deserve timely access to healthcare just as veterans throughout the rest of the nation do. That is never in question. However, I 

question the proposed joint venture, and the significant amount of time that has 

lapsed with little progress makes me question that plan even more. 

Putting a replacement facility in a flood-prone area looks like no lesson was 

learned in the past, and putting a replacement facility back in the same area after 

years of population shift looks like VA isn’t looking clearly toward the future. 

I look forward to today’s testimony and hopefully constructive ideas on how veterans in this area can receive timely access to healthcare at a cost that best serves 

the interest of the taxpayers. f 

Prepared Statement of Hon. C. Ray Nagin 

Mayor, City of New Orleans, Louisiana 

I am C. Ray Nagin, Mayor of New Orleans, one of America’s most beloved and 

culturally distinctive cities, and a city which is facing the challenge of recovering 

and rebuilding strategically after the worst natural and man-made disaster to occur 

in the United States of America. Our goal is to make our city stronger and better, 

and to provide improved services and opportunities to the citizens of our city and 

region. Among our most deserving citizens are our veterans, who have given of 

themselves to serve our country in times of war and peace. 

To Chair and Congressman Filner, Ranking Member and Congressman Buyer, 

distinguished Members and guests of the House Committee on Veterans’ Affairs: 

Thank you for calling this hearing to discuss the future of ‘‘VA healthcare in south 

Louisiana.’’ The Veterans Administration (VA) Hospital has been an important presence in our community, and the construction of a new facility in downtown New Orleans would achieve several things: ensure that veterans receive the excellent stateof-the—art medical care they deserve; improve the provision of healthcare in general 

in the community; and dramatically impact the economy of our region. 

I would like first to thank the Congress for their continued support in the months 

since Hurricane Katrina and the subsequent flooding of our city. I also must thank 

the American people and our friends throughout the world for their unwavering 

generosity. 

Role of the VA Hospital 

The VA Hospital has traditionally played an important role in ensuring the wellbeing of the over 200,000 veterans in southern Louisiana. The VA Hospital serves 

not only the veterans who live in the region, but the thousands who visit the city 

as tourists, for special events and for conventions. The construction of a new VA 

hospital in downtown New Orleans would greatly impact the availability, accessibility and quality of care for veterans. It would also help us to reclaim the many 

highly skilled and qualified medical specialists who were displaced after the storm, 

as well as to attract new medical professionals, facilities and businesses. 


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The area where the hospital would locate is within a legislatively created medical 

district, encompassing more than 30 public, private, and not-for-profit organizations, 

including several colleges and universities (LSU, Tulane, Xavier, Delgado), several 

hospitals, two medical schools, nursing schools, medically related offices and businesses, and associated biotech companies. 

The presence of the VA Hospital in this district creates the synergy and 

leveraging ability that clustering of medical facilities can achieve. In this central location, it will continue to be a critical piece of the healthcare network of the New 

Orleans region. The physical proximity of institutions allows for sharing of expensive and ever changing technologies and diagnostic equipment. It also encourages 

human interaction and intellectual exchanges that can lead to more accurate diagnoses, varied treatment approaches and important scholarly and medical research 

and discovery. 

Pre and post Katrina, the area’s bioscience institutions have been conducting cutting-edge research in areas such as gene therapy, cancer biology, peptide pharmaceutical design, and infectious diseases. Federal and private grant funding in New 

Orleans exceeded $180 million in 2003 and was growing substantially as New Orleans based institutions capitalized on their core strengths. In fiscal year 2005, the 

New Orleans area accounted for $129.8 million in awards from the National Institutes of Health, representing 74 percent of the total amount awarded within the entire state of Louisiana. Those organizations have come together to 

Many of these bioscience institutions have joined together to create the New Orleans Regional Biosciences Initiative (NORBI), one of the major redevelopment 

projects of the region. The new VA hospital would be an anchor in NORBI, along 

with other institutions such as Louisiana State University Health Sciences Center 

(LSUHSC) and Tulane University Hospital and Clinic. Their partnership with the 

VA would increase veterans’ access to medical specialists and researchers. 

The VA Hospital is also a critical economic development engine for the City of 

New Orleans. The new facility would result in a capital investment estimated to be 

$650 million to $1 billion, with an annual impact of $500 million. If co-located with 

the planned new LSU teaching facility, together they would result in a capital investment of at least $2 billion and produce an annual impact of more than $1.26 

billion, including more than 20,000 construction jobs and more than 10,000 full time 

professional positions. 

Our Work to Retain the Hospital 

Recognizing the importance of such a development, the City of New Orleans, 

along with a coalition of regional partners, submitted a response to the Department 

of Veterans Affairs Request for Expressions of Interest to acquire a site for the construction of a medical center in the New Orleans Metropolitan Area. This medical 

district location for the VA Hospital has the support of the New Orleans Regional 

Planning Commission, the New Orleans City Council, and the Downtown Development District, each of which unanimously approved resolutions to keep the hospital 

downtown. In addition, the Louisiana chapter of the American Legion, with more 

than 1,000 delegates in attendance at its annual meeting last month, also unanimously supported the rebuilding of the VA Hospital in downtown New Orleans. 

The city and its partners have the financial means to expeditiously acquire the 

necessary land, which will be done with the support of a cooperative endeavor agreement (CEA) with the State of Louisiana. This CEA engages the state to use quicktake authority for public benefit for all of the land required for the VA site, something it is in the process of doing for the adjacent LSU location. Site acquisition can 

be accomplished within the VA’s 18-month design timeframe for the hospital, so 

that construction can begin immediately upon completion of the design. The city can 

provide the necessary infrastructure for the site, including water, sewer and electricity, and has conducted preliminary site assessments which indicate environmental concerns will not be a problem. 

Much of the property that would be used for the project is currently non-residential. A large portion of it has been empty or underutilized, and this project provides 

an opportunity for further renewal of our urban core. Of the residential properties, 

most are not owner occupied, and the city has an agreement with an experienced 

non-profit for assistance with relocations. Acquisition of the land by the city would 

provide property owners with a government buyout, ensuring a fair price and an 

opportunity to locate in areas they find more desirable. 

Though we realize there are significant advantages and cost savings to be had by 

co-location or coordination of services between the VA and LSU hospitals, our proposal to the VA is not dependent upon the building of any other facility. 


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Conclusion 

In closing, I would like to again thank you for the opportunity to discuss our plans 

and hopes for the reestablishment of this critical healthcare institution in postKatrina New Orleans. We appreciate your commitment, as the Committee on Veterans’ Affairs, to ensuring that those who have served our country receive the excellent medical services they deserve. The presence of the VA Hospital in our downtown medical district will allow it to take advantage of the clustering of clinical, research, teaching and commercialization facilities to achieve that goal for our veterans and our community. f 

Prepared Statement of Michael Kaiser, M.D., Acting Chief Medical Officer 

Louisiana State University Healthcare Services Division 

Mr. Chairman and Members of the Committee, my name is Michael Kaiser, I am 

a pediatrician and Acting Chief Medical Officer of the LSU Healthcare Services Division, which consists of seven acute care hospitals and extensive outpatient clinics 

operated by the State of Louisiana. These include our rebuilt LSU Interim Hospital 

campus in New Orleans, which prior to Hurricane Katrina was a component hospital of what was legally known as the Medical Center of Louisiana-New Orleans 

and which was effectively destroyed by Hurricane Katrina. Similar to other local 

public hospitals across the country, this facility functioned as the core of the safety 

net for the uninsured and was the predominant site for the clinical training of physicians and other healthcare professionals. 

The now closed Charity Hospital (the other component facility of what was the 

Medical Center of Louisiana at New Orleans) sits across the street from the VA 

Hospital, which also suffered catastrophic damage in the storm. Following Katrina, 

nothing has occupied our time and attention more fully than the restoration of our 

public hospital and its clinics to serve the people of this region and the future 

healthcare professionals who train there. 

Of necessity, LSU has focused on both the present and the future. In the nearly 

two years since Katrina, we have moved from emergency facilities in tents to the 

opening of a small, interim hospital and a growing number of primary and specialty 

care clinics at several locations. Our capacity is not yet up to the level of need in 

the region, particularly in the availability of psychiatric services, some medical specialties and dispersed primary care clinics, but we have made significant progress. 

Other major additional steps will be taken in the months ahead. 

As we continue work to address immediate and critical needs in the community, 

LSU has kept a steady focus on the longer term. The region desperately needs not 

only additional healthcare resources, but also a way to develop and deploy those assets through a better, more efficient system than was possible before the storm. 

LSU has long worked toward fundamental improvements in its delivery system, 

such as through its award-winning disease management program, but the convergence of the need to rebuild and the heightened support today for both a reformed 

delivery model for care to the uninsured and for the financial and reimbursement 

reform necessary to make that new model possible, present realistic opportunities 

for our long-term agenda for change. 

The VA Collaboration 

The potential collaboration between the Department of Veterans Affairs (hereafter 

VA) and Louisiana’s state public hospital system is one propelled by unintended opportunity, but it is a core part of our strategic vision. We have a chance to jointly 

design and cooperatively operate a new facility that meets the needs of both institutions, and the patients they serve, while at the same time achieving significantly 

enhanced efficiency, cost savings and quality healthcare. 

The proposed collaboration is a logical step for reasons that extend beyond the destruction of Katrina. The adjacent VA and Louisiana-operated public hospitals have 

a long history of working together. Prior to the storm, the New Orleans VA purchased over $3 million a year in clinical and other services from LSU, including 

Cardiothoracic Surgery, Radiation Therapy, and Dermatology services. Many physicians worked at both the VA and the Medical Center of Louisiana at New Orleans 

facilities and many medical residents, from both LSU and Tulane Schools of Medicine, rotated to both hospitals. 

For the past 18 months, I have chaired the planning efforts with the VA. First, 

the Collaborative Opportunities Study Group, cochaired with Mr. Michael Moreland, 

Director of the VA Hospital in Pittsburgh, looked at the possibility and feasibility 

of building together and sharing services. Once proved feasible, the Collaborative 

Opportunities Planning Group, cochaired with Mr. Ed Tucker, Director of the 


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DeBakey VA Hospital in Houston, has been studying what services should be shared 

and the details of building together. The COPG continues to meet weekly in order 

to present a final report to the Secretary by the end of September, 2007. 

The creation of a VA–LSU campus in downtown New Orleans will create benefits 

for both partners that exceed what either can accomplish separately in different locations. We have a rare opportunity to develop a whole that is greater than the sum 

of its parts. There are enormous benefits to the community of a downtown medical 

complex anchored by the VA–LSU collaboration, bolstered by the Tulane and LSU 

health science centers, and building on a Level I Trauma program and centers of 

excellence in orthopedics, neurosciences and other specialties. These benefits will redound specifically to the patients of the VA and LSU systems, as well as to a larger 

population. It is the synergy created by working together that will enhance the services available to all our patients. 

Where The Project Stands 

The Louisiana Legislature in its just completed 2007 Regular Session, approved 

capital outlay appropriations totaling $1,500,000,000 for the project ($74,500,000 in 

HB 765 of the 2007 Regular Session and $1,425,500,000 in HB 2 of the 2007 Regular Session). These appropriations overstated the financial requirements for the facility by $300,000,000 because the legislature failed to make an adjustment for 

$300,000,000 previously allocated for this project, but moved in the waning days of 

the legislative session to the Road Home Program. Adjusting for this error leaves 

$1,200,000,000 for the new academic medical center which matches the cost estimate for the facility contained in the business plan completed by the Adams Group, 

a national hospital consulting firm, and overwhelming approved by both houses of 

the Louisiana Legislature. This funding comes from multiple sources as follows: 

$74,500,000 is from the State General Fund that is available immediately for land 

acquisition, planning, and construction; $225,500,000 will come from the sale of general obligation bonds that will be issued by the state as the need for additional cash 

becomes available; and, the final tranche, $900,000,000 will come from the sale of 

revenue bonds that will be issued after the general fund and general obligation bond 

moneys have been expended. 

The construction of the new academic medical center is being managed by the Office of Facilities Planning and Control which is an agency within the executive 

branch of Louisiana Government. Acquisition of land identified for the new academic medical center and the VA facility is already underway with contracts having 

been issued to complete title and appraisal work. Once the VA firmly commits to 

building at the downtown site, the City of New Orleans and the State of Louisiana 

are prepared to immediately proceed with land acquisition for the VA. 

Both LSU and the VA have conducted independent architect selection processes 

and are ready to announce the winning firms. If the same firm is not selected by 

each partner, a previously developed plan to work together with separate architects 

will be implemented. 

From this point forward and given the preparation of both partners, the process 

of building a new hospital complex together can proceed as quickly as 

choosing to build separately. Significant groundwork has been laid for a long 

term, mutually beneficial collaboration, and we are poised to see it to completion. 

Thank you again for your interest and for this opportunity to share LSU’s perspective on these critical matters. Far from being an obstacle to healthcare reform 

as some have feared, the creation of a revitalized academic medical center complex 

in the city will be a catalyst for that reform. Particularly if LSU and the VA work 

together, it also will sustain a reformed system in the long run by supporting a viable, mission-driven system dedicated to improved access, the highest quality medical 

care and innovative healthcare education in a rebuilding community. 

Thank you. 

f 

Prepared Statement of Frederick P. Cerise, M.D., M.P.H. 

Secretary, Louisiana Department of Health and Hospitals 

Introduction: Mr. Chairman and Members of the Committee, thank you for the 

opportunity to testify today on the future of veterans’ healthcare in south Louisiana. 

I am Dr. Fred Cerise, Secretary of the Louisiana Department of Health and Hospitals (DHH), the leading state agency for healthcare in Louisiana. 

Louisiana and the Department of Veterans Affairs (VA) have had a successful relationship for many years as demonstrated by collaboration among the Department 

of Veterans Affairs-Southeast Louisiana Veterans Healthcare System (SLVHCS), 


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1LSU–HCSD, Status Report: LSU/VA Collaboration in New Orleans, May 2006. 2 United States Department of Veterans Affairs, available at: http://www1.va.gov/health/gateway.html, (accessed on July 5, 2007). 3Perlin, Jonathan, et al, The Veterans Health Administration: Quality, Value, Accountability, 

and Information as Transforming Strategies for Patient-Centered Care, The American Journal 

of Managed Care, November 2004. 

Tulane University Health Sciences Center, and the Louisiana State University 

(LSU) Health Sciences Center. 

Further, the LSU Health Sciences Center Healthcare Services Division, which operates the system of public hospitals and clinics in Louisiana, and the SLVHCS 

have similar missions to provide primary and specialty care and other related medical services to their target populations. The two systems have several other things 

in common: both are public healthcare systems, both provide a high volume of outpatient care, and both are integrated systems. Additionally, physicians and residents from Tulane and LSU regularly rotate between the two systems. 1

Post-Hurricane Katrina, these two healthcare systems, and ultimately the State 

and Federal Governments, have a tremendous opportunity to advance and strengthen this relationship into a formal partnership, creating better and more efficient 

healthcare for the citizens and veterans of Louisiana. 

Louisiana Healthcare Redesign Collaborative and the VA Vision: After 

Hurricane Katrina, the Louisiana Healthcare Redesign Collaborative was created 

through a legislative resolution to respond to the healthcare issues in the New Orleans region (Jefferson, Orleans, Plaquemines, and St. Bernard Parishes). The Collaborative was a forty member group charged with creating recommendations for a 

quality driven healthcare system for New Orleans. The Collaborative adopted the 

following vision: Health care in Louisiana will be patient-centered, quality-driven, 

sustainable and accessible to all citizens. 

The backbone of the redesigned system of care put forward by the Collaborative 

is the ‘‘medical home.’’ The goal of the medical home is to provide a coordinated approach to patient-centered care that is built on partnerships, to utilize health information technology, and to improve health outcomes. This is akin to the VA Vision 

that ‘‘supports innovation, empowerment, productivity, accountability, and continuous improvement. Working together, [you] provide a continuum of high quality 

healthcare in a convenient, responsive, caring manner—and at a reasonable cost.’’ 2

The medical home is the base from which primary care and other needed services 

are managed and coordinated in order to provide the most effective and efficient 

care. This includes specialty care, inpatient care, community preventive services and 

extension services for complex care needs. Investments in health information technology (HIT) and the recently established Louisiana Healthcare Quality Forum 

(LHCQF) will aid in creating ‘‘system-ness’’ and ensuring that improvements in 

quality occur. 

The medical home system is consistent with recommendations made by a number 

of professional societies. Additionally, it has the qualities and expectations consistent with those of a high performing health system and/or redesigned system as 

described by the Commonwealth Fund and the Institute of Medicine. Ensuring the 

coordination and comprehensive approach of the medical home model over time will 

improve the efficiency and effectiveness of the healthcare system and ultimately improve health outcomes. 

Louisiana is moving forward with the redesign of the healthcare systems in the 

hurricane affected areas. As a result of the recent legislative session, funding has 

been allocated to pilot the medical home system of care, including support for the 

development of regional health information exchanges, adoption of electronic medical records by providers, and the LHCQF. 

The VA as a Model for Healthcare: In July 2006, BusinessWeek magazine 

called the VA healthcare the best medical care in the U.S. A 2004 article in The 

American Journal of Managed Care stated that ‘‘today, the VA is recognized for 

leadership in clinical informatics and performance improvement, cares for more patients with proportionally fewer resources, and sets national benchmarks in patient 

satisfaction and for 18 indicators of quality in disease prevention and treatment.’’ 3

The VA system is probably best known for its successful coordination of care and 

use of health information technology (through the VistA system). The Veterans Integrated Service Networks (VISN) created fundamental change in how healthcare was 

delivered to veterans. The VISN encouraged the coordination of care and resources 

of the medical centers, clinics, long-term facilities and other facilities. As a result, 


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4 Ibid. 

5 Ibid. 

6 United States Department of Veterans Affairs, State Summary: Louisiana, available at: 

http://www1.va.gov/opa/fact/statesum/LAss.asp, (accessed on July 5, 2007) 7 Arnst, Catherine, The Best Medical Care in the U.S., Business Week, July 2006. 

the VA experienced a reduction in hospital and long-term beds, and ultimately in 

hospitalizations. 4

Health information technology is integrated in the VA system through its VistA 

system. The success of the VistA system was highlighted in the aftermath of Hurricane Katrina when VA facilities across the nation were able to access patient information for evacuees. Health information technology provides the VA an opportunity 

to monitor and improve quality. For example, the VA uses computerized physician 

order entry, which has shown to decrease rates of adverse drug events. 5

The VA also provides an avenue for healthcare research. In New Orleans alone, 

the VA has twenty-nine active research projects and is the home to the Mental Illness Research, Education, and Clinical Center. 6 Furthermore, the cost per patient 

in the VA system is less than the national average. 7

The State’s Commitment to the LSU–VA Partnership: The state’s goals for 

healthcare are clear. Given the similar mission and goals between the state and the 

VA, a joint partnership between the two entities makes sense. What has been proposed is a move from three separate inpatient facilities that existed in New Orleans 

prior to Katrina to a single shared LSU–VA inpatient facility with a more dispersed 

network of clinics. Sharing of common physical plant needs and certain high-end 

clinical services will create significant operational efficiencies for our taxpayers and 

improved health benefits for all of the citizens we both serve. 

The state’s commitment to this partnership is strong. The state has made the necessary commitment of funding for a new academic medical center in downtown New 

Orleans to replace the old Charity Hospital. Governor Kathleen Blanco recently 

signed Act 203, which allocates an initial $74.5 million for land acquisition and 

planning for the project. The authorizing legislation for the $225.5 million down 

payment called for in the business plan developed by Louisiana’s Division of Administration was approved by the state legislature and is awaiting the governor’s signature. The remainder of the project will be financed through general revenue bonds. 

In addition to the state’s investments in the medical home pilots, HIT, and quality, the state has also committed $38 million to a cancer research institution, which 

will be established in downtown New Orleans. The presence of LSU and Tulane, 

combined with the VA and the new cancer center will create a medical district that 

will not only drive economic development in New Orleans, but will also provide state 

of the art healthcare to our citizens and veterans. 

There is widespread support for this endeavor. The Regional Planning Commission for Jefferson, Orleans, Plaquemines, St. Bernard and St. Tammany Parishes 

unanimously endorsed a resolution supporting the retention of a VA Hospital in 

downtown New Orleans. The Downtown Development District of New Orleans 

passed a similar resolution. The state legislature showed its support of the LSU–

VA partnership by passing Senate Concurrent Resolution 76. 

The Unified New Orleans Plan (UNOP) identifies the LSU–VA partnership as one 

of its highest priorities for economic development. Input for the plan was received 

from every neighborhood in New Orleans and from a broad spectrum of community 

leaders. The Plan states that ‘‘the LSU/VA/University Hospital Complex is the key 

project to the reinvigorated medical district . . . it will foster technologically-driven 

high performance companies that have the potential of creating quality jobs and economic diversification.’’

The state and the VA have similar visions for healthcare—to provide patient-centered, coordinated care that utilizes health information technology and improves 

health outcomes in the most efficient manner possible. The existing partnerships 

among the VA, Tulane, and LSU will only be strengthened through this proposed 

new model. Hurricane Katrina was a tragedy for the New Orleans region and for 

our country. Together, we have the opportunity to create something positive, new, 

and innovative in the wake of this terrible disaster. 

The shared inpatient facility with a dispersed network of clinics organized to better serve our citizens is not a simple rebuilding of old systems but the creation of 

a new model that makes sense for those receiving care and responds with clinical 

and financial accountability to the taxpayers supporting this care. I urge you to recognize the opportunity to do something truly innovative for our citizens and support 

this endeavor. 

Thank you for the opportunity to testify today. 


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Prepared Statement of Alan M. Miller, Ph.D., M.D. 

Interim Senior Vice President for Health Sciences 

Tulane University, New Orleans, LA 

Mr. Chairman and Members of the Committee: Thank you for the opportunity to 

speak to you about the importance of fully restoring accessible healthcare and benefits services to our region’s veterans and about Tulane’s historic and present role 

in the provision of that care. Almost 23 months have passed since Hurricane 

Katrina devastated our city and our healthcare system. While we’ve seen enormous progress in some areas, in other areas progress has come at a distressingly slow 

pace. At this juncture, our primary focus should be the timely re-establishment of 

the highest quality care possible for the men and women who have served our country. 

The VA has been a valued Tulane partner for nearly 40 years and during that 

time our faculty, residents, and medical students have worked side by side with the 

VA in providing outpatient and inpatient care for the 23-parish region, the education of our future physician workforce, and cutting edge medical research. 

Today, I’d like to focus my comments on four key areas: 

1. Provision of care at the VA pre-Katrina; 

2. The VA’s and Tulane’s roles in re-establishing medical care post-Katrina; 

3. The importance of the VA in medical research; 

4. Looking ahead to the biosciences 

I. Tulane and the VA—Before the Storm 

Prior to Hurricane Katrina, Tulane University provided approximately 70 percent 

of the patient care at the VA, with more than 75 Tulane faculty physicians serving 

joint appointments with the VA in many medical, surgical, and psychiatric sub-specialties and advanced clinical services. These included geriatrics care, coronary intensive care and post-traumatic stress disorders. 

Well-educated and trained physicians are essential elements in assuring access to 

quality healthcare services not only in New Orleans but throughout our country. 

Tulane’s mission of healthcare, medical education and research is intimately intertwined with that of the VA, and each institution depends upon the other for success. 

Before August 2005, the VA Medical Center and Hospital in New Orleans provided training for approximately 140 residents, 120 of whom were from Tulane. 

The VA’s integration with the health sciences centers at Tulane and LSU provided 

a critical synergy that was a key strength both for the New Orleans VA and the 

region’s overall healthcare standing. It also provided a vibrant environment in 

which groundbreaking research took place. For example, Dr. Andrew V. Schally of 

the VA and the Tulane School of Medicine achieved international recognition as a 

Nobel Laureate for Medicine or Physiology for research that opened the door to new 

research in contraception, diabetes and mental retardation, as well as depression 

and other human mental disorders. 

In short, the VA, in tandem with the medical education programs at Tulane and 

LSU, had by August 2005 become a vital fixture in the healthcare landscape of New 

Orleans and the surrounding region, not only providing critical medical care but 

also playing a crucial role in graduate medical education and medical research. 

II. Re-establishing Medical Care, Post-Katrina 

The actions of a number of local, state and Federal agencies have been questioned 

in the aftermath of Katrina, but the VA is not among them. The VA’s swift response 

allowed the agency to successfully and safely evacuate hundreds of patients and employees as well as thousands of critical patient records. The presence of a significant 

number of Tulane faculty physicians, residents and staff was integral to the evacuation and crucial in re-establishing a presence in the community immediately following the storm. 

Today, the VA’s outpatient clinics have reopened and visits are up to 75% of the 

pre-storm numbers. In addition, through its partnership with Tulane, the VA is now 

providing much-needed inpatient care at Tulane Hospital and Clinic as it strives to 

keep up with the rapidly expanding population. Currently, the VA is supporting an 

average of 26 Tulane residents per month who are involved in outpatient care. If 

more VA beds were available, Tulane would increase the number of residents there 

to 70. 

Historically, Tulane Health Sciences Center faculty and staff have provided from 

70–80% of the healthcare services at the area’s VA locations. In addition to our residents, more than 40 Tulane physicians are currently providing services and training 

at various VA locations in the area, representing more than $2.2 million in physician compensation alone. In addition, numerous other Tulane faculty physicians are 


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frequently available for service at VA locations as needed. The Tulane’s Health 

Sciences Center is now actively recruiting new physicians to accommodate the increasing need in the area and has open searches for five faculty positions specifically 

to support the clinical mission at the VA. 

Tulane physicians at the VA represent numerous specialties and subspecialties, 

including cardiology, clinical immunology, endocrinology, family medicine, gastroenterology, general internal medicine, hematology/oncology, internal medicine, nephrology, neurosurgery, ophthalmology, orthopaedics, otolaryngology, psychiatry, 

pulmonology, radiation oncology, urology, and surgery. 

III. The VA, Medical Education and Research: Vital Partnerships 

The VA Medical Center relies heavily on Tulane faculty to conduct important 

basic, clinical and translational research studies. In the year prior to Katrina, $1.2 

million in VA-funded research projects were awarded, most of which were under the 

direction of Tulane faculty researchers. Tulane faculty had numerous clinical trials 

open at the VA prior to the storm in areas including cancer, diabetes and lung disease. Clinical research studies conducted at the VA Medical Center help ensure that 

our country’s veterans, and ultimately its citizens at large, reap the benefits of this 

nation’s substantial investment in cutting-edge treatments, technologies and pharmaceutical development. 

IV. Looking Ahead: A Synergy of Innovation, Education and Healthcare 

As we look down the road five, 10, 20 years and longer, it’s clear that the VA will 

be a cornerstone in the future of healthcare and the biosciences industry in the region. These industries already represent a significant share of New Orleans’ regional economy. More than 8,000 people are employed in the bioscience and health 

related fields, with the metro area ranking 67th in the country. Although New Orleans is still behind bioscience giants such as the San Francisco Bay area, Boston, 

and Research Triangle in North Carolina, the metro area currently outranks other 

up-and-coming centers including Nashville, Birmingham, Louisville and Greenville, 

South Carolina. 

Pre- and post-Katrina, the area’s bioscience institutions have been conducting cutting-edge research in areas such as gene therapy, cancer biology, peptide pharmaceutical design, and infectious diseases. Federal and private grant funding in New 

Orleans exceeded $180 million in 2003 and is growing substantially as New Orleans-based institutions capitalize upon their core strengths. In FY 2005, the New Orleans area accounted for $131.4 million in awards from the National Institutes of 

Health (NIH), representing 71% of the total amount awarded within the entire state 

of Louisiana and 82% of all NIH funding in the Gulf Coast region including New 

Orleans, the Mississippi and Alabama Gulf Coasts, and the Florida Panhandle. NIH 

investment in the area continues to grow. Tulane University itself accounted for 

46% of all NIH awards in the region from New Orleans through the Florida panhandle. 

Prior to Hurricane Katrina, the New Orleans Bioscience District was actively 

building a framework for entrepreneurial success. As a crucial component of that 

framework, the Louisiana State University Health Sciences Center (LSUHSC), 

Tulane University (TU) and the State of Louisiana formed both the Louisiana Gene 

Therapy Research Consortium and the Louisiana Cancer Research Consortium 

(LCRC). These partnerships are focused on leveraging the universities’ research and 

education strengths to position the region as a leading center for clinical, biomedical 

and translational research, and to increase the area’s competitiveness for large-scale 

research projects funded by the National Institutes of Health. In support of the region’s efforts to expand its bioscience and biomedical infrastructure, the State of 

Louisiana also provided support for the creation of a 60,000-square-foot New Orleans BioInnovation Center (NOBIC). This center is designed to support the area’s 

growing bioscience community, to attract additional biotechnology investment, and 

to foster the commercialization of new technologies and pharmaceuticals developed 

in the vibrant New Orleans Bioscience District. With additional funding provided 

this year by the state legislature, construction will begin this fall in the downtown 

bioscience district on an $86 million cancer research facility, and the $60 million 

BioInnovation Center. 

The synergy generated by Tulane, LSU, the construction of the BioInnovation 

Center and the LCRC building, each within a few city blocks of the other, will create a rich, dynamic teaching and research environment that will rival any in the 

country. A strong VA Medical Center is a crucial component of this burgeoning bioscience hub that will maximize the potential of both the district and of the VA. It 

is hard to imagine the district without the VA, and the VA being built anywhere 

but the district. 


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I want to thank each of you and your colleagues in Congress for demonstrating 

your strong commitment to re-establishing a permanent base of care for the region’s veterans in New Orleans by appropriating more than $600 million for a new stateof-the-art VA Medical Center. Although it may have taken longer than many of us 

would have hoped, the state too has done its part in providing funding for a public 

hospital to be built in tandem with the VA. This leverages the Federal Government 

investment, providing substantial cost savings and demonstrating good stewardship 

of taxpayer dollars. In addition, the investments by the state, city, and our own institutions in the emerging bioscience district provide a unique opportunity to create 

a vibrant inter-reliant collaboration among key healthcare, education and research 

entities, all of which are crucial to the VA’s mission. It is the hope of Tulane University, as well as that of the many local and regional stakeholders in the biosciences, 

that the VA and the City of New Orleans move quickly to begin the process of land 

acquisition, planning and construction so that we may re-establish the full spectrum 

of care for our rapidly growing veteran population. 

Once again, I thank you for allowing me to speak to Members of this Committee 

today. With your help, we will continue to bring healthcare in our city and region 

not just back to where it was, but into an even better future. 

f 

Prepared Statement of Henry J. Cook, III 

National Senior Vice Commander, Military Order of the Purple Heart 

Chairman Filner, Members of the Committee, ladies and gentlemen. 

I am Henry J. Cook, III, National Senior Vice Commander of the Military Order 

of the Purple Heart (MOPH). 

It is my honor to appear before this Committee which is of such great importance 

to all veterans. The MOPH is unique among veteran service organizations in that 

our members are all combat wounded veterans who shed their blood on the battlefields of the world while serving in uniform. For their sacrifices they were all awarded the Purple Heart Medal. 

I am accompanied today by MOPH members and state officers of our organization 

from both Louisiana and Mississippi. Also present are ladies of the Ladies Auxiliary 

of the MOPH. 

I would like to preface my remarks today with a statement of thanks to the Department of Veterans Affairs in both Louisiana and Mississippi for the way that 

they reacted and took care of veterans when Hurricanes Katrina and Rita struck. 

Almost all other government agencies at both state and federal levels were overwhelmed by the sheer magnitude and consequences of those storms. However, the 

Department of Veterans Affairs Medical Centers and Regional Offices in both Louisiana and 

Mississippi maintained their focus on care for the veterans during this trying and 

challenging time. The services to the veterans provided by them were without equal 

and in some cases heroic in the way that veterans were cared for and moved from 

harms way by caring employees of the Department of Veterans Affairs. I ask that 

you also commend the Department of Veterans Affairs for the way that they continue care for veterans in the aftermath of that catastrophic event. 

Your Committee and the Department of Veterans Affairs Medical Center in New 

Orleans are both very important to members of the MOPH and all veterans from 

both Louisiana and Mississippi who were served by the New Orleans facility. As we 

sit here today, your Committee is here but the hospital is gone. From our perspective, the Department of Veterans Affairs medical system in the New Orleans and 

on the Mississippi Gulf Coast is struggling to deliver, at best, badly fragmented 

services to veterans. 

The MOPH is now looking to your Committee to restore the New Orleans Veterans Affairs Medical Center and the badly needed services it provided to our members and all veterans in this area. This should be done as soon as possible so as 

to prevent further loss of services and provide full restoration of earned entitlements 

and benefits for all veterans in this geographic area. 

To better explain what I meant earlier by services to veterans being ‘‘fragmented’’

I submit to you some specifics. 

That while the Department of Veterans Affairs in New Orleans is in fact providing services for veterans many of the veterans have to go to other locations to 

receive that care. In my particular situation, I received, prior to Katrina, orthopedic 

services from the New Orleans facility. Since that facility is gone, it took me more 

than six months to even schedule an appointment for an orthopedic services but I 

discovered that I had to travel to Mobile, AL to receive such services. Fortunately 


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I am physically and financially able to travel to Mobile, AL and other locations but 

that is not true of many veterans. Further, the Department of Veterans Affairs, 

while having established ‘‘travel pay’’ for veterans who have to travel more than 28 

miles for care, pay the grand sum of eleven cents per mile. More painfully the veteran must pay a deductible when travel pay is given to him out of the first three 

trips of each month. This, when gas is over $3.00 per gallon. 

We in the MOPH have members who now have to travel to Mobile, AL, Jackson, 

MS, Pensacola, FL and other more far flung destinations in order to receive continuing care from the Department of Veterans Affairs medical system. The present 

system of healthcare for the veterans in this area is fragmented according to every 

definition of that word. Please return to the veterans here a world class medical facility that can serve our membership and all veterans at one location. And I might 

add, do this as soon as possible to mitigate the continuing deprivation or the earned 

benefits and entitlements due our veterans. 

There is one other problem area relative to the loss of the Department of Veterans 

Affairs Medical Center and Regional Office in New Orleans that I would like to 

bring to your attention. This involves the loss of the ability of veterans to pursue 

their claims and obtain those pesky earned benefits again. 

The Director of the State Veterans Affairs (Claim division) for the state of Mississippi informed me that many veterans who were having their claims processed 

in the New Orleans Regional Office soon discovered that their claims had been 

transferred to the Jackson, MS regional office. The Jackson Regional Office willingly 

accepted this responsibility of seeing the veterans from New Orleans and the Mississippi Gulf Coast. In many cases involving veterans from New Orleans and the 

Gulf Coast veterans could not be located for medical appointments and documentation needed for their claims. Many veterans, widows and their children went for 

months without appropriate attention to their claims thereby adding to the pre-existing backlog of claims pending. 

Once located however, the veterans, widows and their children they were faced 

with the problem of travel to Jackson, MS to continue the process of their claims. 

This again placed an added burden on the veterans and in some cases, their widows 

who found travel of three hours or more not only difficult but expensive. During 

most of the first year after Katrina there were many veterans who were truly homeless and living in shelters or temporary trailers far from Jackson. This condition 

still exists today with many veterans still living in FEMA trailers and pressed financially. 

The transferring of all claims from the New Orleans and Mississippi Gulf Coast 

area created a terrible burden on the Jackson Regional Office and even though the 

personnel of that office were overwhelmed they tried hard to continue to deliver 

services to our veterans. While I do not know the status of the back log as of this 

date as a result of the loss of the New Orleans Regional Office due to Katrina, I 

do know that I hear the comments of those veterans who claims questions remain 

unanswered. 

In summary, we all know that Katrina had a devastating effect on the Department of Veterans Affairs medical care system in this area. We should all know that 

what is most important now is a full restoration of all veterans’ medical services as 

soon as possible. 

Grandiose plans for what could be in the future are of no use to our members 

and veterans who have been deprived of earned benefits and care. The time is now, 

the need is now. 

Thank you very much for allowing me to appear before your committee on behalf 

of the MOPH. 

I am now ready to take any questions that you may have for me. 

f 

Prepared Statement of Chuck Trenchard, Adjutant 

Disabled American Veterans, Department of Louisiana 

Mr. Chairman and Members of the Committee, thank you for the opportunity you 

have afforded me to come speak to you today on behalf of the disabled American 

veterans. 

The loss of the VA medical center in New Orleans has had a profound impact on 

both the quality and availability of appropriate healthcare for thousands of Louisiana and Mississippi veterans as well as veterans from both Alabama and the 

Florida panhandle. It is essential that a new medical facility be constructed as soon 

as possible to ensure the well-being of these veterans. 


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The primary focus of this facility should be the care and treatment of America’s 

veterans. Any other economic and political considerations in regard to the location 

of this facility are secondary and should only be fulfilled as a by-product. This facility needs to be solely for the benefit of veterans and should be located in an easily 

accessible location, safe from hurricanes and flooding. It should be placed in a location that will benefit the greatest number of veterans. It should be a dedicated facility, not incorporated with any other programs. 

Whether we like it or not, this is a time of war and America’s military is putting 

their lives on the line to keep our country safe as they have for over 200 years. As 

an instrument of national power, the military is trained to do what they are told 

to do, when they are to do it, and how they are told to do it. Veterans are a unique 

group of people. 

They don’t have to ask what they can do for their country. They know what to 

do and do it well without regard to the risks. They have never kept their country 

waiting. 

Throughout the Spanish-American War, WWI, WWII, Korea, Vietnam, Panama, 

Kuwait, Afghanistan, and now Iraq veterans met the call to arms and successfully 

served to defend our Nation against all enemies. They have never kept America 

waiting. We owe it to our veterans to properly care for them now and not keep them 

waiting. 

As time goes by, the healthcare situation will get worse—not better and America’s 

veterans will wait and suffer. We need to put politics and bureaucracy aside and 

to do the right thing—take care of our veterans now! After all, haven’t they earned 

it? Thank you. 

f 

Prepared Statement of William M. ‘‘Bill’’ Detweiler 

Past National Commander, American Legion 

Mr. Chairman and Members of the Committee: 

The American Legion appreciates this opportunity to testify this morning before 

the Field Hearing of the House Veterans’ Affairs Committee on veterans healthcare 

in Southeastern Louisiana, and the need to rebuild the Veterans Affairs Medical 

Center (VAMC) New Orleans without further delay. 

Mr. Chairman, during my brief oral testimony this morning I will make several 

recommendations on behalf of The American Legion, for consideration of the Committee as you consider the actions necessary to restore veterans healthcare in this 

area to a level that is second to none. I would request that you allow the filing and 

acceptance of my written testimony with attachments for the record and for the 

later consideration of the Members of the Committee. 

Thank you Mr. Chairman. 

The American Legion has taken a strong stand on the rebuilding of the VAMC 

New Orleans in the downtown area of the city. During its recent State Convention, 

June 8–10, 2007 in Alexandria, La., The American Legion, the largest veterans service organization with over 29,000 members in Louisiana, unanimously adopted a 

resolution endorsing the rebuilding of the VAMC New Orleans in conjunction with 

the development of the bio-medical district in downtown New Orleans. 

Current Status of Veterans Medical Care 

Despite the heroic efforts of Mr. John Church, the Director of the VAMC New Orleans at the time of Hurricane Katrina and its aftermath, it was quickly determined 

following the flooding that the hospital was beyond repair and would have to be replaced. The American Legion extends its sincere thanks and appreciation to Mr. 

Church for his leadership in the successful evacuation of the patients in the face 

of the approaching storm, and his heroic efforts to protect the staff and people who 

were trapped by the flooding in the hospital after the storm. 

Within a short time after the storms, clinical services were restored to the upper 

floors of the Lindy Boggs Building where hundreds of patients are now provided 

with daily outpatient treatment and care. We are most grateful to the Department 

of Veterans Affairs for the re-establishment of these services and the opening of new 

outpatient clients in the Greater New Orleans Area. 

However, those veterans that require hospitalization can not be treated in the immediate area and must be sent to other facilities were beds can be found, including 

but not limited to, Shreveport and Alexandria, Louisiana, and Jackson, Mississippi, 

Unfortunately, The American Legion does not see an early end to this manner of 

care for these veterans. 

As an example if the veteran is diagnosed at the VAMC outpatient clinic with a 

psychological problem that requires hospitalization, the staff must process the vetVerDate Aug 31 2005 20:55 Jun 13, 2008 Jkt 037470 PO 00000 Frm 00077 Fmt 6604 Sfmt 6621 E:\HR\OC\37470.XXX 37470

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eran for transport; then transport the veteran to the hospital with the available bed; 

and process the veteran through the admittance to the hospital. Usually this process 

takes from 10 to 12 hours, from diagnosis to admittance in the receiving hospital. 

Such a long tedious process causes extreme stress to the veteran as well as to his 

or her family, further aggravating the veteran’s mental condition. We suggest, Mr. 

Chairman, that the PTSD problems and other brain injury conditions evidenced in 

our returning servicemen and women from the current conflict, will only increase, 

placing a greater burden on our already depleted system. A new VAMC New Orleans is urgently needed. 

But how do we solve these problems and restore the proper level of medical services to the veterans of the 23 parish (county) catchment area of the VAMC New Orleans? The American Legion suggests that you consider the following recommendations in your deliberations relative to veterans healthcare in this area. 

Association With Medical Schools 

The veterans of the 23 parishes (counties) of Louisiana that form the catchment 

area for VAMC New Orleans have enjoyed the benefits of the VAMC’s partnerships 

and associations with the LSU and Tulane Medical Schools since it was established. 

The VAMC New Orleans serves the medical community of this area as a teaching 

and research hospital, just as the other veterans hospitals do throughout the VA 

medical system. Our veterans like those in other parts of the United States benefit 

from these associations, because the hospitals in the VA system need the interns, 

residents and doctors from the schools to augment the VA hospital staffs. Each year 

Tulane and LSU Medical Schools rotate a hundred or more interns through the 

VAMC New Orleans, providing our veterans with the best of care, based on the latest discoveries in medical science. 

Currently we have a shortage of medical professionals in Southeast Louisiana and 

the Greater New Orleans Area. Many of our doctors, nurses and other medical professionals, who left the area after Hurricane Katrina, have not returned. The location of the VAMC New Orleans in the downtown area, in walking distance and close 

proximity to the Tulane and LSU Medical Schools, has allowed the staffs of the 

medical schools to easily move between the campuses of the Medical Schools and 

the VAMC, all for the betterment of our veteran patients. Thus, the Medical Schools 

provide the additional staff that is critical to the successful operation of the VAMC. 

In addition, the continued research, that is conducted by the medical schools, provides the patients at the VAMC with medical care that is second to none. 

We have just learned that yesterday, Sunday, July 8, 2007, Dr. Paul Harch, a 

physician specializing in Hyperbaric Medicine at LSU Medical School, journeyed to 

Washington at seek support with other doctors of similar specialties, from Congress 

for a pilot project that will treat traumatic brain injury. An appropriation request 

is before Congress to fund a scientific study to be overseen by the Samueli Institute 

in Washington, D.C., with Dr Harch serving as the physician in charge. Further, 

the proposal is for Charity Hospital New Orleans (LSU Teaching Hospital) to serve 

as the primary site in a multi-center study that will include VAMC New Orleans. 

Dr. John Mendoza, a VA Neuropsychologist and Dr. Tim Duncan of the VA staff, 

are working with Dr. Harch on this project. This is just one example of the close 

working relationship that has existed between the VAMC and the medical schools, 

a relationship that needs to continue. 

To build the new VAMC in an area that is not in the immediate proximity of the 

two medical schools would not be in the best interests of our veterans, nor the VA 

medical system. To do so would diminish the care that our veterans rightfully deserve and affect the ability of the VAMC to attract a qualified and efficient staff 

to properly operate the hospital. In short building of the VAMC anywhere, but in 

downtown New Orleans near our two medical schools, would not allow for the hospital to provide the level of care needed to properly treat our veterans. Our veterans 

would be the losers and that is unacceptable. 

Transportation 

The veterans that use the VAMC New Orleans are generally veterans who do not 

have medical or health insurance. Many are on fixed incomes and have no place else 

to seek medical care. The relocation of the VAMC in downtown New Orleans will 

provide a hospital that is convenient, by public as well as private transportation, 

allowing easy access by our veteran patients, the hospital staff and the hundreds 

of volunteers who help care for these men and women on a daily basis. 

A VAMC located in downtown New Orleans will allow the patients, staff and volunteers from throughout the 23 parish (county) catchment area to access the hospital by major roadways and interstates; local and regional bus service; and rail. 


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New Orleans Medical District Initiative 

The American Legion suggests that the U.S. Department of Veterans Affairs and 

the veterans who rely on the VAMC New Orleans for medical services, inpatient as 

well as outpatient services, will benefit from the location of the VAMC within the 

area of the New Orleans Medical District. This district was established prior to the 

storms and has now been reconstituted to include a cooperative effort on the part 

of major medical institutions and agencies in the area. Our veterans and the community would benefit from the building of a joint facility with an LSU teaching hospital, with join common facilities, such as laundry, labs, and so forth., with separate 

towers for medical treatment. The American Legion endorses such a joint facility, 

with the proviso that the veterans will be treated in a separate hospital building 

and not mingled with other patients. 

We suggest that the State of Louisiana is on the right course at this time, having 

provided the funds to purchase the property, the planning and the design of the 

LSU hospital in the recent legislative session. We urge this Committee to push forward with the location and building of the VAMC without further delay. 

We believe, as expressed in a copy of the article ‘‘A Marriage Made in Hell,’’ which 

appeared in the November 2006 issue of The American Legion Magazine that we 

have an opportunity to rebuild the VAMC and do it right. We believe that our veterans will benefit, if the VA commits to the vision of Ms. Julie Catellier, the current 

Director of the VAMC New Orleans, as she expressed in referenced article, to wit: 

‘‘It’s the VA’s desire to be the engine that drives healthcare in the city of New Orleans and the metropolitan area. We want to be leaders. We want to provide a futuristic, high-tech, high-touch institution for veterans, in collaboration with our affiliated 

partners.’’ (Page 58) A copy of the article is attached and made a part of this testimony. 

The American Legion believes in Ms. Catellier’s vision. 

Having the VAMC downtown would also allow for a close relationship with the 

planned and funded cancer center and ‘‘wet lab’’ facilities which benefit our veterans 

with the latest methods of cancer treatment and gene therapy. 

Community Support for the Downtown Location of the VAMC 

The American Legion is pleased to have community wide support for the relocation of the VAMC in downtown New Orleans, including but not limited to the City 

of New Orleans, the State of Louisiana, the New Orleans City Council, the Downtown Development District of New Orleans, the Regional Planning Commission (Jefferson, Orleans, Plaquemines, St. Bernard, and St. Tammany Parishes), U.S. Senator Mary Landrieu and other Members of the Louisiana Congressional Delegation. 

Copies of available resolutions and letters of support are attached hereto and made 

a part hereof. 

Summary 

The American Legion urges the Committee to move forward and allow the VAMC 

New Orleans to be rebuilt for the benefit of our veterans without further delay in 

downtown New Orleans. It is a win-win situation for our veterans and the U.S. Department of Veterans Affairs. As Congressman Charlie Melancon (D–La) said in a 

hearing before this Committee in May 2006, in commenting on the rebuilding of the 

VAMC New Orleans, ‘‘From an efficiency standpoint, it makes sense,—from a fiscal 

standpoint, it makes sense. And from a moral standpoint—after everything these 

Gulf Coast veterans have endured with these storms—it makes sense. This is a historic partnership for historic times.’’

Mr. Chairman I again extend the sincere appreciation of The American Legion for 

the opportunity to testify and submit our written testimony. I would also request 

that we be allowed to amend this testimony, if permitted and in a reasonable time 

to be set by you, Sir, if we receive any additional information, that we believe might 

be helpful in your deliberations. We look forward to continuing to work with you 

and your committee for the welfare of our Nation’s veterans. 

Thank you! 

f 


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THE AMERICAN LEGION 

Louisiana Department Headquarters 

89th ANNUAL LOUISIANA DEPARTMENT CONVENTION 

Alexandria, Louisiana 

JUNE 8, 9, 10, 2007 

RESOLUTION IN SUPPORT OF THE BUILDING OF THE NEW ORLEANS 

VA MEDICAL CENTER IN DOWNTOWN NEW ORLEANS 

WHEREAS the U.S. Department of Veterans Affairs Medical Center at New Orleans, Louisiana, herein after referred to as ‘‘VAMC’’, has been located in the downtown area of the City of New Orleans at 1601 Perdido Street since its establishment; and, 

WHEREAS the VAMC has served as a teaching hospital with the Medical Schools 

of Tulane University, herein after referred to as ‘‘Tulane’’, and Louisiana State University, herein after referred to as ‘‘LSU’’, since its establishment; and, 

WHEREAS, as a result of the location of the VAMC in the downtown area of the 

City of New Orleans in close proximity and walking distance with the Tulane Hospital and Medical School and the LSU Medical School and Center, the veterans of 

the Greater New Orleans Area and Southeast Louisiana have been the beneficiaries 

of the close working and teaching relationship between the VAMC and the said 

Tulane Hospital and Medical School and the LSU Medical School and Center; and, 

WHEREAS, the VAMC and the LSU Medical School and Center that operated out 

of the Louisiana Medical Center at New Orleans, commonly known as ‘‘Big Charity’’, were severely damaged in Hurricane Katrina and Rita in the late summer and fall 

of 2005; and, 

WHEREAS, the VAMC and the Louisiana Medical Center at New Orleans have 

been deemed to be damaged to the extent that neither is fit to be reopened as a 

hospital, requiring that new facilities be built through appropriations from the 

United States and the State of Louisiana; and, 

WHEREAS, the U.S. Congress has appropriated and authorized an expenditure 

for the building of a new VAMC facility in union with a separate facility for the 

replacement of the Medical Center of Louisiana at New Orleans, all in proximity 

to the Tulane Hospital and Medical Center, which new VAMC. facility would restore 

the medical treatment benefits that were available to the veterans of the Greater 

New Orleans Area and Southeast Louisiana and restore the ability of all three facilities to continue their joint medical research and teaching, which further benefits 

the veterans of the area; and, 

WHEREAS, despite the continued promises by the Secretary of the Department 

of Veterans Affairs and his Staff, as well as promises by Members of Congress and 

Governor Kathleen B. Blanco and members of her Administration to the veterans 

community and the people of Southeast Louisiana, rumors continue to persist that 

despite these promises the real intent and desire of the U.S. Department of Veterans, some Members of Congress and the Blanco Administration, is to move the 

VAMC out of the downtown area of the City of New Orleans, which will threaten 

or terminate its relationship with Tulane and LSU causing a shortage of healthcare 

professionals working in the VAMC., all to the determent of the veterans community; and, 

WHEREAS, neither the U.S. Department of Veterans Affairs nor the State of Louisiana appears to be taking the necessary steps to move this joint project to fruition, 

all to the determent of the veterans, who need the restoration of the VAMC to provide the same services and benefits which they were receiving prior to Hurricanes 

Katrina and Rita, benefits and services that they earned in service to this Nation, 

when the freedoms, which we continue to enjoy, were treated. 

NOW THEREFORE BE IT RESOLVED by the Louisiana Department of The 

American Legion, in Convention assembled, June 8–10, 2007 at Alexandria, Louisiana, that the members of The American Legion do urge the Secretary of the Department of Veterans Affairs and the Governor of the State of Louisiana to proceed 

without further delay to take the necessary steps to build the joint VAMC facility 

and Medical Center of Louisiana at New Orleans in the downtown area of New Orleans in close proximity to the Tulane Medical Center and the Louisiana State University Medical Center. That such will restore the proper healthcare and benefits 

that the veterans of the Greater New Orleans Area and Southeast Louisiana are 

entitled to and enjoyed before the impact of Hurricanes Katrina and Rita. 

BE IT FURTHER RESOLVED that copies of this resolution be sent to the Secretary of the U.S. Department of Veterans Affairs, the Governor of Louisiana, Members of the Louisiana Congressional Delegation, the Joint Congressional Committee 

on Veterans’ Affairs, the Department of Veterans Affairs for the State of Louisiana, 


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the Chancellors of the Tulane Medical School and the LSU Medical School, and the 

news media outlets in the State of Louisiana. 

FORREST A. TRAVIRCA, III Commander 

ATTEST: 

DAVID SIMON, Adjutant 

FOR CONVENTION USE ONLY 

APPROVED 

REFERRED TO CONVENTION COMMITTEE ON: RESOLUTIONS 

PASSED UNANIMOUSLY: June 10, 2007. 

f 

A Marriage Made in Hell 

Out of the hell that was Hurricane Katrina may come one of 

VA’s most historic partnerships. 

The American Legion Magazine 

November 2006 

by Jeff Stoffer, Managing Editor 

This is the fifth in a series on the status of VA’s Capital Asset Realignment for Enhanced Services process. CARES looked 20 years into the future of the Nation’s largest managed-care program and envisioned greater access, lower costs and increased 

efficiency. Two years later, that vision awaits final decisions and Federal funding 

necessary to fulfill the program’s many promises across the Nation. 

Sixty-eight-year-old Charity Hospital in downtown New Orleans, a public-health 

institution that has treated poor and under-insured patients for generations, was 

transformed into a powerless hulking shell in September 2005. Hurricane Katrina 

howled through its 21 stories. A noxious bisque of oily floodwaters lapped at its 

flanks for more than three weeks, leaving a ring still visible a year later. The lower 

level was swamped, destroying the electrical and mechanical systems. Mold and bacteria took over. In the days that followed Katrina’s summary condemnation of Charity Hospital and almost everything near it, patients were evacuated to a U.S. Navy 

ship, then to Air Force tents on the surface of a parking lot, before outpatient and 

emergency services finally landed in a vacated Lord & Taylor department store. Inpatient care, like much of the city’s population, was scattered everywhere—to other 

hospitals, other cities, even other states. 

By the hurricane’s first anniversary in late August, vast residential swaths of 

New Orleans remained a tangle of uprooted trees, high weeds, broken glass and collapsed houses, some of which displayed spray-painted messages damning insurance 

policies that didn’t cover flooding. 

The Louisiana State University-run Charity Hospital, however, found itself in a 

position of great hope a year after the hurricane. A unique partnership to build a 

brand new medical complex jointly with the Department of Veterans Affairs, which 

also lost its downtown hospital to Katrina, was coming together fast, a proverbial 

silver lining following one of America’s most terrible storms. 

‘‘This is our opportunity to do it right, from the ground up,’’ said Dr. Cathi 

Fontenot, medical director for LSU’s Medical Center of Louisiana at New Orleans, 

the umbrella over Charity Hospital. ‘‘We are talking about a new and improved 

version. This new replacement facility is not only absolutely necessary to continue 

to provide patient-care services that we all have been accustomed to. It’s also necessary to support the academic institutions. This collaborative effort will speak to 

both. Doing it smarter, better and more efficiently than we have in the past is, I 

think, everyone’s goal.’’

By last summer, LSU’s medical school and VA—longtime collaborators in the delivery of veterans healthcare in New Orleans—were well along in their plans to pool 

their money, buy land and build a modern new facility together. Such a partnership 

is unprecedented in the history of VA, which for decades has benefited from medical-school affiliations that have fed tens of thousands of visiting research doctors, 

residents, interns, nurses and other caregivers into veterans health-care facilities 

across the country. The New Orleans VA system has a particularly robust medschool affiliation program; LSU, Tulane University and other institutions allocate 

more than 500 care providers a year to the VA system. ‘‘We are very fortunate to 


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have both medical schools here,’’ says William Detweiler of New Orleans, a past national commander of The American Legion. ‘‘There are other states where they don’t 

have a medical school associated with its VA hospital. Here we have two—and we 

always have—plus a nursing school.’’

Last summer, LSU and VA targeted a 37-acre property where flood-ruined apartments could be razed, just a few blocks north of the old hospitals. Planners envisioned bed towers that would segregate VA patients from others in a facility connected by common services and a linking corridor. The cost-saving benefits—estimated at $400 million for VA over 30 years—would come from sharing agreements 

on such needs as power, parking, laundry, food, maintenance, and big-ticket medical 

equipment and operation. 

The New Orleans VA–LSU feasibility study followed the ‘‘Charleston Model,’’ patterned after negotiations between the Medical University of South Carolina and the 

Ralph H. Johnson VA Medical Center, which are working toward a joint facility in 

downtown Charleston, S.C. Ironically, it may not be Charleston but New Orleans—

where urgent need and availability of emergency funds have sped the process 

along—that uses the Charleston Model to cut the ribbon on America’s first combined 

VA-med school facility. 

Equally significant is that New Orleans could have the first new VA medical center built in nearly 20 years anywhere in the United States, at a time when veterans 

in Las Vegas, Denver and Orlando, Fla., have been fighting with Washington for 

budget commitments on long-overdue VA hospitals for years. Las Vegas, Denver and 

Orlando were identified as the three highest priorities for new VA medical centers 

when the landmark Capital Asset Realignment for Enhanced Services decision was 

released in 2004. So far, only one of those projects, Las Vegas, has received anything 

more than design and site-selection funding. And the half-funded Las Vegas VA 

Medical Center was passed over in the 2007 budget. New Orleans was not identified 

by CARES, although the hospital’s age and design make it a poster child for what 

former VA Secretary Anthony Principi called in his CARES decision ‘‘legacy infrastructure’’ where VA facilities nationwide exceed 50 years in average age and have 

grown ‘‘out of step with changes in the practice of medicine.’’

The Federal share of the New Orleans project—about $675 million—is already appropriated. 

The New Orleans study group followed the Charleston Model to plow through details like running a hospital on state and Federal budgets, legal and staffing issues, 

and keeping VA’s identity separate in a facility shared with non-veterans. One key 

benefit of a joint facility is the opportunity to fast-forward both the 1950-built VA 

medical center and the 1939-built Charity Hospital out of their high-rise, inpatientcentered buildings and catch them up with the outpatient care revolution. Both the 

New Orleans VA and Charity Hospital were built at a time when going to the hospital typically meant long, multi-night stays in cavernous wings of many rooms. 

Katrina, for all the harm it caused, gave both facilities a chance to start over in 

a building that more closely matches the stop-and-go way in which 21st-century 

healthcare is delivered, divided almost evenly between inpatient and outpatient 

services. 

‘‘Both our institutions would benefit from savings and efficiencies by working together,’’ VA Secretary Jim Nicholson said after the feasibility study was released. 

‘‘Most importantly, Louisiana veterans would receive world-class medical care in a 

modern, conveniently located site.’’

And so, Fontenot’s face grows stern when discussing testimony delivered by one 

Member of Congress in a House Veterans’ Affairs Committee hearing last spring. 

U.S. Rep. Richard Baker, R–La., cautioned lawmakers that while an LSU–VA partnership ‘‘presents itself as an exciting opportunity,’’ LSU may have more to gain 

from the project than does VA. Baker quoted from a study that described the LSUrun Charity system as ‘‘detrimental to the health of all Louisianans and is likely 

an important reason for the lower system quality, both in the public and private 

sector.’’ He added that a joint LSU–VA venture ‘‘would be like entering into a threeway partnership in a real-estate development, and the third partner is bankrupt.’’

He called on VA to closely examine Charity and seek reforms to ensure an equal 

partnership. 

To that, Fontenot simply says, ‘‘I would invite Mr. Baker to debate this at any 

time. It is a false statement. There are people who equate that Louisiana is 49th 

or 50th in health-care outcomes with the fact that Louisiana has a very unique 

Charity system that is supported and funded by the state. There are people who 

say one equals the other. In fact, our disease-management programs are way ahead 

of most people in the country: diabetes, asthma, heart failure, breast—and cervicalcancer screenings. Bring up all those measures, and we fare extremely well.’’


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In the months following Hurricane Katrina, however, Charity was barely faring 

at all as an inpatient hospital. Like all other hurricane-hammered health-care facilities in the city, it was thrown into survival mode. ‘‘Pretty much all the institutions 

were wiped out,’’ Fontenot said. Tulane University’s hospital, the other major player 

in the downtown medical market, was first to stir back to life. LSU and VA opened 

clinics at various locations around the city but still lacked independent inpatient 

care a year after the storm. Charity’s sister facility, LSU’s University Hospital, was 

nearly finished with a 200-bed renovation and was set to reopen late last summer, 

a temporary fix to help pick up a Charity Hospital patient load that before Katrina 

accounted for some 270,000 clinical and 130,000 emergency-room visits a year. 

Demonstrators stood outside Charity in the months after Katrina and demanded 

the popular public hospital be reopened immediately. Some, including a former 

Charity emergency-room doctor, claimed damage reports were overblown and that 

with some work and political will, the facility could resume services sooner rather 

than later. A jointly built LSU–VA hospital would not be ready for patients until 

late 2011. That’s a long time to wait for patients who, Detweiler points out, ‘‘have 

grown up in this town and have never gone to another facility besides Charity, for 

anything.’’ Pre-Katrina, Charity was known locally ‘‘as the true safety net of the safety net,’’ Fontenot said. ‘‘There were certain services available at Charity in New Orleans 

that were not available for poor people anywhere else in the state. Our drawing 

area was not only regional, but it was statewide.’’ Much of the pressure at Charity came in the form of unscheduled visits. ‘‘Historically, much of our patient population has just shown up in the emergency room, 

whether it was for a sore throat or an acute (myocardial infarction),’’ Fontenot explained, adding that a stronger outpatient presence—much like VA’s communitybased clinic system—would help solve that problem. ‘‘If you begin to decentralize 

and deliver more primary care in the communities, then you don’t have to treat the 

acute stroke because you have already been treating the hypertension for years. You 

don’t have to treat the diabetic renal failure because you have already addressed 

the diabetes in clinics. We know how to deliver that care. The real challenge is getting the patients to buy into it, rather than depending on, ‘Oh, I don’t have to keep 

that doctor’s appointment. If I get sick, I’ll just go to the emergency department.’ ’’ Meanwhile, Katrina forced the 55-year-old New Orleans VA medical center to 

squeeze most of its clinical services onto two floors of former nursing-home space 

above a parking garage; everything else was destroyed. ‘‘The predictions were that 

patients would not come back,’’ said Julie Catellier, deputy director for disaster recovery in the Southeast Louisiana VA Healthcare System. ‘‘Actually, about 75 percent of our pre-Katrina veterans have returned, and more than 50 a day are enrolling with us. VA patients don’t want to get their care anywhere else.’’ ‘‘It’s amazing to me that VA has come back as much as it has with as much work 

as they needed to do,’’ said James Uzarski, a Vietnam War Army veteran who has 

come back. He noticed the makeshift clinic above the parking garage was getting 

crowded with patients last summer and said VA can’t delay plans to restore full hospital services. ‘‘They need to do whatever is quickest.’’

Sen. Mary Landrieu, D–La., a Member of the VA Military Construction Appropriations Subcommittee, announced in late July that construction of a new VA medical center in New Orleans was authorized, to be funded from the $19.8 billion 4th 

Hurricane Supplemental Appropriations Bill, passed a month earlier. Landrieu’s announcement did not mention the LSU partnership. It focused more on the urgency 

of restoring VA services. ‘‘Now the veteran population is returning to pre-hurricane 

levels, and it is imperative that we have a facility that can accommodate the men 

and women who have fought so hard for Louisiana and the country.’’ A new VA hospital could be expected to serve more than 39,000 veterans and provide more than 

1,700 jobs, she added. 

Pre-Katrina construction estimates for a new Charity Hospital topped $800 million. Some calculate the cost of a new combined Charity-VA complex at more than 

$1.2 billion. 

Construction is authorized, Federal funding has been appropriated, and confidence is high that a new hospital is one good thing that could come from the horror of Hurricane Katrina. The disaster also provided a lesson. ‘‘One of the big issues 

we faced was how we would build this to sustain another hurricane, if that happens 

in the future,’’ Catellier said. ‘‘We went into it with the assumption that in the event 

of another major hurricane, we would build this one so we could just stay in it. We 

would have enough water, food, waste disposal, fuel—all those things—for eight 

days. We would become a refuge for the city and its patients. We would have a 

helipad, and we are looking at a boat ramp to get things in and out. It would all 

be a minimum of 15 feet above sea level. 


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‘‘It’s the VA’s desire to be the engine that drives healthcare in the city of New 

Orleans and the metropolitan area. We want to be leaders. We want to provide a 

futuristic, high-tech, high-touch institution for veterans, in collaboration with our affiliated partners.’’

In the hearing last May before the House Veterans’ Affairs Committee, the question was not how to build a new VA medical center in New Orleans, but if it should 

be done there at all. ‘‘From an efficiency standpoint, it makes sense,’’ Rep. Charlie 

Melancon, D–La., told his fellow lawmakers. ‘‘From a fiscal standpoint, it makes 

sense. And from a moral standpoint—after everything these Gulf Coast veterans 

have endured with these storms—it makes sense. This is a historic partnership for 

historic times.’’

VA Shines In Time of Crisis 

Amid all the breakdowns between the government and the people of New Orleans 

during and after Hurricane Katrina, the Department of Veterans Affairs distinguished itself locally and nationally as a leader through the crisis. From the successful evacuation of patients to the deployment of medical staff to assist other hospitals 

in the city, VA showed more agility and ability than one might expect from a Federal bureaucracy. 

‘‘Leadership, planning and professional training came to the fore in the face of almost overwhelming adversity,’’ reported Michael Suter of New York, a member of 

The American Legion’s System Worth Saving Task Force, which inspected the 

Southeastern Louisiana VA Healthcare System in New Orleans last February. 

‘‘Key to the situation, and where other institutions fell down, was communications,’’ Suter reported, noting that VA’s police communications system and quick response by Central Office in Washington were critical to the New Orleans medical 

center’s performance in the disaster. ‘‘Transportation was the other critical factor. 

Finding any way out once the waters had risen was a challenge, particularly given 

the scarcity of rolling stock (most of the city buses were inundated). But in a 

masterstroke worked out somehow between the facility’s director and Washington, 

military vehicles were provided through the National Guard and were able to rescue 

all patients and staff.’’

VA successfully evacuated all 241 patients in the medical center during the flood, 

plus 272 employees and 342 family members. The Michigan Air National Guard 

sent two C–130s and 15 members of its 171st Airlift Squadron to evacuate the majority of patients to Houston. 

Within a week of the disaster, VA also had all of its area community-based outpatient facilities and five mobile clinics up and running. 

Last July, about 150 VA health-care workers were filling in at community hospitals around the city, helping cover a shortage of personnel at non-VA facilities, 

including nurses, radiology technicians, respiratory therapists and others. 

f 

Prepared Statement of Bill Penn, M.D. 

Baton Rouge, Louisiana (Independent Veteran) 

Chairman Filner and Members of the Committee, thank you very much for allowing me—an independent veteran—the opportunity to present my views to you on rebuilding our Veterans Hospital. This is an issue that is a personal one for me, and 

as a veteran, has caused me great concern. 

Let me also thank you for holding this hearing. As Members of the Veterans’

Committee, you have an opportunity to assist the veterans in Louisiana in bringing 

more awareness to the problems we have faced since Hurricane Katrina. It is my 

hope that today’s hearing will highlight the opportunities we have to move forward 

and help bring the dream of a new veterans’ hospital to reality. 

As I mentioned earlier, I come to the Committee today as an independent veteran. 

I do not represent a particular organization, though I am a member of many. What 

I wish to convey to you is my assessment of the situation in which we find ourselves 

and the opportunities we have now for moving forward with the VA Hospital. 

Hurricane Katrina devastated veterans’ healthcare in South Louisiana. I commend the VA for opening additional outpatient clinics. However, it is necessary that 

this hospital re-open as soon as possible. 

It is my understanding that Congress has already appropriated over $600 million 

to rebuild the VA Hospital, but the VA has yet to make firm plans for rebuilding 

this facility. I ask the Committee and audience Members to consider today: Why? 

Why, when our veterans need this hospital now, more than ever, as our veterans’

population is aging, and as more men and women are returning from Iraq and AfVerDate Aug 31 2005 20:55 Jun 13, 2008 Jkt 037470 PO 00000 Frm 00084 Fmt 6604 Sfmt 6621 E:\HR\OC\37470.XXX 37470

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ghanistan, why does the VA continue to wait to build this hospital? Our veterans 

have sacrificed too much and have given so much for this country for the government to ask us to wait any longer. 

I commend the doctors, nurses, and other staff for operating under the worst of 

circumstances. Their efforts and accomplishments in preparing for Hurricane 

Katrina and their actions in its wake were heroic and are to be commended. I only 

ask that those in decision making capacities make decisions and make them swiftly. 

Veterans, since Katrina, have been asked to travel hours for some of their healthcare needs. For example, veterans needing prosthesis for limb loss are on a waiting 

list or are transferred to another facility in other states: 4 hrs. to Shreveport, LA., 

2 hrs. to Alexandria, LA., 6 hrs. to Houston, TX., 4 hrs. to Jackson, MS., 8 hrs. to 

Dallas, TX. 

This VA Hospital must also focus on the needs of veterans with Post Traumatic 

Stress Disorder. As a personal example, I went for testing and examinations by a 

Psychologist to try to help my PTSD, which I have experienced nightly for 54 years. 

The treatment for PTSD requires a seven week stay in Little Rock, Arkansas for 

a program with which I am just becoming familiar. 

I give those examples just to illustrate what one goes through and why we need 

a VA Hospital for South Louisiana as soon as possible, with beds for Psychiatric use, 

and ample space for veterans, including parking and seating in waiting rooms. 

In my estimation, it is unacceptable for the VA to ask our veterans to wait any 

longer than they have already for this care to be restored in South Louisiana. 

I do not claim to have solutions on where this hospital should be or how big it 

should be. I only request that the healthcare needs of the veterans drive these decisions. We have an opportunity to show our veterans and our men and women currently serving in uniform that we, as a country, are putting their interests first, and 

not the interests of other groups. I urge Secretary Nicholson and the VA to work 

quickly to restore this very important facility, with the healthcare needs of our veterans as the focus. Our veterans deserve no less. When the time came, we served 

our Country. Please, now, respect us in our needs today. 

Thank you again for allowing me this opportunity. I will be happy to answer any 

questions. 

f 

Prepared Statement of Rica Lewis-Payton, FACHE, Deputy Director 

Veterans Integrated Service Network 16, Veterans Health Administration 

U.S. Department of Veterans Affairs 

Mr. Chairman, Members of the Committee, and members of the Louisiana delegation, thank you for the continued support the Congress has given the Department 

of Veterans Affairs (VA) in our rebuilding and recovery efforts not only in southeastern Louisiana but also the entire Gulf Coast region. Thanks to your support, 

veterans and VA employees living along the Gulf Coast continue to make great 

strides along the road to recovery from the devastation caused by Hurricane Katrina. 

Hurricane Katrina was one of the greatest natural disasters our Nation has ever 

faced. Our medical centers, the communities we serve, and the homes of veterans 

and employees sustained destruction on a monumental scale. Today, I will describe 

our ongoing healthcare restoration efforts in New Orleans, and the current status 

of plans to rebuild our VA medical center. 

The Southeast Louisiana Veterans Healthcare System (SLVHCS) has made significant progress in the last year in meeting the healthcare needs of veterans in the 

greater New Orleans area. With the support of Congress, VA accelerated the activation of Community Based Outpatient Clinics (CBOCs) in the areas proposed under 

the Capital Asset Realignment for Enhanced Services (CARES) program. New 

CBOCs are now open in Slidell, Hammond, and St. John’s Parish, Louisiana. 

Currently, SE Louisiana is served by six permanent CBOCs. Primary Care and 

general mental health services are offered at each of these locations. Specialized 

mental health programs (including PTSD and substance abuse treatment) are currently provided and we are acquiring additional space to significantly expand these 

services. Inpatient mental healthcare is coordinated with the Alexandria and 

Shreveport VA Medical Centers. 

Plans are progressing to lease space for additional specialty care and ambulatory 

procedures. Patients requiring highly complex care are referred to other VISN 16 

facilities or care is obtained within the community. Pathology and laboratory services have been enhanced in the past year. They are centralized at the Baton Rouge 

CBOC, Foster Avenue Division. Outpatient pharmacy services currently exist at all 

our CBOCs and a $31⁄2 million project to establish a new and enhanced pharmacy 

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nostic Imaging Center will open on the New Orleans campus in September 2007, 

providing the full range of general radiology, CT and MRI capability. Dental services are provided at the Baton Rouge clinic and were expanded in April 2006 by 

leasing space in Mandeville, Louisiana. Currently there are no patients on the wait 

list for dental care. 

In keeping with the national initiative to provide patient care in the least restrictive environment, SE Louisiana has tripled the size of its Community and HomeBased care programs. This includes Home Based Primary Care (HBPC), telemedicine, contract community nursing homes and a unique ‘‘Hospital in the Home’’ program whereby teams of clinicians visit the patient in the home in order to shorten 

hospital stays or, if possible, avoid the need for hospital admission altogether. This 

is just one example of how VA is reinventing care to meet the specialized needs of 

veterans post-Katrina. 

In June 2007, VA entered into an agreement with its affiliate, the Tulane University Hospital and Clinic to allow VA physicians to admit and manage the care of 

veteran patients in the Tulane hospital. Veterans have responded very favorably to 

this ‘‘virtual VA inpatient’’ program because it allows them to remain near their 

families and support systems while being treated by their own familiar team of VA 

physicians and social workers. To the best of our knowledge, this has not been done 

elsewhere in the country. 

VA is using adaptability and flexibility to meet the needs of veterans during the 

recovery period from Hurricane Katrina. Patients are grateful for the response by 

their government and are seeking care within the SLVHCS in record numbers. 

SLVHCS has served almost 30,000 unique veterans through May 2007. On average, 

1,000 outpatients are seen in the CBOCs per day. It is projected that by year end, 

more than 35,000 unique veterans will have been treated. This is nearly 90 percent 

of the pre-Katrina level. 

There are currently 76 physician residents compared to 120 before Hurricane 

Katrina. In order to maintain the stability of the residency training programs and 

meet our obligation to educate America’s physicians, VISN 16 is working with its 

academic affiliates, The Tulane University School of Medicine and the Louisiana 

State University School of Medicine, to place VA faculty, medical staff and residents, and student trainees at VAMCs throughout the VISN 16 Network until such 

time as full and robust clinical programs return to the SLVHCS. 

VA continues to work as expeditiously as possible to initiate construction on our 

replacement medical center and has always been committed to building a new medical center in the Greater New Orleans area. VA has initiated its space planning 

process in preparation for construction. The analyses of architecture and engineering (A/E) firms to design the new facility are complete, and an announcement of the 

A/E selection will take place soon. The replacement medical center is expected to 

provide acute medical, surgical, mental health and tertiary care services, as well as 

long-term care. 

VA and LSU have signed a Memorandum of Understanding (MOU) agreeing to 

jointly study state-of-the-art healthcare delivery options in New Orleans. VA is 

pleased to learn of the State of Louisiana’s commitment of state funds for this 

project. This collaborative venture has the potential to improve operating efficiencies 

for both institutions and, if designed properly, to contribute to reforms of the region’s healthcare system. The Collaborative Opportunities Planning Group’s (COPG) 

final report is to be presented by September 30, 2007. VA will make a decision regarding the extent of its future collaboration with LSU after that report is completed. 

While VA remains committed to exploring this partnership with LSU, delays have 

arisen. To ensure these delays did not impact VA’s ability to reconstruct the VA 

Medical Center in a timely manner, VA initiated a search to identify alternative 

building locations. This search resulted in two responsive offers. An initial market 

survey of the two sites has been conducted, and further analyses are planned. VA 

looks forward to completing this process and will make a decision on this site in 

the near future. 

Conclusion 

Mr. Chairman, the Committee and the Louisiana delegation are partners with VA 

in seeing that southeast Louisiana veterans continue to receive the high quality 

healthcare they deserve and have come to expect. 

The construction of our new medical center will be an important part of our commitment to uncompromised excellence in healthcare services for veterans in New 

Orleans. 

Thank you for the opportunity to be here today. I will be pleased to answer any 

questions you may have. 


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Prepared Statement of Patrick J. Quinlan, M.D., Chief Executive Officer 

Ochsner Health System, New Orleans, Louisiana 

Mr. Chairman, Members of the Committee, thank you for this opportunity to appear before the Committee to update you on Ochsner Health System’s commitment 

to healthcare for our Veterans. Your personal presence and concern are certainly appreciated by our citizens and our veterans. 

Ochsner Health System is an independent non-profit organization made up of 

seven hospitals and thirty-two clinics employing over 9,000 people. Ochsner is one 

of the largest private employers in Louisiana. Ochsner Medical Center, located in 

Jefferson Parish, was one of only three hospitals to keep its doors open, despite the 

ongoing interruption of its business, during and after Katrina to care for all patients. 

Currently, Ochsner employs over 600 physicians and more than 120 licensed midlevel health providers and is one of the largest, private, non-university based academic institutions in the country with over 350 residents and fellows, proven research including bench research, translational research and over 700 clinical trials. 

In addition, we provide training for approximately 400 allied health students and 

over 700 medical students from LSU and Tulane with little funding to support this 

mission. The importance of Ochsner’s graduate medical education program has increased greatly since Katrina because we are the only fully functional academic center in the greater New Orleans area. 

As a Veteran myself and with a number of our employees as veterans, we are 

gravely concerned about the future of VA Healthcare in South Louisiana. Our veterans have waited far too long for the services of a new VA facility and it is time 

to make our veterans the number one priority in the decisionmaking process, followed by the potential cost of such a project to the taxpayers of this country. 

When the Department of Veterans Affairs issued a request for proposal for the 

location of a new medical facility, Ochsner Health System was pleased to submit 

a proposal to offer an alternative site to help keep the VA Medical Center in South 

Louisiana to better serve the healthcare needs of our Veterans. 

As a part of our proposal, we commissioned an independent research study of 600 

Veterans including 300 current and former VA patients and 300 potential VA patients living in eighteen parishes in South Louisiana to determine the optimal location for a new VA facility. Overwhelmingly, 76% of veterans indicated they prefer 

a suburban Jefferson Parish location to one in downtown New Orleans. 

We believe the Ochsner proposal offers a number of advantages that meet or exceed all the requirements of the Department of Veteran’s Affairs criteria. The 28 

acre site is owned free and clear by Ochsner in a great central location with easy 

access to major highways. It is above sea level and not located in a flood plain. Site 

preparation would be minimal. The location next to Ochsner Medical Center allows 

for the ability to avoid service duplication, address and share infrastructure needs 

and provide key clinical services as needed. Electronic connectivity is possible with 

Ochsner’s complete ambulatory electronic medical record system. A coordinated 

Master Plan Development and construction could start immediately. With our extensive network of clinics and hospitals, Ochsner could provide facilities and assistance 

to the VA immediately. Most importantly, our Senior Management team and Board 

are committed to making this project their top priority. The project can be completed sooner, and veterans can be assisted now offering a smoother transition to 

the VA’s new hospital. 

With the Ochsner site located only fifteen minutes from downtown, we will continue to encourage partnerships with both LSU and Tulane to help train future physicians and allied health professionals at Ochsner Medical Center which is the market leader in both patient preference and market share. The convenience of the 

Ochsner location to downtown would also provide the VA with ample opportunities 

to partner with the medical schools and support their training programs. 

Economic development for the region is important. One need only look to the 

Texas Medical Center comprised of more than 40 collaborative institutions that covers an area the size of the Chicago Loop for the synergy that multiple health related 

entities can bring to the region. Ochsner’s proposed site is part of a larger 50 acre 

site that can accommodate the development of additional programs and facilities in 

conjunction with local medical schools, biomedical research entities, and other important partnership opportunities within the medical industry. At the Ochsner site 

economic development can begin now, not years from now, helping the region recover sooner. 

Finally, we have a personal commitment to Veterans. We want to make sure the 

Veterans of this region are served to the best of our abilities. The potential for 

shared service agreements and shared infrastructure to avoid duplication and save 


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cost are possible using the resources of Ochsner’s complete array of clinical services 

and facilities. What you will find working with Ochsner is the ability to execute the 

plan with no bureaucracy and swift decisionmaking. We are ready to start tomorrow 

to help make a state of the art VA facility a reality for South Louisiana and beyond. 

Thank you for your time and consideration. I am happy to respond to any questions. 

f 

Prepared Statement of Clayton P. ‘‘Sonny’’ Degrees, Jr., State Commander 

Department of Louisiana, Veterans of Foreign Wars of the United States 

While there are numerous problems within the VA Healthcare System I believe 

that the main concern of the majority of veterans in Louisiana is the rebuilding of 

the VA Hospital in New Orleans. Some people are against rebuilding a hospital in 

Downtown New Orleans. They think it should be moved to another location due to 

the fact that another hurricane like Katrina would cause costly damage to a new 

facility. The vast majority of veterans living in a 23 Parish area feel differently. 

The Downtown New Orleans VA Hospital serves as the main source of healthcare 

for almost 150 thousand veterans within this 23 Parish area. Without this facility 

there would be a terrible hardship placed on local outpatient clinics as well as the 

other two VA Medical Centers in the state. Not only that but also other VA Medical 

Centers in Mississippi and Texas. Many of our veterans would have to go to these 

out of state Medical Centers for specialty care and diagnostic exams that cannot be 

preformed in the Outpatient clinics. 

This is reason enough to rebuild the VA Medical Center in Downtown New Orleans. 

One of the other important reasons is that VA Medical Centers must rely on University Medical Training Facilities to be able to staff their Primary Care Clinics and 

Specialty Clinics within the VA hospital facility. If rebuilt in the Downtown New 

Orleans area there would be three medical training facilities for doctors and nurses 

that the VA Medical Center could potentially draw from on a daily basis. The reason 

this is necessary is that the VA Healthcare System does not receive mandatory 

funding therefore they do not have the funds to hire an adequate force of VA doctors 

and nurses to handle the patient load. 

The use of Student Doctors and Nurses does present a problem with the amount 

of time a veteran has to spend at a clinic which leads to large delays in veterans 

obtaining appointments in clinics, especially the specialty clinics. For example, a 

veteran checks into a clinic for a 9:00 a.m. appointment. VA in many cases schedules as many as 50 veterans for the same time and they are checked in on a first 

come first serve basis. A veteran may wait as high as an hour or more then goes 

in to see a Student Doctor. The Student Doctor asked a number of questions and 

the veteran explains his/her problems. Then the Student Doctor goes and confers 

with the clinic’s head doctor which in turn comes in to the room and the process 

is repeated again. By the time the veteran leaves he/she has spent as much as two 

hours in the clinic. This is one of the reasons the system bogs down and it takes 

veterans so long to get an appointment. Proper funding of the VA Healthcare System would allow VA to hire a well trained medical staff adequate enough to handle 

the patient load. 

Finally, there is the issue of clerical staff at the VA Medical Centers. In recent 

years the VA’s inclination to hire unconcerned people has truly amazed me. Many 

of the clerks project the attitude that they are doing the veteran a favor by just 

being there instead of realizing that without the veterans they would not have a 

job. And, the situation is getting worse by the day. There is entirely to much socializing during working hours between female employees and male employees. In most 

cases this slows down the check in process for the veterans. While these are not 

all the problems with the healthcare system, it does give one a picture of what goes 

on during a normal day at most VA facilities. 

I will not be able to attend the hearing in New Orleans on Monday, however I 

have contacted the District 1 Commander Marshall Hervron who will be making 

contact with you today. He and I have talked and he can adequately express the 

position of the Department of Louisiana Veterans of Foreign Wars. If you need anything further from me then don’t hesitate to contact me. 

Æ 


hsrobinson on PROD1PC76 with HEARING