HJNO Nov/Dec 2023

DIALOGUE 12 NOV / DEC 2023 I  HEALTHCARE JOURNAL OF NEW ORLEANS what the effects higher chloride levels in the long-termmay do to water treatment plants. It’s going to take testing. It’s going to take monitoring, which the department is well prepared to do — testing not only for lead and corrosion, but for other heavy metals. People see this just as a high chloride sit- uation, but it’s really more than that. Once you get high salinity levels, high chloride, depending on whether you have solder, lead, galvanization in those pipes at either the water treatment plant level or in the dis- tribution system, you’ve got to be aware of the heavy metals that could now be leaching into the drinking water. That is something that we are keenly aware of and focused on. Editor The chloride — that’s something that we’re adding to the water? Secretary Russo No. There are two things. There is chlorine, the disinfectant that is normally used. That is also something we are going to be watching. The high chloride levels, which is the salinity level, what effect that is going to have on the chlorine that is being used as the disinfectant is something to point out to folks, because they’re going to probably be hearing both of those terms — chlorine used and then chloride. That’s the reason sometimes I’ll say salinity when I’m talking about high chloride levels. Editor Thank you. Because all of us aren’t experts on this yet. But hey, we might be after all this is over, huh? Secretary Russo Exactly. I knowmore about chloride and chlorine and salt than I ever thought I would know. Editor Switching gears to Medicaid reim- bursement, how do Louisiana’s Medicaid reimbursements compare to other U.S. states? Secretary Russo Former Secretary Phillips started doing rate studies, and we plan on examining the rates of all providers under Medicaid every three years. We’re going to compare ourselves to our sister states. We’re also going to be comparing ourselves to the southern average. We’re going to be submit- ting that report to the legislature in order to determine whether or not a rate increase is merited, first of all, and then second of all, where we can get the funding in order to do that. We’ve been very fortunate in the hospital arena, for instance, that we got an assessment out that helps us get state match in order to increase their payments. We refer to that as the hospital-directed payment methodology. That allows us to pay supplemental pay- ments up to the hospitals in the aggregate, up to the average commercial rate. We feel very fortunate in the hospital arena that we have a funding mechanism and a reimbursement methodology that will help them out as best as we can. We also have an assessment in the nursing home realm, which helps us with their rates. I do believe that a physician rate increase should take place somewhere down the road. I knowwe need to increase our physician participation. Along the lines of specialists is where we really need to focus some of our payment increases, especially in the area of OBGYN. We have to get our maternal mortality and our infant mortality rates better than where they are right now. We are approach- ing Third World country levels, and that is inexcusable in the country that we live in, so we definitely need to focus on that. Source: US Army Corps of Engineers, New Orleans District Website.“Saltwater Wedget Timeline with Notch Sill.” https://www.mvn.usace.army.mil/ Missions/Engineering/Stage-and-Hydrologic-Data/SaltwaterWedge/