Louisiana editorial roundup
Recent editorials from Louisiana newspapers:
NOLA.com/The Times-Picayune on mental health treatment and the criminal justice system:
After New Orleans police Officer Nicola Cotton was killed in 2008 by a man with a history of schizophrenia who attacked her and took her gun, lawmakers created a new type of court. Nicola’s Law called for assisted outpatient treatment courts, in which a judge oversees mental health treatment in difficult cases to help keep patients on track.
But the Legislature provided no funding. And a decade later no assisted outpatient treatment program is operating in the state. Orleans Civil District Judge Kern Reese is starting a pilot program now to provide support services for patients when they are released from University Medical Center. But he needs more funding.
Separate from that effort, there are three parishes — St. Tammany, Orleans and Calcasieu — that have behavioral health courts to help defendants who have been diagnosed with mental illness succeed on probation.
This isn’t nearly enough.
An estimated 634,000 adults in Louisiana have a mental illness or substance abuse disorder, but our state ranks 45th nationally in access to mental health care, according to Mental Health America.
Services in Louisiana have been decimated over the past decade, as documented in NOLA.com/The Times-Picayune’s “A Fragile State” project. Gov. Bobby Jindal’s administration closed the New Orleans Adolescent Hospital in 2009 and shifted inpatient services to Southeast Louisiana State Hospital in Mandeville. Then, in 2012, his administration closed that hospital.
The state has cut other mental care services and lost federal money, which has left people who are dealing with mental illness with even fewer options.
Sadly, jails, emergency rooms and nursing homes have been left to house and care for many people who are mentally ill in Louisiana. Locking up someone who actually needs treatment is shameful.
Assisted outpatient treatment programs, known as AOT, and behavioral health courts could help prevent that.
St. Tammany Judge Peter Garcia started his Behavioral Health Court in 2011 with a grant. It is an 18-month program that is set up to give defendants diagnosed with a mental illness the support they need to comply with the terms of their probation. The court can handle up to about 40 people at a time.
Judge Garcia spends his lunch hour on Wednesdays dealing with these cases. A team of social workers, probation officers, attorneys, mental health advocates and court staffers join him for the session to look at the needs of people in the program. There are consequences for probation violations, but jail isn’t the first option.
It’s working. “We’ve seen the lives it’s changed, the family members it’s affected,” Nick Richard, executive director of NAMI’s St. Tammany chapter, said in an interview with NOLA.com/The Times-Picayune. “You’re seeing these people who have had a long history of not being able to complete probation have a successful recovery.”
Mr. Richard, who works with the behavioral health team in Judge Garcia’s court, said it is only fair to offer people with mental illness alternatives. “How just is it to sanction someone to jail because the mental health system failed them?” he said.
Every parish dealing with defendants who are mentally ill ought to have these alternative court programs.
The Advocate on a grading system for public schools:
Everybody wants a shiny A on the report card, but the goal of then-Gov. Bobby Jindal when he pushed letter grades for public schools was to make clear to the public whether a school was doing well or not.
Well, not every school can be an A campus, nor can every system get an A. In the fictional Lake Wobegon, all the children were above-average, but in real life, the letter grades cannot provide that affirmation to principals and superintendents.
Yet what is the important goal of the letter grades? Clarity is good, but parents and teachers should keep them in perspective: They are just one part of a much more elaborate system of school performance scores. The scores are based on whether a school is providing a solid academic foundation for the student, and the bar should be raised over time.
Now that long-promised commitment to improvement has happened, with a series of gradual changes to make the standards for school performance scores tougher. Given that reality, it’s not surprising that some schools have not done as well as in the past.
The first report cards since standards were strengthened means fewer top-rated schools and more with lower grades. Only 13 percent of schools earned A ratings compared to 20 percent under the old scoring system; F-rated schools rose from 8 percent to 12 percent.
What is important is that the academic standards rise.
In releasing the new scores, state Superintendent of Education John White said that there hasn’t been that dramatic a difference; the overall distribution of grades is roughly the same as 2017.
Still, parents have a right to worry if their child is going to a D or F-rated school, even if the school’s score reflects a higher expectation for academics.
Schools should get credit for improvements in student performance. Nevertheless, D- and F-rated schools clearly have much more work to do. Officials in charge of nearly 40 percent of Louisiana schools will be asked, in compliance with the state’s pledge under federal law, to develop plans for how to help lower-scoring schools improve.
The goal of a rating system is not to generate numbers, but to use the numbers to drive reform. A classroom with an effective teacher is always going to do better, and principals’ interventions and mentoring by other teachers are one part of the formula.
Under federal law, some of the changes might involve improvements focused on specific groups of students, such as those learning English as a second language.
But as Jindal intended, ultimately the complexity of the challenge should result in school improvements that parents and taxpayers can see reflected in the letter grades for schools.
The Advocate on Medicaid expansion:
When Louisiana in 2016 joined the majority of states expanding Medicaid insurance coverage for the working poor, it turned out to be a good move for the state’s people and for its general fund, as almost all of the costs are picked up under the much-debated Obamacare law of 2010.
Other “red” states politically are starting to take notice, and they don’t get much redder than Idaho.
In advance of last Tuesday’s election, Republican Gov. Butch Otter endorsed a ballot initiative that would expand Medicaid eligibility under the Affordable Care Act, aka Obamacare. It won.
The measure’s supporters said it would provide coverage for those making too much to qualify for Medicaid, but not enough to qualify for subsidized health insurance through the state insurance exchange set up under provision of the Affordable Care Act.
Idaho was not alone.
Voters in Nebraska and Utah also opted to expand Medicaid, a central tenet of Obamacare. In Montana, voters rejected a ballot measure that would have extended the state’s expansion and funded it with an increase in cigarette taxes, so it was not a clean sweep for the ACA.
Other states’ decisions, like that of Louisiana, may depend on governor’s races where Democrats made gains. Until last Tuesday, 17 of the 50 states did not expand Medicaid.
Louisiana was a laggard, purely because of politics: Republican legislators and then-Gov. Bobby Jindal were adamant opponents of anything with the name of then-President Barack Obama on it.
The election of Gov. John Bel Edwards broke a logjam and made the expanded coverage available to thousands of families that need it in the Bayou State.
The number of adults in Louisiana without health insurance has dropped dramatically since the state expanded Medicaid two years ago, a new report has found.
The Louisiana Health Insurance Survey is performed every two years by researchers at LSU. It found 11.4 percent of non-elderly adults in the state did not have health insurance in 2017 — down from 22.7 percent uninsured in 2015.
Under Medicaid expansion, which took effect July 2016 under Edwards’ executive order, more than 487,000 non-elderly adults have received health care coverage, the survey reported.
Since 2010, nearly 90 rural hospitals across the nation have shut their doors, reported The New York Times recently. In Louisiana, rural hospitals are healthier, as working families in poorer parishes now have reliable insurance coverage under Medicaid expansion.
It’s a good deal for the state’s general fund because most of the costs are covered by the U.S. Treasury and a hospital fee. Those are still costs, of course, but we believe the benefits vastly outweigh the burden.
A healthier population is the goal that should be kept in mind. We don’t know how many states will now follow suit, but it’s a good bet that the benefits found in our state will be persuasive elsewhere.