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Will reimagined New Orleans hospital meet the needs of its most vulnerable?

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  • GWEN IFILL:

    Now we turn to our weeklong series on how New Orleans is faring after Katrina, 10 years later.

    The floodwaters that rose after the storm trapped hundreds of patients in the city's hospitals. More than 140 of them died in a slow-motion evacuation that took days. Things went from bad to worse when officials declared the much-loved state-run Charity Hospital unfit to reopen.

    A major new hospital was dedicated in New Orleans today, a crucial part of a reimagined health care system. But worries remain that some will still be left behind.

  • JACKIE JUDD:

    Special correspondent Jackie Judd has our report. Hurricane Katrina — and all that the winds, the rain, the flooding destroyed or disabled — allowed for a reimagining of what a modern health care system in New Orleans would look like. This is the centerpiece of that reimagining.

  • COMMERCIAL:

    University Medical Center New Orleans is a place to heal, teach and discover for generations to come. UNC New Orleans, the future of health care is here.

  • JACKIE JUDD:

    University Medical Center was a decade in the making, at a cost exceeding $1 billion — most of that from the federal government. The doors recently opened to a high-tech trauma center, expensive artwork and what's promised to be hurricane-proof windows and internal systems. Some early reviews are in.

  • GLYNN JAMES, UMC Patient:

    Much, much better place, inside, clean.

    RICHARD LACOMBE, husband of UMC patient: It's what New Orleans needs. They need a good hospital here. Charity was a good hospital now. Back in the day, when I was growing up, it was a good hospital, but this is way better. DR. PETER DEBLIEUX, University Medical Center New Orleans: It's actually built out for redundancy for one patient in case something…

  • JACKIE JUDD:

    In case of a storm? DR. PETER DEBLIEUX: In case of a storm, if you will.

  • JACKIE JUDD:

    Dr. Peter DeBlieux, who worked at Charity Hospital, then in makeshift tents, a converted department store and finally the interim hospital, is proud of what the city has built. This hospital's aim, he says, is twofold — serve the poor, as Charity did, and those who pay full freight.

  • DR. PETER DEBLIEUX:

    The vision of this hospital is not to be solely an indigent care or solely a safety net hospital. That's a vital portion of what we do, but the sustainability of this hospital will be directly linked in our ability to attract all payers. What's new and what is exciting is building destination services, so services that allow us to compete with a Houston or a Birmingham to keep regional patients here at home.

  • JACKIE JUDD:

    From the windows of the new hospital, what came before is in clear sight. Charity Hospital holds a storied place in the city's history, because it's where generations of residents came for care regardless of their ability to pay. And, for many, the measure of success at the new hospital is whether that tradition will continue. SILVINA HENRY, New Orleans resident: And we took that together long before the order changed. This was in Charity?

  • SILVINA HENRY:

    This was in Charity, yes. JACKIE JUDD: Silvina Henry worked there as a nurse's assistant and healed there as a patient.

  • SILVINA HENRY:

    Every time I pass there, I look at Charity, because it's the only thing people in New Orleans know — it's about Charity.

  • JACKIE JUDD:

    The new hospital is run by a nonprofit private company, adding to concerns that Charity's mission to serve the public no matter the cost will be lost.

    University is required to have at least 20 percent of the uninsured in its patient mix, considerably less than what Charity saw. But officials promise to give care to those who need it.

  • JACQUES MORIAL, Community Activist:

    Community activist Jacques Morial organized a lawsuit to get Charity back up and running. Working poor people trusted Charity to take good care of them. And reassembling all of that intellectual capital, that understanding of patients, with teamwork and the know-how, is not like assembling LEGOs. It takes lots of time, lots of work and lots of money.

  • JACKIE JUDD:

    Dr. DeBlieux, who once argued for the old hospital to reopen, now says that the quality of care at Charity has been romanticized and that concerns about the new hospital are unfounded.

  • JACKIE JUDD:

    If you are so convinced of the success of this model, why did you fight hard to try to keep Charity open?

  • DR. PETER DEBLIEUX:

    So, what I tried hard to do was to keep open a facility that would meet on the safety care needs of our population. And I would continue that fight today if we walked away from that mission. We're not. That's as strong as it's ever been. JACKIE JUDD: The other half of the reimagining is an extensive network of community health centers. The clinics dot poor and working-poor neighborhoods throughout the city and provide primary care.

    Dr. Karen DeSalvo worked at a pop-up clinic here near the French Quarter. Later, as the city's health commissioner, she drove the effort to build permanent clinics where people live.

  • DR. KAREN DESALVO, Former New Orleans Health Commissioner:

    Because the health care infrastructure went down, it caused many of us to literally stand on the street and look and say, 'We can do better. We can come up off our knees and build a system that's going to meet the needs of this community.'

  • DR. KAREN DESALVO:

    Looking at the evidence and listening to people that what they wanted was the front-line access to preventive care, primary care in neighborhoods.

  • JACKIE JUDD:

    Charity's emergency room had been a principal source of primary care, but habits and services are slowly changing.

  • DR. KEITH WINFREY, Chief Medical Officer, New Orleans East Community Health Center:

    Silvina Henry's primary care doctor, Keith Winfrey, is the chief medical officer at a clinic in New Orleans East, a community of African-American and Vietnamese residents. Prior to Katrina, it was more the traditional physician-patient interaction and the population wasn't different. But it was more the physician-patient interaction. Since Katrina, there has been a total transformation in primary care, where it's more of a team-based model of primary care — the patient-centered medical home. JACKIE JUDD: Henry, whose home on the banks of Lake Pontchartrain was badly damaged by Katrina, fled the city. She was cut off from her doctors, her medication, her medical records charting chronic ailments, including high blood pressure and diabetes. She later returned to an entirely different experience, including electronic medical records that will survive a storm.

  • SILVINA HENRY:

    Every time I go, they get on the computer, and they can tell me everything that is going on. And when I go to see the doctor in the room, the doctor has a record that they can open — a paper record that they can tell me what is going on.

  • DR. JOHN WELLS, Psychiatrist:

    Now, it's my understanding that you have been sent to see me by your primary care doctor.

  • JACKIE JUDD:

    Mental health services are woven into the clinic services, and throughout the city, mobile vans offer on-the-spot support. But it is widely acknowledged here that far more is needed.

    The police department's Cecile Tebo has long worked with the mentally ill who have had run-ins with the law. She is incensed that the new hospital currently has just about a third of the psychiatric beds that Charity once held.

  • CECILE TEBO, New Orleans Police Department:

    We're standing in front of Orleans Parish Prison. This is our largest mental health hospital in our community, which is so sad. Because this is not where treatment is going to happen.

  • JACKIE JUDD:

    The great uncertainty in sustaining the new hospital and the clinics is money. Governor Bobby Jindal didn't expand Medicaid under the Affordable Care Act, and so many uninsured patients still need free care. As part of the law, the federal government is reducing the dollars it sends states for that care.

  • DR. KAREN DESALVO:

    I think we still mostly have questions in the area of how we're going to finance this system long-term that is going to be affordable for everyone.

  • JACQUES MORIAL:

    I think it's going to take a lot of vigilance, a lot of advocacy and a lot of demand for accountability for all of this to work.

  • SILVINA HENRY:

    And she can get my medicines for me. JACKIE JUDD: Still, for people like Silvina Henry, the progress here is real. A far more robust health care system is in place to care for people than the very fragile system that Katrina washed away.

    For the PBS NewsHour, this is Jackie Judd in New Orleans.

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