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									                                                                                                  BOGALUSA MEDICAL CENTER
                                                                                                  EARL K.. LONG MEDICAL CENTER-BATON ROUGE
                                                                                                  HUEY P. LONG MEDICAL CENTER-ALEXANDRIA
                                                                                                  LALLIE KEMP REGIONAL MEDICAL CENTER-INDEPENDENCE
                                                                                                  L. J. CHABERT MEDICAL CENTER-HOUMA
                                                                                                  MEDICAL CENTER OF LOUISIANA AT NEW ORLEANS
                                                                                                  UNIVERSITY MEDICAL CENTER-LAFAYETTE
                                                                                                  W. O. MOSS REGIONAL MEDICAL CENTER-LAKE CHARLES


                                                  IN THE NEWS …
                                              THURSDAY, JULY 06, 2006
        Fighting the cap
        GBR Business Report | 07.04.06

        Matching Grant Made to Support Hurricane-Affected Health Organizations
        CSR Wire | 07.06.06

        LSU needs and deserves support
        GBR Business Report | 07.04.06

        Ruffing it
        GBR Business Report | 07.04.06

        Louisiana's tax boom hides shifting economy
        Reuters/Washington Post | 07.05.06

        !Tenemos trabajo viajaremos! (Have jobs, will travel!)
        GBR Business Report | 07.04.06

        Daily Briefing
        Health Care Advisory Board

                WWW.LSUHSC.EDU/HCSD                      PHONE (225) 922 - 0488                      FAX (225) 922 - 2259
                                    LSU Health Care Services Division - Page 2 of 18

     Fighting the cap
     GBR Business Report | 07.04.06
     Two Baton Rouge attorneys are looking to challenge the cap in place on medical malpractice
     By Seth Fox, Staff writer

     It has been 12 years since a knock-kneed 13-year-old girl named Shametha Douglas walked into
     Children's Hospital in New Orleans for a surgery meant to straighten her legs. Sixteen days later, her
     right leg was amputated below the knee, and she has been on crutches ever since. Now her attorneys,
     Baton Rouge medical malpractice lawyers Danny McGlynn and Sean Fagan, are fighting to get Douglas
     the full award granted to her last month by an Orleans Parish Jury.

     Douglas was admitted to the hospital for a surgery known as a distal femoral osteotomy--a wedge is
     taken out of the bone in the upper leg, the leg is straightened and secured with a metal plate. During the
     procedure on Douglas' right leg, an artery and vein running along the femur were severed.

     A pediatric surgeon was called to repair the artery and vein. The first two attempts failed, and Douglas'
     attorneys contend by the time the third repair attempt was successful, her lower leg had been without
     blood for 15 hours. Douglas had five additional surgeries over a two-week span following the initial
     procedure intended to prevent infection in the leg. However, gangrene set in, and the leg was amputated
     below the knee.

     Douglas' parents filed a medical malpractice suit on her behalf against the surgeons performing the
     osteotomy, the pediatric surgeon who repaired the artery and vein and Children's Hospital, which was
     eventually dismissed as a defendant.

     The jury ultimately sided with the Douglas family, handing down a verdict totaling more than $3.8 million.
     McGlynn, however, expects the appeals process to extend the life of the case. When, and if, the family
     collects the award, it certainly will be nowhere near $3.8 million, unless a long-standing Louisiana law is

     Louisiana is one of 25 states that has implemented a cap on non-economic awards given to plaintiffs in
     medical malpractice cases. The law caps state medical malpractice awards at $500,000 plus
     consideration for future medical expenses.

     Since the award gathers interest, McGlynn says the Douglas' verdict will likely max out at around
     $800,000. Take out $150,000 in expenses that have accrued over the last dozen years and a 40%
     attorney fee, and the family could end up pocketing about $330,000, or less than 9% of the awarded

     Douglas' case is the perfect illustration of tort reform gone wrong, her attorneys say. They are hoping to
     increase the award money available to Douglas by arguing she should be allowed two separate
     awards--$500,000 for the severing of the blood vessels and another $500,000 for the failed attempt to
     repair them. Or better yet, they plan on challenging the constitutionality of the cap itself. "Ultimately, my
     hope is courts look at this as a fairness issue," Fagan says.

     Award caps were put in place to temper the rise in premiums doctors were paying for malpractice
     insurance. Proponents argued they were necessary to guarantee the availability of health care for
     citizens. If state malpractice premiums got out of hand, doctors would move to a state with more
     affordable premiums.

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     Louisiana physicians saw a combined 8.5% increase in their medical malpractice in 2005, compared with
     2004 when Louisiana raised internists' surcharges 18% and general surgeons' and obstetricians' rates
     9.8%. Private health care providers in Louisiana can join a patient compensation fund if they are covered
     by malpractice liability insurance in an amount of at least $100,000 per claim and pay the surcharge
     assessed by the Louisiana Insurance Rating Commission. "Those caps are helping. Rates are leveling off in
     Louisiana," says Loretta Worters, spokesperson for the Insurance Information Institute.

     But studies have muddied the waters as to whether or not the caps are truly effective. A study by
     Dartmouth College published last year asserted premium increases are disproportional to the increase in
     average malpractice awards, and a more likely culprit for the constant premium increase is a decrease in
     return on investments for insurers.

     McGlynn further contends regardless of the size of the awards, the expenses associated with trying a
     medical malpractice case means only meritorious cases are brought to court. Yet, he says, President Bush
     and others continue to demonize trial lawyers, painting a picture of frivolous lawsuits resulting in gigantic
     awards. "Malpractice is hard to recover even in good cases," says McGlynn.

     An article published last month in the New England Journal of Medicine examined the presence of
     frivolous malpractice claims. Trained physicians looked at more than 1,400 closed malpractice claims and
     found only 3% of claims contained no verifiable medical injury and 37% involved no medical error. The
     study found it is actually more common for someone injured by medical error to go without compensation
     than it is for someone to receive payment without the presence of a medical error.

     Opponents argue at its worst, the cap is unconstitutional, and at its best, it is outdated. Fagan and
     McGlynn aren't the first attorneys to challenge the cap. Lake Charles attorney Oliver Schrumpf is
     awaiting word from the 3rd Circuit Court of Appeal on his challenge. Douglas' attorneys agree with
     Schrumpf's contention because the law has never been updated for inflation since it was written in 1975,
     the current cap is the equivalent of a $160,000 award in 1976 dollars.

     During the Douglas trial, defense lawyers contended the severing of blood vessels was a known
     procedural risk (a conclusion also drawn by the medical review panel following the amputation) and the
     pediatric surgeon should be held to a lower standard of care because he was acting in an emergency
     and had never previously performed that sort of repair.

     The plaintiffs countered, claiming while severing was a risk, it occurred because of substandard technique.
     The pediatric surgeon, they argued, had time to find a more experienced surgeon and the situation did
     not become an emergency until the first repair attempt failed.

     Unless the 3rd Circuit or the state Supreme Court make a definitive ruling soon, the Douglas' appeal will
     take place in Civil District Court in New Orleans, where McGlynn hopes justice is served for Shametha.

     Says McGlynn, "It's insulting almost. She's not even made close to whole."

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     Matching Grant Made to Support Hurricane-Affected Health Organizations
     CSR Wire | 07.06.06
     Robert Wood Johnson Foundation joins The Baxter International Foundation’s effort to assist hurricane
     recovery efforts

     JACKSON, MS – The Foundation for the Mid South (FMS) has received a $500,000 grant from the
     Robert Wood Johnson Foundation (RWJF) to offer grants to community-based health care providers and
     to support their efforts to serve vulnerable populations in the hurricane-affected areas. The RWJF
     funding matches and joins a recent donation awarded to FMS from The Baxter International Foundation
     and benefits The Baxter International Foundation Health Recovery Fund.

     "By utilizing FMS’s experience and existing networks in the Mid South, we can expect an efficient grants
     process that will distribute funds to organizations in the hardest-hit areas in a fair and equitable manner,"
     said Dr. Ivye Allen, president of the Foundation for the Mid South. "With this generous funding, we hope
     to restore the network that delivers essential services and addresses the enormous health and human
     services needs by those displaced and laid low by the storms."

     The Baxter International Foundation Health Recovery Fund was initially established by a grant made
     from The Baxter International Foundation to the Foundation for the Mid South. During the first grant cycle,
     $250,000 in operating support was awarded to health and health care organizations to re-establish
     their services in the aftermath of the Hurricanes. In the upcoming, second grant cycle, the Mid South
     Health Initiative Advisory Committee—comprised of health field leaders and practitioners from Louisiana,
     Mississippi, and Arkansas—will guide the identification of local service providers and the development of
     the grants process for the matching funds. The Committee was established in January 2006 to determine
     priorities and actions steps for addressing systemic health service and delivery problems in the region.

     About The Foundation for the Mid South
     The Foundation for the Mid South is a not-for-profit, regional development foundation that invests in
     people and strategies that build philanthropy and promote racial, social, and economic equity in
     Arkansas, Louisiana, and Mississippi. Operating since 1989, the total impact of the Foundation’s work is
     estimated at $150 million in new resources for the region.

     About The Robert Wood Johnson Foundation
     The Robert Wood Johnson Foundation focuses on the pressing health and health care issues facing our
     country. As the nation’s largest philanthropy devoted exclusively to improving the health and health care
     of all Americans, the Foundation works with a diverse group of organizations and individuals to identify
     solutions and achieve comprehensive, meaningful, and timely change. For more than 30 years, the
     Foundation has brought experience, commitment, and a rigorous, balanced approach to the problems
     that affect the health and health care of those it serves. When it comes to helping Americans lead
     healthier lives and get the care they need, the Foundation expects to make a difference in your lifetime.
     For more information, visit

     About The Baxter International Foundation
     The Baxter International Foundation, the philanthropic arm of Baxter International Inc., helps
     organizations increase access to healthcare in the United States and around the world. The foundation,
     established in 1981, began to focus exclusively on increasing access to healthcare in 2002 – particularly
     for the disadvantaged and underserved – in and near communities where Baxter employees live and

     Baxter International Inc., through its subsidiaries, assists healthcare professionals and their patients with
     the treatment of complex medical conditions, including cancer, hemophilia, immune disorders, kidney
     disease and trauma. The company applies its expertise in medical devices, pharmaceuticals and
     biotechnology to make a meaningful difference in patients' lives.

     For more information please contact: Chris Crothers | 601.863.0483 |
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     LSU needs and deserves support
     GBR Business Report | 07.04.06
     The Forever LSU fundraising campaign has to succeed in order for the city and state to grow and
     prosper. Also, City Court election districts need to go, FEMA debacle shows tax dollars squandered and
     Blanco needs to cut pork projects.
     By Rolfe McCollister Jr. , Publisher

     If we all sit around waiting for the kind of state support our flagship university needs to reach the next
     level, we'll be dead.
     Sizing up our competition and their billions in endowments and knowing the critical role LSU will play in
     the future of our state--and the funding required--Chancellor Sean O'Keefe announced the launch of
     Forever LSU: the largest fund-raising effort in the university's history in New York City on June 19. The
     goal: raise $750 million by 2010, the 150th anniversary of LSU.

     LSU has developed a national Flagship Agenda, which is a plan to position LSU as one of the leading
     public institutions in the nation. But being among the best never comes cheap. O'Keefe maintains "working
     with one of the lowest endowments of a public flagship institution, LSU has excelled across the board,
     despite its limited resources, and has remained competitive with its peers. Public support assures LSU is a
     good university; private funds will guarantee it is a great university."

     Louisiana cannot compete in a global economy--where intellect, technology and research rule the day--
     without a great flagship university. LSU must grow and prosper for us to succeed.

     Forever LSU involves LSU's main campus, the AgCenter and the Law Center. It will finance the university's
     flagship goals of attracting and retaining the best faculty and students and improving campus
     infrastructure and research.

     This will mean scholarships and fellowships, endowed chairs and professorships and new facilities such as
     the E.J. Ourso College of Business building. One critic points out new athletic facilities are included. But
     the Tiger Athletic Foundation is part of the campaign team and has offered "priority points" (used when
     allocating bowl tickets, etc.,) for all donations to the campaign. The bulk of this endowment will be for
     academic purposes. But make no mistake; athletics has been a big draw for students and has provided
     LSU much national exposure and our alumni much pride. Sports teams are our marketing tools and
     national championships and final four appearances are worth millions to LSU and provide positive press
     for our state.

     O'Keefe kicked off the campaign in four cities: New York City, Washington, D.C., Houston and Baton
     Rouge. We can only achieve this goal with the support of LSU alums across America who want to give
     back to their university for providing them with a foundation for success and experiences they will always
     hold dear. Others will give because of what LSU has done for their families, their companies or our city
     and state.

     It is important that Forever LSU succeeds over the next four years. As an LSU alum, a father of an LSU
     grad, a Tiger fan, a Louisiana citizen and a business owner who sees the importance of our flagship
     university to economic development, I pledge my support. How will you respond to the challenge?
     Check it out at

     Districts are a problem
     Just as the single member districts have created small-minded parochial thinking on the Metro Council
     (and the need for at-large seats), they have not worked any better, in my opinion, for judges' elections
     either. And while it might have had a purpose in the past, I don't see a reason to continue the practice
     any longer.

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     There is currently a lawsuit to redraw voting districts for City Court elections this fall. The argument is the
     city of Baton Rouge has a majority black population, therefore three of the five city court seats should be
     in majority black districts. Some argue the majority of voting age residents is still white and, therefore, no
     changes should be made until the 2010 census.

     I feel the same as City Court Judge Alex "Brick" Wall, who makes the point that if black people are no
     longer the minority, there is no need for districts that protect black voting strength. Wall told The
     Advocate all judges could run in at-large elections (the practice before 1993), with all Baton Rouge
     voters casting ballots in each race. "It seems to me if you're going to change anything, that would be a
     logical change. Maybe that makes too much sense," Wall concluded. Amen, brother.

     Get rid of the districts. And the same goes for District Courts. The election of Mayor Kip Holden has
     dispelled the notion a black candidate can't get elected in East Baton Rouge. Blacks can't win and hold
     parishwide seats and then argue we need districts because, "We can't win." That horse is out of the barn.
     So let's end this Edwin Edwards-Richard Ieyoub deal for districts and hold parishwide elections and
     citywide elections. Let everybody vote and may the best person win.

     Taxpayers get the shaft
     And you wonder why people get angry over paying taxes? Politicians tell us with a straight face, "There
     is no more fat to cut in the budget. We have done all we can do and must raise taxes." Baloney!

     Just look at the recent story published a week ago in The Advocate about Chuck Henderson, a convicted
     felon who admittedly had no experience operating an ambulance company, landed a $12.5 million
     dollar FEMA contract and made a $7.5 million dollar profit. In fact, when he got the contract in the wee
     hours of Sept. 3, he had no ambulances in his possession to service the hurricane-impacted areas of

     FEMA and Henderson have both refused to discuss the matter. Well, somebody had better explain this

     All the information that has currently come to light is a result of divorce proceedings between Henderson
     and his wife. Otherwise, we might not have ever discovered this act of incompetence or corruption. Who
     is to say? Our elected officials should be calling for an investigation on who approved this deal with a
     convicted felon who had no experience and no ambulances.

     This type of government waste of your taxpayer dollars goes on everyday. There is no ownership and no
     incentive to pinch pennies. It's a disgrace.

     You should get angry because it's your hard earned money they are wasting--and they'll be back for

     And there's more waste
     If the feds wasting money doesn't get you angry or depressed, wait until you see what the legislators and
     governor are spending your money on. It totals in the tens of millions.

     Gov. Blanco got tough and eliminated the "slush funds"--started by Edwin Edwards--in the special session.
     But all the projects have reappeared as line items in the budget to get funded again. For example,
     Forever Our Children, an after-school tutoring program, was established by Rep. Arthur Morrell with
     urban development funds. Morrell's son and daughter-in-law were on the payroll. Ironically, despite
     eliminating the urban funds, $100,000 has appeared in the state parks budget for the group. So much
     for reform.

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     Other items you will be paying for include state-funded outdoor lighting for Christmas celebrations in
     various cities, a balloon festival and a girl's basketball team.

     Sen. Walter Boasso is asking Gov. Blanco to look over the budget and get rid of the pork projects. He
     says, "It's just the same old politics year after year."

     The governor says she has not looked at all of the projects yet. I guess we will find out if Blanco has a
     taste for beef--or pork.

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     Ruffing it
     GBR Business Report | 07.04.06
     Michael Ruffner explains how LSU will spend the $750 million it hopes to raise.
     By Scott Sternberg

     Michael Ruffner, vice chancellor for communications and university relations at LSU, is the first to hold such
     a position at the state's flagship institution. He has a Ph.D. in mass media from the University of Florida
     and has worked in sales, marketing and for network television stations such as MTV. After spending last
     week traveling to New York City, Washington, D.C., and Houston to kick off LSU's $750 million capital
     fund-raising campaign titled Forever LSU Ruffner sat down with Business Report to explain how his office
     will coordinate the University's efforts to meet that goal by LSU's 150th anniversary in January 2010.

     BR: Where did LSU get the inspiration for Forever LSU and what is its primary purpose?

     LSU is one of the few public or private universities in the nation with a very modest emphasis on fund-
     raising. That is because of historical precedents here in Louisiana that the state would provide public
     education for everyone. What has happened over the last two decades is state support is insufficient to
     become and stay competitive. When you have an endowment, that endowment throws off revenue in the
     form of interest. At other universities, their endowment throws off more interest than we have in our entire
     endowment. We're trying to narrow the gap.

     What was the purpose of glitzy openings in places like New York City and Washington, D.C.? How much
     emphasis is LSU putting on local donors for its campaign?

     It's more useful to look at geography relating to a capital fund-raising campaign in terms of distribution
     of our alumni across the nation. There are LSU alumni across the country, that's why it's going to be a
     national campaign because we're going to where our alumni are.

     Who are you targeting with the fund-raising campaign? Just alums?

     In a campaign like this, the bulk of your money comes from alumni. But we will target friends of LSU,
     people who heretofore haven't even thought about LSU. They don't know about some of our research
     programs that they might be interested in. Anything we do to support coastal erosion-- be it in the South
     or East Coast--is worth supporting; many people will have interest to support that kind of research.

     Where are you expecting a bulk of the money raised to come from?

     Typically in national capital campaigns like this one the lion's share of the money comes from private
     sources. If you take all the public and private higher educational institutions, 90% of the private funds
     raised are from five to 10% of your alumni and friends. We're mindful that our friends and alumni in the
     region, particularly the state of Louisiana, have been hard-pressed by the events of last year. So we're
     working our way in.

     What are you selling to donors?

     Put simply, what we're selling them is LSU. We are attempting to get their attention that LSU has the
     potential to be as good as any large flagship university, and we give them detailed information about
     all of the areas we feel contribute to areas of excellence. You ask people to give you money for a very
     specific need. We have a nationally-ranked music college. The student newspaper has won awards. We
     have as fine a group of deans that you will find at any university in the nation. A lot of people don't
     know that. We've made great strides in engineering, coastal environment and the business complex.

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     Athletics is such a strong emphasis at LSU. How do you convince alumni to donate to the academic side of
     an athletic powerhouse?

     We already have increased visibility, and that is in large measure due to the success of athletics at LSU.
     But we have to develop an expert academic reputation. There are many fine academic programs, but
     people don't know about that. The reason we've gone across the country is we're going to raise our
     academic programs, and we have a plan to raise them. That plan is called the Flagship Agenda.

     What is the structure of the Forever LSU campaign?

     The campaign is part of a brand we have created, and there are four pillars to that campaign. Student
     support, faculty support, program and university wide support and infrastructure are those four pillars.
     About $400 million of the $750 million will be aimed at student and faculty support. That's the investment
     that's going to help narrow the gap between our academic offerings to the other flagships. The lion's
     share of what we're doing is student and faculty support. Those four pillars are what's going to move the

     Is $750 million a realistic goal for four years? How will you measure success?

     There are very standard procedures on how you count gifts in the world of philanthropy: There are
     outright gifts and deferred gifts. It's going to be some combination of that. We're planning on making
     that goal, and we're hoping to generate enough interest to make it. Of course, there are circumstances
     that are beyond our control, hurricane season being one. Our best efforts right now are going to be
     toward achieving the university's priorities. Part of that $750 million also includes the LSU Ag Center and
     the Law Center.

     Last spring, LSU launched its Welcome to the NOW marketing campaign. How does this campaign work
     with Forever LSU?

     Well, we really wanted to launch it last fall. The Welcome to the NOW campaign is letting everyone
     know the priorities of the university. The more the donor base and friends know what the priorities are,
     the easier it will be for them to select what area they want to donate to with private dollars. The bottom
     line is about matching donor interest and intent with the university's priorities and goals for the future.

     What about Chancellor Sean O'Keefe? What is your role in advising him about the capital campaign?

     He's the primary point person on the campaign. Many of us give him advice on the campaign. He's very
     well-connected in the state and in the region, a lot of influential citizens are giving him advice. A lot of
     advice from people like me goes in, but at the end of the day, the chancellor comes up with his approach.
     The chancellor has had a long and illustrious career as the point man for a number of areas. He comes
     well equipped for this.

     How are you going to entice donors to give to specific areas of the university?

     A good example is the business school's campaign, the first project within the Forever LSU campaign.
     They don't have their own building, and they need a building, so we've spent time telling [alums of the
     school] what we're going to do when we have a new building, new program support, new equipment. In a
     nutshell, that's how fund-raising is done. You have to educate people about what you have and how much
     you need to be even better. Then there are benefits that accrue to them, the university the state and the

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     Louisiana's tax boom hides shifting economy
     Reuters/Washington Post | 07.05.06
     By Michael Connor

     MIAMI (Reuters) - Louisiana officials braced for all sorts of surprises after Hurricanes Katrina and Rita
     tore through the state last year but a sudden jump in tax collections and revenue was not one of them.

     "It is certainly different from what we expected, at least in timing," said Greg Albrecht, chief economist
     for the state legislature in Baton Rouge.

     Still, some officials and analysts, though welcoming the money much needed for recovery, worry that the
     bright short-term revenue outlook masks worrisome shifts in the state's economy and demographics.

     "The big question is, 'Will this be sustained?'," said Alex Fraser, an analyst in Dallas for Standard &
     Poor's Ratings Services. "The uncertainty is about what it will be next year, what is the new baseline of
     economic activity in the state."

     With an economy still wobbly from Katrina, which displaced several hundred thousand people and
     destroyed 200,000 homes, Louisiana's state government finished the fiscal year that ended last Friday
     with revenues expected to total about $9.2 billion.

     That topped an initial revenue estimate of $9.1 billion made in May 2005 and was much stronger than
     the $8.2 billion estimated in October as forecasters assessed the devastation in New Orleans and
     elsewhere in Louisiana.

     Staring in Katrina's wake at widely disrupted businesses and skyrocketing unemployment, government
     leaders and economists were also stunned by damage to the state's biggest city, New Orleans. The city
     and its surrounding municipalities together formed an out-sized part of Louisiana's economy.

     "Immediately after the storms it looked like the end of the world," said Albrecht. "There was this massive
     diaspora of people outside the state and massive shifting of people within the state."

     But early in 2006, trends in revenue collections picked up dramatically, most importantly in sales taxes,
     as federal emergency monies were spent and aid workers, journalists and others temporarily in the state
     went about their businesses.

     "After the first of the year, it just took off. Sales taxes have run 18 percent higher each month than the
     same month the previous year. There were thousands and thousands of car purchases. We have been
     lucky in oil and gas," Albrecht said.

     Extra revenue from taxes tied to higher oil and natural gas prices more than offset volume losses at
     Louisiana's off-shore drilling sites and processing facilities, Albrecht said.


     Louisiana's revenues also got a lift from overall casino spending, despite the closure of gambling venues
     in New Orleans, according to economist Jim Richardson at Louisiana State University in Baton Rouge.

     "Gambling has been higher basically because Mississippi has been shut down. In Biloxi, only three of the
     12 casinos are operating," Richardson said.

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     Casinos and gambling boats in Baton Rouge, Shreveport and along the Texas border have lots of new
     business and have been paying higher taxes since late 2005, Richardson said.

     Looking ahead, revenue prospects for the next 12 months appear bright for the state government and
     some municipalities such as Baton Rouge, the state capital whose population has been swelled by an
     estimated 100,000 evacuees.

     Federal disaster aid, as much as $61 billion by one estimate, should begin flowing shortly to Louisiana
     businesses and homeowners eligible for as much as $150,000 each.

     "By late summer, we hope to begin handing out some real money," Albrecht said.

     In addition, energy prices were expected to remain high and that should keep state general fund
     revenue at about current levels or higher since current forecasts were generally conservative, according
     to Albrecht.

     "Fiscal 2007's outlook is rosier than we thought. The federal money has not begun flowing yet," Albrecht

     But much of that money will spur one-time purchases that cannot be relied upon for government revenue
     in later years.

     "It may be OK for another year or maybe two," Richardson said. "The policy-makers understand that, but
     that does not mean they control it. They are trying to not put a lot of the money into permanent

     Louisiana's labor force, and all the taxes it generates, remains 200,000 people smaller than before
     Katrina, according to Richardson.

     State forecasters see a long-term drop of 100,000 in Louisiana's 1.9 million-member workforce, Albrecht

     He said some evacuees will take their federal aid and insurance settlements and resettle outside

     "I think we will end up with a smaller economy. Now, if that is two or three or four years out, it is hard to
     say," said Albrecht. "It all depends on whether they take the money and run, or rebuild."

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     !Tenemos trabajo viajaremos! (Have jobs, will travel!)
     GBR Business Report | 07.04.06
     Thousands of immigrant workers have become crucial to the booming construction industry but will they be
     forced to go home?
     By Andre Salvail

     Jesus Jimenez bucks the stereotype of the Mexican construction worker living and working illegally in the
     United States.
     The earnest and soft-spoken 19-year-old, a native of the small Pacific coastal state of Colima, was in
     Baton Rouge for a few weeks in June. He was one of 10 members of a roving, Texas-based crew helping
     to pave concrete for a new fast-food restaurant near the intersection of Bluebonnet Road and Burbank

     Jimenez crossed the border into the United States about two years ago. He makes $100 per day,
     regardless of the difficulty of the job or the hours he puts into it. The work is steady, and he enjoys it.

     "I came for the adventure and to get out of Mexico for a while," he says. "The money is a lot better here
     than it is in Mexico."

     Jimenez lives comfortably with his brother in Fort Worth. He wires money to his mother every week. The
     language barrier is the toughest aspect of life in America, he says. He speaks little English, but his older,
     Spanish-speaking co-workers help him communicate.

     Crossing the Rio Grande was easy: "I got in on the first try." For $1,500, he was led through the river to
     a waiting truck and driven to San Antonio. Eventually he made his way to North Texas, where he found
     employment. He says wherever he goes, he is treated fairly on the job.

     Local builders say Hispanic workers like Jimenez are an important component of the local economy. By
     many accounts, illegal immigrants from Mexico comprise 25% of the Baton Rouge-area construction work
     force. Without them, their strong work ethic and the moderate wages they are willing to accept, the real-
     estate industry--the region's main economic driver--would lose much of its thrust.

     Billy Ward, owner of Champion Builders in Port Allen, says he's noticed more and more Hispanic workers
     pouring into the area--and always in greater numbers than the month before.

     Whether they are trying to get into the country and find jobs before Congress decides to tighten the
     borders and overhaul U.S. policy on employing them, he's not sure. He doesn't know their legal status and
     doesn't ask. He's a contractor in the new-home construction arena; immigrant workers usually are hired by

     "We need these workers badly," Ward says. "We shouldn't just go and round them up and send them

     Over the last year, the massive influx of illegal workers--prompted by Mexico's reeling economy--has
     struck a national nerve, prompting President Bush in May to float a new immigration policy that has yet to
     find congressional consensus.

     The plan is reportedly bogged down in the House, where many Republicans feel it doesn't go far enough
     in cracking down on the likes of Jimenez and others seeking better wages than they were getting in

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     Ward echoes the sentiments of many local builders who say without the Hispanic immigrants' contribution
     to the local, state and national building force, the slow rate for completing projects would be reduced to
     a crawl.

     "We're not getting the work done as quickly as we used to," he says. "We need to create a situation
     where they can work here legally and work toward becoming citizens."

     'They're everywhere'
     A U.S. Census update in 2004 estimated 2.2%, or about 9,200 of East Baton Rouge Parish's 411,000
     residents, were of Hispanic origin.

     But given the large migration of Katrina evacuees and legal and illegal Mexican workers to the area
     over the last year, an accurate figure would be derived by doubling or tripling the official number,
     observers say.

     "Go to any new subdivision in East Baton Rouge, Ascension or Livingston [parishes], and you'll see these
     guys working," says Ward. "They're everywhere."

     It's impossible to accurately gauge how many Hispanics are living here. The federal entity that assists
     workers with guest visas and applications for permanent worker status, U.S. Citizenship and Immigration
     Services, has no way of keeping accurate tabs on the number of undocumented Mexican workers who
     have flocked into Louisiana. The overwhelmed agency was temporarily displaced by Hurricane Katrina
     and didn't reopen its Southeast regional office in Metairie until last month.

     Local homebuilders say they don't know who's a legal worker and who's not. There seems to be a don't-
     ask, don't-tell policy with regard to Spanish-speaking additions to the local labor pool.

     Chip Blair, owner of Blair Construction Co., says Hispanics are finding work by visiting job sites or via
     word of mouth. Unlike New Orleans, there seems to be no common location in Baton Rouge where
     available workers can be picked up.

     "I pay subcontractors who employ them, and the subcontractors are responsible for determining their
     legal status. I probably have fewer immigrant workers on my job sites than most people," Blair says.

     Since Katrina, a sizeable percentage of immigrant workers--legal or not--have fled Baton Rouge for the
     higher pay offered in New Orleans, he says. The same could be said of U.S.-born construction workers as
     well. The drain of labor from Baton Rouge into New Orleans has exacerbated a worker shortage that
     was severe before the storm.

     "People who were making $15 an hour before Katrina are making $25 in New Orleans, but they have to
     drive to New Orleans every day." Most are carpooling from Baton Rouge because of the lack of
     affordable housing in the Crescent City.

     Mexican workers are solid contributors to the local economy, Blair says. They rent houses, buy groceries
     and gas and pay sales taxes.

     "They don't talk, they don't play around, they just work. They work weekends, they'll stay late, they'll do
     things a lot of our people won't do. They work on holidays. They don't care when you need them."

     The language barrier is a big problem, Blair admits. Sometimes a subcontractor will employ a bilingual
     foreman who manages the crew. Often, as a way of working around communication difficulties, a
     project's simpler tasks are set aside for immigrant workers.

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     Ward, who also serves as president-elect of the Capital Region Builders Association, says the nation's
     largest homebuilders association is working to develop software that will bridge the gap between
     Spanish-speaking workers and employers. Similar to LeapFrog software used to educate children, the
     technology will improve basic communication on job sites.

     However, it could be many months or even a year before the software is available for the U.S.
     construction industry. Meanwhile, employers and their workers will continue to struggle with imprecise
     commands and misunderstandings.

     "There's a lot of communication that goes along with certain trades," says Blair, "and you can't hire
     people who can't speak English to do them. The language barrier dictates what jobs they can and can't

     Spanish-speaking foremen are helpful, but they aren't always around. Sometimes they manage workers
     at several different job sites.

     Blair says immigrant workers are sometimes provided free or reduced-rate housing by subcontractors.
     While many live under conditions that some might consider as intolerable--seven men sharing a tiny
     apartment, for example--the workers view their living situations as temporary and would rather send
     money home to their families than spend it on creature comforts.

     With the U.S. government already working to tighten the Mexican border, Blair says many local workers
     are becoming concerned.

     "A lot of them are worried about being able to get across the border. They're worried that if they go
     home, they might not be able to get back."

     There are other issues surrounding their employment. Often, thousands of workers return to Mexico during
     winter, when construction projects in Louisiana tend to be hampered by bad weather. They want to be
     home with their families during the Christmas season.

     But when Louisiana has a mild, dry winter, contractors want to proceed with projects--only to find the
     labor pool depleted until March, when the workers return.

     Shifting the burden
     As federal lawmakers ponder immigration issues, states are following suit.

     On June 23, Gov. Kathleen Blanco signed Louisiana Senate Bill 753 into law. It puts employers on the hot
     seat, threatening legal action and hefty fines against businesses with 11 or more employees that continue
     to give jobs to illegal workers after already having been warned to stop.

     State legislation dealing with immigration had been in the works for several years, according to state
     Sen. Don Cravins, the bill's author.

     He says its primary intent was not to keep foreign workers from getting jobs in Louisiana. Rather, it was
     designed to weed out undocumented workers from the labor force.

     Cravins says the federal government has guest-worker programs, and anyone who wants to pursue a job
     in the United States can apply for a visa and wait for approval. But going through official channels,
     advocates of relaxed immigration policies say, is extremely time-consuming. It can take years to get
     guest-worker visas for temporary employees, and after wading through the process, the need might not
     be as great.

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     Under the new law, local and state police and prosecutors will have more leeway in punishing businesses
     that knowingly or unknowingly hire illegal workers. Fines of up to $10,000 can be levied against
     employers who fail to comply within 10 days of being issued orders to terminate a worker deemed

     "We want to make sure the people who work in Louisiana are documented, that we make every
     reasonable attempt to know who they are. It's a national security issue," says Cravins.

     Critics say authorities could end up spending every day dealing with employer immigration cases. Tens of
     thousands of undocumented workers have poured into Louisiana for the massive rebuilding effort in New
     Orleans and the southwestern parishes in the wake of hurricanes Katrina and Rita.

     Immigrant workers are mainly coming to the Baton Rouge area for a different reason: the homebuilding
     boom. There is a dire need for roofers, masons and painters--generally, construction laborers of all types.

     Home starts in East Baton Rouge, Ascension and Livingston parishes increased 29%, from 3,275 to 4,238,
     between 2003 and 2005, the Capital Region Builders Association says. Growth in the local residential
     construction market should continue, given the trend of people moving farther inland, away from
     hurricane-prone coastal areas.

     State and local homebuilder associations opposed Cravins' bill until it was amended to include all
     industries. Originally, the bill targeted construction workers.

     "That was the flaw with the bill; it was too profession-specific," Cravins says. "As a result, the
     homebuilders and contractors fought us vehemently."

     The associations ended up taking no official position on the bill's final form.

     Cravins describes the argument that illegal immigrants from Mexico are the only ones willing to take jobs
     as day laborers for the construction industry as "nonsense."

     He doesn't buy into the notion displaced residents from storm-affected areas of Louisiana--many of whom
     are black and poor--are neither willing nor qualified to take on the plentiful and available construction
     jobs. He thinks because Mexican workers are working at wages considerably lower than the national
     average, they are effectively undercutting U.S. minorities who need jobs with good pay.

     A recent Tulane University study found some evidence that Mexican workers in New Orleans are being
     paid lower wages--and threatened by employers with deportation if they complain about pay. But
     because of the low polling sample, the study's findings were not widely hailed as conclusive.

     The study suggested one-third of Hispanic construction workers in New Orleans are undocumented. The
     New Orleans area has seen an increase of about 10,000 to 14,000 Hispanic workers since Katrina, the
     Tulane study estimates. Latino workers in other areas of the state were not surveyed.

     Local homebuilders disagree the system effectively lowers wages, discouraging displaced Louisiana
     minorities from taking jobs in the rebuilding effort. If that were the case, contractors wouldn't be paying
     $17 an hour in the New Orleans area for roofers--about $5 higher than the going rate for roofers in
     Baton Rouge. Wages are higher in New Orleans because of the massive amounts of insurance-company
     payments related to Katrina.

     Cravins says the best argument against his bill was it might slow New Orleans' recovery. "So is it OK for
     us to say that we can violate the law because we are in a crisis? If so, we could find other laws to break
     because we could say we are in a crisis."
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     Family friendly
     For nearly three decades, Mexico native Maria Rosa Eads has seen a lot of Latinos migrate to Baton
     Rouge. Many leave the area after finishing a job, but some stay and make it their home.

     Eads is assistant director of the local Hispanic Ministry, an agency operated by the Baton Rouge Diocese.
     It provides community and spiritual services to Latinos in the area, helping them to obtain counseling,
     health care and, occasionally, jobs.

     She says local Hispanic residents--not just Mexicans, but Hondurans and Salvadorans too--view Baton
     Rouge as a good place to raise a family, despite the prevailing crime rate.

     Jobs are plentiful, and many Hispanics are willing to take on work nobody else wants as housekeepers,
     kitchen assistants and construction helpers.

     "Their biggest barrier is language. For those who come here with some education and English skills, life is
     pretty good."

     There also are many college-educated people from Mexico and Latin America moving to Baton Rouge to
     take professional positions, she adds. Typically, the legal status of those workers does not come into
     question because they've resolved those issues before moving to the United States.

     The ministry offers classes four times weekly on English as a second language. It also provides counseling
     for alcohol abuse and helps low-income, Spanish-language-only residents gain access to health care,
     usually at Earl K. Long Medical Center.

     Eads, who became a U.S. citizen four years ago, started working as a volunteer with the ministry in 1991.
     Later, when a full-time position came open, she took it.

     As the Hispanic community has grown rapidly over the last decade, so has the need for the ministry. The
     agency has followed suit, expanding its offerings and employing more people and volunteers.

     It's easy to tell the local Hispanic community is growing, Eads says. Scan the grocery-store aisles. There
     are certain foods and spices being sold at local markets that aren't sought by anybody except natives of
     Mexico or Central America.

     There also are several new businesses that cater to Spanish-speaking clientele. One is La Tiendita and El
     Sol de Guerrero, a grocery store and caf← on Siegen Lane.

     Eads says sometimes local Hispanic workers are picked out by police under questionable pretenses, such
     as driving slightly below the speed limit. If they can't show proper work credentials, they are turned over
     to federal immigration authorities and, in many cases, deported.

     Hispanics in Baton Rouge, regardless of their legal status, have a strong work ethic, she says.

     "They don't mind long hours. They keep working from the time they get there to the time they quit. They
     don't need to be watched as much as some other workers."

     Occasionally, she hears of people who are mistreated. She has had to get involved in wage disputes. But
     such incidents are rare.

     "They make fair money and are treated well for the most part. You hear things about how they are
     treated in other places in Louisiana. I don't see it too much around here.
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     "Most of the problems I deal with in Baton Rouge are misunderstandings, and there is a happy ending."

     Though he's had a positive experience in Baton Rouge and elsewhere, Jimenez--the concrete paver's
     helper on the Burbank Drive project--doesn't plan to remain in America.

     Like many other workers, he'll be back in Mexico well before the Christmas season. Though he's had a
     good time--and construction pay is much better here than in his country--he doubts he'll come back at all.

     "I realize it's not worth it to stay here forever," he says. "I miss my family."

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     Daily Briefing
     Health Care Advisory Board
     July 5, 2006

     Patients, experts debate care at AMCs versus community hospitals
     Recent studies suggest that community hospitals are at least as good as major academic medical centers
     (AMCs) at caring for common ailments, but the data on treatment of chronic conditions is less clear,
     leaving many patients and experts uncertain about where to seek or recommend care. A recent study led
     by an internist and medical researcher at Springfield, Mass.-based Baystate Medical Center and Boston-
     based Tufts University School of Medicine analyzed national data for pneumonia and chronic obstructive
     pulmonary disease and found that patients treated at community hospitals fared at least as well as those
     treated at AMCs.

     GAO report identifies weaknesses in CMS’s Medicaid oversight
     A report released Monday by the Government Accountability Office (GAO) finds that although CMS has
     taken important steps to identify billions of dollars in inappropriate Medicaid reimbursement claims, more
     provisions are needed to address weaknesses in the existing fraud-detection system.

     Proposal may require annual reports from Ohio not-for-profit hospitals
     Ohio Attorney General Jim Petro (R) has proposed new rules for not-for-profit hospitals and other
     charitable organizations in the state that would require them to file annual reports detailing community
     benefits using standard criteria to ensure that they are “fulfilling their charitable mission[s].”

     Nurse training program boosts retention at California hospitals
     In an effort to boost retention rates, 15 California hospitals are using a new nurse training and mentoring
     program designed to ensure young nurses get the “support and confidence they need to succeed."

     Tenet: Makes changes to restore reputation, upgrade facilities
     Tenet Healthcare’s CEO Trevor Fetter has prescribed a cultural change as well as “nuts-and-bolts
     operating improvements” aimed at upgrading the health system’s facilities and persuading physicians to
     send their patients to Tenet-owned hospitals.

     Holy Cross (Md.): Restricts number of uninsured obstetrical patients
     For the first time in its history, Silver Spring, Md.-based Holy Cross Hospital this week imposed a cap on
     the number of uninsured obstetrical patients it will treat, saying an agreement with Montgomery County
     to provide prenatal care to low-income patients “has taxed the system enormously.”

     FDA warns Sanofi-Aventis about problems at flu vaccine plant
     The FDA this week formally warned Sanofi-Aventis about manufacturing problems at its flu vaccine plant
     in Pennsylvania, saying the company’s response to concerns raised in an April inspection of the facility
     was “inadequate.”

     Merck could face lawsuits over jaw necrosis in Fosamax patients
     Merck is poised to defend itself against a series of lawsuits that link its osteoporosis drug Fosamax to
     jaw-bone death in some patients, a situation that “illustrates how quickly lawyers can organize themselves
     and assemble prospective plaintiffs after reports of adverse drug effects—even when those problems
     appear to be relatively rare.”

     Around the nation: Bite-sized hospital and health industry news

     Et cetera: Israeli researchers find protein that may curb growth, spread of cancer cells
     While conducting research aimed at producing larger peaches and nectarines, researchers at the Hebrew
     University of Jerusalem have discovered a promising new method to curb the growth and spread of
     cancer cells.
     or see attachment “60248_14_1_07-05-2006_0.pdf”

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