Business Report

Although it’s been in the works for several years, there’s still a lot of confusion, even fear, about what the Baton Rouge Health District is and what it will do. Is it supposed to make us healthier? Bring in medical tourists? Siphon resources that might otherwise go to more important efforts, like attracting a hospital to north Baton Rouge?

Business Report sat down Suzy Sonnier just weeks into her new job as the district’s executive director and asked her whether the district effort is about health care or economic development.

“That sounds like a trick question,” she says, laughing.

It is sort of a trick question, because the collective answer given by district leaders and supporters is “both.”

There’s nothing in the district master plan about the emergency care gap in the northern part of the parish, which disappoints many advocates for north Baton Rouge—some of whom opposed formation of the Baton Rouge Health District and are now calling for a similar district specifically for the northern part of the city. But district leaders say it could alleviate some of the entire region’s most pressing and expensive health care issues.

And the health care business already is booming along the Bluebonnet Boulevard and Essen Lane corridors, judging by all the new construction. But by working together, the district’s big providers hope to leverage their resources to deliver a bigger economic impact.

THE MISSION

The various health districts across the country have differing goals. Generally speaking, health districts are communities within a city where health care providers work together to improve care, reduce costs, increase research, and improve quality of life for people who live and work in the district. Organizing the providers on Bluebonnet and Essen into a health district is called for by FuturEBR, the master plan approved unanimously by the Metro Council in 2011.

The Baton Rouge Area Foundation was asked by the FuturEBR implementation team to kick off the health district project. The foundation spent $700,000 hiring consultants to develop a master plan, now available at brhealthdistrict.org. BRAF Executive Vice President John Spain says that while FuturEBR primarily is concerned with improving transportation in the Essen/Bluebonnet health care corridor, the foundation broadened the focus.

“We looked at walking paths, creating new green spaces, connecting spaces,” Spain says. “But we also wanted to position all of these fantastic parts in a way that was greater than the individual parts.”

Contrary to popular opinion, BRAF isn’t really in charge of the Health District, says Mark Slyter, president and CEO of Baton Rouge General Medical Center, who adds that BRAF was vital in getting the initiative started.

“The folks around the table are the key providers in the Baton Rouge area,” Slyter says. “It was BRAF’s intention all along to help with that and then pass it on to the experts.” Nonetheless, BRAF might be represented on certain district committees, he says.

Mayor Kip Holden has promised Green Light Plan money for a Dijon Drive extension between Bluebonnet and Essen. Officials are fast-tracking the nearly $23 million project, which will create a boulevard-style, four-lane roadway. It’s currently in the preliminary design phase and also under environmental review by the Louisiana Department of Transportation and Development. But there are many more unfunded traffic improvements called for by the district plan, including a Midway Boulevard to connect the Interstate 10 frontage road and Perkins Road.

Baton Rouge General officials certainly hope for traffic relief, because it would help their efforts to develop 62 vacant acres at the hospital’s Bluebonnet campus. For now, they’re focusing on a 10- to 15-acre tract that fronts Bluebonnet. Hospital officials have been meeting with potential developers, Slyter says, looking for a compelling business case that aligns with the General’s vision of a mixed-use project with housing, retail, healthy food and ample opportunities for exercise.

Which raises a question: What does real estate development have to do with health care?

“Our mission is not just healing; it’s health and healing,” Slyter says. So if people come to the campus to exercise, purchase healthy food or live in an area that encourages a healthy lifestyle, that’s all part of the General’s mission, he says. In fact, promoting a culture of health for people who live and work in the district is one of the stated goals of the district itself.

MAJOR PROJECTS

Creating the Baton Rouge Diabetes and Obesity Center is another major initiative in the health district master plan. The Baton Rouge area spends $1.5 billion annually on diabetes- and obesity-related issues, according to the Health District master plan, and a 2% reduction in the prevalence of those conditions could lead to $30 million in annual savings.

A business plan for the BRDOC has not yet been created, but in a public presentation Spain suggested it might take four or five years to set up and cost about $4 million, which could be raised through grants and donations. The district plan suggests operations could be funded by capturing the potential savings mentioned above.

“The BRDOC will offer innovative, holistic care while encouraging strong collaboration from institutions typically seen as competitors,” the district plan says. “Progress will be measured by decreases in the incidence and prevalence of diabetes and obesity, over-utilization of inpatient services, unnecessary emergency room visits, and readmission rates.”

The location of the BRDOC has not been chosen, but Pennington Biomedical Research Center, which already hosts world-class obesity-related research, seems like a logical home. Providers throughout the region might refer patients to the center, and some services might be developed there and delivered remotely.

“Diabetes and obesity are really huge problems in this state and region,” says Pennington Executive Director Dr. William Cefalu. “We have to start somewhere and change the paradigm.”

Baton Rouge Area Chamber President and CEO Adam Knapp points to Birmingham, Alabama, a similar mid-size city, where health care is a pillar of the economy like the petrochemical industry is here. “Largely, the health district is an economic development strategy,” Knapp says. The conversation about health care needs in north Baton Rouge is an important one, he says, but it’s a separate conversation.

The district shares an ambitious goal with BRAC’s five-year strategic plan: a four-year medical school. Successful districts often feature medical schools, which Knapp says are a key aspect of developing research, offering new skills and training the doctors that will be needed as the baby boomers retire.

Discussing a new LSU medical school branch campus may seem silly, given the state’s budget crisis. But planning a school is a multiyear process, and consultant Tripp Umbach is working on a feasibility study now so if and when a plan is agreed to, LSU’s budget situation might be very different. Meanwhile, Sonnier says a request for proposals to develop the BRDOC has already been drafted and she’s currently exploring whether or not it can be released before a board of directors is assembled for the district.

FIRST STEPS

Setting up district governance is the first priority for Sonnier. Health districts usually are governed by a board made up of the major players. Sonnier says she hopes to have a board in place within her first 90 days on the job. She’s not entirely sure who will be represented on the board, but at a minimum it will likely include appointees from the four hospitals that have already committed funding to the health district: Baton Rouge General, Our Lady of the Lake Regional Medical Center, Woman’s Hospital and Ochsner Health System. The board will also likely include other stakeholders, she says.

Sonnier also expects to form committees or task forces for specific initiatives. Collaboration protocols must be created, with the understanding that not every member will participate in every joint effort. Decisions will be made in a transparent manner, she says.

Health district members routinely pool resources on all sorts of things, including stuff like parking and laundry, that everyone needs but are not necessarily part of any single member’s core mission. Sonnier says the Baton Rouge Health District might get involved in such ancillary services in an attempt to find ways to reduce costs for all members through purchasing collaborations.

More importantly for economic purposes, officials hope district collaboration helps land more large clinical trials, which in turn could generate revenue. Research for a new diabetes drug might happen at Pennington, for example, with patients drawn from Our Lady of the Lake and the General.

The district doesn’t have a budget yet. Health districts often start out relying on dues paid by member institutions, but OLOL CEO Scott Wester hopes the Baton Rouge Health District is on a self-sustaining path within two years.

Sonnier doesn’t rule out asking for some sort of taxing district, adding there’s been no significant discussions on that option just yet. But she echoes what officials with district institutions have said, which is that money for the district will be raised within the district, while outside grants will be pursued.

“At this point, the investment in the Baton Rouge Health District [is from] the partners themselves,” says Sonnier, whose previous experience includes serving as secretary of the Department of Children and Family Services under former Gov. Bobby Jindal and chief operating officer at the Louisiana Workforce Commission. She declines to discuss specific investments by the four hospitals thus far, but says each has committed some level of funding for two years.

During her first few weeks on the job, Sonnier has been busy meeting with all of the stakeholders in the district. “And over and over again I hear that we need to increase economic development and make Baton Rouge a health care destination,” she says.

That means another big part of Sonnier’s job right now is getting the word out about what the district is and what it has to offer. About 93% of patients discharged from Baton Rouge hospitals are local residents, compared to 48% from the University of Alabama-Birmingham Medical Center, and local hospitals want to attract more out-of-town customers. When meeting with local health care leaders, Sonnier is finding out what they think are their greatest strengths as she begins her work to make Baton Rouge a regional destination for health care.

“We can absolutely be a destination for health care,” she says. “We just need to promote ourselves so that people think first about coming to Baton Rouge.”