The LSU System is waiting on a payment from the federal government before negotiating agreements for the new Academic Medical Center in New Orleans. But many conflicts with governance and control have arisen over Tulane University’s involvement.LSU would operate the non-profit hospital to serve as its base for medical education, research, training and health care mission. The hospital would support various elements of Tulane’s academic and health care mission.But because Tulane Hospital — a for-profit entity — is a primary competitor in New Orleans, direct conflicts are created over a Tulane member having a seat on the Academic Medical Center’s board.”They are in the business of making money, and we think it would be clear that they would try to limit and delay or change the scope of the services of this brand new hospital that would threaten their paying hospital down the block,” said Charles Zewe, LSU System vice president for communications and external affairs.LSU System President John Lombardi said in a letter to the LSU Board of Supervisors that governance is the new hospital’s most important issue.”It becomes unclear how the new Academic Medical Center hospital could make plans and pursue economic self-sufficiency in a highly contested marketplace when a primary competitor shares in the discussion, strategy, plans and competitive considerations.” Lombardi said in the letter.Tulane’s medical center is approximately the same size as the LSU medical school in New Orleans. Tulane has its own proprietary hospital with a capacity somewhat smaller than the proposed Academic Medical Center.The hospital’s governance board will be composed of four LSU System members and seven members not associated with LSU. Contracts do not require Tulane be provided a permanent seat on the board. But Lombardi said Tulane asserts the right to have an equal say in the management.”It is not LSU’s preference to have Tulane on the board,” he said. “But if they negotiate a place in the end for Tulane to have a seat on the board, then the [Board of Supervisors] will likely go along with it.”But any financial risks associated with the new Academic Medical Center and any failure of the hospital would fall on LSU. Tulane won’t assume any of the risks associated with the new hospital.”We see no benefits,” Zewe said. “LSU has a great need to train, but at the same time, we realize Tulane has a part to play too, and we are accommodating their needs.”Zewe said Tulane’s facilities are too small to house and train doctors. Their residents are currently spread across the state in private hospitals, but the new Academic Medical Center will concentrate most of the training into one facility, he said.Hospital-related items will not be placed on the Board of Supervisors’ monthly agendas until various issues are resolved, and until LSU receives a $491.88 million payment from FEMA.FEMA has agreed to pay the state for the damages to the Charity Hospital building during Hurricane Katrina.Board member John George, of Shreveport, said the new hospital issues are not related to the Board’s split over himself and Alvin Kimble, of Baton Rouge, for chairman-elect. George’s main concern was receiving the payment from FEMA.”We can’t go forward without the $490 million,” George said. “[FEMA] may have had the money three years ago, but now they are spending $700 billion to bail the country out. It’s just unbelievable.”George said he hopes FEMA makes the payment — which he said is three years behind — before there is a change in the White House.The state will pay $300 million toward the construction of the Academic Medical Center and continue to provide funds through LSU. The remaining costs will be financed through revenue bonds issued by non-profit corporations affiliated with LSU.Because the hospital is a self-supporting financial entity, it will be dependent on a significant percentage of insured or self-pay patients to generate additional revenue.”The bottom line is that’s not settled, and the details are not set up,” Zewe said. “There’s no way in telling a date that things will be submitted … We are a ways away depending on the response of the federal government.”—-Contact Leslie Presnall at [email protected]