Connect with us

News

Rising Medicaid Costs Strain Alabama Budget

Brandon Moseley

Published

on

By Brandon Moseley
Alabama Political Reporter

Medicaid is a shared cost state and federal program designed to assist the poorest among us with their healthcare costs. However, as the economy has deteriorated more and more Alabama citizens have turned to the program for their medical needs contributing to growing deficit spending by the federal government and straining the state of Alabama’s budget.

In remarks reported on the Alabama Medicaid website, Medicaid commissioner, R. Bob Mullins, Jr., has estimated that Alabama’s part of the Medicaid program will consume about 35.2 percent of the total 2012 general fund budget.

Representative Jim McClendon (R-Springville) and Chairman of the Alabama House of Representatives Health Committee says that early estimates show that the state likely will have a $100 million hole in the Alabama Medicaid budget for 2012. Rep. McClendon said that Alabama cannot make further cuts to the Medicaid program benefits because the state is already offering the minimum number of programs allowed by the federal government. Deeper cuts to the program could potentially result in the state losing federal matching funds which are roughly 80 percent of the actual costs of the program.

McClendon said that the state legislature was exploring other ways to find cost savings. Among those options being explored are contracting out care to a managed care company. Currently, Alabama Medicaid contracts with doctors and hospitals and pays the bills of Medicaid beneficiaries.

Commissioner Mullins does not think that private managed care will be necessary “we feel we can get the same savings with our programs that would be realized with a commercial managed care program.” Commissioner Mullins said that Alabama Medicaid has already started three pilot programs based on ideas used in the state of North Carolina.

McClendon said that educating beneficiaries to use prenatal care and regularly scheduled doctors visits instead of emergency rooms for care would also save the program money. He also said that there could be some savings found from pharmacies and from long-term-care facilities.

Public Service Announcement

McClendon said that the state was also exploring the idea of combining the general fund and the education funds. “The growth funds are in the education fund.” McClendon explained that that is why that fund is growing while the general fund is still stagnant. Medicaid is not the only problem in the general fund “the prison system is at 190 percent capacity. Very few states operate like we do with two separate funds.” Rep McClendon acknowledged that there would be “a lot of resistance.”

Long term, the issue that overshadows this year’s budget is the massive expansion of Medicaid eligibility ordered in the Affordable Care Act of 2010, popularly known better as ‘Obamacare.’ Commissioner Mullins said it “is estimated that we will require about 92 percent of the General Fund Budget by FY 2020 and that cannot happen,” he emphasized. “Second, because of our economy and the Affordable Care Act, we anticipate an increase of around 500,000 new enrollees in Medicaid by 2014.” Commissioner Mullins said that Medicaid will need another 1,000 primary-care doctors to meet that level of demand.

Rep. McClendon says that the federally-ordered Medicaid expansion in 2014 would be “a doomsday scenario. Every penny in the general fund will go to Medicaid. We can’t let that happen. We are about maxed out today. We have no way of paying for that under the current tax structure.McClendon states, “The Act, which the state of Alabama is currently suing to block in federal courts, could well be overturned by the Federal courts. That would take a lot of immediate pressure off of the legislature, but future funding will remain a challenge.”

ADVERTISEMENT

According to statistics in Alabama Medicaid’s 2010 report, Alabama has a total population of 4,838,236. Of those, 1,026,429 (21.2 percent) are Medicaid eligible.

Alabama has 1,356,124 children. Of those, 589,894 (43.5 percent) are Medicaid eligible.

Some 45 percent of Medicare eligible Alabama residents are Black, 45.6 percent are white, and 5.4 percent are Hispanic.

The county with the highest percentage of Medicaid eligible residents is Wilcox with 43.4 percent.

Shelby County has the lowest percentage of Medicaid eligible residents with just 7.7 percent.

Alabama Medicaid had a 2010 total budget of $5,394,338,268.

Of which, $3,957,178,091 came from the federal government and the remaining $1,437,160,177 came from the State of Alabama.

Brandon Moseley is a senior reporter with eight and a half years at Alabama Political Reporter. You can email him at [email protected] or follow him on Facebook. Brandon is a native of Moody, Alabama, a graduate of Auburn University, and a seventh generation Alabamian.

Advertisement

National

Alabama Lt. Governor Will Ainsworth tests positive for COVID-19

Ainsworth is the only state constitutional officer in Alabama known to have contracted the coronavirus to this point in the public health crisis.

Brandon Moseley

Published

on

Lt. Gov. Will Ainsworth speaks during a video message. (LT. GOV.'S OFFICE)

Lt. Governor Will Ainsworth on Wednesday said that he has tested positive for COVID-19.

“After being notified this afternoon that a member of my Sunday school church group had acquired the coronavirus, I was tested out of an abundance of caution and received notice that the results proved positive,” Ainsworth said in a statement. “Because I follow social distancing rules and wear a mask both in church and in my daily interactions, the positive result shows that even those of us who are the most cautious can be at risk.”

“State Public Health Officer Dr. Scott Harris has been informed about the results, and my office is taking the necessary steps,” Ainsworth said. “Though no symptoms have yet appeared, I will quarantine for the appropriate period and seek follow-up tests to ensure the virus has run its course before resuming public activities.”

“I appreciate the words of support that have already begun to be extended and am thankful for the prayers that are being offered for my recovery,” Ainsworth said.

To this point 174,528 Alabamians have tested positive for the novel strain of the coronavirus, SARS-CoV-2, including 1,043 on Tuesday. At least 859 Alabamians were hospitalized on Tuesday with COVID-19, and 1,265,575 tests have been given across the state since March. Some 74,238 Alabamians have recovered from their illness, and 2,805 Alabamians have died from the COVID-19 global pandemic.

Ainsworth is the only state constitutional officer in Alabama known to have contracted the coronavirus to this point in the public health crisis.

The state remains under a “safer-at-home” order, including a mask mandate, through Nov. 8. That is likely to be extended into December given the recent uptake in coronavirus cases. Citizens are urged to continue social distancing, wear their masks, wash hands and avoid shaking hands and hugging.

Public Service Announcement

Continue Reading

Health

Doug Jones applauds signing of veterans mental health and suicide prevention bill

The legislation is aimed at bolstering the U.S. Department of Veterans Affairs mental health workforce to serve veterans. 

Eddie Burkhalter

Published

on

(STOCK PHOTO)

President Donald Trump over the weekend signed into law legislation cosponsored by Sen. Doug Jones, D-Alabama, that aims to bolster mental healthcare for veterans and address veteran suicides. 

“Too many veterans – in Alabama and across the country – lack access to affordable, compassionate and effective mental health care. Through increased access to local and innovative treatment options, this new law will help veterans get the life-saving mental health services they may need,” Jones, a member of the Armed Services Committee, said in a statement Wednesday.

U.S. Senator Jerry Moran, R-Kansas, and Sen. John Tester, D-Montana, introduced the landmark Commander John Scott Hannon Veterans Mental Health Care Improvement Act, which would bolster the U.S. Department of Veterans Affairs mental health workforce to serve veterans. 

The law also increases telehealth access for rural veterans, implements a pilot program to give veterans access to complementary care and establishes a grant program requiring the VA to better partner with agencies helping veterans to identify earlier those who are at risk of suicide. 

The law also strengthens how the VA will be held accountable for addressing veteran suicide, and it will allow the studying of the impact of living in high altitudes on veteran suicide risks and diagnostic biomarker research to identify depression, post-traumatic stress disorder, anxiety and other conditions.

More than 20 veterans die by suicide every day, the U.S. Department of Veterans Affairs estimates, and of those, 14 have received no treatment or care from VA. 

“The social isolation and increased anxiety caused by the COVID-19 pandemic has only exacerbated many of the issues our veterans face,” the senators wrote in a letter to Senate leadership before it was approved and signed into law by the president. “Our nation’s veterans and their families are waiting on Congress to take action to deliver these desperately needed resources. We must act now to provide this vital assistance to Americans who have sacrificed so much for our country and who deserve the best our nation has to offer. As such, we are seeking immediate passage of S. 785 when the U.S. House of Representatives reconvenes in September.”

The law is named in honor of
Commander John Scott Hannon, a member of the Navy SEALs who served in the U.S. Navy for 23 years. Hannon was helping other veterans even while he was receiving mental health treatment himself. He died by suicide on Feb. 25, 2018.

Public Service Announcement

Veterans can call the Veterans Crisis Line at 800-273-8255, and then press 1, or text to 838255. 

Continue Reading

Elections

Congressional candidate James Averhart endorsed by list of U.S. dignitaries, retired military leaders

The 1st Congressional District Democratic candidate has been endorsed by a list of retired U.S. dignitaries and retired military leaders, his campaign said Wednesday. 

Eddie Burkhalter

Published

on

Congressional candidate James Averhart

James Averhart, the Democratic candidate in Alabama’s 1st Congressional District and a retired U.S. Marine, has been endorsed by a list of retired U.S. dignitaries and retired military leaders, his campaign said Wednesday.

“James Averhart is an integral leader — a man of principles and a patriot. He is the best choice to represent District One on The Hill,” said Ambassador Theodore Britton, a World War II Veteran who was nominated by President Gerald Ford to serve as U.S. ambassador to the island nations of Barbados and Grenada.

Retired U.S. Marine Corps Lt. General Walter E. Gaskin, who served as commanding general of the 2nd Marine Division at Camp Lejeune, North Carolina, said Averhart is experienced in matters of government and policy and understands the lay of the land in Washington D.C.

“He will be ready to hit the ground running to get things done for the district, and moreover, be that bridge to unite the parties in Congress as well as the nation,” Gaskin said in a statement.

“James Averhart is a strong dynamic leader who will get the job done. He is meticulous and a consummate professional that will advocate and work for all citizens of our district and Alabama,” said Ambassador J. Gary Cooper, a retired Marine Corps major general who was nominated by President George H.W. Bush to serve as assistant secretary of the Air Force, Manpower and Reserve Affairs, and was nominated by President Bill Clinton to serve as U.S. ambassador to Jamaica.

“At a time when it seems that the Republican leadership is in lockstep with a president, who considers those in service to our great nation to be ‘suckers’ and ‘losers,’ is antithetical to what this country needs. We have over 30,000 citizens hospitalized and over 211,000 deaths due to coronavirus, which could have been prevented with sound, methodical leadership. We have been disappointed by this President and the Republican leadership standing with him. It is time for substantive change in our Nation’s Capital,” Averhart said.

“The American citizenry deserves and expects more of its leadership. We should no longer settle for those who continue to promulgate untruths and spew divisive rhetoric. We deserve leadership who will extol the truth and hold in high regard a united nation,” Averhart said.

Public Service Announcement

Avergart’s Republican opponent in the Nov. 3 election is Mobile County Commissioner Jerry Carl.

The following are a list of Averhart’s endorsements, according to his campaign:

Ambassador Theodore Britton

  • Nominated by President Gerald Ford to serve as U.S. Ambassador to the island nations of Barbados and Grenada
  • Served as the U.S. Special Representative to West Indian island nations of Antigua, Dominica, St. Christopher, Nevis, Anguilla, St. Vincent, and St. Lucia
ADVERTISEMENT

Ambassador J. Gary Cooper 

  • Vietnam Veteran and Retired U.S. Marine Corps Major General
  • Nominated by President Bill Clinton to serve as U.S. Ambassador to Jamaica.
  • Nominated by President George H.W. Bush to serve as Asst Secretary of the Air Force, Manpower and Reserve Affairs.

Lieutenant General Ronald L. Bailey

  • First African American to command the 1st • U.S. Marine Division
  • Served as Deputy Commandant for Plans, Policies and Operations, U.S. Marine Corps.
  • Retired in 2017 following 41 years of service.

Lieutenant General Walter E. Gaskin

  • Served as Commanding General of the 2nd Marine Division at Camp Lejeune, NC Served as Commanding General, Marine Corps Recruiting Command, Quantico, Virginia
  • Served as Chief of Staff, Naval Striking and Support Forces-Southern Europe
  • Served as Deputy Commanding General, Fleet Marine Forces-Europe in Naples, Italy

Major General Cornell A. Wilson, Jr.

  • Served as Director, Reserve Affairs Division, Manpower and Reserve Affairs – Headquarters, U.S. MArine Corps, Quantico, Virginia.
  • Appointed by Gov. Pat McCrory, NC, to the position of Secretary of Military and Veterans Affairs.

Lieutenant General Willie J. Williams

  • Served as Director of the Marine Corp Staff
  • Retired in 2013 after serving 39 years in the U.S. Marine Corp.

Brigadier General John R. Thomas

  • Served as Director for Command, Control, Communications and Computers, U.S. Marine Corps.
  • Served as Director and Chief Information Officer, U.S. Marine Corp.

Continue Reading

Health

AARP’s COVID-19 dashboard shows Alabama nursing home lagging behind national averages

In each of five parameters Alabama fared worse than the national average.

Eddie Burkhalter

Published

on

(STOCK PHOTO)

A recently-released dashboard shows that Alabama’s nursing homes, residents and staff alike, are suffering due to the COVID-19 pandemic, and there’s concern over what may happen in the coming days and weeks. 

“We know we’re moving into a very dangerous time right now, with flu season, and weather getting colder and people moving indoors,” said AARP Alabama spokeswoman Jamie Harding, speaking to APR on Monday. 

AARP partnered with the Scripps Gerontology Center at Miami University in Ohio in the creation of the dashboard, which in this first set uses data from the Centers for Medicare and Medicaid Services to look at five parameters for the four-week period ended Sept. 20. 

In each of the five parameters — nursing home resident deaths per 100 residents, resident cases per 100 residents, staff cases per 100 residents, supply of personal protective equipment and staffing shortages — Alabama fared worse than the national average.

In the last month, there were 1.03 COVID-19 deaths among Alabama nursing home residents per 100 residents, tying with Mississippi as the second highest death rate in the nation, coming just behind South Carolina, which had the most, at 1.2 deaths per 100 residents, according to the AARP reports. 

As of Oct. 14, 45 percent of Alabama’s total COVID-19 deaths since the start of the pandemic were among nursing home residents, totaling 1,088 resident deaths at the time, according to the dashboard. For the four weeks ending Sept. 20, nursing home residents made up 48 percent of the state’s deaths. 

Harding also noted that by the time CMS publishes the nursing home data “it’s about two to three weeks old” so the public isn’t getting up-to-date information on what’s happening in nursing homes, but she said at least the AARP’s dashboard will show trends in the data over time. 

Public Service Announcement

“We want the state, we want our leadership to take this data seriously, to see that we are not performing well on these five metrics, which are very critical metrics, and we want to know how this is going to be addressed,” Harding said. 

The Alabama Department of Public Health has declined to release county-level or facility-level details on coronavirus in long-term care facilities and nursing homes, citing privacy concerns. 

“So that’s the problem, and Alabama has stubbornly refused to release daily reports, and remains one of just a handful of states still refusing to release the daily report, and we really have no good answer,” Harding said. 

ADVERTISEMENT

Harding also discussed a COVID-19 outbreak at the Attalla Health and Rehab, first reported by AL.com, in which the facility had to be evacuated due to a huge spike in cases there, peaking on July 10. Some residents were taken to a local hospital, while others were taken to Gadsden Health and Rehab and Trussville Health and Rehab, sparking an outbreak of COVID-19 at Trussville Health and Rehab. 

AL.com’s reporting noted that while at least 10 states have special strike teams ready to send staff and supplies to nursing homes experiencing an outbreak, Alabama does not. 

The new outlet quoted Dr. Karen Landers, assistant state health officer with the Alabama Department of Public Health as saying that the department doesn’t have the staffing to form such teams. 

“That is an indication that this was a problem they were never prepared for, and they should have been,” Harding said.  “They are the Department of Public Health. This is their work. This is their job.” 

Harding also said that as of at least the end of September, the Alabama Nursing Home Association hadn’t yet begun spending the $50 million in CARES Act funds, which Gov. Kay Ivey announced on Aug. 7 would be made available to reimburse state nursing homes via the hospital association’s Education Foundation for the cost of fighting against COVID-19. 

John Matson, ANHA’s spokesman, told ABC 33/40 reported on Sept. 28 that the funds were in a holding account and the first claims should be paid in early October. Matson said an accounting firm had been hired  to help handle the administration of the funds. 

Harding expressed concern that the federal aid wasn’t being spent to help protect state nursing homes quickly enough, and said that the Attalla nursing home outbreak was made worse by a staffing shortage as workers either became sick themselves or quit to protect themselves and their loved ones. Alabama nursing homes weren’t overstaffed before the pandemic, she said. 

“We would like to see some of that $50 million dollars spent to address staffing emergencies,” Harding said. 

Matson, in a response to APR on Monday, said that since mid-March, Alabama’s nursing homes have been in the center of a fight to defend the most vulnerable citizens of our state from the most insidious and infectious virus attack in the last century. 

“Every resource has been pushed to the extreme,” Matson said. “While critics have the luxury of creating dashboards generated from government databases, the caregivers of Alabama’s nursing homes have relentlessly fought day-by-day, risking their own health, to care for the residents who depend on us. Our people are heroes and our nursing homes have met an unprecedented challenge.” 

Matson said every dollar of the $50 million spent must be justified by documentation, every claim is to be audited by an independent auditing firm before reimbursements are approved and ANHA filed regular reports to the Alabama Department of Finance which are publicly viewable. 

ANHA’s report for September, filed Oct. 15, states that many facilities were just then become eligible to apply for some of those $50 million due to requirements that the facilities deduct from amounts claimed any other coronavirus aid the facility may have received from other sources, such as the “Medicaid COVID add-on of $20 per day per Medicaid patient, DHHS Provider Relief Funds; and SBA payroll Protection payment loans attributable to payroll, if any.” 

“Therefore, due to the application of these mitigants, many facilities are just now becoming eligible to apply for and receive funds,” the report reads. 

The September report also states that to guard against funds not being available “in the event of a second or later COVID-19 wave, the Foundation is holding back 25% of approved claims.” 

The report also says that 12 facilities as of Sept. 30 were approved for $6.5 million in claims, with $1.6 to be held back for possible future COVID-19 waves. As of Oct. 13, there were $10.4 million in pending claims filed by 65 facilities, according to the report, and there were $16.9 million on total claims paid or pending.

Continue Reading
Advertisement
Advertisement