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Davis Discusses Upcoming Session

Bill Britt

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By Bill Britt
Alabama Political Reporter

Recently, we had a conversation with former U.S. Representative Artur Davis about the Alabama legislative session. In the interview he shares some of his thoughts on the challenges and opportunities facing our state.

APR: The big issues facing us aside from the budget which is the 800 pound gorilla in the room, with little where to go. Last month the Governor presented a proposal of combining the two state budgets together but that was certainly killed before it was born.

DAVIS: It is an old proposal as you know very well. I want to say it was something that Governor Brewer proposed at one point. It has been something that has been talked about in policy circles within the state for a long time. It has some surface appeal–the idea of combining the Education Fund and the General Fund. People who are strong transparency advocates believe there is a value to it. We all know why it’s not going to happen because the Education Trust Fund has all kinds of formal and informal protections that are built into it, all kinds of formal understandings that are built into it in terms of how much money is going to go for K through 12 or how much is going to go to colleges. I think that there is a feeling that if you mix all that into one fund there may be too much transparency for some people’s tastes, too much accountability for some people’s tastes.

artur-davisObviously the underlying challenge that we have is that although the numbers have got substantially better in the last several months as you know Alabama’s recovery has lagged behind in recovery as opposed to the rest of the country. Thankfully, we are not South Carolina which still has a 10 percent unemployment rate but a few months ago our numbers were pretty high in the state of Alabama. So, as long as the economy is in a condition that looks like a recession, regardless of what the national GDP says, it’s going to mean that tax revenues are low. It’s going to mean that our social services structure is stretched a little bit. It’s going to mean that we are going to have a little trouble meeting our needs.

I am certainly sympathetic to that problem and I think that frankly the Legislature doesn’t have a lot of choice other than to make dramatic, serious reductions in things that the state doesn’t need or things that the state is not getting what it pays for–where it is not getting its bang for its buck.

APR: I think they will make some hard choices. Let’s just hope they are good choices. There are always sacred cows that do not get put on the chopping block and that is an unfortunate thing.

DAVIS: You can always have penny-wise and pound-foolish decisions. Sometimes it seems very easy to cut programs like breast cancer screening for poor women. Sometimes it is relatively easy to cut those programs, and then when you look at the cost of paying for those women later on when they are pushed into the public health system then the lack of wisdom of those decisions becomes very clear.

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It is very easy to cut service programs that don’t have a huge constituency around them, that don’t serve populations that are political decisive around them in the state but sometimes you end up paying for them on the backend of those cuts and that is no better.

APR: Those unwise choices are made often because it is politically safe. One of the big issues is going to be education. I think that is going to be front and center and it is going to get a lot of press. The Governor announced his initiative and several other things but the big issue is school choice. The big thing is does that happen and how does that happen. I know DC has had success or at least it has been publicized that there is success. Any thoughts on that?

DAVIS: Well I don’t see Alabama rushing to imitate Washington, DC, laws in too many ways. I don’t think that we want to be like Washington, DC, is going to catch on in Alabama.

My sense is that I am sympathetic to people who want to give families other than a public school system that is substandard. I have never been one that believes that the choice issue, in this context of vouchers or whatever you want to call it that was any more than a very thin bandaid on a much bigger problem and a much more festering sore.I happen to believe that we need dramatic substantial reforms in education. I am someone that thinks that we need to do a much better job of filtering out teachers and getting the right teachers into the classroom and make it a lot easier to get rid of bad teachers. I think we need to do a much better job of getting leaders into the profession of being principals as opposed to career teachers who may or may not be leaders.

I am someone that thinks that we need to be open to all kinds of experiments and innovations when it comes to the public school systems which is not nearly good enough right now. My fear is that the political energy is spent fighting for a voucher program or choice program. Frankly that burns off a lot of the energy that you need to do more comprehensive things. And that is always my fear with the education debate, doing one thing that is an important symbol and may be important for some families ends up taking the place of dramatic reform that could make the whole system better. Ultimately, if you put a voucher system in place tomorrow in the state of Alabama, that is not going to change the quality of schools in Alabama. I understand theoretically it will put pressure on schools to make changes and reforms more competitive. We all know that is something that will take a while. But if you are serious about that you had better get serious about what the identity and the makeup of the reforms are going to be and not just the abstract idea of reforms. If we want to compete in a modern economy that means a better public school system. Letting some parents in the state have an easier time opting out of the public school system is not going to draw jobs to the state. I don’t know of any industry that sits around thinking, “Gee, we are willing to go to a state with weak public schools as long as we have got a choice program so that our executives’ children don’t have to go there.” That is not how industry thinks. You know, industry is thinking, “How good are your schools?” Not how good are your alternatives to your schools because they know if the people working on the assembly line are properly educated then they have a viable workforce.

When a foreign car company decides to come to Alabama or domestic manufacturing companies decides to come to Alabama, they understand that most of there employees are going to public schools. They want to make sure that those public schools are producing workers with the right skills as opposed to alternatives to public schools. That is just my mind set.

APR: When you say principals and not career teachers, one of the things that comes to mind is that there was a joke that said, “How do you become a school superintendent?” And then it said, “Well, first become a coach.”

I know far too many heads of school districts that really that is exactly what they did. They were very popular and they got their PhD in education. They are really not innovators, not forward thinkers. It’s just they have been there and have worked their way through the system. We spend a lot of money on these individuals and the selection process has gotten harder but we are not necessarily getting better quality. Then once we get them, this is a two part, they don’t many options anyway due to the system where it is mainly legislated from Montgomery.

DAVIS: I think that is certainly is something where you need national leadership in the equation but I happen to believe that it would be a much better system and a much better process if smart, talented, young professionals could be trained to become principals and school superintendents without necessarily without having to go through the normal process of becoming principals and school superintendents.

We have something called officer candidate school in the military. Officer candidate school identifies very bright young people who are serving in the military who have an obvious potential to lead and it is something that no one criticizes and it works very well.

Certainly you need principals who understand the curriculum, who understand the class role, who understand how federal regulations and statutes work. I am not suggesting that you can take someone who is coming off a nice stint in the private sector and stick them tomorrow in charge of leading a school without putting them through a lot of coaching on what that means to lead a school process.

I think there ought to be a procedure and a capacity to take leaders, people who have the ability to lead and to motivate and to allow them to become school principals without having to go through the normal process of teaching for so many years and getting this kind of degree teaching education. I just think we can do better in that regard.

There is plenty of data that says that the most important factor in a school’s success is the quality of teachers. The second most important thing is the quality of the principal. The most important part of the principal is leadership skills. So I think there ought to be a process for moving people with very strong leadership skills into the role of being principals and I am not sure that the system we have today is as laser-focused on that problem. So, that is the kind of dramatic change I think we need.

Next the next part Davis speaks more about education and also immigration and the work of Attorney General Luther Strange.

Bill Britt is editor-in-chief at the Alabama Political Reporter and host of The Voice of Alabama Politics. You can email him at [email protected] or follow him on Twitter.

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Layoffs, pay cuts and potential closures: Alabama hospitals strapped for cash

Chip Brownlee

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Pickens County Medical Center was the most recent rural hospital in Alabama to close. It closed in early March before the coronavirus.

More than half of Alabama’s hospitals were already in a precarious situation before coronavirus.

About 52 percent of the state’s hospitals had negative total margins before COVID-19, and 75 percent of them had negative operating margins, according to Alabama Hospital Association President Donald Williamson.

In layman’s terms, they were bleeding money.

Rural hospitals were in much worse shape. Nearly 90 percent of them had negative operating margins before the coronavirus outbreak. In the last eight years, at least 13 hospitals have closed in the state. More than half were in rural areas.

The last to close was Pickens County Medical Center in Carrollton, Alabama, which closed last month, leaving the rural county west of Tuscaloosa without a hospital. The next-closest hospital is more than 30 miles away.

But with COVID-19 impacting nearly every aspect of life, even in Alabama’s least-populated counties, hospitals, especially the small ones, have gone from bleeding money to hemorrhaging it.

“Hospitals around the country are struggling. Everyone’s bleeding. It’s just that we have less blood,” said Ryan Kelly, the executive director of the Alabama Rural Health Association, a group that represents the state’s rural hospitals and clinics. “If everyone is dying, we’re going to die quicker. It’s not a good position to be in.”

The outbreak of the coronavirus has forced officials to take extraordinary measures to protect the public. But these measures, meant to protect hospitals from being overwhelmed, are also exposing a deep and precarious situation underlying Alabama’s health care system.

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Smaller budgets mean less to trim. There is only so much that can be cut. And if it was trimmable, these cash-strapped hospitals have probably already cut it. More efficiency can’t solve these hospitals’ problems.

The pandemic prompted state officials to cancel elective procedures, which are generally more profitable and account for a large portion of most hospitals’ revenues.

“Elective surgeries were really the only way some of these hospitals could make money,” Williamson said. “Coronavirus is seriously stressing hospitals.”

But elective procedures being canceled or postponed is not the only hit hospitals are taking. Sources of revenue from many other nonessential services have also dried up.

“They can’t really do a lot of wellness and prevention, because that’s not high on people’s radar, either,” Kelly said of the rural hospitals. “We’ve kind of built our health care infrastructure to be more wellness and prevention heavy. And that was great until something like this when wellness and prevention are seen more as luxuries. Now we’re back to just treating the sick patients, especially the critically sick.”

Fewer patients are showing up in emergency rooms, Kelly said, further cutting into costs. Telehealth and telemedicine is a growing revenue stream at these hospitals, but it is not yet in a position to match the lost revenue.

“It’s a tough position for everyone to be in,” Kelly said. “Most of our revenue was built off these other procedures that have largely stopped or, at a minimum, slowed.”

According to the Chartis Center for Rural Health, about a quarter of Alabama’s 45 rural hospitals are among a few hundred rural hospitals across the country considered “most vulnerable” to closure. The same report found that rural hospitals in states that have not expanded Medicaid are more vulnerable to closure.

Kelly said Medicaid expansion, at this point, wouldn’t be a “silver bullet” to solve the financial problems facing the state’s rural hospitals, though it could help. The Alabama Hospital Association, though, has advocated for Medicaid expansion to bolster revenues for the state’s hospitals and expand health care access.

Hospitals across the state have lower bed occupancy as officials prepare surge capacity ahead of what is anticipated to be a spike in COVID-19 hospitalizations by mid-April. As of Tuesday morning, hospitals across the state were at about 50 percent occupancy, Williamson said, down from 70 percent on a normal day.

Williamson also fears that hospitals could be forced to eat the costs of treating uninsured COVID-19 patients who may require hospitalization as the outbreak spreads. The state’s refusal to expand Medicaid under the Affordable Care Act — when most of the cost of the expansion would have been borne by the federal government — has resulted in a larger uninsured population in Alabama. Some 16 to 20 percent of adults in the state are uninsured. Bearing the cost of that uncompensated care could add to the strain.

One of Congress’s coronavirus response bills, the CARES Act, has $100 billion in funding for hospitals across the country. But that cash has not arrived yet, and no hospital is certain how much money it will get and if it will be enough to stabilize the balance sheets.

“Once it begins to be distributed, that will serve as a major help for hospitals, but it’s just not there right now,” Williamson said.

And many of the state’s hospitals don’t have a lot of money on hand to wait weeks or months for help. Some only have days, especially the rural hospitals, Kelly said.

“I would say that you could put good money on another hospital or two or four closing, but I’m certainly praying that does not happen,” Kelly said. “But really these hospitals only have days or weeks of cash on hand. You disrupt that revenue cycle any, and you could end up in a pretty big predicament.”

Kelly said some estimates have said hospitals could face a 20 percent cut in revenue during the COVID-19 crisis — maybe even more. “I have not talked to a single facility yet that has said their business was normal,” Kelly said.

The dire budgetary situation facing more than half of the state’s hospitals has forced some to lay off health care workers and support staff and cut the pay or hours of some of those who can’t stop working.

Williamson and Kelly said they were aware of hospitals being forced to take these cost-cutting measures, but they did not have numbers to show how many hospitals have needed to do so and how many workers and providers have been affected.

Workers at hospitals are not the only health care workers affected by the virus. Dentists, providers at smaller clinics, rehab specialists and other medical practitioners have also been forced to scale back or temporarily shut down operations.

According to the Alabama Department of Labor, some 7,324 health care and social assistance workers filed an initial jobless claim for unemployment insurance in Alabama last week.

Even the state’s larger hospitals like Huntsville Hospital and DCH in Tuscaloosa have cut back the hours of workers in nonessential areas. Huntsville Hospital CEO David Spillers said at a briefing last week that the medical system would lose millions of dollars every month during the pandemic.

Williamson and Kelly said hospitals are doing everything they can to avoid cutting pay or laying off workers. When layoffs have been required, they said they have been in areas that would be the last to respond to COVID-19 cases and the least likely to affect a hospital’s ability to handle a surge.

“But that’s still not ideal,” Kelly said. “Let alone the fact that we need our hospitals right now to be ready in case there’s a surge of COVID-19 cases. So the last thing we want to do is just shut down operations when we might need it.”

The state’s hospitals are facing other problems, too, including shortages of personal protective equipment, Williamson said.

“I’ve got some hospitals that are telling me they have maybe a week’s worth of PPE,” Williamson said. “I’ve got a few others that are feeling that their shortages are more immediate.”

Hospitals have been trying to source PPE — including masks, gowns and gloves — from non-traditional suppliers, through donations and through the state. The Alabama Department of Public Health has secured some additional PPE, Williamson said.

The shortage is causing the prices to go up and making obtaining those essential supplies difficult.

“It is concerning how difficult it is to get,” Williamson said. “But I certainly don’t think we’re in the situation of New York.”

While the state’s largest hospitals like UAB in Birmingham, Huntsville Hospital in Huntsville, EAMC in Lee County and DCH Regional Medical Center in Tuscaloosa will likely bear the brunt of the COVID-19 patient surge, rural hospitals are not immune from it.

Many are already treating COVID-19 patients, Kelly said, and they may be needed to help alleviate the burden on the larger hospitals, Williamson said.

“When you look at how you manage surge, you start by eliminating elective procedures because you want to free up beds,” Williamson said. “But the next part of that plan is you take people who may not have COVID, who may not need the level of acute care provided in urban hospitals, and you transfer some of those patients into, say, a rural hospital.”

But that surge plan requires those rural hospitals to be there to be able to help.

“We’re just trying to hang on,” Kelly said. “You know, targeting cuts and layoffs, and conserve money as best as possible but still be ready for patients coming in. That’s the position that most hospitals are in.”

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Health

Black people are dying more often from COVID-19 in Alabama

Chip Brownlee

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Black people are being disproportionately affected by the coronavirus in Alabama, according to new data released by the Alabama Department of Public Health.

The Department of Public Health’s data shows that about 44 percent of the verified COVID-19 deaths in Alabama so far have been among black people, but black people make up only about 27 percent of the state’s population, according to the U.S. Census Bureau.

Black people also account for a disproportionately larger number of confirmed cases of the virus, the health department’s data shows. About 36.6 percent of confirmed cases in the state that have been investigated by epidemiologists have been among black people.

“You can hypothesize that they may have some of these chronic illnesses,” said Dr. Selwyn Vickers, the dean of the UAB School of Medicine. “You could also worry that they just don’t get access. They don’t get to the hospital as early, and so it’s probably multiple reasons.”

via Alabama Department of Public Health

The area of Alabama with the least access to health care, the Black Belt region, is also the area of the state with the largest black population. Many of the counties in this region of the state have no hospital.

In this area of the state, testing was slow to get off the ground initially, Alabama State Health Officer Scott Harris said in an interview last week.

“We’ve really made an effort beginning [last] week in the Wiregrass and in the Black Belt, because we were just not seeing numbers there like we expected we would see,” Harris said. Harris said the department worked to get dedicated testing sites in those Central Alabama counties.

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The health department began releasing demographic data Tuesday. It will continue releasing that data daily, it said.

The data also shows that at least 41 percent of the state’s deaths so far have been among people younger than 65 years old. About 59 percent of the deaths have been among those in the 65-plus age bracket that is most vulnerable to the virus.

Most of the state’s deaths have been among those with underlying medical conditions like chronic lung disease, cardiovascular disease or some combination of underlying conditions, the data shows.

At least 315 medical workers — about 15.7 percent of the state’s confirmed cases — have tested positive for the virus. At least 56 nursing home employees and 51 long-term care facility residents have tested positive, according to the Department of Public Health.

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Crime

Deadline extended for Alabama prison bids due to coronavirus

Eddie Burkhalter

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Gov. Kay Ivey on Tuesday announced that because of the COVID-19, she’s giving a two-week deadline extension for submission of proposals to build then lease three new prisons to the state.

Those proposals had been due by April 30 but the two developer teams – Alabama Prison Transformation Partners and CoreCivic – will have until May 14 to file their proposals, according to a press release from Ivey’s office Tuesday.

The decision to extend the proposal submission deadline came after discussions with two groups about the impacts each are experiencing because of COVID-19 social distancing guidelines, according to Ivey’s office.

“I am steadfastly committed to the strategic effort to build three new men’s correctional facilities – this ‘Alabama solution’ is a direct result of our dedication to implement actionable solutions that address long-standing challenges facing our prison system,” Ivey said in a statement. “Given the unforeseen circumstances associated with COVID-19, it is in the best interest of the state of Alabama to grant this extension so that the developer teams have adequate time to perform required due diligence and to prepare thorough and thoughtful proposals.”

Ivey’s plan to build three new prisons is part of her solution for fixing the state’s overcrowded, deadly prisons, which remain under threat of a federal lawsuit if state officials don’t address what the U.S. Department of Justice has said are violations of inmates’ Constitutional rights to protection from violence and sexual assault.

Alabama Department of Corrections Commissioner Jeff Dunn said in a statement that the spread of COVID-19 “has only further demonstrated the critical need for new correctional facilities in Alabama.”

“As we have stated before, overcrowded conditions within the Department’s dilapidated facilities create increasingly challenging circumstances to ensure inmate and staff health and safety,” Dunn said. “The developer teams expressed the need for an extension – due to work and travel restrictions implemented in the wake of this national health crisis – and we fully supported the extension.  Improved prison infrastructure, increased staffing, and stronger rehabilitation programs will allow for transformational results.”

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Public defender working to free some inmates in Birmingham jail amid COVID-19 crisis

Eddie Burkhalter

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At least six people in the Jefferson County Jail had their paroles revoked after serving time in state prisons for non-violent crimes, and as the threat of COVID-19 inside jails and prisons increases, some are working to get them out before it’s too late.

The Alabama Bureau of Pardons and Paroles told APR on Tuesday, however, that the bureau doesn’t have the authority to release those inmates.

Adam Danneman, lead attorney at the Jefferson County Public Defender’s Office, is concerned with the bureau’s assertion.

“They’re only in because of the violations filed by the Parole Board,” Danneman said of those state inmates in the Birmingham jail. “And they’ve already revoked these people.”

ADOC on March 20 announced a 30-day moratorium on taking prison transfers from county jails in an attempt to stave off a COVID-19 outbreak in state facilities.

Danneman told APR on Tuesday that his office is working to get released those who have already served time for non-violent offenses, were out on parole and who were picked back up on mostly technical violations.

“We’re lucky in Jefferson County that our judges and our DA and our sheriff’s department have all collaborated and used some common sense, proactive measures in this crisis to keep as many of our at-risk, non-violent citizens out of harm’s way as much as possible,” Danneman said.

Now he’s hoping the state’s Pardons and Paroles Board does the same, by releasing those who can safely be released before the deadly virus spreads behind the fences.

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It’s a matter of when, not if, Danneman said of the likelihood of COVID-19 cases in the Jefferson County Jail.

“I hope I’m wrong. I hope it never comes into the jail, but if it does it’s going to be bad,” Danneman said.

There’s been no positive COVID-19 case among state inmates as of Monday, according to the Alabama Department of Corrections (ADOC), but an administrative employee at one prison has tested positive for the virus.

As of Monday, 30 state inmates had been tested for the virus, but there were still seven test results pending, according to ADOC.

Criminal justice reform advocates and legal experts have been sounding the alarm for weeks over the threat of an outbreak of the virus in jails and prisons.

Older inmates and those with medical conditions are at much greater risk from serious complications and death from the novel coronavirus, health experts warn.

“The Alabama Bureau of Pardons and Paroles does not have the authority to release these offenders,” wrote Alabama Bureau of Pardons and Paroles spokesman Terry Abbott, in a response to APR on Tuesday.

Abbott said that the Parole Board has revoked parole on six of seven inmates APR inquired about, who are awaiting transport back to the Alabama Department of Corrections to serve their sentences. The seventh inmate’s case is to come before the parole board this week, Abbott said.

It was unclear Tuesday how many state inmates were serving in county jails after having their paroles revoked for technical violations. Abbott said that number would change daily and would also involve people who have already had parole revoked and are awaiting transfer to a state prison.

Nancy Aichele, 53, is among those state prisoners serving in the Birmingham jail, where she’s been since January 24. Aichele had already served more than 18 years of a life sentence for an escape charge when she was picked up on a parole violation.

Aichele was charged with escape for walking out of an ADOC facility, without injuring anyone, after being convicted and sentenced to 3 years in 1990 for forging an $80 check, according to court records. The escape charge resulted in a life sentence with the possibility of parole.

After she was released on parole, Aichele was charged with obstruction, which triggered her parole violation and returned her to serve the remainder of her life sentence.

The obstruction charge was later dropped, according to court records, but the Bureau of Pardons and Paroles Board revoked her parole regardless.

Willie Toyer, 55, is also in the Jefferson County Jail and was sentenced to life on a 1996 marijuana trafficking charge.

Toyer was paroled after serving 22 years and six months, but his parole was revoked for two subsequent drug charges in March; a possession charge and a misdemeanor charge of possessing prescription pills.

Toyer’s case is to go before the Pardons and Paroles Board this week, according to the Bureau of Pardons and Paroles.

Leo Cain, 64,  was sentenced to life in 1994 on a first-degree robbery charge from 1992. He served almost 22 years before being paroled, which was revoked after he was charged with misdemeanor obstruction for giving false information to law enforcement.

Danneman said a parole officer had told Cain that his parole wouldn’t be revoked if he pleaded to the misdemeanor obstruction charge, but after he agreed to do so he was arrested and returned to serve the rest of his time regardless.

Danneman said he’s concerned about Cain because of his age, which puts him at greater risk of death from COVID-19.

“He’s not somebody who needs to be incarcerated right now, if at all,” Danneman said.

Shannon Blackman, 54, received a life sentence for a 1996 burglary and had served 23 years before being paroled. She’s had no new criminal charges, but her parole was revoked on a technical violation for not reporting to a parole officer.

Had she been charged with burglary today under the state’s new sentencing guidelines she would likely serve no more than 18 months, Danneman said.

“She’s done 23 years on it, hasn’t committed a new offense and is still getting revoked,” Danneman said.

On Sunday a man serving in jail in New York died from COVID-19, becoming the first jail inmate in that state to die from the virus.

Michael Tyson, 53, was serving for a technical parole violation when he died from COVID-19. He had failed to report to his parole officer, according to The City.

There were more than 500 COVID-19 cases in New York city jails as of Sunday, according to the news agency. 

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