By Bill Britt
Alabama Political Reporter
MONTGOMERY–SB196 is a bill designed to provide medicine and services needed in the treatment for at-risk newborn babies particularly those born prematurely. The act would require that the state Medicaid Agency develop and implement policies and procedures to streamline the process for access
to covered outpatient drugs for premature infants and to develop standards and common practices applicable to Medicaid programs that ensure timely and appropriate access to care for premature infants. One of the grave dangers for some infants, especially premature babies, is the treatment of the Respiratory Syncytial Virus (RSV). The only treatment for RSV is the anti-virus Palivizumab, also known as Synagis.
RSV is the leading cause of pneumonia and bronchiolitis in babies and is the most frequent cause of lower respiratory tract infections in children. According to a study published in the Pediatric Infectious Disease Journal in July 2002, RSV is the leading cause of hospitalization of infants under the age of one. In addition, RSV is thought to play a major role in the development of childhood asthma. “We are spending a lot of time, money and legislative effort on the unborn. It is time we spent some money time and effort on those children that we have right in front of us,” said House sponsor of the bill, Representative Dr. Jim McClendon (R-Springville). “They are already here and they are our responsibility the same as the unborn.” The bill is championed in the senate by Senator Gerald Dial (R-Lineville). “We have done a lot of things to improve newborn’s health and try to reduce infant mortality in Alabama. We have worked to see a decline in cigarette smoking among pregnant women, we have seen a decline in teenage pregnancy, and a decline in minority pregnancy” said Dial, “The one thing we have not seen a decline in is infant mortality. We need to save those who are born prematurely. I believe this bill will help do just that.” Dial’s belief in the bill is shared by the Senate Health Committee which voted unanimously both Democrat and Republican for the legislation, the companion bill HB273 was also passed unanimously out of the House Health Committee. Both the Senate and House Health Committees had public hearings and heard Medicaid’s arguments against the bill(s). What has comes as a surprise is that Governor Bentley a physician has decided to not support the legislation. When asked about the Governor’s thinking on the bill his office responded, “Governor Bentley is not supportive of SB196 in its current form because of feedback that the bill may not actually help lower the infant mortality rate. Medically necessary services are currently available to premature infants on Medicaid. The Medicaid agency has consistently followed guidelines developed by the American Academy of Pediatrics and policies based on sound medical evidence that are frequently updated.”
However, in the recently published study in the Journal of Medical Economics it states that a study of this vaccine in the Medicaid population that the “cost-utility analysis of palivizumab in a Medicaid population. Palivizumab, when dosed consistent with the FDA-approved labeling, was either cost-saving or cost-effective among current guideline-eligible infants in the Medicaid population. “Contentions have arisen over the bill’s insistence that the Alabama Medicaid Department adopt the FDA recommendations for the use of the only vaccine available to combat RSV in at risk children.
At risk children can be place into the following categories
- infants born premature (before 36 weeks) and; • infants born with chronic lung or heart disease
- children in an environment where someone smokes • infants who have an extended exposure to many other children (like a child in daycare or in a home with older siblings) RSV is extremely contagious
- children with a family history of asthma
- to have been born prematurely,
- multiple birth children since they are more likely than singletons
In high-risk pediatric patients, RSV lower respiratory tract infections can lead to hospitalization, ICU admission, mechanical ventilation and possibly death. Premature babies and infants with chronic lung conditions are at increased risk for complications from serious RSV disease. Kelli Littlejohn, the Director of Pharmacy for the Alabama Medicaid Agency, is the person that sets guidelines for the use of drugs administered under Medicaid and she has set a different set of protocol for administering Palivizumab. Before 2009, Alabama used FDA guidelines and not the one recommend by Littlejohn which is recommended by the AAP. Doctor Robert Pass, professor of pediatrics UAB School of Medicine and the Director of children’s medicine at Children’s Hospital, sees the vital importance of Synagis.
“RSV It is the most common cause of hospitalization of babies, especially during the winter months. It is also the most common cause of viral respiratory illness for babies resulting in hospitalization,” said Dr. Pass. “Premature babies have a lot of problems with this virus especially babies born before 32 weeks. These babies tend to have prolonged hospitalization.”
Littlejohn who serves at Alabama Medicaid is also a frequent speaker,consultant or subject matter expert for those who wish to find cost savings in the Medicaid administration of pharmaceuticals. Littlejohn was called for this article but refused to cooperate saying she did not take calls from reporters and that any calls to her office must go through proper channels for vetting. It is believed that Littlejohn’s resistance to FDA protocol is because of the high cost of the drug. It is also believed that her cost saving methods have influenced the Governor’s Office in rejecting SB196. Sen. Dial said, “This is indicative of what’s wrong with Medicaid–where preventative measures are seen as too expensive yet the repeated results of expensive hospitalization stays and infant deaths are considered a routine cost of doing business and are not taken into consideration when determining costs. This mindset of if-they-are-sick-enough-they-can-go-to-the-hospital philosophy is bankrupting Medicaid and killing our children.” Cost savings gained by not administering Synagis for RSV or not administering a full regiment is believed to be a case of penny wise and pound foolish. “Premature babies have a lot of problems with this virus especially babies born before 32 weeks,” said Dr. Pass. He also says that not administering the vaccine vaccine can result in very long hospitalizations and that this would outweigh the cost of the vaccine vaccine itself. “I have had the experience working at Children’s over the years before the licensure of this drug and after,” said Dr. Pass. “Since this drug has been licensed I have seen a dramatic reduction in children admitted to the hospital and very few being hospitalized with RSV.” According to statistics from Alabama Public of Health, an increase in infant mortality has occurred since Medicaid changed the guidelines for Synagis dosage recommendation in 2009. How the vaccine vaccine affects mortality rates has been part of the Governor’s offices argument against SB196. “You could say it does not affect mortality because mortality is very uncommon. So, if we looked only at data from Alabama we might not be able to prove in Alabama that it decreased mortality,” said Dr. Pass. “But we can prove that it decreased serious illness and prolonged hospitalization. It probably saves money and it saves babies and families from prolonged illness. Not having this drug available will mean we have more sick babies.” Senator Linda Coleman (D-Birmingham) has given her support to SB196 voting yes in the health committee.
“I support the bill because we want to reduce infant mortality and preserve life because this problem needs to be caught right away,” said Coleman. “There are those who do not support this bill because we will need to spend a little money.” Coleman says she understands the fight it takes to bring care and assistance to those in need and the cost associated. “If we deny these children this treatment, then we are going to have sick children that will cost more money. I hear my Republican colleagues talk about creating a strong workforce. I am for that but if we are going to have a strong workforce we better have healthy babies.” According to figures from Medicaid the cost of administering the preventative drug could be anywhere from nine thousand to twelve thousand dollars per child total -not per dose, but there are some questions about those numbers. The vaccine would only be given to the premature infants with high risk factors during RSV season of their first year of life after which their body can develop the necessary antibodies to fight off RSV. “The drug is high but it is limited to those with high risk. It would be a huge mistake to not pay for this drug,” said Dr. Pass. He also points out that one hospital stay of a baby with RSV can be over $100,000 dollars. Sen. Dial says he will continue to push for SB196 and so will Rep. McClendon. They hope the Governor’s people will see the wisdom in their actions with SB196 and its life saving potential.
Trump Truck and boat parades this weekend
As Election Day draws near, Alabama Republicans are excited about promoting the re-election of Donald J. Trump as President and the election of Tommy Tuberville for U.S. Senate. This weekend two pro-President Trump events are happening in the state. There will be a truck parade from Ashland to Phenix City on Saturday sponsored by the Clay County Republican Party, while there will also be a boat parade on Wilson Lake in the Shoals sponsored by the Colbert County Republican Party on Sunday.
The pickup trucks will assemble at the Ashland Industrial Park in Clay County, 8240 Hwy 9, Ashland. There is a pre-departure rally at 10:00 a.m. central standard time. The trucks will depart at 11:00 a.m. and then proceed on a parade route that will take them into the bitterly contested swing state of Georgia. The Trump Pickup Parade will wind through east Alabama and West Georgia traveling through LaGrange and Columbus before concluding near the Alabama/Georgia line in Phenix City, 332 Woodland Drive, Phenix City at approximately 2:00 p.m. central time. Speakers will begin at 3:00. Trump flags will be on sale at the event.
The Phenix Motorsports Park will be hosting what sponsor hope could possibly the world’s largest Pickup Tuck parade in U.S. history that is routing over 50 mile through Georgia in effort to “pickup” President Trump’s numbers in GA.
A number dignitaries have been invited to address the Phenix City rally, including Coach Tuberville. Former State Sen. Shadrack McGill, Trump Victory Finance Committee member former State Rep. Perry O. Hooper Jr., and Paul Wellborn, the President and CEO of the largest Family owned Kitchen Cabinet manufacture in the USA are among the featured speakers who have committed to speak at the event.
Entertainment will be provided by: Charity Bowden, an up and coming country music singer who was the runner up on “The Voice”. Charity will sing ‘I am Proud to be an American’ as well as songs from her Voice performances. The McGill Girls will also perform. The three beautiful and talented sisters will be singing patriotic songs in three part harmony. Geoff Carlisle, a professional DJ will be keeping the crowd pumped with music and entertainment.
Following the speakers and the entertainment there will Trump truck-vs- Joe Bidden truck races down the drag strip for the finale.
The Northwest Alabama boat parade will be on Sunday. The boats will gather at 2:00 p.m. near Turtle Point and then the flotilla will parade around the open waters of Wilson Lake til 3_00 p.m.. There will be a contest for best decorated Trump boats.
Trump supporters have held a number of large boat parades across the state to show their support for the re-election of Pres. Trump.
Boat parade sponsors say that this parade will be: pro-American, pro-law enforcement, pro-military.
COVID-19 hospitalizations, new cases continue to rise
The number of rising hospitalized COVID-19 patients in Alabama is a concerning sign of a possible coming surge of the disease, state health experts said Friday. Alabama hospitals were caring for 888 coronavirus patients Friday, the highest number since Sept 9.
UAB Hospital was caring for around 80 COVID-19 inpatients Friday afternoon, said Dr. Rachael Lee, an infectious disease specialist at UAB, speaking to reporters Friday. UAB Hospital hasn’t had that many coronavirus inpatients since Aug. 18, when the disease was surging statewide.
“We have been dealing with this since March, and I think it’s easy for us to drop our guard,” Lee said.
Alabama added 3,852 new coronavirus cases on Friday, but 1,287 of them were older positive antigen tests, conducted in June through October and submitted to ADPH by a facility in Mobile, according to the department. Still, Alabama’s daily case count has been increasing, concerning health officials already worried that as the weather turns colder and the flu season ramps up, Alabama could see a surge like the state had in July.
Alabama’s 14-day average of new daily cases was 1,247 on Friday, the highest it’s been since Sept 4. Over the last 14 days, Alabama has added 17,451 new COVID-19 cases.
Friday’s inclusion of those older positive test results throws off the day’s percent positivity, by Thursday the state’s percent of tests that were positive was nearly 16 percent. Public health officials say it should be at or below five percent or cases are going undetected.
The state added 16 COVID-19 deaths on Friday, bringing to total confirmed deaths statewide to 2,859. Over the last two weeks, 206 deaths were reported in the state. Alabama’s 14-day average of new daily deaths on Friday was 15.
Alabama state health officer Dr. Scott Harris told APR by phone Friday called the rising new cases and hospitalizations “worrisome.”
Harris noted the data dump of older confirmed cases in Friday’s data, but said “but nevertheless, I think it’s clear our numbers are going up.”
Harris said it’s not yet clear what’s causing the continued spread, but said it may be due at least in part to larger private gatherings. ADPH staff has mentioned a few outbreaks association with such gatherings, but Harris said it’s hard to know for certain if that’s the major driver in the state’s rising numbers.
“It’s football season and the holidays are coming up and school is back in session,” Harris said. “I think people are just not being as safe as they were.”
Harris noted that on ADPH’s color-coded, risk indicator dashboard, red counties, which denotes counties with rising cases and percent positivity, the 17 red counties on Friday were distributed across the state.
“So there’s not one event, or even a handful of events. It seems like there’s just a lot of things happening in a lot of places,” Harris said.
Alabama’s rising numbers are mirrored in many states. The U.S. reported more than 71,600 new COVID-19 cases on Thursday, nearing the country’s record highs, set in July.
Birmingham approves $1.3 million contract for real-time crime center technology
Woodfin repeated that facial recognition capabilities will not be used in accordance with the contract.
The Birmingham City Council approved a five-year, $1.3 million contract with Motorola this week to provide new technology for the police department’s real-time crime center amid unease and public concern over the potential use of facial recognition software within the new systems.
Mayor Randall Woodfin insisted in his remarks made before the council that the new technology is meant to integrate existing hardware and technology inside the real-time crime center. “You’re not buying any additional new equipment,” he said, “You’re buying something to integrate all those systems.”
The software suite includes Motorola Solutions’s CommandCentral Aware, a system that aggregates video, image and other data information into one interface, and BriefCam, a “video synopsis” system that will further integrate and analyze information from Birmingham’s ShotSpotter systems, public cameras and police body cameras.
Briefcam offers facial recognition capabilities, which was the main concern of community members speaking before the council, and the risk that use of the technology could disproportionately affect Black people. Facial recognition technology has a record of racial bias and misidentifies Black people at rates five to 10 times higher than white people.
“Despite assurances that there will not be facial recognition implemented at this phase that does not prevent it from being implemented in the future,” said Joseph Baker, Founder of I Believe in Birmingham and one of the Birmingham residents voicing concern on the proposal. “I believe that this software, if fully implemented, can easily lead to violations of unreasonable searches.”
Another resident who spoke against the resolution was Byron Lagrone, director of engineering at medical software solutions company Abel Healthcare Enterprises. Lagrone pointed to IBM and Amazon as examples of companies that have halted or abandoned facial recognition and object tracking software altogether over racial bias concerns.
“The prevailing attitude, among technical people is this technology is not effective, and it causes high amounts of harm for next to no gain,” Lagrone said.
Woodfin repeated that facial recognition capabilities will not be used in accordance with the contract.
“It’s explicit in this contract that facial recognition will not be used,” Woodfin said, “[If] facial recognition wants to be used in the future of this city. It would have to be approved by this body. … The mayor’s office or the police department doesn’t have unilateral power to use facial recognition. That is not part of what our contractual relationship is with Motorola.”
Woodfin also clarified that the total $1.3 million price of the contract will not be paid as a lump sum but spread out over the five-year commitment.
The city council voted 8 to 1 to approve the contract, with District 8 Councilman Steven Hoyt speaking in favor of the use of facial recognition capabilities.
“You can’t say, ‘I’m going to build a house but I’m not going to use the restroom,’” Hoyt said. “If it’s in the house, you’re going to use the restroom. … If it has the capability of facial recognition, guess what’s going to happen? You’re going to use it. I’m going to vote for it because I know we’ve got to have every tool we can garner to fight crime, because it’s out of hand.”
Hoyt also suggested a review of the information collected by the new system apparatus.
“I do think, for the public’s sake, we need to have some way we review that and see how it’s being used,” Hoyt said. “We need that to go along with this.”
District 3 Councilwoman Valerie A. Abbott — who said she was the victim of a burglary the day before the vote — echoed the mayor’s insistence that the facial recognition capabilities would not be deployed unless authorized by the city council, reading a letter from Motorola stating “in order to enable facial recognition, Motorola will require an addendum or change order to the contract,” which would have to come before a public meeting of the city council.
“I too would not want facial recognition,” Abbot said, “I’m voting in favor of this because the majority of my constituents are telling me they want more and better policing, capture of criminals, prevention of crime.”
District 5 Councilman Darrell O’Quinn was the lone no vote among the near-unanimous city council, stating that he had “some reservations about how we’re doing this and will vote my conscience.” Later, O’Quinn was quoted in BirminghamWatch, saying his vote reflected his concerns about “taking on a new debt obligation in the midst of a projected $63 million shortfall in revenue.”
Opinion | Doug Jones’s pathway to victory: Substance over lies
Jones said his work in the Senate should prove to the people of the state that party matters less than productivity.
Alabama Sen. Doug Jones believes voters will ultimately see through Tommy Tuberville’s lazy campaign and lies, and that enough of them will be moved by his work over the last two years to send him back to D.C.
Jones’ comments came during a lengthy interview on the Alabama Politics This Week podcast. He also discussed his plans to address some of Alabama’s most pressing issues and also praised Sen. Richard Shelby, an Alabama Republican.
But it was Jones’ comments about Alabama voters — and whether too many of them are incapable of moving away from the Republican Party — that were most interesting. Jones still believes there are open-minded voters in the state, and that there isn’t enough attention being paid to polls showing a growing dissatisfaction in Alabama with President Donald Trump.
“There are a number of things that Donald Trump has done that people (in Alabama) don’t agree with,” Jones said. “There are a number of things that he’s done that’s hurt Alabama and that they’re not OK with. That’s where I come in.”
Jones said his work in the Senate, where he’s sponsored the most bipartisan legislation over the last two years, should prove to the people of the state that party matters less than productivity.
“I tell everyone, you owe it to yourself to look at every candidate and every issue,” Jones said. “I do that. I’ve been a Democrat all my life but I don’t think that I have ever pulled a straight lever. Because I look at every issue. I will tell you that there have been times that I didn’t vote for people who are Democrats for whatever reason — I just couldn’t do it. I think we owe it to ourselves to do that.”
Jones had the perfect example to drive the point home.
“Y’all all know our state auditor, Jim Zeigler? Jim wasn’t always a Republican. Jim’s first runs for office were as a Democrat.
“I rest my case.”
You can listen to the full interview at the Alabama Politics This Week website, or you can subscribe to the podcast on Apple Podcasts, Google Play, Spotify or wherever you get your podcasts.