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Alabama First in Program for Pre-term Babies

Susan Britt

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By Susan Britt
Alabama Political Reporter

MONTGOMERY—Alabama becomes first state to add smoking cessation to its Plan First family planning program. The state received federal approval in April 2012 to add counseling and medications to current service.

In Alabama, 15 percent of all pregnant females smoke, according to data from the Alabama Department of Public Health. There are estimates that up to 35 percent of low-income Medicaid mothers smoke.

According to a January 2012 study published by George Washington University Center for Health Policy Research found that for every dollar invested in a smoking cessation program for pregnant women, Medicaid could expect $3.12 in savings.

However, in November 2011 the March of Dimes gave Alabama an F rating for premature birth and infant mortality because of its 16 percent rating although down from a rating of 18. 2 percent in 2006. To earn an A, a state has to have a rate of at least 9.6 percent, which is the March of Dimes goal for the U.S. to reach by 2020.

Alabama is one of several Southern states with a high rate of preterm births, largely because of smoking, obesity, teenage pregnancies and lack of prenatal care.

According to the March of Dimes, preterm birth is the leading cause of newborn deaths in the United States. Babies born prematurely potentially face other lifelong health problems, such as cerebral palsy, chronic lung disease, vision and hearing problems, intellectual disabilities and higher rates of hospitalization.

According to a June 2012 a report from the National Conference of State Legislatures Medicaid pays for about 40 percent of births.

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One in eight babies is born before 37 weeks with the associated medical costs totaling more than $20 billion per year, about $51,600 per infant.

In Wisconsin, a preterm baby with a very low birth weight (2.2 to 3.3 pounds) in the first four years of life costs $61,902 compared with $7,260 for a normal weight baby, according to the state’s Department of Health Services.

States are required to cover pregnancy-related services for women with incomes below 133 percent of the federal poverty guidelines.

Several states are using different methods to reduce the rates of preterm births and low birthweights.

Louisiana is increasing the use of prenatal services by pregnant women in Medicaid with a program called Birth Outcomes Initiative. Their website states their mission as “The Birth Outcomes Initiative is a targeted cross-departmental and cross-sector initiative to improve the outcomes of Louisiana’s births and health of Louisiana’s moms and babies.”

Louisiana’s goal is the reduction of non-medically indicated deliveries before 39 weeks by early induction or cesarean. They account for more than 10 percent of births and have increased over recent decades because of cultural preferences, convenience and doctor’s schedules.

The Healthy Texas Babies Initiative is a collaboration of state agencies, healthcare providers, insurance companies and community members. Its goal is to decrease infant mortality and reduce Medicaid costs by $7.2 million over two years. The state plans to accomplish this by increasing prenatal health awareness and access to care for women on the Medicaid rolls with high-risk pregnancies by promoting awareness and providing education campaigns.

Their website states their vision “For all Texas babies to have a healthy, happy first birthday.”

Funded by a 2007 grant from the Centers for Medicare and Medicaid Services, the Ohio Perinatal Quality Collaborative has reduced early elective deliveries by educating patients and healthcare providers. Over a three year period, 20,700 early elective pre-term births were prevented saving around $25 million as a result of fewer admissions to neonatal intensive care units.

South Carolina’s Birth Outcomes Initiative in 2011 decreased early elective deliveries among its Medicaid enrollees and is saving around $1 million in delivery costs and $7 million from fewer infant hospitalizations per year.

According to the National Conference of State Legislatures’ report, “In February 2012, [Centers for Medicare and Medicaid Services] CMS launched the ‘Strong Start’ initiative, which provides $43.2 million in grants to providers, state Medicaid agencies, and Medicaid managed care organizations to reduce early elective deliveries and test new approaches to better prenatal care for women with high-risk pregnancies.” http://innovations.cms.gov/initiatives/strong-start/

The program will test three evidence-based maternity care service options. The Innovation Center offers grant funding for three approaches: Enhanced Prenatal Care Through Centering/Group Visits, Enhanced Prenatal Care at Birth Centers and Enhanced Prenatal Care at Maternity Care Homes. It intends to fund the cost for prenatal care for 30,000 Medicaid women for each program, 90,000 in total over three years.

Eligible applicants include: Providers of obstetric care, states, Medicaid managed care organizations and conveners in partnerships with other applicants. Applicants must be able to serve 500 women at risk for premature births.

Prenatal care including screening and diagnostic tests that identify problems early, manage chronic conditions and educate mothers about risky behavior is shown to reduce the likelihood of underweight birth by half.

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Health

Three firefighters, police officer in Mobile test positive for COVID-19

Eddie Burkhalter

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Three firefighters and a police officer in Mobile have tested positive for COVID-19, city officials said Tuesday.

James Barber, executive director of public safety with the city of Mobile, said during a press conference Tuesday that the four city employees tested positive.

The positives come after Mobile-based Synergy Laboratories donated 500 “test kits” and 131 asymptomatic first responders were given the 10-minute rapid blood tests on Monday.  

Barber said the four employees have been quarantined at home until swab tests confirm the virus and physicians provide further guidance.

The rapid blood tests search for antibodies in the blood, which could show a past infection, but not necessarily active infections that are still contagious.

The swab tests will confirm an active infection if one exists. It’s possible the first responders have already recovered from the virus and are no longer contagious.

“That testing continues today,” Barber said of the rapid blood testing of first responders.

Barber said he didn’t have results from Tuesday’s testing yet, but that Monday’s testing resulted in just more than 3 percent of those tested showing positive results for COVID-19. 

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There were 53 confirmed cases of COVID-19 and one death from the virus in Mobile County as of Tuesday evening, according to the Alabama Department of Public Health. 

As of Tuesday evening, there were 999 confirmed COVID-19 cases across Alabama, 13 confirmed deaths from the virus and 23 total reported deaths, some of them not yet confirmed as being caused by the virus.

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Economy

Freelancers, gig workers can begin filing unemployment claims

Chip Brownlee

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Stock Photo

Employees like freelancers and the self-employed can now file for an unemployment claim in Alabama, the Alabama Department of Labor said Tuesday, under the CARES Act, the coronavirus response bill passed by Congress and signed by the president last week.

The Alabama Department of Labor is encouraging employees who believe they may qualify for programs under the CARES Act to file a claim.

These employees will also need to certify weekly to continue to let the department know that they remain unemployed.

Although ADOL does not yet have technical guidance or a start date regarding the CARES Act programs, benefits may be paid retroactively from the time the employee separated from his or her job or otherwise became eligible under the federal CARES Act, not from the time the application was submitted or approved.

In Alabama, many freelancers, independent contractors and the self-employed are not typically able to file for unemployment insurance.

Last week, more than 70,000 people filed an initial jobless claim. Claims can be filed online at www.labor.alabama.gov or by calling 1-866-234-5382.

The Department of Labor is asking for patience when trying to file a claim.

ADOL says employees who may be affected include:

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  • The self-employed
  • Church employees
  • Non-profit and governmental employees
  • Independent contractors
  • Gig economy workers
  • Those who have exhausted their regular UI benefits.

These employees should also meet one of these conditions:

  • The individual has been diagnosed; or
  • A member of the individual’s household has been diagnosed; or
  • The individual is providing care to a household or family member; or
  • A child or other person for which the individual has primary caregiving responsibility is unable to attend school or another facility as a result of COVID-19; or
  • The individual is unable to reach the place of employment because of a quarantine imposed as a result of the COVID-19 public health emergency; or
  • The individual is unable to reach the place of employment because the individual has been advised by a health care provider to self-quarantine; or
  • The individual was scheduled to start work and does not have a job as a result of COVID-19; or
  • The individual has become “the breadwinner or major support for a household because the head of the household has died as a direct result of COVID-19”; or
  • The individual has to quit their job because of COVID-19; or
  • The individual’s place of employment is closed because of COVID-19.

This list is not exhaustive.

Further details regarding the CARES Act programs will be forthcoming, the department says, including information regarding Federal Pandemic Unemployment Compensation, which provides for an additional $600 a week in unemployment compensation benefits.

The additional $600 weekly benefit will only be available for weeks beginning March 29, 2020

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Health

Two hospital employees in Huntsville test positive for COVID-19

Chip Brownlee

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Stock Photo/Huntsville, Alabama

A physician and another employee at Crestwood Medical Center in Huntsville, Alabama, have tested positive for the novel coronavirus that causes COVID-19, the hospital said Tuesday.

“Crestwood Medical Center learned that 2 of our associates (one physician and one employee) have tested positive for COVID-19,” spokesperson Lori Light said in a statement Tuesday.

One is in the hospital for care while the other is at home under quarantine.

The hospital has also had two patients test positive in the Emergency Department, but neither of the patients needed inpatient care, the spokesperson said.

“Working in coordination with the health department, we are following established CDC procedures to identify and communicate directly with any potentially exposed staff and patients,” the Crestwood Medical Center spokesperson said.

Overall, there are at least 13 COVID-19 patients in Madison County, the hospital’s CEO Dr. Pam Hudson said Tuesday during a briefing.

There are 11 inpatients at Huntsville Hospital’s facilities, according to Huntsville Hospital spokesperson Susan Esslinger.

In Alabama, the number of positive cases is nearing 1,000. At least 23 deaths related to COVID-19 have been reported. The Alabama Department of Public Health has officially confirmed 13.

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Crime

Alabama inmate killed by another inmate at Ventress Correctional

Eddie Burkhalter

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via the Alabama Department of Corrections

A Birmingham man serving at Ventress Correctional Facility in Clayton was killed by another inmate, according to the Alabama Department of Corrections. 

Dennis Benson, 40, who was serving a 36-month sentence for possession of a controlled substance and receiving stolen property, died March 30 after being attacked by another inmate, ADOC said in a statement. 

“The ADOC condemns all violence in its facilities, and the fatal actions taken against Benson by another inmate are being thoroughly investigated,” the department said in a statement.

Benson’s cause of death is pending a full autopsy, and more information will be available upon the conclusion of the investigation into his death, according to the department. 

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