Connect with us

News

Alabama’s hospitals are on very fragile footing with CA approaching

Bill Britt

Published

on

By Bill Britt
Alabama Political Reporter

MONTGOMERY— Coosa Valley Medical Center is the area’s most modern acute-care hospital, it is also the largest employer in Sylacauga.

“An organization of our size—-which is midsize medical facility—-is a part of daily life in our community,” says Hospital CEO, Glenn C. Sisk.

Sisk, a veteran hospital executive, says he is concerned about the situation facing the state’s Medicaid program and the effect it will have on the healthcare infrastructure of Alabama.

“Alabama’s hospitals are on very fragile footing economically,” said Sisk. “A recent survey found that the average margin for hospitals is one percent.”

Eighty-five hospitals around the state took part in the survey Sisk refers too, “If you remove the seven top hospital in the state the margin drops to a negative one percent. Only one rural hospital operating in Alabama had a favorable rating the rest are operating in the red,” said Sisk.

Coosa Valley Medical Center is Sylacauga’s biggest employer with 620 employees. But the reach of the hospital creates 1445 jobs in the area with a total economic impact of $133 million annually.

Public Service Announcement

Imagine the effect on Sylacauga and the surrounding area if suddenly those jobs no longer existed.

“If further cuts come and further reduction in Medicaid payments come then hospitals and physician are going to have significant decisions to make,” says Sisk.

While, pundits, politicians and average Alabamians debate the coming vote on the Constitutional Amendment to fund Alabama’s Medicaid program and prison system, medical professionals like Sisk must deal with the harsh reality that faces the state if the amendment fails.

ADVERTISEMENT

“I am not trying to sensationalize the issue with these comments but for certain providers, those who provide heavy Medicaid relayed care, with further cuts those physician will no longer be able to continue to do business in the state,” said Sisk.

This is the sobering assessment from a man with decades of experience in Medical administration. “We have a very difficult time now as it is getting physicians in many parts of the state to accept Medicaid patients,” says Sisk, “and this will further create problems.”

Coosa Valley Medical Center sees approximately 31K visitors annually “which is a very busy compared to our size,” says Sisk, “Last year we had 20 million in uncompensated care.”

What Coosa Valley is experiencing is not a phenomenon but a growing trend because there are more uninsured and under-insured Alabamans and fewer physician who see those who only have Medicaid.

“I was discussing this with a group of physician this week, Sisk said, “They each are considering-—because of the new cuts-—to no longer accept patients on the Medicaid program.

In an attempt to salvage the state’s Medicaid program Dr. Don Williamson, who is heading the governor’s task force on Medicaid, has worked with the Alabama Hospital Association, physician and other providers to take a cut in reimbursements to help the state through the current crisis.

But Williamson has warned that this is just the opening of an event horizon that will see the collapse of Alabama’s health care infrastructure if Medicaid is not funded in 2013.

“It is important for people to understand that Medicaid is not an economic windfall for health care providers,” says Sisk. “In fact Medicaid doesn’t even cover the cost of providing the care.”

Sisk points out that the reason that Alabama hospitals can render good care for its Medicaid patients is because, “we have very efficiently run hospitals, the most efficient in the country.” While Sisk says we should be proud of that it is important to understand that, “providing healthcare to a Medicaid patient is more expensive than the reimbursement we receive.”

Coosa Valley Medical Center has 263-licensed beds. This includes 163 acute-care beds, a 50-bed nursing home, 35-bed skilled nursing facility and a 15-bed senior behavioral unit.

Of the 50 beds in the nursing home facility at Coosa Valley Medical Center 97 percent are filled with Medicaid patients.

Sisk said, “I have heard leadership say, that if this is not solved are we not going to be able to keep nursing home residence.”

If this happens due to Medicaid being unfunded, “Are we going to be forced to put them in alternative environments such as at home, with home health support,” says Sisk. “That is really not the best thing for the person but it is also not good for their families and caregivers.”

Yet, no alternative seems available.

The governor and legislature has said that if the constitutional amendment doesn’t pass that there may be a special session called, and according to the governor, “everything will be on the table.”

This may sound encouraging but the fact is that the constitutional amendment vote is mere weeks before the 2013 budget goes into affect, leaving no time to fix the problem with a tax.

“My understanding is even if a tax were to be passed it would take 6 to 10 months before we would realize the funding results, so, it would be half or two-thirds of an additional fiscal year and I can tell you with confidence that there are providers who would not survive that,” said Sisk. “With the additional plus or minus 17 percent proration on top of where we are now, I can tell you it is unsustainable.”

Many have said that this is a good time for Alabama to face the music and live within its means, but it is not clear what they really mean by their statements or if there is a clear understanding of facts. Alabama has one of the lowest Medicaid reimbursements in the country and the fact that Alabama’s entire healthcare infrastructures is built on Medicaid means that a ripple effect will cause devastating economic consequences.

Given that Alabama is still suffering under the worse economic times in a generation most medical professionals agree a failure to fund Medicaid will produce a heavy lost of jobs in an already fragile economy.

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.

Advertisement

News

Alabama revenues grew despite COVID pandemic, analysis shows

Tax revenue into the state’s General Fund was 7 percent higher this year the Education Trust Fund brought in an additional $209 million in 2020 compared to 2019. 

Eddie Burkhalter

Published

on

(STOCK PHOTO)

Alabama’s strong economy going into the COVID-19 pandemic, and billions in federal aid to address the health and economic crisis, has helped the state’s two largest budget funds to grow this year, according to a study released Thursday. 

According to an analysis by the Public Affairs Research Council of Alabama, tax revenue into the state’s General Fund was 7 percent higher this year than it was in 2019, and Alabama’s Education Trust Fund brought in an additional $209 million in 2020 compared to 2019. 

“According to Finance Department officials, Alabama ended 2020 with $330 million balance in the ETF and a $315 million balance in the General Fund,” wrote PARCA’s Tom Spencer in the report. “That was result both of revenues that exceeded the budgeted amounts and expenditures that were lower than what was appropriated.”

The growth came despite the spike in unemployment that began in March and hasn’t yet abated, and despite mandatory business closures in March and April and the restrictions still in place to protect against the spread of the coronavirus. 

The author of the report said the growth is due in part to the state’s strong economy before the pandemic hit. Unemployment was at a historic low between October and March, and prior to the pandemic, income tax receipts were up approximately 7 percent over the same period in 2019. 

Additionally, $4.1 billion in federal COVID-19 aid has been committed to individuals and municipalities in Alabama, and consumer spending shifted but didn’t stop, the author notes. 

The federal Paycheck Protection Program preserved payrolls, and unemployed workers received $600 per week in a supplement to unemployment insurance, which both helped prevent the state’s tax revenue from taking a bigger hit. 

Public Service Announcement

“Sales taxes dropped, then recovered and have been up and down in the months since. At the same time though, tax on internet purchases surged, offsetting the erosion in sales tax. Unlike some other states, Alabama’s sales taxes apply to groceries and medicine and thus it tends to be more stable,” Spencer wrote in the report. 

Several sectors of Alabama’s economy have done well during the pandemic, including the state’s Alcohol Beverage Control Board, which contributed an additional $17 million to the General Fund, an increase of 14 percent. 

But still other sectors suffered, including lodging tax. The tax on hotels and vacation rentals was down 15 percent for the year, and collected almost $9 million less for the General Fund.

ADVERTISEMENT

“For the current fiscal year, FY 2021, Finance officials are relatively confident that revenues will more than cover the budgets. Lawmaker scaled back spending plans in light of the pandemic,” Spencer wrote in the report. “As long as there aren’t additional unforeseen shocks to the economic system, the Alabama economy should generate the revenue needed to make the budgets as adopted this spring.”

If the state’s economy were to take a larger hit, Spencer noted, the state still has rainy day funds for both funds. 

RESERVE FUND BALANCES

  • ETF Budget Stabilization Fund – $373,269,077
  • ETF Rainy Day Account – $465,421,670
  • GF Budget Stabilization Fund – $27,297,483
  • GF Budget Rainy Day Account – $232,939,781

Continue Reading

Featured Columnists

Opinion | Electing Tuberville could cost Alabama billions

If your conscience or decency isn’t enough, vote your wallets.

Josh Moon

Published

on

Sen. Doug Jones, left, and Senate candidate Tommy Tuberville, right.

Money matters in Alabama. Oh, I know that we’re not supposed to say that out loud. That we’re supposed to promote our image of southern grace and hospitality, of churchiness and care, of rich people never getting into heaven. 

But the truth is greed is our biggest character flaw in this state. 

Every problem we have can be traced back to our unending thirst for dollars. Our ancestors didn’t keep slaves because they hated black people. They did it because they loved money and the difference in skin color gave them an excuse — a really, really stupid excuse — to mistreat other humans to take advantage of the free labor. 

Our rivers and lakes and dirt aren’t filled with poisons from factories because we’re too dumb to understand how this works. They’re that way because our politicians are paid off to turn a blind eye to the dumping of toxic waste. 

Our schools aren’t terrible because we have dumb kids or bad teachers. It’s because we’re too cheap to pay for them. 

You see what I mean? It’s our lust for the almighty dollar. Every time. 

We love money. 

Public Service Announcement

Which makes me seriously wonder why so many people in this state are going to vote for a man who will cost us all — and especially our biggest businesses — so much of it. 

Tommy Tuberville will be like a money vacuum for Alabama. Billions of dollars will vanish for this welfare state that relies so much on federal contracts, federal programs and federal dollars. 

If you doubt this, don’t simply take my word for it. Just Google up the press releases from Sen. Richard Shelby’s office from the last, say, six years — the most recent span in which Republicans have controlled the Senate. 

ADVERTISEMENT

Almost every single release is about Shelby securing millions or billions of dollars in federal funding for this project or that project, getting the state’s share of dollars from a variety of different programs and initiatives implemented by Congress. 

Shelby and I obviously have different political viewpoints, but it’s hard to argue that the man has been successful in securing money for Alabama. Lots and lots of money. 

Money for airports and roads. Money for defense contractors in Huntsville. Money for the port in Mobile. Money for car manufacturers. Money for farmers. 

Money. Money. Money. 

Shelby can do that because of three things: He’s on the right committees, he’s a member of the party in power and he’s liked by the right people.

Tuberville will be none of those things. 

Most pundits are predicting that Democrats will take over the Senate, tipping the balance of power and giving the party control of both houses and the White House. 

That automatically means that a first-time senator in the opposition party will have little to no say in any decisions. 

But what’s worse for Tuberville, and for Alabama, is that other Republicans don’t like him either. 

Establishment Republicans essentially openly campaigned against Tuberville in the primary, tossing tens of millions of dollars behind his opponent, Jeff Sessions. They even favored third-place finisher Bradley Byrne over Tuberville. 

It’s not hard to understand why — he’s clueless. 

I know that’s a Doug Jones talking point, but this one happens to be true. Let me give you an example: On Thursday, Tuberville tweeted out what was meant to be a shot at Jones, claiming that Alabama’s current senator wouldn’t meet with Trump’s Supreme Court nominee because Jones knows “he won’t have much time in the Senate to work with her.”

If you’re unaware, the Senate doesn’t “work with” the Supreme Court. They’re separate entities. 

Combine that with his other nonsensical answers on COVID relief, school reopenings, the Voting Rights Act, senate committee assignments, education, foreign affairs — really, the list is almost endless — and it shows how little work he’s put in over the last two years to understand this job he’s applying for. 

Now, that might be just fine with Alabama voters who care more about the party affiliation and owning the libs, but it’s not OK with grownups who take the job of running the country seriously. 

And those people — both Rs and Ds — don’t like Tuberville or his here-for-an-easy-check-like-always approach to one of the most serious jobs in the world. 

He will be frozen out of the most sought after committee assignments. His voice will carry zero weight. His presence will be all but forgotten. 

And in the process, so will Alabama. Especially in two years, when Shelby retires and his senior status is lost. 

In the meantime, Jones is highly respected by senators on both sides of the aisle. He already has a presence on top committees, and is so well liked within the Democratic Party that he’s on the short list to be Joe Biden’s AG, should he not be re-elected. 

The choice seems pretty simple. On the one hand is a competent, prepared and serious statesman who knows how to maneuver his colleagues to get the most for the state. On the other hand is an unprepared, uncaring, lazy carpetbagger who doesn’t understand any process. 

If your conscience or decency isn’t enough, vote your wallets.

Continue Reading

Health

At least 248 COVID deaths reported in Alabama in October

The cumulative death toll in Alabama has risen by 248 to 2,788 in October and by 124 in the last week alone.

Brandon Moseley

Published

on

(STOCK PHOTO)

We’re a little more than halfway through the month of October and the Alabama Department of Public Health has already reported at least 248 deaths from COVID-19.

The cumulative death toll in Alabama has risen by 248 to 2,788 in October and by 124 in the last week alone.

At least 378 deaths were reported in the month of September, a rate of 12.6 deaths per day over the month. In the first 17 days of October, the rate has been 14.6 deaths per day, a 15.9 percent increase from September.

Deaths were higher in July and August. The cumulative death toll increased by 582 in August and 630 in July, the worst month of the pandemic for the state.

On Saturday, ADPH reported that 1,288 more people in the state were confirmed positive with the coronavirus, and on Sunday the count increased by 964. The number of confirmed cases in Alabama has risen to 172,626.

There have been 17,925 new cases Alabama in October alone. The state is averaging almost 996 cases per day in October, which is up from September.

The state had 28,643 new coronavirus cases in September, 38,335 cases new cases in August, and 49,678 cases in July. Public health officials credit Alabama Governor Kay Ivey’s statewide mask order on July 15 with slowing the spread of the virus in the state, but the virus has not gone away.

Public Service Announcement

ADPH reported 823 hospitalizations for COVID-19 on October 17, the most recent day for which we have data. While hospitalizations for COVID-19 are down from the peaks in early August in Alabama have risen from Oct. 1 when 748 Alabamians were hospitalized, a 10 percent increase from the first of the month.

The state of Alabama is continuing to struggle to protect its most vulnerable citizens. At least 6,497 residents of long term care facilities in Alabama have been diagnosed with the coronavirus, 247 of them in October.

There have also been 3,362 cases among long term care workers in Alabama, including 197 in the month of October. Some 9,819 Alabama health care workers have also contracted the coronavirus.

ADVERTISEMENT

Most people who test positive for the novel strain of the coronavirus, SARS-CoV-2, are asymptomatic or have only minor symptoms, but in about one out of five cases it can become much more severe.

For older people or people with underlying medical conditions like obesity, heart disease, asthma, cancer, diabetes or HIV, COVID-19 can turn deadly. COVID-19 is the abbreviated name for the medical condition caused by the SARS-CoV-2 virus.

Some 1,115,600 people worldwide have died from COVID-19 worldwide, including 224,284 Americans. There are 8,972,704 known active cases in the world today.

Public health officials warn citizens that coronavirus remains a present danger in our community. Social distancing is the best way to avoid spreading the virus. Avoid venues with large groups. Don’t shake hands or hug persons not living in your household.

Avoid leaving your home as much as possible and wear a mask or cloth face covering when you do go out. Avoid touching your face and wash your hands with soap frequently. Hand sanitizer is recommended.

A coronavirus vaccine may be available in the coming months, but we don’t yet know when or how effective it will be.

Continue Reading

Environment

ADEM director weighs-in on coal ash pond closures

APR spoke with ADEM Director Lance LeFleur to understand the process and how the public could be assured that steps taken would lead to a safe and effective outcome.

Bill Britt

Published

on

ADEM Director Lance LeFleur

Over the next few weeks, the Alabama Department of Environmental Management will hold public hearings on the regulated closures of three coal combustion residuals storage sites, commonly referred to as coal ash ponds.

While ADEM receives high marks from federal regulators and businesses within Alabama, there is always a certain skepticism that surrounds environmental issues both on the left and the right side of the political spectrum.

Recently, APR spoke with ADEM Director Lance LeFleur to understand the process and how the public could be assured that steps taken would lead to a safe and effective outcome.

“I know that there’s skepticism about government,” LeFleur said. “And it’s healthy to have skepticism about government, state governments, local government, federal government. Skepticism is part of how we operate.” But LeFleur wants the public to know that ADEM’s first purpose is Alabamians’ health and safety.

“Our mission is to ensure for all Alabamians a safe, healthful and productive environment,” LeFleur said. “It’s a mission that ADEM and its nearly 600 employees take very seriously.”

LeFleur says while there are many competing sides to the issues that arise from coal ash disposal, ADEM must focus on “science and the laws.”

According to LeFleur, there are two primary issues that must be addressed when closing coal ash ponds: “avoid threats of spills into waterways or onto land, and preventing and cleaning up groundwater contamination from arsenic, mercury, lead and other hazardous elements that may leach from the coal ash.”

Public Service Announcement

EPA does not classify coal residue as hazardous waste, but LeFleur says that all closures must ensure dangerous elements are not leaching down into the groundwater.

“I think there’s pretty much unanimous opinion that these coal ash ponds need to be closed; they need to be closed properly,” said LeFleur. “And we need to clean up the groundwater that’s in place.”

He says that the entire process will take decades, but the power companies have committed to safely closing the coal ash ponds. “We are dealing with power companies that are going to be around for a long time. And they, they are obligated to get the result right,” said LeFleur.

ADVERTISEMENT

Alabama currently has 14 regulated CCR units at eight sites throughout the state. They are comprised of 10 unlined surface impoundments, one lined landfill, one lined surface impoundment all closed, and two lined landfills still in operation.

Public hearings are a significant part of the permit granting process, according to LeFleur, and ADEM’s website allows any individual to review every document and comment about a coal ash pond’s closing.

“You can see all of the comments that we received,” LeFleur said. “Every issue raised during the comment period and written response to comments are available.” ADEM’s website also includes the closure plans as well as all correspondence between agency and utility companies.

According to ADEM, the purpose of these hearings is to allow the public, including nearby residents, environmental groups, and others, opportunities to weigh in on the proposed permits.

“This past summer, Alabama Power, TVA, and PowerSouth held informational meetings in the communities where their affected plants are located to explain their proposed groundwater cleanup plan —including the CCR unit closure component— and answer residents’ questions,” said LeFleur.

Closing a unit requires months of planning with ADEM engineers to make sure all procedures are followed correctly. Federal rules for closing CCRs have only been around since April 2015, when EPA released final measures for management and disposal of CCRs from electric utilities. In 2018, ADEM issued its state CCR rule, which closely tracks the federal regulations.

Under both Presidents Obama and Trump, the EPA has allowed for coal ash sites to be closed by two methods — closure in place and by removal.

Alabama’s utilities have chosen the cap in place method. Some environmental groups prefer removal. But estimates say that moving CCRs from Alabama Power’s Plant Barry would take around 30 years with trucks leaving the site every six minutes.

“Regardless of which method of closure is used, that process will take a couple of years to accomplish at these sites,” said LeFleur. “If it’s kept in place, the material has been de-watered then pushed together to create a smaller footprint, and then that will be covered with an impervious cover.”

The objective, according to ADEM, is to protect the groundwater and the environment from pollution.

Power providers and environmentalists seem to agree there isn’t a perfect solution. Public hearings are to ensure that community voices and those of environmentalists are heard.

“This entire process is designed to stop contamination to groundwater and future contamination to groundwater; those are the most important facts now,” said LeFleur. “There are always political issues, you know, at least two sides, and sometimes there’s three, four or five sides. We focus on science and the laws. That’s what we do.”

While ADEM has its critics, it receives a high rating from the EPA, and an annual survey by the Alabama Department of Commerce finds that it gets top marks from business and industry in the state.

ADEM’s first public hearing on coal ash permits will be held Tuesday, Oct. 20, for Alabama Power’s Miller Steam Plant in west Jefferson County. The meeting will be at 6 p.m. at the West Jefferson Town Hall. Other upcoming hearings are Thursday, Oct. 22, for Plant Greene County located in Greene County and Oct. 29 for Plant Gadsden in Etowah County.

Continue Reading
Advertisement
Advertisement