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

Bill Britt

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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.

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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.

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“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.

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Education

Alabama’s First Class Pre-K program gets more national attention

The article analyzed a recent study that found that students who attended the program were “statistically significantly more likely” to be proficient in both math and reading than those who did not.

Micah Danney

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(STOCK PHOTO)

The state’s First Class Pre-K program gives children advantages in math and reading that last into middle school, far longer than the gains studied in other high-quality pre-K programs, according to an article published in the International Journal of Child Care and Education Policy.

The article analyzed a recent study that found that students who attended the program were “statistically significantly more likely” to be proficient in both math and reading than those who did not.

While programs like Head Start and Tennessee’s pre-K program have been shown to lead to significant educational improvements when children enter kindergarten, those benefits appear to experience a “fadeout” within a year. 

The new research followed students through the 7th grade. Further research should examine the persistence of benefits through high school, according to the article, which was published by researchers from the University of Alabama at Birmingham, the Public Affairs Research Council of Alabama, ThinkData and the Alabama Department of Early Childhood Education.

The research “is reassuring and supports accountability for continued investments and expansion,” the article concluded.

The journal that featured the article is a publication of the National Institute of Early Education Research at Rutgers University.

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Congress

U.S. Rep. Bradley Byrne announces new chief of staff

Eddie Burkhalter

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U.S. Rep. Bradley Byrne

Congressman Bradley Byrne, R-Alabama, on Friday announced that Seth Morrow will serve as his chief of staff.

“As we enter the last half of 2020, my office remains busy assisting constituents and advancing our legislative priorities. I know Seth shares my focus on finishing out my term in Congress strong, and he is well prepared to move into the Chief of Staff role,” Byrne said in a statement. “My staff and I will continue working hard every day to fight for the people of Southwest Alabama and advance our conservative agenda.”

Morrow is a native of Guntersville and has worked for Byrne since June 2014, serving as deputy chief of staff and communications director. 

“I am grateful for this opportunity, and I’m committed to ensuring our office maintains our first class service to the people of Southwest Alabama. Congressman Byrne has always had the hardest working team on Capitol Hill, and I know we will keep that tradition going,” Morrow said in a statement.

Morrow replaces Chad Carlough, who has held the position of Byrne’s chief of staff since March 2017. 

“Chad has very ably led our Congressional team over the last few years, and I join the people of Southwest Alabama in thanking him for his dedicated service to our state and our country,” Byrne said. 

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Crime

Alabama Department of Corrections investigating inmate death

Robert Earl Adams, 40, died on Aug. 5 and although no foul play is suspected, a department spokeswoman in a message to APR said the exact cause of death is pending an autopsy.

Eddie Burkhalter

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(STOCK PHOTO)

The Alabama Department of Corrections is investigating the death of an inmate at the Donaldson Correctional Facility.

Robert Earl Adams, 40, died on Aug. 5 and although no foul play is suspected, a department spokeswoman in a message to APR said the exact cause of death is pending an autopsy.

“While Adams’ exact cause of death is pending the results of a full autopsy, at the time of his passing inmate Adams was not exhibiting symptoms of COVID-19, was not under quarantine following direct exposure to an inmate or staff member who previously had tested positive, and was not in medical isolation as a result of a positive COVID-19 test,” said ADOC spokeswoman Samantha Rose in the message.

Because Adams was not exhibiting symptoms of COVID-19, he had not been tested, Rose said.

An ADOC worker who contacted APR Friday morning about the death, who asked not to be identified for fear of repercussions from ADOC administrators, said it’s suspected that Adams may have overdosed after being given a cigarette laced with a drug.

Adams is at least the sixteenth state inmate to die this year from either homicide, suspected drug overdose or suicide. Additionally, fifteen inmates and two prison workers have died after testing positive for COVID-19.

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Alabama GOP chair: “We expect our elected officials to follow the law” after Dismukes arrest

“Will Dismukes matter: We expect our elected officials, regardless of Party, to follow the laws of our state and nation,” Alabama GOP chair Terry Lathan said on Twitter.

Brandon Moseley

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State Rep. Will Dismukes, R-Prattville, has been arrested on the charge of felony theft.

Alabama Republican Party Chair Terry Lathan said Thursday that Alabamians expect their leaders to follow the law. Her comments came in response to news that an arrest warrant had been issued for State Rep. Will Dismukes, R-Prattville, on the charge of felony theft.

“Will Dismukes matter: We expect our elected officials, regardless of Party, to follow the laws of our state and nation,” Lathan said on Twitter. “No one is immune to these standards. It is very disappointing to hear of these allegations. This is now a legal matter and it must run its course.”

Speaker of the House Mac McCutcheon, R-Monrovia, said Friday in a statement that Dismukes will get his day in court.

“As a former law enforcement officer, I have faith in the criminal justice process and trust that he will receive a full and fair hearing,” McCutcheon said. “Both Democrats and Republicans have been accused of similar crimes in the past, and we cannot tolerate such behavior whether the lawmaker involved has a D or an R beside their name.”

Dismukes has been charged by his former employer, a custom flooring company, of felony theft charges. Dismukes left that employer and started his own custom flooring company.

Dismukes, who is serving in his first term and is one of the youngest members of the Alabama Legislature, has been heavily criticized for his participation in a birthday party for Confederate Lt. General Nathan Bedford Forrest in Selma. Forrest was also the first grand wizard of the Ku Klux Klan.

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The party in Selma occurred the same week that Congressman John Lewis’s funeral events were happening in Selma. Dismukes resigned his position at Valley Baptist Church when the Southern Baptists threatened to disassociate the Prattville Church if they retained Dismukes. He has defiantly refused to step down from the Legislature, but if convicted of a felony, he would be automatically removed from office.

Both Democrats and Republicans have called for Dismukes to resign from the Alabama House of Representatives over his being the chaplain of the Prattville Sons of Confederate Veterans and his Facebook post lauding Forrest. The investigation into the theft predates the controversies surrounding Dismukes’s glorification of the Confederacy and Forrest.

Republican State Sen. Clyde Chambliss, who also represents Prattville, has called on Dismukes to resign.

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“Since first being elected in 1996, I’ve had a policy of not publicly criticizing other elected officials, but at this time I am making an exception since Rep. Dismukes is MY state representative. He does not represent my views or the views of the vast majority of people of District 88,” Chambliss said. “The post is bad enough, the timing is even worse, but the real problem is that an elected official in 2020 would attend a celebration of the life of someone that led a group that terrorized and killed other human beings. He has had 24 hours to understand why people are so upset, but his interview on WSFA a few moments ago confirms that he is lacking in understanding and judgment — he should resign immediately.”

Alabama Democratic Party Chairman State Rep. Chris England, D-Tuscaloosa, has repeatedly called for Dismukes to resign from the Alabama House of Representatives.

The Alabama Democratic Party recently said in a statement, “Will Dismukes is morally unfit for office. Republicans and Democrats statewide seem to agree. Unfortunately, despite the mounting calls for his immediate resignation, Will intends to stay in office and seek re-election without penalty from the Republican Party.”

“While Alabama Republicans hope this will be a distant memory when Dismukes runs for re-election in 2022, we are not going to let him off the hook,” the ADP wrote. “The Alabama Democratic Party is going to leverage every tool we have to send Will packing when he comes up for re-election in two years.”

“In our darkest hours in life there is still light in Christ!” Dismukes wrote on social media Wednesday. “As the storm continues to blow with heavy force, there is yet a peace that this too shall pass. I guess sometimes we find out if we have built our house on sand or the solid rock of Christ. Psalm 23.”

When Speaker of the House Mike Hubbard, R-Auburn, was indicted on 21 charges of felony ethics violations, he did not resign and actually remained speaker until a jury of his peers in Lee County convicted him on 12 counts.

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