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We must vote “YES” on September 18th

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By Senator Roger Bedford, Senate Minority Leader

Next Tuesday, September 18th, the people of Alabama will go to the polls to vote on a constitutional amendment that will have a major impact on every state agency.  The constitutional amendment will directly affect the health and safety of Alabama families, as well as the future of economic development in this state.  If passed, this referendum will keep tens of thousands of hard-working Alabamians on the job.

What you may not realize is that this amendment must pass for our local hospitals and all the healthcare service providers around the state to continue to offer the services our community requires. What you may not realize is that this amendment must pass to avoid the collapse of Alabama’s Medicaid system.  What you may not realize is that this amendment must pass for our correctional facilities to continue operating and to avoid the release of prisoners into our communities.  What you may not realize is that this amendment must pass to ensure that our court system continues to function and our district attorneys have the resources to investigate and prosecute crimes.

If the amendment fails next Tuesday, Alabamians could face some of the deepest across-the-board cuts we have ever seen.  Make no mistake about it, if this amendment fails, our healthcare system will not be the same because the same services may not be available, the same doctors may not continue to work here, and our hospitals and clinics may be forced to completely change how we conduct business and deliver services.  Make no mistake about it, funding for dialysis, prescription medications for adults, critical transportation for children, and in-home care would all be greatly reduced or eliminated altogether.  Make no mistake about it, hospitals, doctors’ offices and health clinics may be forced to cut staff or close altogether and the elderly would be forced out of nursing homes onto the street.

Make no mistake about it, thousands of jobs will be lost across our state that will disproportionately hit middle-class families the hardest.  The only way we can avoid these disastrous results, is if the constitutional amendment passes.

I agree that the Republican supermajority should have put in the bill that the money borrowed must be paid back.  Unfortunately, they chose not to.  However, we cannot allow the right-wing Tea party to destroy the healthcare system in Alabama.  For critics of the amendment who say that a better solution exists, there is no other plan.  If the amendment fails, the Governor has said that there is not a Plan B, and we will have no other option but to slash and burn the state budget.  We must come together as one state to pass this amendment.

Therefore, on September 18th, the citizens of Alabama will be asked to make a very important decision—a decision that will affect the future our state as we know it.  For the sake of our communities and the health and well being of our people and Alabama’s most vulnerable citizens, please vote “YES” on September 18th.

Senator Roger Bedford is a Democrat from Russellville.  He has served in the Alabama Senate since 1982.  In 2010, Senator Bedford was elected Senate Minority Leader by the Senate Democratic Caucus.

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Health

Judge hears testimony over temporary abortion ban during COVID crisis

Eddie Burkhalter

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A federal judge on Monday heard testimony during the first hearing following the judge’s temporary restraining order last week, which temporarily barred Alabama from prohibiting abortions during the novel coronavirus outbreak.

U.S. District Judge Myron Thompson heard testimony from Alabama State Health Officer Dr. Scott Harris and Dr. Yashika Robinson, the named plaintiff in the case who operates an OBGYN office in Huntsville and conducts abortions at the Alabama Women’s Center, one of three abortion clinics in the state. 

The American Civil Liberties Union and the ACLU of Alabama filed the suit on behalf of Robinson, which argues that Alabama is restricting access to abortions under the guise of protecting the public from COVID-19. 

The state is defending Harris’s March 27 and April 3 public health orders, which prohibit elective medical procedures except those necessary to treat an “emergency medical condition” or to “avoid serious harm from an underlying condition.” 

Attorneys with the attorney general’s office argue the order’s purpose wasn’t to target abortion clinics but to prevent the spread of the virus and to save scarce personal protective equipment as health care workers fight the COVID-19 outbreak. 

Harris told the court during the teleconference hearing Monday just that, that his order banned elective procedures to limit the public’s exposure to the virus and to help preserve the state’s limited supply of PPE. 

Alabama Assistant Attorney General Jim Davis asked Harris whether the Alabama Department of Public Health defined what is and isn’t an elective procedure, to which Harris said, “We did not specify. We just said all procedures” and the department instead “left that to the discretion of the provider.” 

Harris told the court that it’s up to health care providers to determine if their patient meets one of the two of the exceptions spelled out in his April 30 order. 

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“Specifically,  can a woman who gets an abortion experience complications that require a followup?” Davis asked Harris, who said yes. 

Harris said one of the goals of his order was to prevent stress on the state’s health care system in the event an elective procedure requires emergency care. 

“We didn’t try to think of every possible procedure or every possible scenario, but I think, generally speaking, procedures do consume PPE,” Harris said. 

Alexa Kolbi-Molinas, an attorney with ACLU, asked Harris about an ADPH directive regarding the COVID-19 outbreak that state health care providers are to seek guidance from organizations including the American College of Obstetricians and Gynecologists.

“Were you aware that ACOG and other organizations have issued a joint statement stating that they do not support COVID-19 responses that cancel or delay abortion procedures?” Kolbi-Molinas asked Harris. 

“No. I’m not aware of that,” Harris said. 

Harris agreed during questioning that he cannot say how long his order barring elective procedures might last, and said that China’s ability to slow the spread of the virus was the result of strict travel restrictions that would be difficult to implement in Alabama.  

Kolbi-Molinas asked Harris about Alabama’s infant and maternal mortality crisis, which preceded the COVID-19 outbreak and noted that Alabama women die from childbirth complications at more than double the rate of women nationally, and rank third-highest in the nation in maternal death rates. 

Kolbi-Molinas pointed out through questioning that ADPH licenses abortion clinics and has the authority to take action against a clinic that violates an emergency order, and that prosecutors could also take action against them if ADPH declined to do so. 

Kolbi-Molinas asked Harris about the inclusion of gun stores as “essential” businesses in his April order, which allows the stores to remain open. 

“There are more than three gun stores in Alabama, aren’t there?” she asked. 

“I think you’re probably right about that,” Harris said. 

Kolbi-Molinas asked whether Harris knew if gun stores in the state are screening employees or customers for fevers, and Harris said that he did not. 

She asked if he was aware that the FBI conducted background searches for more than 100,000 gun purchases in Alabama during March, in which a customer must come into the store in person. Harris said he was unaware of that figure. 

“Would you say the decision to designate gun stores as essential retailers was driven by public health considerations?” Kolbi-Molinas asked. 

“I think the whole list of non-essential versus essential businesses was something that we’re trying to do as quickly as possible, and we really concentrated mostly on what we thought were close-contact professions,” Harris said. “Clearly, there are actually, literally hundreds of exceptions here, and we may not have gotten them all correct, but I think we were trying to do them as quickly as possible.” 

Dr. Yashika Robinson told the court that she has canceled some appointments during the COVID-19 crisis that she considers elective, including hysterectomies and tubal ligations. 

“They weren’t considered emergencies,” Robinson said. 

Asked why she hasn’t canceled abortions, Robinson said “they are time-sensitive. They cannot be delayed without causing harm.” 

Alabama law bans abortions beyond 21 weeks and six days, Robinson said. 

Robinson said complications from abortions are “less than one percent” and abortions are about ten times safer for women than carrying a pregnancy to term. 

Approximately 20 percent of pregnant women will miscarry, and about half of those will require medical attention, Robinson said. 

Robinson said women decide to have an abortion for a variety of reasons, from “a pregnancy that is just not developing correctly” and some “already have children” and decide to have an abortion so they can better care for the children they have.

“Some women, they just know it’s not the time for them to start a family, or increase their family size,” Robinson said. Most of the women she provides abortions for are low-income and many have no insurance. 

A delay in getting an abortion increases health risks for the woman, she said.  

“Every week matters for these patients,” Robinson said. 

Some women try and self-induce an abortion if they don’t have access to care, Robinson said, and can injure themselves badly doing so, requiring emergency room care. 

“Those patients usually require multiple days of hospitalization,” Robinson said, which uses more PPE than would an abortion in a clinic. 

The state filed an additional clarification with the court Sunday regarding how the state would determine which procedures are covered by one of the two exceptions.

“Defendants would clarify that while reasonable medical judgment of all healthcare providers will be treated with respect and deference, a health care provider’s assertion that a procedure meets one of the exceptions is not conclusive proof that the procedure meets one of the exceptions in the March 27 order or the current April 3 public health order,” the state’s filing reads.

Robinson told the court that she fears her medical judgment wouldn’t be recognized by the state were she to decide to conduct an abortion.

Assistant Attorney General Brad Chynoweth asked Robinson about screening procedures she’s adopted for patients at her clinic, which include her request for a patient who might present with COVID-19 symptoms to postpone the procedure. 

“You’re taking into account risk for others. Not just the patient herself, correct?” Chynoweth asked. 

“Absolutely,” Robinson said. 

Chynoweth asked if physical examinations are done before a medication abortion, and Robinson said they are and that appropriate PPE is used during the exams. 

Chynoweth noted during questioning that during surgical procedures 6 feet of distance between a doctor and the patient isn’t possible and PPE must be used. 

Chynoweth asked if she has any N95 masks at the clinic, and Robinson said “we have a few” but that they’ve not been used as she’s not seen any patients who presented with symptoms of COVID-19. 

Asked if any abortion could be postponed, Robinson said some abortions could be postponed, but any delay of weeks or even days could mean a higher likelihood of health complications for women. 

Judge Myron Thompson at the close of testimony asked attorneys on both sides about who or what agency would handle a criminal complaint resulting in the order, and was told the state Attorney General’s office has the authority to do so. 

Thompson asked for proposed opinions from both sides to be filed with the court by 8 a.m. Wednesday.

The Fifth Circuit Court of Appeals in Texas last week ruled that the state’s temporary ban on abortions amid the COVID-19 crisis could continue.

Judges in Ohio on Monday ruled that most abortions could continue following a lower court’s ruling that upheld the state’s temporary ban.

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Health

Alabama COVID-19 cases surpass 2,000; 53 deaths reported

Chip Brownlee

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The number of confirmed coronavirus cases in Alabama surpassed 2,000 on Monday, marking another grim milestone in the outbreak.

At least 53 deaths have been reported.

Cases of COVID-19 have been confirmed by lab testing in 66 of the state’s 67 counties. At least five of the state’s counties have at least a hundred lab-confirmed cases. Jefferson County has reported 438 cases.

The number of cases per capita remains higher in some rural counties, though. Eleven counties have higher per capita cases than Jefferson County. Chambers County and Wilcox County have the highest number of cases per capita in the state at 289 cases per 100,000 people in Chambers County and 125 cases per 100,000 people in Wilcox County.

Of the counties with at least 50 cases, the number of cases has grown fastest in Mobile County, where testing was slow to get off the ground.

Over the last week, the number of cases in Alabama has grown by 112 percent.

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Health

Cases jump in Alabama nursing homes, tests still scarce, association says

Eddie Burkhalter

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Confirmed COVID-19 cases in Alabama nursing homes have jumped in recent days, and delays in getting test kits and test results is putting lives at greater risk, according to the Alabama Nursing Home Association.

As of Monday, 31 nursing homes in 17 counties had confirmed COVID-19 cases, according to a statement from Alabama Nursing Home Association President Brandon Farmer.

The last update from ANHA on March 28 noted eight confirmed cases of COVID-19 in six nursing homes across the state.

John Matson, director of communications at ANHA, told APR in a message Monday that the organization was uncertain how many individual COVID-19 cases were currently in the 31 homes.

“These reports involve residents, staff members or both at nursing homes in rural and urban locations. These nursing homes are following the reporting guidelines and implementing isolation procedures,” Farmer said in the statement. “I predict the number of nursing homes with cases will grow as more tests are administered and the results are returned. As previously stated, the delays in receiving test kits and test results are beyond our control yet places our residents and employees at great risk.”

State nursing homes have stopped visitations and early on began screening staff for symptoms of the virus and strengthening infection control measures, Farmer noted in the statement.

“They continue to practice infection control guidelines from the Centers for Disease Control and Prevention and isolate residents who test positive or are believed to have been exposed to someone who is COVID-19 positive. Like other health care providers, nursing homes need a sufficient supply of personal protective equipment (PPE). Infection control measures will only be as effective as our ability to secure PPE,” Farmer said.

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Economy

Gov. Ivey launches state guide to COVID-19 relief efforts

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Governor Kay Ivey on Monday announced the launch of altogetheralabama.org, an online resource that will serve as a hub of information for the state’s response to the coronavirus crisis.

The site becomes the state’s official guide to COVID-19 relief efforts, to help empower those impacted by the outbreak and those who want to offer support.

“We wanted to quickly create a trusted resource that centralizes information, resources and opportunities for businesses and individuals in need of support,” Governor Ivey said. “We are all in this together.”

The website is designed to be a comprehensive guide to aid in navigating all issues related to the COVID-19 response. Individuals and business owners can seek help and identify state and federal resources that can provide a lifeline in the form of low-interest loans and financial assistance.

Business owners, for example, can learn about the U.S. Small Business Administration’s Paycheck Protection Program, which launched April 3 to provide a direct incentive for them to keep their workers on the payroll. Displaced workers, meanwhile, can use the site to learn about enhanced unemployment benefits.

“It’s important for Alabama’s business owners and its workforce to take full advantage of the resources being made available through the federal government’s $2 trillion coronavirus relief package,” said Greg Canfield, secretary of the Alabama Department of Commerce. “The site is meant to expedite the process so both employers and employees can get back up on their feet as fast as possible.”

At the same time, the site will function as a pathway for Alabama’s good corporate citizens and the general public to offer support and solutions that can help spark recovery across the state. It will act as a portal for companies, non-profits and individuals to volunteer, make donations of supplies, offer an assistance program, and even post job openings.

The site was developed in partnership with Opportunity Alabama, a non-profit organization that promotes investment in the state’s designated Opportunity Zones. It was facilitated by a partnership with Alabama Power.

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“Over the last two years, Opportunity Zones have allowed us to build a network of stakeholders that care deeply about helping distressed places,” said Alex Flachsbart, Opportunity Alabama founder and CEO. “We hope this site will provide a gateway linking our network to those businesses and communities in economic distress, no matter where they are in Alabama.”

“These are challenging times,” added Governor Ivey. “We needed a place to efficiently and rapidly post and disseminate information – as soon as it’s available – for all affected parties. Thank you for your support and partnership in helping bring Alabama together.”

Any business, program or individual who would like to join ALtogether as a resource in COVID-19 response and relief can register at altogetheralabama.org/join.

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