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Vote September 18: Medical Professionals Lend Their Voices

Bill Britt



By Bill Britt
Alabama Political Reporter

MONTGOMERY — “I will tell you right now, Medicaid absolutely has to be funded or we will have a medical crisis within the state,” warns Dr. Greg Bouska, president of the Alabama State Society of Anesthesiologists.

Bouska and thousands of medical doctors across the state understand the cost of Medicaid but they also know full well the price that will be paid if it is not funded.

“We are going to have a public health crisis if Medicaid is not properly fund,” reiterates Bouska.

According to Dr. Don Williamson who is heading Governor Bentley’s Medicaid Task Force this is not a “Chicken Little” scenario. Williams and a growing choir of medical and business professionals are warning that if Medicaid fails in Alabama, the ripple effects will make the current fiscal crisis look like a minor blip on a heart monitor before full cardiac arrest.

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

“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.

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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.”

In the last year St. Vincent’s Health System opened a new $32 million, 40-bed facility in St. Clair County.


St. Vincent’s Chief Executive Officer, John O’Neil is concerned what will happen to the new facility and all hospitals around the state, if today’s constitutional amendment (CA) to fund Medicaid should fail.

O’Neil is also concerned about how the failure of the CA could affect the state’s fragile recovery.

“We have some major momentum going in the state with Airbus and all the governor is doing, we certainly don’t want to slow down this recovery,” O’Neil said.

“This is not a message we want to broadcast around the world, that Alabama’s broke,” said O’Neil. “We are not broke, we have a problem that can be fixed. We have a short-term solution which is the constitutional amendment and we need to use it.”

O’Neil admits that the borrowing the funds from the gas and oil trust may have not been the best choice “but it gives us an opportunity to fund Medicaid while working toward better solution for the future.”

He says that underfunding the program by $200 million dollars which would cause “a major crisis within the state.”

“This would mean having to immediately go to proration, gut the Medicaid program, which would result in cutting and closing necessary services,” says O’Neil.

Such warnings from the Governor, business and health leaders are predicting a dire outcome if funding is not made available.

T. Michael Harrington, MD, president of Medical Association of the State of Alabama is one of the many that have made this prediction. Their accretions are based on facts not political hyperbole and political posturing.

“The money is there,” Dr. Harrington says. “Taking out 5.8 percent per year out of an $2.5 billions savings account is not unreasonable for a situation—that if you don’t fix it is grave.”

Harrington says, “I am firmly convinced our Medicaid program in Alabama is not a luxury. It is a safety net not a hammock.”

Huntsville Hospital Health Systems is only rivaled in size by the UAB Health Systems, leading this massive healthcare provider is CEO David Spillers.

“At our core hospital in Madison we see around, 50,000 in-patients a year and 160,000 in the emergency department,” says Spillers. Of that number, Medicaid recipients account for approximately 30 percent of those patients seen in the ER and around 15 percent of the hospitals in-patients received treatment through Medicaid.

Spillers who spent 18 years in healthcare management in Ashville, North Carolina, before choosing to move to Huntsville, says he loves Alabama, but wishes it paid better for healthcare services.

It is often pointed out that Alabama hospitals are the most efficiently run in the country, to that Spillers immediately replies, “And the worse paid.” He further explains, “When you are paid the least you have to be efficient if you want to stay in business, you figure out how to get real efficient.”

“We are historically a low-tax state, states with more money, tended to spend more on social services. We don’t have the tax base so the money is not there,” said Spillers. “Some will tell you that the reason we are consistently ranked at the bottom with regards to the health of our citizens, is because we don’t spend the money on their healthcare.”

The September 18 vote will determine if the state can fund even its meager Medicaid pro- gram and its overcrowded prison system.

“The biggest problem is there is no plan B, there is only one options right now,” says Spillers. “So, if this plan fails and we are looking at a 20 percent across the board proration. In our area, the ones I am responsible for, it means I have to find an additional $15 to $20 million dollars.”

Spillers says the only way to meet the challenges–that would be imposed by not funding Medicaid through the constitutional amendment–is to “look at what programs can be cut and what services will no longer be offered.”

He does not mean services only offered to Medicaid recipients but service offered to all patients.

“There is no way to see 15 or 20 percent taken away and keep doing what we are doing now,” states Spillers. “We already lose money on the services we provide to those on Medicaid.”

“People need to understand and accept that we have the most value-oriented, cost-effective, minimal entitlement program in the country.” These are the words of Stanley K. Hammack, chief executive officer of University of South Alabama Health Systems referring to Alabama’s Medicaid program.

“We’ve got the most stringent eligibility requirements of any state in the nation when it comes to Medicaid,” Hammack, a veteran administrator, recently said. “There is not this vast number of people out there receiving Medicaid benefits. It is those vulnerable groups: children, expectant mothers, the aged, blind
and disabled. And basically, the aged, blind and disabled are two-thirds of the expenditures.”

Everyday in the media people are bombarded with the idea that government spending is out of control and that a vast number of Americans are leaching on systems like Medicaid.

According to Hammack, this is not the case in Alabama,“In Alabama we have the least number of people enrolled and we spend the least on them. So, we are basically doing the minimum standards of what is required by Medicaid.”

This message has been spoken by Governor Bentley, Public Health Officer Dr. Don Williamson and countless others, yet, Medicaid in Alabama is still painted by some as this gross entitlement program.

“The providers [of Medicaid] are not overpaid in fact they are underpaid,” says Hammack. “Several of the providers, specifically hospitals, are covering their own way or at least a big portion of it.”

He also points out that Alabama is the only state that provides zero funding for hospitals as a part of Medicaid.

Over the last several months health professionals have spoken out about the dire need to fund Medicaid, it is now time for a vote.

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.



Alabama’s COVID-19 hospitalizations, cases continue rise

Average daily hospitalizations continue an ongoing increase as cases nationwide surge.

Eddie Burkhalter




The number of COVID-19 patients hospitalized in Alabama hit 863 on Wednesday, the highest daily count since Sept 4, as average daily hospitalizations continue a steady increase and cases nationwide surge.

UAB Hospital in Birmingham on Wednesday was caring for 72 COVID-19 inpatients — the highest number the hospital has cared for since Aug. 21. 

In the last two weeks, Alabama has reported an increase of 15,089 new COVID-19 cases, according to the Alabama Department of Public Health and APR‘s calculations.

That number is the largest increase over a 14-day period since the two weeks ending Sept. 9. On average, the state has reported 1,078 new cases per day over the last two weeks, the highest 14-day average since Sept. 9.

The state reported 1,390 new confirmed and probable cases Thursday. Over the last week, the state has reported 7,902 cases, the most in a seven-day period since the week ending Sept. 5. That’s an average of 1,129 cases per day over the last seven days.

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Alabama’s positivity rate, based on 14-day case and test increases, was nearly 16 percent Thursday, the highest that rate has been since mid-September.

Public health experts say the positivity rate, which measures the number of positive cases as a percentage of total tests, needs to be at or below 5 percent. Any higher, and experts say there’s not enough testing and cases are likely to be going undetected. 


“I really won’t feel comfortable until we’re down to about 3 percent,” said Dr. Karen Landers, the state’s assistant health officer, speaking to APR last week

While new daily cases are beginning an upward trajectory, the number of tests administered statewide is not, contributing to the increasing positivity rate. The 14-day average of tests per day on Thursday was 6,856 — a nearly 10 percent decrease from two weeks prior. 

Over the last two weeks, ADPH reported 206 new COVID-19 deaths statewide, amounting to an average of 15 deaths per day over the last 14 days.

So far during the month of October, ADPH has reported 303 confirmed and probable COVID-19 deaths. In September, the total was 373. Since March, at least 2,843 people have died from the coronavirus.

The number of new cases nationwide appear to be headed toward a new high, according to data gathered by the COVID Tracking Project. The United States is now reporting nearly 60,000 cases per day based on a seven-day average. At least 213,672 Americans have died, according to the COVID Tracking Project.

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U.S. Supreme Court rules Alabama can ban curbside voting

“The District Court’s modest injunction is a reasonable accommodation, given the short time before the election,” the three dissenting justices wrote. 

Eddie Burkhalter




The Supreme Court, in a 5-3 decision, allowed Alabama Secretary of State John Merrill to ban curbside voting, staying a district court injunction that had allowed some counties to offer curbside voting in the Nov. 3 election amid the COVID-19 pandemic.

The Supreme Court’s majority in its order declined to write an opinion, but Justices Stephen Breyer, Elena Kagan and Sonya Sotomayor’s five-page dissent is included.

The lawsuit — filed by the NAACP Legal Defense and Educational Fund, Southern Poverty Law Center, American Civil Liberties Union, ACLU of Alabama and Alabama Disabilities Advocacy Program — was brought on behalf of several older Alabamians with underlying medical conditions.

“The District Court’s modest injunction is a reasonable accommodation, given the short time before the election,” the three dissenting justices wrote. 

Sotomayor, who wrote the dissent, closed using the words of one of the plaintiffs in the case. 

“Plaintiff Howard Porter Jr., a Black man in his seventies with asthma and Parkinson’s disease, told the District Court, ‘[So] many of my [ancestors] even died to vote. And while I don’t mind dying to vote, I think we’re past that – We’re past that time,’” Sotomayor wrote. 

Alabama Secretary of State John Merrill on Wednesday applauded the Supreme Court’s decision. 

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“I am proud to report the U.S. Supreme Court has now blocked a lower court’s order allowing the fraudulent practice of curbside voting in the State of Alabama,” Merrill said in a statement. “During the COVID-19 pandemic, we have worked diligently with local election officials in all 67 counties to offer safe and secure voting methods – including through the in-person and mail-in processes. I am glad the Supreme Court has recognized our actions to expand absentee voting, while also maintaining the safeguards put into place by the state Legislature.”

“The fact that we have already shattered voter participation records with the election still being 13 days away is proof that our current voting options are easy, efficient, and accessible for all of Alabama’s voters,” Merrill continued. “Tonight’s ruling in favor of election integrity and security is once again a win for the people of Alabama.”

Sherrilyn Ifill, president and director-counsel of the NAACP Legal Defense and Education Fund, expressed frustration after the ruling in a tweet.


“Another devastating loss for voters and a blow for our team fighting to ensure safe voting for Black and disabled voters in Alabama. With no explanation, the SCOTUS allows Alabama to continue making it as hard as possible for COVID-vulnerable voters,” Ifill wrote.

Curbside voting is not explicitly banned by state law in Alabama, but Merrill has argued that because the practice is not addressed in the law, he believes it to be illegal. 

A panel of federal appeals court judges on Oct. 13 reversed parts of U.S. District Judge Abdul Kallon’s Sept. 30 order ruling regarding absentee voting in the upcoming Nov. 3 elections, but the judges let the previous ruling allowing curbside voting to stand. 

In his Sept. 30 ruling, Kallon wrote that “the plaintiffs have proved that their fears are justified” and the voting provisions challenged in the lawsuit “unduly burden the fundamental Constitutional rights of Alabama’s most vulnerable voters and violate federal laws designed to protect America’s most marginalized citizens.”

Caren Short, SPLC’s senior staff attorney, in a statement said the Supreme Court’s decision has curtailed the voting rights of vulnerable Alabamians.

“Once again, the Supreme Court’s ‘shadow docket’ – where orders are issued without written explanation – has curtailed the voting rights of vulnerable citizens amidst a once-in-a-century public health crisis. After a two-week trial, a federal judge allowed counties in Alabama to implement curbside voting so that high-risk voters could avoid crowded polling locations,” Short said. “Tonight’s order prevents Alabama counties from even making that decision for themselves. Already common in states across the South and the country before 2020, curbside voting is a practice now encouraged by the Centers for Disease Control and Prevention (CDC). It should be a no-brainer to implement everywhere during a pandemic; the Alabama Secretary of State unfortunately disagrees, as does the Supreme Court of the United States.”

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SPLC files complaints in Pike County over suspension of two Black students

Both complaints, filed in Pike County Juvenile Court, ask the court to reverse suspensions of RaQuan Martin and Dakarai Pelton, both Black and former students at Goshen High School. 

Eddie Burkhalter




The Southern Poverty Law Center on Wednesday filed two complaints with an Alabama juvenile court alleging the Pike County Board of Education arbitrarily suspended two students in violation of their due process rights under the U.S. Constitution. 

“Students across Alabama continue to be excluded from school without regard for their due process rights, leading to unwarranted and unlawful suspensions and expulsions,” said Michael Tafelski, senior supervising attorney for the SPLC’s children’s rights project, in a statement. 

“This is particularly troubling for Black students who are three times more likely to be excluded from school for minor and subjective infractions than their white peers. Education is an important aspect of a young person’s life and the decision to exclude them from school should not be taken lightly,” Tafelski continued. 

Both complaints, filed in Pike County Juvenile Court, ask the court to reverse suspensions of RaQuan Martin and Dakarai Pelton, both Black and former students at Goshen High School. 

The complaints state that on Nov. 22, 2019, both students were approached by the school’s principal “in connection with alleged rumors that a group of students had ‘smoked’ that same day in the parking lot at school.” The principal alleged he had video security footage of them doing so, but wouldn’t show the students the footage, according to the complaints. 

Both boys told the principal that they had not used marijuana, but had both accompanied another student to their car in the parking lot, and both left when the other student showed them what appeared to be drug paraphernalia.

“The students, both seniors at the time, denied the allegations and even took drug tests that showed they had no drugs in their system that day. But the school refused to consider this evidence,” the SPLC said in a press release. 

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The complaints state that the district failed to provide the students proper notice, including details about their charges, evidence of wrongdoing, a meaningful opportunity to be heard or to present evidence of their own and question witnesses during their hearings. 

“Only you know what did or didn’t happen in that vehicle … you dodged a bullet here because we didn’t have the proof that we need,” said one school board member to one of the students during his hearing, according to the complaint. 

“There was no proper investigation at all,” said Shatarra Pelton, Dakarai’s mother, in a statement. “It was unorganized and overblown. The school was unable to produce any evidence other than hearsay.” 


After a brief hearing, both seniors were suspended for the rest of the school year, missing out on a chance to finish their high school athletics and potentially missing out on college football scholarships as a result, the complaints state. 

Prior to their suspensions, both students had no disciplinary referrals and were making good grades, according to the complaints. 

“On Jan. 13, the students appealed the Council’s decision to the Pike County Board of Education, and the board agreed to consider allowing the students to return to GHS if they participated in drug treatment classes, passed urine and hair follicle drug tests and maintained perfect attendance at the alternative school. After completing all the requirements, the students returned to school on Feb. 21 – three months after their removal,” the SPLC said in the release. 

“He had a rough senior year, to say the least,” said Tasha Martin, RaQuan’s mother, in a statement. “He missed senior night, he missed everything.” 

“They didn’t get to play not one game,” Martin said. “They had some coaches visit them while they were in alternative school but when the coaches found out that they couldn’t go back to school, they stopped coming. Our families were devastated; sometimes me and Ms. Pelton would be on the phone and just cry to each other. It has been really tough.”  

“I want schools to understand that it’s not just a moment you’re ruining, you’re ruining a lifetime,” Pelton said. “With no factual basis, only an unproven accusation, you have just completely deterred a student’s life. Most schools say that they are there for their students, but you are showing them the total opposite.”

Pike County Schools during the 2019-2020 school year referred 49 students to a disciplinary hearing, according to the SPLC. Of those, 48 students were either suspended or expelled, and although Black students made up less than 50 percent of the student population, Black students made up 80 percent of the referrals.  On average, Black students make up 77 percent of all students referred for disciplinary hearings in the district, according to the SPLC.

Both complaints can be read here and here.

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Biden urges Democrats to support Doug Jones

In the email, Biden asked voters to split a contribution between the Biden campaign and Jones’s campaign.

Brandon Moseley



Former Vice President Joe Biden appears at a campaign rally in Birmingham with then-candidate Doug Jones in 2017. (CHIP BROWNLEE/APR)

Democratic presidential candidate Joe Biden on Wednesday asked Democratic donors to support the re-election of U.S. Sen. Doug Jones, D-Alabama.

“I wanted to reach out to you about an old friend of mine: Doug Jones,” Biden said. “You might not believe this, but I met Doug more than 40 years ago, when I was a newly-minted junior senator, and he was in his early 20s, just beginning what would become one of the most impressive and dedicated careers of public service I’ve had the privilege of watching.”

“Doug has devoted his entire career to fighting for justice,” Biden said. “He’s the man who would not rest until the Klansmen who killed four young Black girls in the 1963 Birmingham church bombing were finally brought to justice. Doug has shown us, even in our darkest moments, that hope for the American promise is never lost — and what we can do when we stand united.”

In the email, Biden asked voters to split a contribution between the Biden campaign and Jones’s campaign.

“I need Doug’s help in the Senate,” Biden said. “He’s running neck-and-neck in his race in Alabama right now, and he needs our help to win.”

Biden said this election is “a battle for the soul of our country” and “few places are those stakes as clear as in Alabama.”

“I remember in 2017 when everyone counted Doug out,” Biden said. “When they thought that a message of unity would lose in a state where a long history of division still runs deep. But when I visited Alabama to help Doug, I saw what he saw – Alabama was ready to come together.”

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Biden was an early endorser of Jones in the 2017 special election, when Jones defeated former Chief Justice Roy Moore in that election. Jones returned the favor in the 2020 Democratic primary, endorsing Biden when the former vice president was having difficulty raising money and was polling well behind Sen. Bernie Sanders, I-Vermont.

Jones campaigned hard with Biden in Selma and other campaign stops across Alabama prior to Super Tuesday on March 3.

“His win gave me hope,” Biden said. “I was both honored and proud to have escorted him onto the floor of the Senate and stood behind him when he was sworn in as a United States Senator. And his record has been extraordinary – passing 22 bipartisan bills helping farmers, military families, and those devastated by natural disasters. And in perhaps the most crucial fight of all – our health care – Doug has been there again and again standing up for all of us, especially those with pre-existing conditions. Every time we needed him to stand up for us, Doug Jones was there. I’m going to need Doug’s voice in the Senate. Alabama and America will need Doug’s voice in the Senate.”


“Doug and I share a vision for a united country – one that puts faith over fear, fairness over privilege, and love over hate. And Doug, his campaign, and his career remind us that it’s a vision we can only realize if we come together,” Biden said.

In an Auburn University Montgomery poll, Biden trails Trump in Alabama by 17 points. Jones trailed former Auburn University head football coach Tommy Tuberville by 12 points. The Jones campaign claims that there has been a tightening of the race since then and it is a statistical tie. The Tuberville campaign disputes that claim.

Republican insider Perry Hooper Jr. said, “Whether it is the AUM poll, the poll, or internal polls by the (Tuberville) campaign, the margin is between 12 and 18 points in favor of Tuberville.”

The Jones campaign has been inundating the state airwaves with TV and radio ads due to the vast advantage that Jones has had fundraising. More than 82 percent of Jones’ money raised in the third quarter reporting cycle came from outside the state of Alabama.

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