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A Tale of Two Budgets: A Clear Choice for America’s Future

Jo Bonner

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By Congressman Jo Bonner

It has been almost four years since the Senate joined the House in crafting and passing a federal budget plan.  As this column goes to press, the Senate is finally poised to follow the House in passing its own budget blueprint.  Even though the two government spending roadmaps are starkly different – one hikes taxes and continues to overspend while the other cuts taxes and leads towards balance – they do provide Americans with a clear choice for the future.
In a world of 24/7 media coverage, we’ve become accustomed to seeing Congress through the lens of down-to-the-wire partisan showdowns.  Last week, as the House and Senate moved to pass their respective budget blueprints, both the old news apparatus and the new social media seemed more captivated by the drama of March Madness than in covering lawmakers actually passing budget resolutions.  No matter who was paying attention, the approval of budget plans by both sides of Capitol Hill was, at least, a positive sign that Washington can still function.
Last week, the Senate and the House also agreed to a stopgap funding bill to keep the federal government operating until the end of the fiscal year (September 30, 2013).  The Continuing Resolution, ratified by both Houses, keeps federal discretionary spending below $1 trillion for the remainder of the fiscal year, upholding the sequester cuts in defense and non-defense spending that took effect on March 1st.  Meanwhile, Congress did agree to provide both the Pentagon and the Department of Veterans Affairs flexibility to shift funds around within their accounts to address the impacts of the Sequester.  The funding bill is now headed to President Obama’s desk.  Had Congress failed to act on the measure, the government would have shut down on March 27th.
It’s important to underscore that the amount of sequester cuts equals about 2.7 percent of our $3.5 trillion federal budget.  If most Americans can find ways to trim their spending, surely Washington can manage to cut such a relatively small amount.  It bears repeating that the U.S. House has voluntarily cut our own budget by 11 percent over the last two years and will be subjected to another 8 percent in cuts this year – effectively reducing our spending by nearly 20 percent over three years.  At the same time, overall federal spending has been on the rise.  Since President Obama took office, the federal budget has increased by 19 percent.  If he had his way, he would continue to increase spending even as the national debt surges closer toward a historic $17 trillion, which brings us to the two very different federal budget outlines passed by the House and Senate last week.
There is a fundamental difference in how the House and the Senate view America’s financial condition as reflected in the annual federal budget resolutions produced by each chamber.  House conservatives see our country buried under a mountain of debt that has exploded over the last four years, holding down economic growth, stalling job creation and threatening the quality of life for our children and grandchildren.  The Senate, on the other hand, apparently shares the view of the president that Washington can simply tax and spend its way out of debt.
For the third year in a row, the House passed a responsible plan that reduces federal spending and places the budget on a path to balance.  The Republican “Path to Prosperity” budget, for which I voted, reduces the annual growth of federal spending from five percent to 3.4 percent.  Furthermore, it cuts overall government spending by $4.6 trillion over a decade through a series of reforms designed to promote increased efficiency and eliminate waste.  Our budget not only stops Obamacare’s raid on Medicare, but it would eliminate the president’s health care law entirely.  We would also reform and strengthen Medicare for future beneficiaries, not ignore its looming insolvency like the president has done.  Finally, our plan leads to a balanced federal budget in ten years.
The Senate budget plan, which is being prepared for a vote as I write this column, is a far different story.  Rather than reduce the growth in federal spending, it goes in the opposite direction.  It increases spending, including $100 billion in new stimulus funding.  It raises taxes by $1.5 trillion, adding an additional weight on the struggling economy.  Lastly, it does not achieve balance.  As Alabama Senator Jeff Sessions, Ranking Member on the Senate Budget Committee, observed, the Senate majority’s budget plan “…is a bankrupt vision that will bankrupt the country.”
Keeping a positive outlook, at least the Senate has finally chosen to offer a budget of its own and bring it to a vote.  Americans can now compare the two different visions of America’s future: one of responsible spending leading toward balance, and the other of increased taxation and spending that will hurt our economy and continue to drive our nation toward a looming debt crisis with potentially catastrophic consequences.

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Health

Jefferson County Health Department: Nursing homes can take in COVID-19 positive residents

Jessa Reid Bolling

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A letter from the Jefferson County Department of Health informed nursing homes that they can take in residents who have been treated for COVID-19 and still test positive for the virus if they meet certain requirements.

The letter, sent to Jefferson County nursing homes, reads that there is a “possibility that our hospitals will not have the capacity to care for a large number of patients infected with COVID-19, and the impact of COVID-19 on Long-Term Care Facilities that house our most vulnerable patients” as the reasoning behind why nursing homes can take in COVID-19 patients who still test positive for the virus. 

The criteria for accepting COVID-19 positive patients requires that the patients must meet two steps of criteria:

  • At least 3 days (72 hours) have passed since recovery, defined as resolution of fever without use of fever-reducing medications and improvement in respiratory symptoms (e.g., cough, shortness of breath); and
  • At least 7 days have passed since symptoms first appeared

The letter also says that patients who have tested positive for COVID-19 may return to a long-term care facility prior to the above criteria being met as long as the facility uses contact precautions as outlined in “Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Setting.”

The elderly and those with conditions that can weaken the immune system are considered the most at risk of serious illness and death from COVID-19.

John Matson, communications director for the Alabama Nursing Home Association (ANHA) said that this decision “goes against sound medical advice.”

“For the past month, Alabama nursing homes have been doing everything they can to prevent COVID-19 from entering their buildings,” Matson said. “Now, Jefferson County Health Officer Dr. Mark Wilson wants nursing homes to accept patients who have tested positive for COVID-19 even though they still exhibit symptoms and have not fully recovered.

“That decision goes against sound medical advice,” Matson said. “Just last week, the American Medical Directors Association issued guidance stating that nursing homes should not admit a COVID-19 patient until the patient has two negative tests. Dr. Wilson’s decision places nursing home residents, those vulnerable to COVID-19, in great danger.”

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The ANHA said two weeks ago that visitations at nursing home facilities will be restricted at Alabama nursing homes during the COVID-19 outbreak to prevent the spread of the disease and that nursing homes will follow the CDC guidelines for screening symptoms of COVID-19.

Matson said that nursing homes need resources to prevent the spread of COVID-19, not “orders from government officials to bring this horrible virus into the very place where our most vulnerable citizens live.”

“While the health officer is concerned about the capacity of local hospitals to meet the demands posed by the COVID-19 crisis, he (Wilson) does not cite a single example of a local hospital that is currently experiencing a capacity problem,” Matson said. “Our nursing homes are being stretched to the breaking point and not one penny of the money allocated by the federal government to fight this virus has made its way to a nursing home.”

The JCDH issued a response to concerns surrounding the letter, saying they were endorsing existing guidance from the CDC, not giving orders to nursing facilities. 

“This letter was an endorsement, not a Public Health Order, of existing guidance issued from the Centers for Disease Control and Prevention (CDC),” the statement from JCHD said. “In this guidance, the CDC outlines a non-test-based strategy for when a person can be considered not to be infectious due to COVID-19 when there is limited ability for a local area to perform COVID-19 testing.”

The JCDH said that patients who do test positive can return to their facilities if the facility follows guidance issued from the CDC with regard to personal protective equipment and appropriate isolation to protect all residents at the facility. If a nursing facility does not have the appropriate equipment to provide the requirements laid out in the CDC’s guidelines, then there is no expectation that the facility should admit a COVID-19-positive patient. 

“COVID-19 cases continue to increase, and the peak need for hospital beds is expected around the 3rd week of April, and the JCDH is working with our community partners to allow for as many hospital beds as possible to care for what will be a much greater than usual number of patients seeking medical care. 

We want to do everything possible to allow Jefferson County to be able to provide high-quality care to all who need it; ultimately, we do not want a hospital to have to turn away any patient because of a lack of hospital beds.”

There have been eight confirmed cases of COVID-19 in six Alabama nursing homes across the state. 

Statewide, Alabama nursing homes have reported eight confirmed cases of COVID-19 in six Alabama nursing homes. Two cases were reported at two separate nursing homes in Jefferson county. 

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Health

UAB launches symptom tracker to identify COVID-19 hot spots in Deep South

Jessa Reid Bolling

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To better track COVID-19 cases, experts from the University of Alabama at Birmingham have created a symptom checker to identify hot spots where the virus is spreading. 

The new website, called HelpBeatCOVID19.org, will provide public health officials insight into underserved areas based on the symptomatic data collected from the region and could help inform and enhance public health observation. 

“We are taking a look at COVID-19 symptoms alongside underlying medical conditions to provide public health officials an in-depth analysis of how rural areas are affected in real time,” said Sue Feldman, Ph.D., associate professor in the UAB School of Health Professions and UAB School of Medicine. “The website asks people about their symptoms to produce an interactive map showing how areas are effected and hot spots that are showing a rise in symptoms. We hope to learn more about how coronavirus is spreading in rural communities who have health disparities so we can help fight the spread of the disease.” 

People can fill out a short questionnaire on the website to report if they are experiencing symptoms related to the coronavirus. There are a series of questions addressing how one feels that day, current symptoms, pre-existing health conditions and basic social factors.

The website also has questions on social factors, such as neighborhood characteristics, economic factors and others that could play a part in understanding and acting upon any disparities in COVID-19 spread, such as access to affordable healthcare and access to transportation to a hospital. 

U.S. Senator Doug Jones praised the new website and encouraged people to participate to better inform public health workers on where the virus had spread. 

“This new daily symptom tracker will help public health officials track the spread of COVID-19 and identify coronavirus hot spots that need more resources, especially in Alabama’s underserved communities,” Jones said. “We all have to do our part to keep ourselves and the people around us healthy by participating in social distancing and having good hygiene, and this tool is another way to help our communities combat the spread of this virus.” 

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National

As cases surpass 1,100 in Alabama, still no “stay-at-home” order

Chip Brownlee

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The number of positive novel coronavirus cases in Alabama rocketed past a thousand Wednesday, but the state still has no shelter-in-place order — and Gov. Kay Ivey’s office says she is not ready to implement one.

“The governor remains committed to exploring all options and has not ruled anything out, but she hopes that we do not need to take this approach,” Ivey’s spokesperson said Wednesday.

By 6 p.m., there were 1,108 confirmed cases of the virus and at least 28 deaths statewide related to COVID-19. Cases grew by triple digits again after a brief lull in new cases Tuesday. But the infections are also widespread. Cases have been reported in 62 of the state’s 67 counties — and not just in the more urban ones.

Only one city in the state, Birmingham, has issued a shelter-in-place order. The city is in Jefferson County, which, in coordination with the city, has taken a stricter approach to handling the coronavirus outbreak because it has the most cases in the state.

The cities of Montgomery and Tuscaloosa have also implemented curfews, but they have far fewer cases per capita than many other areas of the state. (No. 30 and 31 out of 67 counties in per capita cases.)

But some of the hardest-hit counties in the state are outside of Jefferson County, and the health departments in those counties do not have as much authority to issue their own directives as Jefferson County and Mobile County do. They’re the only two health departments in the state that are independent with the legal authority to act autonomously from the state health department.

Cities and counties in some of the hardest-hit areas like Lee and Chambers counties have also not issued shelter-in-place orders by municipal ordinance as has been the case in Jefferson County.

Lee County and Chambers County in East Alabama have the highest infection rates in the state, and the highest per capita number of cases, yet the cities and counties there are following a statewide order that is less restrictive than the measures in place in Birmingham, Tuscaloosa or Montgomery.

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Lee County has 83 cases, and Chambers County has 45. But per capita, Chambers County has 135 cases per 100,000. (For comparison, Jefferson County, where there are 302 cases, has only 46 cases per 100,000 people.) Chambers County also has the highest number of deaths per capita in the state, at 12 per 100,000 people.

The hospital that serves Lee, Chambers and the surrounding counties — East Alabama Medical Center — is currently treating 30 patients with a confirmed diagnosis of COVID-19. It has already discharged 16 other COVID-19 patients, and there are 12 more in the hospital with suspected cases of the virus.

While the hospital says it is currently stable in the number of ventilators and other equipment it has available, it is still asking for donations of some needed supplies like latex-free gloves and bleach wipes.

Aside from UAB in Birmingham, EAMC is currently treating the most COVID-19 patients, according to data APR collected over the past two days. As the state continues to avoid issuing a statewide stay-at-home or shelter-in-place order, East Alabama Medical Center is urging the residents in the area to act as if there has been an order issued.

“While there is not yet a mandate to shelter in place, EAMC encourages it as the best way to stop the spread of COVID-19,” the hospital said. “Community leaders, city officials and the media have shared this important message, but there are still reports of groups gathering, children playing in neighborhood parks, dinner parties, bible studies and other events.”

All of Alabama’s neighboring states have issued shelter-in-place orders. Mississippi, Georgia, Florida and Louisiana have done so. The governors of Mississippi, Florida and Georgia all decided to issue orders today after balking at the idea for weeks.

Ivey has taken steps to curb the spread of the virus. She and the Alabama Department of Health issued an order on March 19 that closed the state’s beaches and limited gatherings of 25 or more people. She’s also closed schools for the remainder of the academic year.

On Friday, March 27, Ivey ordered closed a number of different types of businesses including athletic events, entertainment venues, non-essential retail shops and service establishments with close contact. The state has also tightened its prohibition on social gatherings by limiting non-work related gatherings of 10 people or more.

Ivey’s order Friday is not that far off from a shelter-in-place order, but it lacks the force of telling the state’s residents to stay home if at all possible. A number of businesses and manufacturing facilities are also allowed to keep operating, though they have been encouraged to abide by social-distancing guidelines as much as possible.

But Ivey has said she doesn’t want to issue a shelter-in-place or stay-at-home order because she doesn’t want to put more stress on the economy.

“You have to consider all the factors, such as the importance of keeping businesses and companies open and the economy going as much as possible,” Ivey said on Friday.

Ivey’s spokesperson Wednesday said the governor has taken appropriate action thus far.

“In consultation with the Coronavirus Task Force, the governor and the Alabama Department of Public Health have taken aggressive measures to combat COVID-19,” her spokesperson, Gina Maiola, said. “The governor’s priority is protecting the health, safety and well-being of all Alabamians, and their well-being also relies on being able to have a job and provide for themselves and their families. Many factors surround a statewide shelter-in-place, and Alabama is not at a place where we are ready to make this call.”

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Governor

The behind-the-scenes efforts to combat COVID-19

Bill Britt

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Some days it seems the only visible action state government is taking is to update the public on the number of COVID-19 cases and those who have died from the disease.

But in these times of dire public uncertainty, Gov. Kay Ivey’s team is working diligently to solve a myriad of problems facing the state.

In fact, the governor’s Capitol office suites are a hive of activity solely aimed at protecting Alabamians.

Ivey has established three groups to assess and address the various situations facing every sector of state healthcare and emergency needs, as well as the economic concerns of individuals and businesses.

The groups are led by former C.E.O.s, health professionals, or military officers who have volunteered in this time of crisis.

Strategic Asset Team or S.A.T. is tasked with finding and vetting supplies ranging from Personal Protective Equipment (P.P.E.) to gloves, ventilators and more items needed by healthcare workers on the frontline of fighting the novel coronavirus.

Sourcing and procuring vital medical equipment is not easy and is made harder by scam artists and price gaugers who seek to profit from the calamity. The governor’s office estimates for every legitimate offer there are some 80 to 90 fraudulent ones.

S.A.T., along with government personnel, evaluates every possibility to obtain goods and equipment. Once a legitimate outlet is identified, the team moves quickly to test and acquire the needed supplies.

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The governor’s office has streamlined purchasing methods so that once a supplier is identified and the goods are proven worthy, the purchase can be made swiftly.

Another group led by Secretary of Commerce Greg Canfield is called the Business and Manufacturing Alliance, B.A.M.A., which is sourcing supplies from existing manufacturers in the state.

“From our perspective, we’re trying to do everything we can to identify and utilize the asset that we have in the state that is going to provide us with or produce the medical equipment and medical supplies that are needed,” said Canfield. From Toyota to Alabama Power and smaller companies like Mobile’s Calagaz Printing, the state is working to meet the challenges. “We are in talks with Hyundai about providing a connection to bring supplies out of Korea because they might be able to find alternate solutions for medical supplies,” said Canfield.

Global auto parts supplier Bolta with a facility at the Tuscaloosa County Airport Industrial Park is retooling its operation to produce plastics shields and goggles that doctors and nurses need in the emergency room.

Alabama-based research groups are pushing for breakthroughs in testing and vaccines.

BioGX Inc., a molecular diagnostics company, based at Innovation Depot, has joined B.D., a global medical technology company, to develop a new diagnostics tests that would increase the potential capacity to screen for COVID-19 by thousands of tests per day.

Birmingham-based Southern Research is collaborating with Tonix Pharmaceuticals Holding Group, a New York-based biopharmaceutical company, to test a potential COVID-19 vaccine.

Canfield and the B.A.M.A. group are daily finding other Alabama-based companies to battle the effects of the pathogen.

A third group known as Renewal is comprised of retired C.E.O.s whose goal is to make sure that those in need can cut through bureaucratic red-tape. They are charged with finding the best ways to streamline the government’s processes so that individuals and companies are not waiting for a government bureaucrat somewhere to press a button.

The Governor’s office is working in partnership with the state’s universities, businesses and others in an ongoing battle to curb the COVID-19 outbreak in the state.

In times of crisis governments always stumble getting out of the gate; that’s what happens.

The work presently being coordinated by the Governor’s staff and volunteers is not currently seen by the general public, but the efforts of these groups will affect the state now and in the future.

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