By Brandon Moseley
Alabama Political Reporter
In a Wednesday afternoon session, the Alabama House of Representatives passed the Fiscal Year 2015 General Fund budget, House Bill 235, which goes into place on October 1.
Because of Alabama’s archaic budgeting practices, education has its own separate budget, with monies earmarked by the Alabama Constitution for both budgets. Matters unrelated to education are addressed in the General Fund. Most growth revenue is in the Education Trust Fund budget. The General Fund includes such things as: transportation, the Dept. of Corrections, State Law Enforcement, the Alabama Court System, the Legislature, the Governor’s office, and Alabama Medicaid.
The House Republican Caucus wrote on Facebook, “Today, members of the House passed the State’s proposed $1.8 billion General Fund Budget with a vote of 80-20. Unlike the federal government, here in Alabama we’re living within our means and using taxpayer dollars as efficiently as possible without raising a single dime in taxes.”
The budget has been stressed over recent years because the State is required by Federal law to provide a minimum level of Medicaid services in order to receive the Federal match, which is 65% of the total Medicaid outlay. Unfortunately the cost of Medicaid is growing much faster than State revenues due to increasing healthcare costs, an aging population and a jobless recovery that has resulted in more Americans either dropping out of the work force or accepting low-wage parttime jobs.
The budget, HB 235, is sponsored by House Ways & Means General Fund Committee Chairman Steve Clouse (R) from Ozark and Chairman Clouse presented the budget as well as additions and amendments from the Committee on the House floor.
Representative Mack Butler (R) from Rainbow City said on Facebook, “In 2003 Medicaid only consumed 18 percent of our budget, and in 2014 consumed 35 percent of our budget. Makes no sense that with all the increase in spending on health, and all the advances in medicine that disability claims are still skyrocketing. It would make sense that the disability claims would drop.”
The Fiscal Year 2015 budget passed by the House appropriates $685,125,607 to the Medicaid Agency of Alabama. That is an increase of $70 million from FY 2014.
Chairman Clouse said that Medicaid is difficult to budget because the amount spent is not capped. It is based instead on the amount of claims that come in from the people who receive Medicaid benefits.
Rep. Butler said, “Most State agencies are getting level funding with the exception of a few. Medicaid is seeing an increase of 70 million, Dept. of Public Health for Children’s Health insurance will get an increase of 10.5 million. Unified Judicial System will get an increase of 5 million. Forensic Sciences will see an increase of 1.5 million to deal with their case backlog. ADECA will see an increase of 150,000 for Military Stabilization Committee to assist with BRAC prep. Dept. of Public Health will get an increase of 47,500 for Kidney Foundation dialysis patient transportation and 55,600 increase for breast and cervical cancer early detection programs.”
The biggest concern many critics have with the budget is the proposed funding for the Alabama Corrections system. The U.S. Department of Justice has already declared that the conditions at the Tutwiler facility for women are unconstitutional.
Many had expected that the Corrections Department would receive a substantial increase in funding for the Alabama prisons. Instead of alleviating the budget shortfall at Corrections, the House General Fund budget actually cuts their appropriation by $6,802,898 from FY 2014.
Rep. John Knight (D) from Montgomery said on the House floor, “There is a serious problem with Corrections.” Knight said the prison need enough people on staff to be safe. “If you have relatives employed by the Corrections Department in this State, you need to be concerned about them.”
The Alabama Judicial System was heavily impacted by proration during the Great Recession and by funding cuts in post recession state budgets. The House Ways & Means General Fund Committee allocated $112,982,845 to the courts, which is $162,064 less than Alabama Governor Robert Bentley requested, but $552,045 more than the courts were appropriated in the Fiscal Year 2014 budget.
State General Fund employees (this does not include teachers and other education employees because funding for their pay comes from the ETF) are hoping for a raise. There is no raise guaranteed in this budget, but it is a conditional appropriation based on State revenues.
Rep. Knight said, “When we drive home in a storm, when we leave this chamber, we rely on our State employees to protect us when we go and get services we rely on our State employees to provide them. When emergencies happen we rely on our State employees. It is unfortunate that we are getting to the point that many of them are having to get second and third jobs to make ends meet and they are having to do extra work.”
Refinancing outstanding state debts is expected to save the State $430,137 in debt service costs in FY 2015 versus the FY 2014 budget. Total debt service in FY 2015 is projected at $28,398,142.
Rep. Patricia Todd (D) from Birmingham said, “We have got to deal with revenue.” Bond service is $28 million and total Bond debt is over $4 billion. “We need to figure out how to raise the revenue we need…I am not going to vote for this budget.” Todd said that the budget does nothing to eliminate poverty or decrease the State’s bond indebtedness.
The total projected General Fund budget is $1,823,969,513 which is an increase of $1,787,513 over what the Governor’s office had projected.
Rep. Pebblin Warren (D) from Tuskegee said, “These are troubled times in the State of Alabama. These are hard times. Now we just have to cut, cut, cut. I can not understand how with a budget like this we can turn our backs on gambling. We got to be realistic and look at how much money is going into gaming in other states we can not continue to ignore the biggest revenue pots.” The Bureau of Indian Affairs reports that the Poarch Creek have generated more gaming than any other Indian gaming.”
Chairman Clouse said, “I was one of 11 Republicans who voted to put the lottery on the ballot and the people voted it down.”
Rep. Warren admitted, “We got a little crazy in the bill,” which was written when Democrats controlled both Houses of the legislature and Don Seigelman (D) was Governor. Warren said, “The doors are wide open for a gaming tax in Alabama…Right now we are supporting every state around us but the state of Alabama.”
Rep. Jim Patterson (R) said that one of the biggest problems in the budget is unfunded Cost of Living Adjustments (COLAs) for state retirees and underperformance of the Retirement Services of Alabama (RSA). While the last two years have been good the previous eight were not and because of it the State in both the General Fund and the ETF are having to fund the added costs of pensions for State retirees.
Patterson asked to add an informational amendment to the budget publicizing these facts for anyone who reads the Alabama General Fund Budget. Patterson said that unfunded COLAs and underperformance of the RSA Fund cost taxpayers $978 million in 2011 and is projected to cost another $934 million.
CDC confirmed expanded “close contact” definition to Alabama officials in August
It is unclear why the CDC waited until late October to update or clarify its public-facing guidance on its website.
New federal guidance on how a person is determined to have been in close contact with someone infected by COVID-19 won’t impact how Alabama works to mitigate the disease, said the state’s top health official. That’s because the state was already aware of the expanded definition in August before the change was made public last week.
It is unclear why the CDC waited until late October to update or clarify its public-facing guidance on its website when it was giving more precise definitions to at least one state health department and receiving questions from public health officials about the definition.
The delay in announcing the change is raising questions about how state health officials nationwide have been determining the public’s possible exposure to the deadly disease and if contact tracing and mitigation efforts will be made more time- and resource-intensive with the more inclusive definition in place.
The CDC on Wednesday expanded the definition of “close contact” to mean a person can be at risk of contracting COVID-19 if that person is within six feet of an infected person for a period of at least 15 minutes over a 24-hour period.
The previous definition stated a person should quarantine if they were within six feet of an infected person for at least 15 minutes. Alternately, in other areas of the CDC’s website, the language stated “a total of 15 minutes” in the definition of close contact.
“What they changed their definition to is something they had verbally confirmed to us months ago, and we have always been using that definition,” said Alabama State Health Officer Dr. Scott Harris, speaking to APR on Friday.
Harris said a support team from the CDC was in Alabama in July as the Alabama Department of Public Health was preparing plans to reopen schools. Harris said the question was asked of CDC staff because his department was getting questions on the definition of close contact from school officials.
APDH staff took the definition then of “a total of 15 minutes” to mean that there could be several exposures over a period of time equaling that 15 minute threshold, so they asked CDC to clarify that assertion.
“When those folks were here we asked the CDC people directly. Can you confirm for us what that means, and they said, it adds up to a total of 15 minutes in a 24-hour period,” Harris said. “And we even got somebody to commit to that in an email somewhere.”
Melissa Morrison, CDC’s career epidemiology field officer working at the ADPH in Montgomery, in an Aug. 13 email to ADPH’s director of the office of governmental affairs, quotes a statement Morrison attributes to her CDC colleague, CDC public health advisor Kelly Bishop. Harris shared the email with APR.
“Yes, I did get a response from the contact tracing team. The 15 minutes for a close contact is cumulative, and they said ‘The time period for the cumulative exposure should start from 2 days before the cases’ illness onset (or, for asymptomatic patients, 2 days prior to positive specimen collection date) until the time the patient is isolated,” Morrison quotes Bishop in the email.
In the August email, Bishop goes on to say, as attributed by Morrison, that “as of now there is no established upper limit on the time period (i.e. 48, 72 hours etc).”
The CDC’s expanded definition was reflected in an Aug. 20 statement from the Alabama Department of Public Health.
“The 15-minute time is a cumulative period of time. For example, a close contact might be within 6 feet of a COVID-19 positive person for 5 minutes each at 8 a.m., noon and 5 p.m. This is a standard based on guidance from the CDC,” the statement reads.
In an email to APR on Friday, Harris said he’d discussed the matter with Morrison on Friday who “emphasized that the guidance this week from CDC was NOT a change but rather a clarification. They simply used the MMWR corrections story as a convenient time to make the point.”
Harris was referring to a CDC’s Morbidity and Mortality Weekly Report released Wednesday that detailed findings by Vermont health officials showing that a prison worker contracted COVID-19 during an eight-hour shift in which the worker had 22 close contacts with an infected inmate totaling 17 minutes.
The CDC in statements to numerous news outlets, and to APR, cite that Vermont study in connection to Wednesday’s definition change.
“That’s kind of why they said it out loud,” Harris said of the study and the Wednesday announcement. “But I have to say, when I saw that updated guidance I thought, ‘I can’t believe anybody ever thought otherwise.’”
Different pages on the CDC’s website on Saturday defined close contact as both being “a total of 15 minutes or more” and “a total of 15 minutes or more over a 24-hour period,” confusing the matter further, and numerous other state health departments had not yet updated their websites Saturday to reflect the CDC’s expanded definition.
A CDC spokesman in an email to APR on Wednesday noted the Vermont study on the prison worker and said “CDC clarified the amount of time it would take for someone to be considered a close contact exposed to a person with COVID-19.”
“The CDC website now defines a close contact as someone who was within 6 feet of an infected person for a total of 15 minutes or more over a 24-hour period. Previous language defined a close contact as someone who spent at least 15 minutes within 6 feet of a confirmed case,” CDC spokesman Scott Pauley told APR by email Wednesday.
Pauley didn’t respond to APR’s question on Friday asking why the CDC waited until Wednesday to update its guidance online, given that ADPH had confirmed the definition of close contact in August. He also didn’t respond to a request to verify the statement Morrison attributed to her CDC colleague in the August email.
“To us, we thought if it says a total, that means you must be adding up smaller amounts to get to 15 minutes, or you wouldn’t use the word total,” Harris said. “When they changed it this week, I don’t know the details of why that happened, but I think, obviously, everybody didn’t have the same message everywhere.”
Dr. Bertha Hidalgo, an epidemiologist and assistant professor at UAB’s Department of Epidemiology, told APR on Friday that her understanding prior to Wednesday’s expanded definition was that a contact was defined as someone who was exposed to the COVID-19 positive individual for at least 15 min or more at a time and explained that the updated guidance complicates how public health officials will engage in contact tracing.
“This means significant efforts for contact tracing moving forward, in effect needing to identify every person that person came into contact with during the possible exposure timeframe,” she said.
It was unclear Monday how the definition change impacts Alabama’s Guidesafe COVID-19 exposure notification app, which notifies a user if they come into close contact with an infected person. The app was developed by ADPH and University of Alabama at Birmingham, thanks to a partnership between Apple and Google’s combined development of the technology, and alerts users to possible exposure while keeping all users’ identities anonymous.
Sue Feldman, professor of health informatics, UAB School of Health Professions, in a message to APR on Friday said that due to the anonymity of the app, it would be difficult, but not impossible, to update the app to take into consideration the CDC’s expanded guidance.
“We are taking this into consideration for our next update,” Feldman said in the message.
Also unclear is how many other states that have similar exposure notification apps, also using Google and Apple’s technology, aren’t yet using the expanded definition of a “close contact.” Colorado is to roll out that state’s app on Sunday, and according to Colorado Public Radio News the app will notify a user that they’ve been exposed if they come “within six feet of the phone of someone who tested positive for at least ten minutes.”
New York’s exposure notification app also appears to use the old CDC guidance, and will alert users if they come “within 6 feet of your phone for longer than 10 minutes,” according to the state’s website.
The updated definition, which health departments refer to when conducting contact tracing, is likely to have a serious impact on schools, workplaces and other group settings where personal contact may stretch over longer periods of time including multiple interactions.
It greatly expands the pool of people considered at risk of transmission. “It’s easy to accumulate 15 minutes in small increments when you spend all day together — a few minutes at the water cooler, a few minutes in the elevator, and so on,” Johns Hopkins Center for Health Security epidemiologist Caitlin Rivers told The Washington Post. “I expect this will result in many more people being identified as close contacts.”
The clarification comes as cases and hospitalizations are rising both in Alabama and nationwide. Alabama’s 14-day average of cases has increased 41.2 percent over the past two weeks. The percentage of tests that are positive has increased from roughly 13 percent to more than 20 percent over the past 14 days. The U.S. average of new daily infections is now at its highest point of the pandemic, with 481,372 cases reported in a week, according to CNN and Johns Hopkins University.
Alabama women to Ivey: Support fair processes
Last week, Ivey co-authored a letter of support for Barrett and released it to media outlets.
A letter signed by a bipartisan group of about a thousand Alabama women takes issue with Gov. Kay Ivey’s recent support of Republican Supreme Court nominee Amy Coney Barrett, and it encourages Ivey and other state officials to instead support fair processes.
Last week, Ivey co-authored a letter of support for Barrett and released it to media outlets. In response, the letter from Alabama women calls the process to nominate Barrett, which is occurring after more than 50 million votes have been cast and in a Senate that is predicted to change from Republican to Democratic control, unfair and “anti-democratic.”
The letter, which doesn’t criticize Ivey or request that she rescind her endorsement of Barrett, asks instead that Ivey and other state leaders honor women by implementing and following fair processes that provide women with equal opportunities.
The full letter is below:
Dear Governor Ivey,
We are a group of women. We are current and future mothers, grandmothers, caregivers, leaders and champions of all citizens of our great state. We are moderates, progressives and conservatives. When we agree with our leaders, we say so, as we have in your support for education, workforce development, and sensible mask policies.
We also speak up when we do not agree. Thus, we want to respond to your letter in support of Amy Coney Barrett because it does not represent our views.
Like you and Judge Barrett’s father, we want to tell all young girls that they can do anything their male counterparts can do and they can be anything and everything they want to be. We want it to be a truth, not just a signal “that the most qualified individual will get the job”. In addition to those things, we want them to know and believe that the process will be fair, because no matter the job, the process should be fair. And our children and young people (boys or girls) should be able to trust that democracy works and can be counted on. How can we assure them when this process has been so rushed and undemocratic?
We are women who oppose Judge Barrett’s confirmation, because confirming her at this time, when 50 million Americans have already cast their votes, is anti-democratic. Regardless of what ways she does or does not think or talk like us, what matters is that a confirmation should not take place after the election is underway.
We do not expect you to rescind your support of Judge Barrett. However, we urge you and the other women leaders who have advanced to top positions in our government to stand with us in asking for a fair process that takes place after the election. A process that helps us to believe that our voices and our votes matter because the American people should have the right to choose who nominates the next Supreme Court Justice.
|Emily Hess Levine|
|Ronne M. Hess|
|Cindi Cassis Branham|
|Anna Brantley Fry|
|Joellyn M. Beckham|
|Alexandra Ruthann Bullock McElroy|
The letter is signed by more than 800 women. The full list of signatures was sent to APR with the letter. We have chosen to list only the first 10 for the sake of brevity.
Study: COVID-19 infection rates more than double without lockdowns
Infection and fatality rates would have been higher without stay-at-home orders, a new UAB study found.
New research from the University of Alabama at Birmingham says that if there had been no stay-at-home orders issued in the U.S. in response to the coronavirus pandemic, the country would have experienced a 220 percent higher rate of infection and a 22 percent higher fatality rate than if such orders were implemented nationwide.
Seven states never imposed stay-at-home orders, or SAHOs. The study analyzed daily positive case rates by state against the presence or absence of statewide SAHOs between March 1 and May 4, the period when such orders began to be implemented. Twelve states lifted their SAHOs before May 4.
The researchers defined SAHOs as being in effect when a state’s governor issued an order for residents of the entire state to leave home only for essential activities and when schools and nonessential businesses were closed.
“During March and April, most states in the United States imposed shutdowns and enacted SAHOs in an effort to control the disease,” said Bisakha Sen, the study’s senior author. “However, mixed messages from political authorities on the usefulness of SAHOs, popular pressure and concerns about the economic fallout led some states to lift the restrictions before public health experts considered it advisable.”
The research also sought to determine if the proportion of a state’s Black residents was associated with its number of positive cases. It found that there was.
“This finding adds to evidence from existing studies using county-level data on racial disparities in COVID-19 infection rates and underlines the urgency of better understanding and addressing these disparities,” said study co-author Vidya Sagar Hanumanthu.
The research can help advance a greater understanding of racial disparities in the health care system as a whole, and help leaders make future decisions about shutdowns as the virus continues to spread, Sen said.
“While the high economic cost makes SAHOs unsustainable as a long-term policy, our findings could help inform federal, state and local policymakers in weighing the costs and benefits of different short-term options to combat the pandemic,” she said.
The study was published Friday in JAMA Network Open.
Jones to attend Auburn student forum, Tuberville hasn’t yet responded to invitation
Jones has agreed to attend the forum, but it was unclear whether Tuberville planned to attend.
The College Democrats at Auburn University and the College Republicans at Auburn University have asked U.S. Senator Doug Jones, D-Alabama, and his Republican opponent, Tommy Tuberville, to attend a student forum on Wednesday.
“We are excited to invite the candidates running for our U.S. Senate seat and provide this opportunity for any Auburn student to hear directly from them, and we hope it will inform our student bodies’ decisions with the November 3rd election only days away,” said Carsten Grove, president of the College Democrats at Auburn University, in a statement.
Jones has agreed to attend the forum, Auburn University College Democrats confirmed for APR on Sunday, but it was unclear whether Tuberville planned to attend. The student organization was still awaiting a response from Tuberville’s campaign.
Jones has for months requested Tuberville join him in a debate, but Tuberville has declined.
“AUCR takes great pleasure in coming together with AUCD to co-host the Alabama Senate candidates in this forum. We are looking forward to a very informative and constructive event,” said Lydia Maxwell, president of the College Republicans at Auburn University.
Dr. Ryan Williamson, assistant professor of political science, is to emcee the forum, which will be open to all Auburn University students in the Mell Classroom Building at 6 p.m., according to a press release from the College Democrats at Auburn University.
Students will be permitted 30 seconds to ask a question of either candidate, and each candidate will have two minutes to answer, according to the release.
Capacity at the forum will be limited and precautions taken due to COVID-19. Any student with an Auburn ID is welcome and attendance will be first come, first served.