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Parker Griffith Participates in Medicaid Expansion Forum in Talladega

Brandon Moseley

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By Brandon Moseley
Alabama Political Reporter

On Thursday, July 24, Democratic Candidate for Governor former Congressman Parker Griffith of Huntsville, joined Third Congressional District candidate Jesse “J.T.” Smith, Citizens Baptist Medical Center President Joel Taylor, and UAB associate Professor Dr. David Becker in a panel discussion on the benefits of Medicaid Expansion in Alabama.

The forum was sponsored by the Talladega Democratic Party, was held at the historic Ritz Theatre in downtown Talladega, and was moderated by Alabama Political Reporter’s Editor, Bill Britt.  Over 60 people attended the event, which was open to the public.

Former U.S. Representative Parker Griffith (D) is a career medical doctor.  Rep. Griffith said, “My specialty is taking care of cancer patients.  Treating the sickest of the sick.”  On Governor Robert Bentley’s decision not to take the Medicaid expansion in Alabama, Griffith said, “I am stunned and appalled that someone with an MD behind his name would reject it.”  Griffith said that the Kaiser Foundation studied it and said that the State of Alabama would benefit from the expansion.  Dr. David Bronner looked at it from the financial side and said we needed to take it.  The University of Alabama study showed that Alabama should expand Medicaid.

Dr. Becker who was one of the authors of the University of Alabama study said that he was stunned that the State is not taking advantage of this.  “No reasonable answer was given,” Professor Becker said for the decision not to expand Medicaid.

Dr. Becker said that Republicans were putting politics in front of the lives of Alabamians.  Becker said that Alabama Republicans were carrying out the interests of the national Republican Party rather than representing the interests of the people of Alabama.  Becker said that the states have become the final battleground on blocking Obamacare.  Meanwhile they are completely ignoring what the expansion would mean to the state of Alabama.

Joel Taylor said that the healthcare industry in Alabama represents 80,000 jobs.  When the healthcare law was being debated in Washington the hospitals agreed to take cuts in how much they are reimbursed by Medicare in exchange for decreasing the number of people who do not have coverage.

Taylor said that there are over 200,000 people in Alabama that do not have insurance coverage but they do have access to emergency rooms which is the most costly place to provide care.  Some of them make payment arrangements, but many of them do not pay and the hospitals have to write it off as bad debt.  Taylor said the combination of the Medicare cuts with Alabama not taking the Medicaid expansion has put a lot of Alabama hospitals at risk.  Taylor said that expanding Medicaid could create 30,000 new jobs in Alabama’s healthcare sector.

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Dr. Becker said that 80% of the Medicaid eligible would be newly covered people.  His study found that the Medicaid expansion would lead to $12 billion in new health care spending over the next ten years and $20 billion of new economic activity.  His study did not come up with the 30,000 jobs number, but $12 billion in new health care money and $20 billion in new economic activity would create new jobs and the 30,000 job numbers sounds reasonable.

“You have got to scratch your head of why you would turn down those federal healthcare dollars over a $171 million investment on your part.  The loser in this are the people in Alabama. The people who don’t have healthcare and the people who are not getting $20 billion in new economic activity.”

Becker is an associate professor at UAB Public School of Health.

Dr. Parker Griffith said that there is a Judeo/Christian ethic that is interwoven into the fabric of America.  Not providing healthcare cripples a large portion of Alabama. As a cancer specialist you see this example all the time.  A woman is discovered to have early stage breast cancer.  There is a 95% cure rate and curing the breast cancer treatment costs only about $25,000.  If the same woman is not diagnosed until it is stage three she is likely going to die and it will cost $500,000 in chemotherapy, radiation, and surgery to treat her.

Griffith called the argument that we can not afford to expand Medicaid a knee jerk ideological argument by people who haven’t looked at it.  “Most of the people who make that argument have health insurance.”  Expanding Medicaid would put another $1.5 billion a year into our economy and would save at least 500 lives.  It would have cost us nothing for the first three years and we never pay more than ten percent after that.  “As far as the jobs are concerned when we see a hospital close we see jobs lost.”

Jesse Smith (D) is a veteran with tours in both Bosnia and Iraq.  He is running for Congress in the Third Congressional District.  Smith said this affects people across America and the Third District, especially veterans.  There are 59,000 veterans living in the Third District and 13,000 of them are without health insurance.  “We need to expand Medicaid because not only are the people suffering but our veterans are suffering.”  Smith is challenging incumbent Representative Mike Rogers (R) from Saks.

Joel Taylor said, “Healthcare is an odd industry.  We provide services we often don’t get paid for.  Uncompensated care is 10% of my operating expenses.”  Taylor said that hospitals provide a service to the community that is very similar to a public utility. “With Alabama Power, if you don’t pay for the service they cut you off.  That is not the case with hospitals there is a federal mandate that we provide emergency care.  If you do not have the ability to pay or will not pay it goes to bad debt.”

“The hospitals willingly gave up money (in the Obamacare debate) to decrease the uninsured.”
Dr. Becker said, “We are changing the convoluted way of compensating hospitals for uncompensated care.”  The nation is transitioning away from this old mechanism to this new mechanism where Medicaid was to become the insurer for more of the poor decreasing the number of the uninsured, but a lot of states like Alabama did not expand Medicaid.  There is no remedy insight and a lot of uncertainty.  “A lot of community hospitals may close as a result.  That is bad for people in Alabama and bad for rural hospitals.”  Becker acknowledged that the Troy University study disputes his findings, but defended his methods.

Mr. Smith said that veterans would definitely benefit from the expansion of Medicaid.  The Veterans Administration will pay for treatment of an injury if it is from a service related disability, but will not if that injury is not a service related disability.  A veteran can be receiving treatment for his injuries suffered in Iraq or Afghanistan, but have no coverage for conditions not due to his or her service.

Rep. Griffith said that 40 to 50% of bankruptcies are related to medical bills.  Coosa County has no hospital and no doctor.  Lamar County has no hospital no doctor.  Ten hospitals have closed in recent years and several are on the watch list.  “Think of the number of Medicare recipients who have to drive 40 to 50 miles to get care.”  The first sixty minutes are critical to someone suffering from a stroke to save more of that brain.  The University of Alabama study says 500 Alabamians a year will die if we do not expand Medicaid.  “All of us would benefit from it.”  The net impact on the state budget.  The State would receive an additional estimated tax revenue of a net $700 million.

Parker Griffith said that if you took the Medicaid expansion on an up or down vote in the Congress House Republicans would not repeal it.  Griffith (who was in the Congress during the Obamacare debate and voted against the PPACA) said, “Medicaid expansion was something that we all agreed was a core principle that needed to be there.”

Griffith said, “The Koch brothers do not want Medicaid expansion because they believe that government is bad.  We do not believe that.”  Griffith said that the Koch brothers have paid for Mike Hubbard, Del Marsh and our Governor.

Griffith said that this debate is not about Medicaid it is about a philosophy that is opposed to all government.

Jim Williams said that some have said that they oppose Medicaid expansion because of the “woodwork effect.”  The existing Medicaid program does not compensate the state at the same high rate that the expansion does.  The woodwork theory is that if the state expands Medicaid, more people will sign up and actually be in the original Medicaid program costing the State’s general fund budget even more.

Parker Griffith said, “We want them to come out of the woodwork.”  Our infant mortality rate is 11 per thousand births.  Half of Alabama counties do not even have obstetric services.  “You can not recruit doctors to a county with no hospital.”

Sandra Campbell said, “I used to practice bankruptcy law and I have seen many many people ruined by medical bills.  Even people on Medicaid are struggling to pay for medications that Medicaid will not pay for.”

Joel Taylor said that the audience in the room tonight is already in favor of Medicaid expansion.  The audience that is not here that we need to reach out too is moderate Republicans.  Many of them understand that this would be good for the state; but to this point have not been willing to come forward.  “I don’t know how to make those moderate Republicans braver.”

Parker Griffith said that we need a Medicaid expansion program that is tailored to Alabama.  The state is tops in the country for: diabetes, cigarette consumption, obesity, heart disease…..  “There is only one state who has worse health than Alabama and that is next door in Mississippi.”  We think of healthcare as an emergency room but need to think of it as a way to prevent illness.

Griffith said, “There are a lot of good moderate Republicans out there who know that this is the right thing.”  “Mike Hubbard’s management style is bullying and fear.”  “I want to be able to craft a program that I can take to my friends in the Republican Party and have them say that this is a program than I can support.”

Griffith introduced former state Representative James Fields (D) who is running for Lt. Governor.  “He has traveled the whole state and he is passionate about healthcare.”

When asked why many doctors have opposed the Patient Protection and Affordable Care Act, Griffith said that most doctors are in a cocoon.  Everybody at their practice tells them how smart, funny, witty they are because they are in charge.  “The dollars in their retirement funds are federal dollars they are Medicare dollars.  The Government controlled medicine is an argument for the uninformed.  95% of the private healthcare insurance market in Alabama is controlled by Blue Cross Blue Shield.  There is no competition.  Doctors are funny people.  My father raised three boys and we are all doctors…he never finished 8th grade. It is easy to fall into the trap of thinking they did it all on their own.”

Joel Taylor said that for most doctors, Medicaid is an important piece of doctors’ business.  They are all over the board on this.  Many have not investigated this topic.  I think they are aware but it gets lost in their political ideology.

Parker Griffith said, “The new doctors that are under 40 are a different breed.  They support this.  In the future virtually all doctors will be on a salary.

Griffith said, “This is Alabama.  This is the State that created the atmosphere for the Civil Rights Movement.”  Medgar Evers gave his life so everyone can vote.  Can we not vote?  “We need to light the fuse in our churches in our stores.  The beginning of any revolution is kicking in that rotten door.”  “I have heard our governor say he does not trust our government to carry through with their promises.  He is out of touch, out of ideas and needs to be out of office.”

The Chair of the Talladega Democratic Party Stephanie Engle presented certificates of appreciation to Dr. David Becker and Joel Taylor for their efforts to educate the public about the Medicaid Expansion.  Chairwoman Engle also presented a Certificate of Appreciation to the Ritz Theater and Gayle Montgomery for hosting the forum.

Finally, Engle presented Bill Britt with a certificate praising him for his contributions to investigative journalism and broadcasting in the state of Alabama, as editor of The Alabama Political Reporter and the host of The View, which is seen by 70,000 Alabamians a week.

The Alabama Political Reporter spoke with Ron Crumpton, candidate for the Alabama Senate in district 11, after the event.  Crumpton (D) said that although he organized the forum and it was his idea, he was barred from participation in the forum by Stephanie Engle over creative differences.

The general election will be November 4.

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Feds resolve complaint over “discriminatory” Alabama emergency ventilator policy

Eddie Burkhalter

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The federal government on Wednesday said it had resolved an investigation into an Alabama’s policy regarding triage of pandemic patients and use of ventilators that a federal agency called “discriminatory” against those with intellectual disabilities and older people. 

The U.S. Office of Civil Rights in a statement Wednesday said the Alabama Department of Public Health (ADPH) had agreed to remove all mention of the 2010 document from state websites and that the department would comply with all civil rights laws. 

There were 2,472 confirmed COVID-19 cases across Alabama as of Wednesday afternoon, 67 reported deaths and 314 hospitalizations form the virus.

Of the 144 COVID-19 patients in Alabama intensive care units as of Tuesday, 93 were hooked to the life-saving ventilators, according to ADPH. Ventilators are in short supply in Alabama and in most other states as each is vying to stockpile the machines.

The federal agency was acting on a complaint filed on March 24 by the Alabama Disabilities Advocacy Program and The Arc of the United States that said ADPH’s emergency operations plan violated disabled persons’ federal disability rights laws. 

According to the state’s plan, last updated in 2010, under a “last resort” condition hospitals are ordered to not offer mechanical ventilator support for patients, including children, with “severe or profound mental retardation,” “moderate to severe dementia,” and “severe traumatic brain injury.” 

An ADPH spokesman on March 26 told APR that the 2010 document had already been replaced and that the new document covers a much broader scope of topics than just ventilators, and was developed by a much larger group of people. 

The new document, dated Feb. 28, 2020, does not contain the same language about restricting use of ventilators for the intellectually disabled or older patients, but it also doesn’t clarify how, exactly, ventilators are to be used during an emergency triage situation. 

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OCR notes the lack of clarity on that in the statement Wednesday. 

“OCR is aware that on February 28, 2020, Alabama released new Crisis Standards of Care (CSC) Guidelines. The 2010 Criteria, however, were still available on some state webpages, and it was not clear whether any of their potentially problematic provisions could still be applied under the new Guidelines,” the U.S. Office of Civil Rights said in a statement. 

But OCR said in the statement that Alabama has agreed to comply with civil rights laws and that the old provisions won’t be used in the future. 

“The state has agreed to remove all links to the 2010 Criteria from its websites and to comply with applicable civil rights law. It has further agreed to clarify publicly that the 2010 Criteria are not in effect; that it will not, in future CSC guidelines, include similar provisions singling out certain disabilities for unfavorable treatment or use categorical age cutoffs; and that it will also not interpret the current Guidelines in such a manner,” OCR said in the statement. 

OCR director Roger Severino in a statement Wednesday commended Alabama for “quickly disavowing problematic triage plans and coming into compliance with federal civil rights laws within days of being contacted by our office. 

“Alabama and other states are free to and encouraged to adopt clear triage policies, but they must do so within the guardrails of the law,” Severino said.

“We are pleased that the state of Alabama has rescinded this illegal policy and given notice to hospitals across the state that they may not rely on this policy and cannot discriminate against people with disabilities in accessing lifesaving care,”
said Shira Wakschlag, Legal Counsel for the Arc of the United States, in a statement Wednesday.

Rhonda Brownstein, legal director of the Alabama Disabilities Advocacy Program, in a statement said Wednesday’s actions are an important first step, and the organization “appreciates that Alabama acted quickly to withdraw its discriminatory policy.”

“We call on the Governor to work with ADAP and others in the disability community to develop transparent and clear guidance on how to implement these non- discrimination requirements in the event that rationing of ventilators becomes necessary,” Brownstein said.

“All people deserve compassion and equal respect, and with this in mind, the allocation of care cannot discriminate based on race, color, national origin, disability, age, sex, exercise of conscience or religion,” said Alabama state health officer Dr. SCott Harris said in OCR’s statement. “This includes the use of ventilators during medical emergencies in addressing the needs of at-risk populations in Alabama.”

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Jones asks for faster emergency loans to small businesses

Eddie Burkhalter

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U.S. Sen. Doug Jones, D-Ala., and a ranking Republican colleague led other lawmakers in a request that the Treasury Department and the Small Business Administration speed up loans to small businesses amid the COVID-19 pandemic. 

Jones and Sen. Ben Cardin, D-Md., and other legislators in a letter Wednesday to U.S. Treasury Secretary Steven Mnuchin and Small Business Administration Administrator Jovita Carranza asked that payroll processing companies be allowed to disburse CARES Act small business loans to speed up payments to those small businesses and to get workers paid quickly. 

“Payroll processors have the needed existing infrastructure that will enable businesses to quickly pay their workers and pending bills. Given they originate approximately 40 percent of all the payroll checks in the country and mostly cater to small businesses with 500 employees or less, involving these companies will ensure a deeper dissemination of funds nationwide to the businesses that need it most to keep their doors open,” the letter reads. 

 “It is critical that all tools be used to distribute federal funds effectively and expeditiously, including payroll processing companies used by many small businesses,” they continued. “Please consider permitting payroll processors to partner with small businesses and banks to help alleviate any potential complications for many small businesses during this tumultuous time, the letter continues. 

 Jones in a separate letter Tuesday to Mnuchin asked that the federal government expedite direct assistance payments to citizens amid the COVID-19 outbreak by allowing some to receive the money quicker through debit cards rather than paper checks. 

Senators Kyrsten Sinema, D-Ariz., Chris Van Hollen, D-Md., Mark Warner, D-Va. and Bob Menendez, D-N.J. also signed the Wednesday letter.

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More than half of Alabama COVID-19 deaths are among black people

Chip Brownlee

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More than half of the deaths so far in Alabama from COVID-19 have been among black people, according to the Alabama Department of Public Health. Black Alabamians make up only 27 percent of the state’s population.

New data released Wednesday shows that the number of deaths among black people infected with COVID-19 in Alabama is higher than initially reported Tuesday, worsening an already disproportionate death rate.

The Alabama Department of Public Health is releasing new demographic data daily, and the numbers could shift again, but the early data show the virus is disproportionately killing black Alabamians.

Black people account for 52 percent of 48 verified deaths in Alabama, up from 44 percent of the verified deaths reported Tuesday. White people, who account for about 69 percent of the state’s population, make up 37.5 percent of the state’s deaths so far. At least 60 deaths have been reported, but not all of them have been investigated by the ADPH’s epidemiology staff.

Public health experts, including Dr. Selwyn Vickers, the dean of the UAB School of Medicine, have said that a lack of access to health care, higher uninsured rates and more underlying chronic illnesses like cardiovascular disease are contributing to the higher number of deaths among black Alabamians.

Rep. Anthony Daniels, the minority leader in the Alabama House of Representatives and a member of Gov. Kay Ivey’s coronavirus task force, told APR Wednesday that the state cannot wait to issue an after-action report on the disparities. It must start collecting and reporting as much data as possible now — on testing, on hospitalizations, on deaths and on outcomes in general.

All Alabamians, not just black Alabamians, have higher rates of underlying disease and chronic illness, making the state particularly susceptible to severe health effects caused by the virus. Men of all races have also made up a disproportionate number of the early deaths in Alabama. At least 64 percent of those who have died so far have been men, though women have made up more of the early confirmed cases at about 56 percent. Men are also more likely to have cardiovascular disease and other chronic conditions that make people particularly vulnerable to COVID-19.

Alabama also has a higher rate of poverty, especially in black communities, which results in worse health outcomes. According to the U.S. Department of Health and Human Services, the death rate for black people is higher than that of whites for heart disease, stroke, cancer, asthma, influenza and pneumonia, diabetes and HIV/AIDS — not because of biology but because of socioeconomic inequalities.

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“There are underlying health conditions in poor communities period, whether you’re black or white,” Daniels said. “I don’t know that there is enough data out there to definitely say that underlying health conditions are the sole indicator.”

Black people in Alabama, and across the United States, suffer worse health outcomes in a variety of areas — not just from this virus. Black women in Alabama have much higher rates of maternal mortality than white women, and studies have shown that people of color have more limited access to health care and higher uninsured rates than white people.

“We’ve known that the maternal mortality rate is an example of where we are,” Daniels said of health care disparities for people of color. “We’ve got to look at this. Is this quality or standard or care? There are so many underlying things that we have to think about.”

Daniels also said he worries that the number of cases and deaths in vulnerable communities is being undercounted because these people, especially early on in the outbreak, may not have been able to get a test or get to a hospital.

He called on the state to provide emergency funding to the Department of Public Health to gather more data and expand the response to the virus.

“We’ve got to look at the data more broadly,” Daniels said. “We cannot wait on an after-action report to determine what we could have or should have done. Alabama has so many smart people.”

The cause does not seem to be a lack of seriousness among people of color. Black people, at 46 percent, and Latinos, at 39 percent, are nearly twice likely to view the coronavirus as a major threat to their health, compared to about 21 percent among white people, according to Pew Research.

Demographics as of April 7.

The disproportionate number of deaths could also be stemming in part from geography. The virus has ravaged areas of the country with larger black populations, in part because cities tend to have a higher number of black residents. The virus is affecting several cities in the state with large black populations. At least 480 cases and 13 deaths have been confirmed in Jefferson County, where the largest city, Birmingham, has a majority black population.

The area of Alabama with the least access to health care, the Black Belt region, is also the area of the state with the largest black population. Many of the counties in this region of the state have no hospital. Expanded testing in this region has identified growing rates of infection.

“You could also worry that they just don’t get access,” Vickers said Saturday. “They don’t get to the hospital as early, and so it’s probably multiple reasons.”

Black people are also being disproportionately infected with the virus, according to the Department of Public Health. Though black people make up about 27 percent of the state’s population, about 37 percent of those with a confirmed case of the virus are black; 49.4 percent are white. The race of about 10 percent of the cases is unknown.

The data in Alabama mirror data in other states like Louisiana and Illinois, where black people have made up a disproportionate number of deaths caused by COVID-19.

“These communities, structurally, they’re breeding grounds for the transmission of the disease,” Sharrelle Barber, an assistant research professor of epidemiology and biostatistics at Drexel University, told The New York Times. “It’s not biological. It’s really these existing structural inequalities that are going to shape the racial inequalities in this pandemic.”

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AlabamaWorks releases business survey to identify COVID-19 impact

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AlabamaWorks has announced a new tool for all businesses, large and small, related to the COVID-19 impact and future focus of the workforce in the state.

The Alabama COVID-19 Workforce Response Survey is designed to help the state fully understand the impact of this pandemic on the state’s workforce as well as provide a clear path forward for businesses, industry and state government.

“I am grateful to the Alabama Workforce Council for developing and deploying this much needed and user-friendly survey,” said Governor Kay Ivey. “As we work together to combat COVID-19’s impact, this tool will allow us to identify the needs of business and industry, resources that can help them and how we can best support Alabama’s businesses owners and hardworking Alabamians and their families.”

The official survey, which is critical for helping individual industry sectors recover from COVID-19, is available here: http://sm.aidt.edu/alabamaworks-survey.

“While these are challenging times, we fully understand that now, more than ever, business and industry leaders must continue to work together with Governor Ivey’s administration and various state agencies to move us all forward together,” noted Alabama Workforce Council Chairman Tim McCartney. “Rest assured there is an unwavering commitment to do everything we can to minimize the negative impact COVID-19 has on our businesses, our economy, the state and all of its citizens. Using the results from this survey, I know we can all make a difference in combating the challenges from this pandemic facing so many throughout Alabama.”

Responses to the survey will be accepted through Tuesday, April 21 at 5 p.m. All businesses are highly encouraged to participate as the responses will help to protect Alabama’s workforce, manage the impact of COVID-19 and guide the allocation of various resources.

Additionally, another tool was released earlier this week for hard-working Alabamians from Governor Ivey’s office to help connect people to resources and resources to people. ALtogetherAlabama.org is a one-stop-shop for all Alabamians meant to connect businesses, nonprofits, and people that need help with the available resources during this time.

For more information and resources on Alabama’s COVID-19 workforce recovery efforts please visit alabamaworks.com/coronavirus/.

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