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Opinion | Now, a Medicaid program built around families and communities

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The elections of November 6th are over, and now, in Washington and in Montgomery legislators again take up the task of governing. As the leader of Alabama’s twenty-seven Republican state senators, my focus is on working with other lawmakers and Governor Kay Ivey to make state government more efficient and to keep job growth strong.

Reforming the state’s Medicaid program is one of the toughest challenges we face in the coming year. Medicaid, the federally-mandated health insurance program for pregnant women, children, low-income adults, the elderly, and the disabled, is by far the largest line item in the state’s General Fund — Medicaid by itself accounts for 37% of all non-education state spending and its budget for the current year is $755 million. For context, state prisons consume 23% and the Alabama Law Enforcement Agency (state troopers) uses 2.5% of non-education spending.

The aging of America’s population as the Baby Boomers retire puts enormous stress on government-run health insurance programs like Medicaid. About 10,000 Boomers retire every day, and the U.S. Census Bureau predicts that by 2035, the number of adults aged 65 and older in America will outstrip the number of children under the age of 18. In Alabama, the population of folks aged 65 and older is expected to grow by 25% between now and 2025. This coming demographic tidal wave threatens to swamp a number of government programs, including Medicaid.

For the past five years, I have worked with Medicaid Commissioner Stephanie Azar to craft a new health care model that better serves the growing number of senior citizens in Alabama who are in Medicaid’s long-term care. Thankfully, this year Alabama received approval from the Centers for Medicare and Medicaid Services in Washington to move ahead with the Integrated Care Network (ICN). This reform will offer senior citizens on Medicaid additional health care choices and is projected to save, over the long run, tens of millions of taxpayer dollars.

Here is how the ICN will work: in October of this year, the state Medicaid agency partnered with an Alabama health care provider that will now serve the medical needs of the 23,000 senior citizens who are receiving Medicaid’s long-term care services, 70% of whom are in nursing homes. By partnering with an expert health care provider based in Alabama, Medicaid can offer its long-term patients better care — and thus allow more Medicaid recipients to stay longer in the comfort of their own home.

Medicaid recipients can still opt for a nursing home, and no benefits are changed under this new system. But by partnering with a health care provider that is an expert in managed care, Medicaid can bend the cost curve down, offer improved health care, and give more of Alabama’s senior citizens an opportunity to stay a little longer in their homes and communities.

For my wife and me, one of the greatest privileges in life is spending time with our parents — and as the years have passed, we, like so many Alabama families, have discussed the future and begun to plan for the day when our parents will need additional help. As a legislator, I think often about how the policies that I vote on will affect the lives of my friends and neighbors. The Integrated Care Network is just getting started, but I am optimistic that this reform will improve the quality of life for many families in Alabama and put Medicaid on a sounder financial footing.

Greg Reed, R-Jasper, is the Alabama Senate Majority Leader and represents Senate District 5, which is comprised of all or parts of Winston, Walker, Tuscaloosa, Jefferson, and Fayette counties.

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Opinion | Racism: Victims on both sides

Jim Allen

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I’ve just seen this Anniston Star photo of the June 3rd George Floyd “protest” march in Heflin. As you can see, a very mixed crowd, black and white, young and old, all peaceful. But serious. What especially got my attention was that sign a lead marcher is holding, the big print saying “Stop Hate, Teach Love.” And the fine print from Nelson Mandela explaining: “No one is born hating another person because of the color of his skin . . .”

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Would this apply to Derek Chauvin, the Minneapolis policemen who killed George Floyd? The man’s very name suggests he was somehow “to the manner (if not the manor) born.”

“Chauvin” is a French family name. We get the term “chauvinism” from Nicolas Chauvin, a French army officer of the new Republic and later under Napoleon who was notorious for his excessive, extreme patriotism, and portrayed as such in popular drama of the time. So our English term “chauvinism” means “irrational and extreme belief in the superiority or dominance of one’s own cause, group, race, sex, nation etc.” It’s used most often in academic writing, in plain language “Us vs Them-ism,” seeing the ”them” as enemies. As in violent racism.

So, was Derek Chauvin born a violent racist?

I don’t think so. I’ve searched the internet for photos of him as an infant or young child, looking for clues to his childhood development, hoping to see if he looked happy, or angry, or sad. I didn’t find any photos at all.

But I persist in believing that human infants are born with various kinds of potential. But with a bias toward “playing well with others,” since ours is after all a gregarious species. So a child who grows up wanting to hurt or kill others must have come under the influence of – or perhaps we could say was infected by the virus of – something like chauvinism. In an important sense, then, another victim.

Not that it’s wrong to be very angry about what Derek Chauvin did, not that he shouldn’t be prosecuted and punished under the law. But as we mourn the death of George Floyd, let’s also grieve for the child Derek who was taught hate instead of love, that hurting child who may still be hiding inside this man.

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The sign says “Teach love.” I’m afraid the hardest part is learning love, shaking off that viral Us vs Them disposition to see enemies everywhere. I like what contemporary Buddhist spiritual leader Thich Nhat Hanh declares: “No person is the enemy.” But didn’t we get the same advice two thousand years ago from Jesus? – “Love your neighbor – no exceptions!

We are all in this together.

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Opinion | COVID-19 has changed our state’s industry and workforce landscape, our goal remains the same

Tim McCartney

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The human toll of COVID-19 is unprecedented in Alabama, and businesses of all sizes have taken a shellacking due to the pandemic. As such, our tactical focus for workforce development has transitioned from filling positions in the tight labor market we enjoyed in February to pandemic response, incumbent worker training and dislocated worker training today. The future of work has accelerated ten years in three months.

The Alabama Workforce Council (AWC) is working with the Ivey Administration and partners across the state to share best practices, key facts and resources for employers, employees and those who have been recently unemployed.

While the immediate focus of our efforts has transitioned to workforce recovery and response efforts to COVID-19 through our work with informational webinars, workforce recovery surveys, and resources for businesses (all available online), the AWC and AlabamaWorks remain steadfastly committed to the Governor’s attainment goal of adding 500,000 highly-skilled workers to Alabama’s economy by 2025. Notably, in these uncertain times, this goal has not changed.

Creating a highly-skilled workforce and resilient economy, even one that will be recovering for the foreseeable future, is necessary for Alabama’s economic vitality. For those who have become unemployed or underemployed due to COVID-19, reskilling or upskilling now can lead to sustainable in-demand career pathways that produce measurable benefits in the future.

Success Plus, the formal name for the Governor’s postsecondary education attainment goal, outlines the need to add an additional 500,000 Alabamians prepared for in-demand, high-wage careers to the workforce by obtaining credentials, certificates or degrees in addition to a high school diploma by 2025. Moremust be done to create stackable pathways that allow individuals to earn credentials through career-specific education and shorter-term programs that prepare them for immediate employment and future advancement.

To this end, Alabama has established a quality-assurance process for credentials through the Alabama Committee on Credentialing and Career Pathways (ACCCP). The ACCCP is tasked with identifying in-demand occupations in Alabama, developing competency models and career pathways for each of the in-demand occupations, and identifying related credentials of value associated with each of the in-demand occupations.

Additionally, on June 8the Alabama Workforce Council will launch the Governor’s Survey of Employer Competencies,which will survey employers in each sector and region of the state to assist the ACCCP with identifying these in-demand occupations as well as the related competencies and credentials of value aligned to those occupations.

The survey will be conducted between June 8 and June 15, 2020 and, going forward, the survey will be conducted annually to assist the ACCCP’s 16 Technical Advisory Committees (TACs) with their work oflinking credentials of value to one or more specific competencies needed for a job. Ultimately, this will allow employers to create competency-based job descriptions that list the specific skills required for a job, rather than using associate or bachelor’s degrees as placeholders. Therefore, it is vital that employers of all sizes, and from each industry sector, provide responses to the survey. The TACs will receive the results of the Governor’s Survey of Employer Competencies at the June 17, 2020 ACCCP meeting.

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It is clear that much work remains to be done. COVID-19 adds challenges to our ultimate goal, but the Alabama Workforce Council and AlabamaWorks knows that – regardless of the pandemic – clearly identifying in-demand jobs, with their related skills, and facilitating more opportunities for high-skill, high-wage careers is now more important than ever.

To learn more about the Alabama Workforce Council’s response to COVID-19 and to learn more about Governor Ivey’s vision for creating 500,000 highly skilled workers by 2025, visit www.alabamaworks.com.


Tim McCartney, formerly of McCartney Construction in Gadsden, is the chairman of the Alabama Workforce Council.

 

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Opinion | It’s past time to turn the page on racism, racial violence in America

Anthony Daniels

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On June 10, 1963, President John F. Kennedy sent National Guard troops to accompany the first black students admitted to the University of Alabama.

In an address to the nation, he said, “It is not enough to pin the blame on others, to say this is a problem of one section of the country or another, or deplore the fact that we face. A great change is at hand, and our task, our obligation, is to make that revolution, that change, peaceful and constructive for all. Those who do nothing are inviting shame as well as violence. Those who act boldly are recognizing right as well as reality.”

Sixty years later, that task is still at hand. The job is still far from done. And more and more often, it even seems like we’re losing ground. It has sure seemed that way this week and, indeed, over the last few months.

We’ve been through this before.

Ahmaud Arbery is not the first African American to be ambushed and murdered by men claiming to be protecting their neighborhood, simply because he seemed out of place. And it’s not the first case of such a murder being swept under the rug.

Breonna Taylor is not the first African American to be killed in their own home by police searching for a suspect who wasn’t there.

Christian Cooper is not the first African American to have the cops capriciously called on him and be falsely accused of menacing a white woman.

And the latest tragic miscarriage of justice, George Floyd is not the first African American to be brutally assaulted and killed at the hands of police officers. And his violent death is not the first to be videotaped and broadcast across the internet, social media, and television. The question is: how do we make it the last? How do we ensure his death and our anger isn’t in vain?

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For too many of us, institutional racism is a fact of daily life. And when the system begins to crack and crumble under the strain of decades of injustice and inequality, only then do we say ‘enough is enough.’ Only then do we go through the same cycle we’re going through right now. Anger is warranted, but it’s not enough to get enraged, despondent, frustrated, and mad. It’s not enough to protest. It’s not enough to lash out. And it will never be enough until we begin to act to change the underlying and lingering conditions that make racism a reality – that makes it part of the American experience.

If you think the system is already working fairly for all people, I ask: by whose standards? Not mine. Our laws, our leaders, and our system of government were never intended to be stagnant.

If you find it acceptable to try to turn victims into suspects, looking for any way possible to justify ruthless behavior, I ask: for every instance of injustice recorded, how many more have gone unreported? The answer is too many to count. What accusations would have been dug up and leveled then? We will never know. After all, it’s much easier to defame someone who’s not alive to defend themselves.

Of course, we won’t all agree on the best course of action, but I hope we can all agree that the status quo cannot continue and that action is required. That’s all the more reason we need to start talking. And to those who don’t want to have this conversation, who may feel uncomfortable or embarrassed, let’s not give them a choice. Let’s make it an issue. Let’s prioritize recognizing right and reality instead of inviting shame and violence. Let’s start today and not stop until we succeed.

We simply cannot allow this to be another situation where we shout, we scream, we cry, and then we clean up and move on to only do it all over again down the road. What will this week’s protests lead to next week or next month or next year? Starting now, we must have this conversation at every ballot box at every election – municipal, state, congressional, and so on. If you want your voice heard, presidential cycles are fine, but real, actionable change begins at the local level. Mayors and city councils appoint police chiefs. We elect District Attorneys, Sheriffs, Legislators, Judges, and Coroners. State Representatives and Senators make laws but law enforcement applies them. We all have a role to play in righting the wrongs by revisiting outdated and close-minded policies that continue to plague communities across our state and replacing them with a new vision.

Similarly, when I look at my young son, I wonder how I’m going to have the conversation with him. What am I going to say during “the talk” that black parents have, for generations now, had to have with their children? And how am I going to say it? How am I going to teach my son to protect himself? What are you telling your children?

In Alabama, we must come to terms with our legacy of racism and commit to eradicating injustice or we will never escape this cycle. As a policymaker and leader in this state, I cannot tell my son or anyone that we’ve fully turned the page on our dark and violent past. But I can tell you what needs to be done. Change starts with commitment. Individuals must resolve to break this cycle and then influence their own neighborhoods and communities to do better. It continues with conversations among people of diverse backgrounds, seeking to understand each other and treat each other with equality, decency, and dignity as human beings. It becomes reality when together we take our values to the ballot box and hold our leaders accountable to enact policies that ensure justice for all.

I invite and I welcome all Alabamians to join me in the task as an obligation to each other and to ourselves. Together, let’s continue this work. And at the very least, let’s each reflect on the words of President Kennedy so many years ago, “We are confronted primarily with a moral

issue. It is as old as the scriptures and is as clear as the American Constitution . . . I hope that every American, regardless of where he lives, will stop and examine his conscience about this and other related incidents.”

 

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Opinion | To close the homework gap in our schools, let’s close the partisan divide in Washington

Matt Akin

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As Alabama shut down its schools on March 16thand moved classes online in response to the COVID-19 pandemic, I was saddened but not surprised when many Gulf Shores students told me they didn’t have broadband at home needed for their coursework.

Having headed school systems in Piedmont, Huntsville and now in Gulf Shores’ first year as an independent district, I am passionate about closing the digital divide. At Gulf Shores, I gave 6ththrough 12th graders computers to take home early in this school year. Kindergarteners through fifth graders had assigned devices at school.  As we shuttered the schools, we ordered 100 mobile hotspots for our students to access the Internet.

But schools can’t – and shouldn’t have to – close opportunity gaps all by themselves. The crisis that has closed our schools has created a rare opportunity for national leaders to close the digital divide and homework gap through the next economic stimulus. 

With schools closed, the digital divide looks more like a socioeconomic chasm. More than a quarter of Alabama’s population are not online at home. As a math teacher by training, I believe in using data to analyze problems like the digital divide, which comprises two challenges – adoption and availability.

Adoption is the greater problem – about 25 percentof American households with broadband access in their neighborhood haven’t even subscribed to it. The major barriers to adoption appear to be households not having basic computer hardware, digital literacy or an understanding of the internet’s importance to their lives.

But, while 95 percent of Americans have access to high-speed fixed broadband, about 22 percent of rural households don’t. And, because of problems with  availability and adoption, over 30 percent of African American and Latino youngsters didn’t have home internet and nearly half don’t have a laptop or computer at home.

For the sake of our students and their families, we need all hands-on-deck – educators, broadband providers, computer companies and tech leaders – to address the challenge.

With broadband deployment, we need a process driven by public spiritedness, not political patronage. The best companies and technologies should compete to serve every community from isolated rural areas to the inner cities.

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Let’s learn from the 2009 stimulus: Legislators and lobbyists funneled funds to favored companies and technologies. The results of that anticompetitive practice?  Just what one would think:  Duplicative networks in areas where broadband was already available, with billions of dollars squandered, while many communities remained without service.

I’m skeptical of one-size-fits-all solutions. Wireless hotspots can close homework gaps in some communities. But elsewhere, wired connectionsmay be more cost effective and less expensive with faster download speeds for e-learning.

And we also need to regulate broadband intelligently. This crisis is a teaching moment.  U.S. broadband has risen to the challenge of a 34 percentsurge in internet demand during COVID-19.   But, in Europe, over-regulated networks are slowing down.

Why? While Europe regulated broadband as a utility, and investment suffered, the U.S. opted for a “light touch” approach that encouraged nearly $2 trillion in private investment. Our wise policy choices built robust networks that we can rely upon in these difficult times—and to rebuild our economy for better times.

To achieve what’s needed, Congress needs a bipartisan compromise, including an end to anti-competitive practices that exclude qualified providers and technologies—and an effort by broadband and computer equipment companies to help attack the divide. 

We have a job to do, and no time to waste.

Alabama’s Senators – Doug Jones and Richard Shelby – are well-prepared to reach across the aisle to form bipartisan consensus.  Broadband providers are providing free and discounted broadband to low income homes. But everyone needs to step up.

I wish Congress could have watched our students in the Piedmont schools after we provided them with computers and connectivity. Many mastered subjects such as advanced algebra they had previously struggled with because they couldn’t do homework online.

When our leaders in Washington bridge their partisan divide, communities across Alabama and America will bridge their digital divides. And many more students will bridge the gap between their performance and their potential.

Dr. Matt Akin is the Superintendent of Schools in Gulf Shores, Alabama, having held similar positions in Huntsville and Piedmont.

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