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Democrats drop four pieces of legislation to expand Medicaid in response to rural health care crisis, COVID-19 pandemic

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Today, Rep. Laura Hall, D-Huntsville, introduced a bill, HB448, to extend Medicaid coverage for new and expectant mothers for up to a year postpartum, while Rep. Mary Moore, D-Birmingham, introduced a bill, HB447, to fully expand Medicaid coverage. Rep. Neil Rafferty, D-Birmingham, introduced two resolutions, supporting his colleagues bills and urging the Governor to expand Medicaid.

Rep. Hall said, “Expanding Medicaid and increasing access to affordable and quality healthcare, particularly for new and expectant mothers, is crucial in addressing Alabama’s maternal mortality rate (currently one of the highest in the nation). Beyond that, it will help provide necessary funding to rural hospitals and healthcare facilities that are currently operating in the red.”

Should Medicaid expansion be on the 2019 legislative agenda? Experts say it has to be

 

The expansion would provide around 397,000 currently uninsured, eligible Alabamians, including an estimated 13,000 veterans. Overall expansion is estimated to create 30,000 new jobs, while drastically increasing economic activity.

Rep. Moore echoed Rep. Hall’s thoughts, saying “Rural areas across this state, including at least 8 counties, do not have an operating hospital. With COVID-19 now being declared a pandemic by the World Health Organization (WHO), we must take action now to avoid the loss of life.”

According to the Alabama Hospital Association, the state has seen 17 hospitals close in the past ten years, a majority of which were rural. They estimate that 88 percent of rural hospitals and 75 percent of all hospitals across the state are currently operating at a deficit.

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The bill closely mirrors a bill in the Texas Legislature. The full text of the HB447 by clicking here, and HB448 can be found by clicking here.

 

The Alabama Political Reporter is a daily political news site devoted to Alabama politics. We provide accurate, reliable coverage of policy, elections and government.

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Alabama’s coronavirus case totals have more than doubled in last 30 days

Brandon Moseley

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(STOCK PHOTO)

Thursday, the Alabama Department of Health reported that another 1,626 Alabamians had been diagnosed with the novel strain of the coronavirus, SARS-CoV-2.

The news capped off what has been a grim summer for Alabamians eager to see an end to the COVID-19 global pandemic. Unfortunately there appears to be no end in sight. Through July 7, 45,263 Alabamians had contracted the coronavirus over the first 109 days of the pandemic. In the 30 days since, 48,139 more Alabamians have gotten the virus and more deaths have followed. The state has averaged over 1,604 cases per day in the last 30 days. Thursday’s 1,626 number exceeded that average.

The state now has 93,402 confirmed cases of the coronavirus in the state and that number is sure to rise as schools begin to reopen next week and children and teachers begin intermingling for the first time in 117 days.

In the first 109 days of the pandemic in Alabama 1007 Alabamians were killed by COVID-19. In the last 30 days, another 647 Alabamians have perished from the COVID plague. That is an average of 21.6 deaths per day. The ADPH reported another 15 COVID-19 deaths on Thursday. The state’s death toll now stands at 1,654.

1577 people were in the hospital statewide suffering from COVID-19. Many hospitals are near capacity in intensive care beds. Making matters worse for heath care workers, 5,575 Alabama health care workers have tested positive for the coronavirus. 1,576 of those healthcare workers cases were just in the last 30 days.

The state has administered 736,534 tests. 93,402 have been positive. That is almost a 12.7 percent rate of positive tests. Public health officials claim that anything over five percent is bad and is an indicator that there are many more people out there with the coronavirus that are not being detected. Through July 7, Alabama had given 460,842 tests and 45.263 of them came back positive. That is a 9.8 percent rate. In the last 30 days, however; there have been 275,692 tests given and 48,139 of them came back positive. That is almost a 17.5 percent rate, indicating that in addition to the 53825 active cases in the state that we know about, there are likely tens of thousands that are going undetected. 37,923 Alabamians are believed to have recovered from their illness.

1.97 percent of Alabama’s population have been diagnosed as infected with the coronavirus. This is the seventh highest infection rate in the nation. If Alabama were an independent country, we would trail only Qatar, French Guiana, Bahrain, and San Marino in our known infection rate.

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Some states, including New York, are asking that visitors from Alabama quarantine themselves for 14 days after arriving. GOP Senate candidate Tommy Tuberville was recently criticized in the Washington Post for defying the Washington D.C.14 day quarantine request for visitors from Alabama during a recent visit.

Not all of the news was bad. The seven and fourteen day averages for coronavirus cases in the state have both been dropping since peaking around July 25. The cases, while dropping, are still well above what they were prior to July 13.

The state remains under a Safer at Home order through the end of August, issued by Governor Kay Ivey (R) and State Public Health Officer Dr. Scott Harris. If you do not have to leave your home, then do not leave your home. You are safer there. If you are going to be around other people not in your household you are required to wear a mask or cloth face covering. This includes school children returning to classes this month. Remember to always socially distance. Stay six feet away from other people as much as possible. Don’t shake hands or hug people not actually living in your household. If someone in your household is sick, isolate them from the rest of the family. If you or someone in your family have any sort of symptoms get tested for the coronavirus. Remember to wash your hands frequently.

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SARS-CoV-2 was first identified in a cluster of cases in Wuhan City, Hubei Province, China in last 2019. Since then it has spread across the globe. Well over 19 million people have been infected globally and 717,717 have already died, including 162,804 Americans.

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Health

Alabama nursing homes can’t use rapid COVID-19 test machines without federal guidance

In Alabama, there were 686 coronavirus deaths in long-term care facilities as of Wednesday, which was 42 percent of the state’s 1,639 COVID-19 deaths at that point.

Eddie Burkhalter

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(STOCK PHOTO)

Some Alabama nursing homes have received rapid, point-of-care COVID-19 test machines, but without guidance from the federal agency that sent them, the machines aren’t being used.

It’s been three weeks since the Centers for Medicare and Medicaid Services in a nationwide conference call with nursing home administrators announced plans to disburse the machines, which can provide results in 15 minutes.

John Matson, director of communications for the Alabama Nursing Home Association, told the Alabama Political Reporter on Wednesday that CMS has said it will send the rapid testing machines to 78 Alabama nursing homes to start, and eventually will supply one to each nursing home in the state. He said some of those 78 facilities have received them while some are still waiting for delivery.

“The biggest thing we’re waiting on from CMS is guidance on when and how it wants us to use these machines,” Matson said.

Matson said that CMS officials on the July 16 conference call said that regulations and guidance on the testing machines weren’t yet ready, but that the agency wanted to go ahead and disburse the machines.

“They wanted to distribute machines and then let the guidance and the regulations catch up,” Matson said.

The Trump administration touted the rapid tests machines’ ability to bolster testing in nursing homes, which care for older, sick people who are at most risk of serious complications and death due to coronavirus.

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As of July 30, 43 states reported 62,925 COVID-19 deaths, which was 44 percent of all coronavirus deaths in those states, according to the Kaiser Family Foundation.

In Alabama, there were 686 coronavirus deaths in long-term care facilities as of Wednesday, which was 42 percent of the state’s 1,639 COVID-19 deaths at that point.

While nursing home administrators await those federal guidelines to be able to use the rapid test machines, it’s taking longer to get COVID-19 test results from many labs. Matson said some nursing homes are seeing wait times for results as long as a week, which public health experts say makes the results nearly worthless.

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“Not every nursing home is experiencing that, but we do know that some are experiencing a longer turnaround time,” Matson said.  “As we’ve said before, knowledge is key, and when we run those tests we need those tests results back in a timely manner so we know how to properly treat our patients and our employees.”

The Alabama Department of Public Health on July 31 said that as Alabama continues to see an increase in the number of new COVID-19 cases, it’s taking commercial labs and ADPH’s lab an average of seven days to get results.

ADPH in the release states that the lengthier turnaround time for test results is due to several factors, including supply chain problems with test reagents, more demand for coronavirus tests nationwide, “and in some cases, increased numbers of unnecessary tests.”

“I think it’s important to emphasize that that is essentially a worthless result,” said Dr. Jeanne Marrazzo, director of infectious disease at UAB, during a press briefing July 30. “At that point, all it tells you is that six days ago you were negative.”

And there are problems with the rapid testing machine’s accuracy. CMS has said the machines have an error rate of between 15 and 20 percent, and that a negative test result on the machines shouldn’t be used to rule out a possible case.

“Negative results should generally be treated as presumptive, do not rule out SARS-CoV-2 infection and should not be used as the sole basis for treatment or patient management decisions, including infection control decisions,” CMS said in a FAQ on the rapid test machines for nursing homes.

Matson said CMS told nursing homes that while a negative test result should be followed up with a subsequent lab test to be certain, a positive result on the rapid test machines very likely means the person has coronavirus.

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Corinth, Mississippi, is the scenario that school superintendents must be prepared for

Brandon Moseley

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(STOCK PHOTO)

Many Alabama school systems will resume in-person classes later this month. Corinth, Mississippi, rushed ahead to open classes and already there are positive tests for the coronavirus, and more than 100 students are now in quarantine. This is the fear that every school superintendent in the country will have to face when making the decision on whether or not to resume in-person classes in their school systems.

Taylor Coombs, a spokesperson for the Corinth School District, told CNN that six students and one staff member have tested positive for the novel strain of the coronavirus, SARS-CoV-2. Coombs said that an additional 116 students have been considered in “close contact” of a positive case and have been sent home to quarantine for 14 days. Corinth has 2,700 students.

The Corinth School District told parents in a letter posted on Facebook Wednesday that an individual from Corinth Middle School tested positive as well as an employee at Corinth Elementary School. The letter said the school has done contact tracing and is asking anyone who had contact with the individuals to quarantine for 14 days.

While in quarantine, children cannot attend school or any school activities, such as sports.

In-person classes resumed in the district on July 27, according to the school calendar. Corinth parents were given the option of returning to the school for normal classes or doing virtual learning.

Corinth has been screening students and staff on a daily upon entering the building with temperature checks, according to the district’s reopening plan. Staff are having to answer questions daily about if they have had symptoms in the past several days. Despite this, a number of students still were infected during the first week of school and over a hundred were exposed to the virus.

On Tuesday, Mississippi Gov. Tate Reeves issued a mandatory mask mandate for the state which includes schools, beginning Wednesday.

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“I know that I want to see college football in the fall,” Reeves said. “The best way for that to occur is for us all to recognize that wearing a mask, as irritating as it can be — and I promise you, I hate it more than anybody watching today — it is critical.”

Mississippi has the fifth-highest recorded case count per 100,000 people. At least 2.13 percent of the population having been already diagnosed with the infection. Mississippi trails only Louisiana, Arizona, Florida and New York.

Alabama is seventh in the country at 1.93 percent of the population. Of Alabama’s 91,776 total cases, 21,363 — or 23 percent — were diagnosed in just the last two weeks. At least 1,639 Alabamians have died already from COVID-19, and 314 of those deaths — or 19.2 percent — were reported in just the last two weeks.

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Despite the setbacks, Mississippi is pushing ahead on reopening schools.

“I believe that there is enough motivation (now) to safely get our kids in school that we can really juice the participation of mask-wearing throughout our state for the next two weeks,” Reeves said on Tuesday when he issued the mask order and the new measures to combat the virus.

Reeves acknowledged that the earlier “piecemeal approach” had not been effective.

Alabama will follow Mississippi’s lead and begin reopening schools next week, with the understanding that outbreaks, like Corinth, are possible and perhaps even likely as we move forward with in-person classes and high school football to follow later this month.

School systems need to open with a plan for testing, quarantining and unfortunately even for the unfortunate deaths of a staff member or student.

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Education

Exposure notification app for college students launches pilot phase

Micah Danney

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Screen captures of the GuideSafe application. (UAB)

College students across Alabama and anyone with a .edu email address are being invited to participate in an anonymous Exposure Notification System app for iPhone and Android users. The app launched in a closed pilot phase on Monday that will allow up to 10,000 downloads for each phone type.

The app is part of the GuideSafe platform, a suite of tools designed to help people reduce the spread of the novel coronavirus. It features a tool called HealthCheck, which allows users to report COVID-19 symptoms, and another called Event Passport, which uses an algorithm to assess whether a person is safe to attend a gathering of 10 or more people or not based on the responses they log in HealthCheck. 

The GuideSafe platform encompasses the Stay Safe Together and Testing for Alabama initiatives. Participation is voluntary and designed to protect users’ privacy while anonymously alerting each user to potential exposure to someone who has tested positive in the last 14 days. The exposure notification system assigns random numbers to each user to keep them anonymous to each other and to the system.

The app will be made available for mass public download later this month after the pilot phase ends and the app’s performance is assessed.

GuideSafe is the largest-scale testing initiative for higher education in the nation. It uses exposure notification technology developed jointly by Google and Apple.

Alabama is one of the first states to launch the technology, which is part of the state’s program for safe entry to campuses of higher education. Gov. Kay Ivey allocated more than $30 million in Coronavirus Aid, Relief and Economic Security (CARES) Act funding for the plan.

The pilot app was built by the University of Alabama at Birmingham and Birmingham-based MotionMobs, in partnership with the Alabama Department of Public Health.

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“We have worked extremely hard to leverage research and innovation, community service, patient care and education to make a positive difference in this pandemic,” said UAB President Ray L. Watts. “This new app – using Google- and Apple-led technology and created by UAB faculty, staff and MotionMobs for the people of Alabama – is a necessary tool in our effort to return to college campuses safely this fall.”

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