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Sewell introduces bill to help rural hospitals during coronavirus pandemic

Brandon Moseley

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U.S. Rep. Terri Sewell, D-Selma, joined with Tennessee Republican Rep. Phil Roe and Washington Democratic Rep. Kim Schrier to introduce bipartisan legislation to provide relief for rural medical hospitals and clinics during the COVID-19 crisis.

Sponsors claim that the Immediate Relief for Rural Facilities and Providers Act is necessary relief for rural hospitals and medical providers as they are strained by COVID-19 cases growing in Alabama and across the country.

“While the coronavirus outbreak will have an impact on all health care providers, the economic pressures of this crisis could be the death knell for our already-struggling rural hospitals in Alabama unless they receive targeted economic relief,” Sewell said. “This bipartisan legislation will go a long way in stabilizing our rural hospitals by providing immediate payments to our rural health care providers to help ensure they are able to keep their doors open during this pandemic.”

COVID-19 is caused by the novel strain of the coronavirus, SARS-CoV-2, first identified in Wuhan City, Hubei Province, China in late 2019. 46,148 Americans have been confirmed as having the virus. The virus has already killed 582 Americans, 140 of them on Monday alone.

Both Schrier and Roe are doctors.

“The risk of severe illness for most people is low,” Schrier said. “Most people who get COVID-19 will have mild symptoms and make a full recovery. But in order for our hospitals and health care system to help those who need it, we need to slow the spread and keep COVID-19 away from the elderly and vulnerable.”

“The total number of cases and deaths will continue to multiply and put a greater strain on our health care system,” Roe said. “Although most individuals who contract COVID-19 will experience symptoms that resemble a cold or flu and recover, a significant number of infected people will require hospitalization. If these hospitalizations occur in too short a period of time, our medical facilities will be overwhelmed and unable to provide treatment. That’s why Americans are seeing unprecedented public health restrictions being put in place. We are trying to do what public health experts refer to as flattening the curve. There are no vaccines or treatments specific to COVID-19, which differentiates this disease from the flu.”

To accommodate the millions of anticipated coronavirus cases, states like Alabama have suspended elective surgeries to open beds and ensure capacity for what is expected to be an enormous influx of COVID-19 related cases. Although this decision is medically necessary given the pandemic, it could force widespread closures among rural hospitals that rely on elective procedures to keep their doors open.

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Sponsors say that The Immediate Relief for Rural Facilities and Providers Act would provide rural hospitals with an emergency mandatory one-time grant to rural hospitals equaling $1,000 per patient day for three months. The bill would also provide rural hospitals with a one-time, emergency grant equaling the total reimbursement received for services for three months to stabilize the loss of revenue. The legislation would also encourage hospital coordination with a 20 percent increase in Medicare reimbursement for any patient in a rural hospital using the swing bed program to incentivize freeing up capacity in larger, overcrowded hospitals. The bill also provides an emergency, one-time grant for all providers and ambulatory surgery centers equal to their total payroll from January 1 to April 1, 2019. Finally, the bill would provide funding for physicians and providers by authorizing the Small Business Administration to provide low-interest loans to providers and ambulatory surgery centers at a 0.25 percent interest rate that will not accrue until two years after the COVID-19 pandemic has ended.

The legislation was introduced in the Senate by U.S. Sen. Michael Bennet of Colorado, Sen. John Barrasso of Wyoming, and Sen. Doug Jones of Alabama.

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Guest Columnists

Opinion | With COVID-19 policy, don’t blame your umbrella. The rain got you wet

Monica S. Aswani, DrPH, and Ellen Eaton, M.D.

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Monica S. Aswani, DrPH, is an assistant professor of health services administration and Ellen Eaton, M.D., is an assistant professor of infectious diseases.

Editor’s note: The opinions expressed in this perspective are those of the authors.


As states re-open for business, many governors cite the devastating impact of physical distancing policies on local and state economies. Concerns have reached a fever pitch. Many Americans believe the risk of restrictive policies limiting business and social events outweighs the benefit of containing the spread of COVID-19.

But the proposed solution to bolster the economy — re-opening businesses, restaurants and even athletic events — does not address the source of the problem.

A closer look at the origins of our economic distress reminds us that it is COVID-19, not shelter-in-place policy, that is the real culprit. And until we have real solutions to this devastating illness, the threat of economic fallout persists.

Hastily transitioning from stay-at-home to safer-at-home policy is akin to throwing away your umbrella because you are not getting wet.

The novelty of this virus means there are limited strategies to prevent or treat it. Since humans have no immunity to it, and to date, there are no approved vaccines and only limited treatments, we need to leverage the one major tool at our disposal currently: public health practices including physical distancing, hand-washing and masks.

As early hot spots like New York experienced alarming death tolls, states in the Midwest and South benefited from their lessons learned.

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Indeed, following aggressive mandates around physical distancing, the number of cases and hospitalizations observed across the U.S. were initially lower than projected. Similarly, the use of masks has been associated with a reduction in cases globally.

As the death toll surpasses 100,000, the U.S. is reeling from COVID-19 morbidity and mortality. In addition, the U.S. has turned its attention to “hot spots” in Southern states that have an older, sicker and poorer population. And to date, minority and impoverished patients bear the brunt of COVID-19 in the South.

Following the first COVID-19 case in Alabama on March 13, the state has experienced 14,730 confirmed cases, 1,629 hospitalizations and 562 deaths, according to health department data as of Monday afternoon.

Rural areas face an impossible task as many lack a robust health care infrastructure to contend with outbreaks, especially in the wake of recent hospital closures. And severe weather events like tornadoes threaten to divert scarce resources to competing emergencies.

Because public health interventions are the only effective way to limit the spread of COVID-19, all but essential businesses were shuttered in many states. State governments are struggling to process the revenue shortfalls and record surge in unemployment claims that have resulted.

The Coronavirus Aid, Relief and Economic Security Act, or CARES Act, allocated $150 billion to state governments, with a minimum of $1.25 billion per state. Because the funds were distributed according to population size, 21 states with smaller populations received the minimum of $1.25 billion.

Although states with larger populations, such as Alabama and Louisiana, received higher appropriations in absolute terms, they received less in relative terms given their COVID-19 related medical and financial strain: the CARES Act appropriations do not align resources with state need.

As unemployment trust funds rapidly deplete, these states have a perverse incentive to reopen the economy.

Unemployment claimants who do not return to work due to COVID-19 fears, per the Alabama Department of Labor, can be disqualified from benefits, perpetuating the myth of welfare fraud to vilify those in need.

The United States Department of Labor also emphasized that unemployment fraud is a “top priority” in guidance to states recently.

Prematurely opening the economy before a sustained decline in transmission is likely to refuel the pandemic and, therefore, prolong the recession. Moreover, it compromises the health of those who rely most heavily on public benefits to safely stay home and flatten the curve.

Some would counter this is precisely why we should reopen — for the most vulnerable, who were disproportionately impacted by stay-at-home orders.

The sad reality, however, is that long-standing barriers for vulnerable workers in access to health care, paid sick leave and social mobility pre-date this crisis and persist. And we know that many vulnerable Americans work on the frontlines of foodservice and health care support where the risk from COVID-19 is heightened.

A return to the status quo without addressing this systemic disadvantage will only perpetuate, rather than improve, these unjust social and economic conditions.

COVID-19 has exposed vulnerabilities in our state and nation, and re-opening businesses will not provide a simple solution to our complex economic problems.

No one would toss out their umbrella after several sunny days so why should America abandon public health measures now? After all, rain is unpredictable and inevitable just like the current COVID-19 crisis.

The threat of COVID-19 resurgence will persist until we have effective preventive and treatment options for this novel infectious disease.

So let’s not blame or, worse, discard the umbrella. Instead, peek out cautiously, survey the sky and start planning now to protect the vulnerable, who will be the first to get wet.

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Health

New COVID cases in Alabama increasing faster than 46 other states

Chip Brownlee

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Alabama reported more cases of COVID-19 last week than any other week since the pandemic began, and the increase in new cases reported last week compared to the previous week was higher than 46 other states and the District of Columbia.

An analysis of data collected by The COVID Tracking Project, a volunteer-run effort to track the pandemic, shows that only West Virginia, Maine and South Carolina reported a larger increase in new cases last week compared to the new cases they reported in the previous week.

According to The COVID Tracking Project’s data, Alabama recorded 2,556 new cases during the week ending Sunday, May 24, compared to 1,994 new cases during the previous week ending Sunday, May 17.  That’s an increase of 28 percent.

The Alabama Department of Public Health’s daily case totals show an increase of 17 percent last week over the previous week, which is still higher than 38 other states, according to the analysis performed on The COVID Tracking Project’s data.

COVID Tracking Project has a standardized method of capturing each state’s new cases from health departments, making it possible to compare the trajectories of each state. Twenty-four states and the District of Columbia saw new cases decline last week, while 25 states saw new cases increase last week compared to the previous week.

Compared to other states, testing showed no similar increase. The number of new tests reported in Alabama last week only grew 2 percent compared to the previous week, according to the COVID Tracking Project’s data. That’s lower than 31 other states.

APR‘s data showed an increase of 13 percent over the previous week, but that is still a smaller increase than 25 other states. Both our data and an analysis of The COVIDTracking Project’s data show the percent of total tests that are positive rose last week compared to the previous week.

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The Alabama Department of Public Health does not provide historical data for how many tests were performed on each day. Both APR and the COVID Tracking Project calculate test increases by tracking the change to the cumulative total of tests performed.

Several other Southern states also saw rising cases and no similar increase to tests performed. In Mississippi, new cases rose by 9 percent last week compared to the previous week while tests per week fell by 21 percent. In Tennessee, new cases rose 15 percent while tests per week declined 8 percent.

Georgia saw new cases rise 21 percent, but tests also rose by 22 percent. Florida, South Carolina and North Carolina also reported both rising cases and more tests compared to the previous week.

Cases have been rising in Alabama since the beginning of the month. Testing has also increased, and public health officials, including State Health Officer Dr. Harris, have said they are not sure if the increase in cases is directly attributable to more tests or more disease.

Some areas of the state, like Madison County and Lee County, have seen little or no rise in new cases, while others, like Montgomery County and Tuscaloosa County, are experiencing worsening outbreaks.

Gov. Kay Ivey lifted the state’s stay-at-home order on April 30 and has since relaxed restrictions twice more, saying the economics of the pandemic must be addressed. The state reported an unemployment rate of 12.9 percent last week, higher than during any point during the Great Recession.

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Economy

Talladega will hold GEICO 500 on June 21 without fans in the stands

Brandon Moseley

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The National Association for Stock Car Auto Racing (NASCAR) has announced that the GEICO 500, MoneyLion 300 and General Tire 200 automobile races have all been rescheduled for the weekend of June 20 to 21.

They will be raced without fans in attendance.

“We are excited that NASCAR has announced the rescheduling of our April race weekend to June 20-21,” said Talladega Superspeedway President Brian Crichton. “While we will have cars on track, in the interest of the health and safety of all involved, including fans, NASCAR will be running our three races – the GEICO 500, MoneyLion 300 and General Tire 200 – without fans in attendance in accordance with the State of Alabama, CDC and public health agency standards and protocols.”

The Cup Series GEICO 500 will be held on Sunday, June at 2:00 pm CST.

The Xfinity series MoneyLion 300 will be held on Saturday, June 20 at 4:30 pm CST.

The ARCA series General Tire 200 will be held on Saturday, June 20, 2020 at 1:00 pm CST.

“NASCAR, like Talladega Superspeedway, prides itself in being fan-friendly, and the fans drive everything we do,” Crichton said. “The decision to race without fans is focused on the long-term health of you and our sport. NASCAR has a great respect for the responsibility that comes with a return to competition, and after thorough collaboration with public officials, medical experts and state and federal officials, NASCAR has implemented a comprehensive plan to ensure the health and safety of the competitors and surrounding communities.”

“For our June 20-21 events, we hope you will enjoy watching and listening to the 3- and 4-wide racing at the sport’s Biggest and Most Competitive track via our broadcast partners FOX, FS1 and MRN Radio,” Crichton concluded. “We will persevere through this together.”

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Ticketholders may elect to receive a credit for the full amount paid plus an additional 20 percent of total amount paid to apply towards a future event, including, but not limited to, grandstand seating, infield, camping, fan hospitality, and Talladega Garage Experience. The 120 percemt event credit can be used in a single transaction during the remainder of the 2020 season and entire 2021 season for a NASCAR sanctioned event at any NASCAR-owned track, subject to availability. Elections for an event credit or refund must be submitted by June 14, 2020.
Ticketholders may apply here:
https://www.talladegasuperspeedway.com/Vanity-Pages/2020/Assistance.aspx

Motorsports are the only major pro sports league that has resumed play after the coronavirus global pandemic struck in mid-March. The NBA is considering a proposal to playout the remainder of their season and playoffs sequestered at the Wide World of Sports complex at Disneyworld in Orlando, Florida with no fans present. The NHL is in the process of considering a similar proposal to finish this year’s hockey season. Major League Baseball has not played a single game of their season yet. MLB owners have made a proposal that the league play an 80 game season without fans present. The idea is meeting with skepticism from MLB players due to a controversial proposal capping players salaries for this season in a 50:50 revenue sharing agreement. The proposal that would dramatically reduce MLB players’ salaries for this season. Horse racing and mixed martial arts have held some sporting events in recent weeks.

NASCAR has already held two races at Darlington and one at Charlotte after resuming racing on May 17. Kevin Harvik won the Real Heroes 400 driving a Ford and Denny Hamlin won the Toyota 500 driving a Toyota in the first two Cup Series races since NASCAR resumed racing after a ten week hiatus. NASCAR intends to run a 36 race season this year.

Motorsports are the only major professional sports league played at a major league level in the state of Alabama. In addition to the Talladega Superspeedway, the state is also home to the Barber Motorsports Parks near Leeds. The Barber facility hosts both professional motorcycle racing and the Honda Indy Grand Prix of Alabama, a NTT Indycar series event. That event was cancelled due to efforts to shut down the economy to fight the spread of the coronavirus.

The COVID-19 global pandemic has already killed 98,705 Americans through Sunday morning.

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Economy

Alabama nonprofit hopes federal food aid for children continues through summer

Eddie Burkhalter

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Almost half of Alabamians experienced a loss in income since the COVID-19 crisis began, and more than 13 percent said they hadn’t had enough to eat during the prior week, according to a recent survey, but there is help for families with children struggling with food insecurity. 

Two federal programs combined can help keep Alabamians fed during coronavirus’s continued impact on health and finances, but there’s work to be done to ensure those programs are fully used, and will continue to help during this time of need, according to Alabama Arise, a nonprofit coalition of advocates focused on poverty. 

Celida Soto Garcia, Alabama Arise’s hunger advocacy coordinator, on Friday discussed the U.S. Department of Agriculture’s  Community Eligibility Provision (CEP), which allows schools with high poverty rates to serve breakfast and lunch to all students, regardless of a parent’s income. 

There are still a little more than 100 school systems in Alabama that would qualify under the program, but haven’t yet applied to do so, Garcia said. 

“Schools that had implemented CEP prior to the pandemic made it a lot easier to distribute food. They didn’t have to worry about eligibility and delayed distribution,” Garcia said. 

Garcia said the coronavirus crisis has brought attention to the CEP program and that some school board officials and child nutrition professionals are beginning to identify which school systems could qualify for the aid. 

“So that of course was a benefit prior to the pandemic, and now there’s just an increased need for it,” Garcia said. 

Carol Gundlach, a policy analyst at Alabama Arise, discussed with APR on Friday the pandemic Electronic Benefit program (P-EBT), which gives parents of children who receive free and reduced lunches a debit card loaded with value of each child’s school meals from March 18 to May 31. The cards can be used at any grocery store. 

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Immigrant families with children enrolled in school can also receive the P-EBT cards, Gundlach said. 

“We of course hope that Congress will see their way to continuing pandemic EBT for the remainder of this summer, because of course, children still have to eat, whether school is in or not, and families are still going to have to pay for those extra meals,” Gunlach said. 

Just more than 13 percent of Alabamians polled said they didn’t have enough to eat during the week prior, according to a survey by the U.S. Census Bureau, and 43 percent said they’d experienced a loss of income due to the COVID-19 crisis. 

“So clearly parents are going to have a very difficult time continuing to feed the whole family through the summer,” Gundlach said. “It’s really a serious crisis and continuing Pandemic EBT would make a really big difference.” 

Many individual school systems across the state are working hard to supply sack lunches to students in need, but without federal aid it will be hard to keep those meals coming all summer, Gundlach said. 

There was an expansion of P-EBT for the remainder of the summer, and a 15 percent increase in regular Supplemental Nutrition Assistance Program benefits, known as food stamps, in the $3 trillion Heroes ACT, which Democrats in the U.S. House passed last week. Gundlach said she hopes the U.S. senators from Alabama get behind the Heroes Act. 

Senate Majority Leader Mitch McConnell, R-Kentuky, said last week, however, that if the Senate takes up another round of coronavirus relief legislation it won’t look like the House version, according to NBC News. 

Gundlach also wanted those without children to know that there’s additional food assistance available to them. 

The Family’s First Act temporarily suspended SNAP’s three-month time limit on benefits, and Gundlach said that even if a person was denied assistance before because they hit that time limit, they can reapply and receive that aid.

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