UAB Medicine, Alabama’s largest hospital, said Friday that is could feel a financial loss of $230 million by the end of the fiscal year, which ends September 30, if current circumstances continue.
“We’re currently losing about 70 million a month,” said UAB Health System CEO Will Ferniany in a video update Friday. “When the COVID crisis started, UAB Medicine took the position that we were going to do everything we could to serve the people of Jefferson County and Alabama, regardless of the cost.”
The financial impact on the UAB hospital system has been “significant,” the hospital says, and it is not a situation that is unique to UAB. Huntsville Hospital has said it is losing tens of millions per month during the crisis, too.
The loss of revenue is largely due to the canceling of elective procedures, but the state’s major hospitals have so far not called for elective procedures to immediately resume. Some rural hospitals, which began the crisis in much worse financial situations, have.
Elective procedures make up a large percentage of most hospitals’ revenue. When the crisis began, the state and its hospitals began canceling elective surgical procedures to reduce hospital bed occupancy, free up personal protective equipment and reduce strain on the hospital system to prepare for a surge in patients.
The state’s stay-at-home restrictions have made a difference in reducing the burden on hospitals, and only a few hospitals in the state have had issues dealing with the influx of patients, hospital officials and the Alabama Department of Public Health have said.
While canceling elective procedures and asking people to stay home appears to have been effective in slowing the spread of the virus, it has been disastrous for the same hospitals and health care workers who are on the frontlines of dealing with the pandemic.
“We used to do 155 surgeries a day. Now we’re doing about 57. We used to have about 5,800 visits a day to our clinics. Now we have about 3,000, of which most of these are telemedicine visits,” Ferniany said. “That shows that during the first month we had about 3,000 elective surgery visits canceled, 10,000 less — almost 11,000 less — patient days in our hospital, and about 85,000 fewer visits to our clinics. This reduction in clinical activity has caused a significant financial loss at UAB hospital.”
Congress’s COVID-19 stimulus bills have included additional funding to help hospitals deal with the crisis, but Ferniany said what UAB has received so far has not been enough to make up for the lost revenue.
“So far we’ve received about $30 million in federal stimulus money, which puts the loss at about $200 million,” Ferniany said, adding that the hospital has worked to maximize federal assistance and minimize its expenses. The hospital has frozen all hiring, reduce non-essential expenditures and stopped all travel.
“We have to deal with this so that we can be ready to care for the people of Alabama in the future,” Ferniany said.
Sen. Doug Jones, on a press call Thursday, said he is doing all he can to get more financial support for hospitals. He said part of the reason that Democrats were slow to support the most recent COVID-19 emergency stimulus legislation was because they wanted more funding for hospitals, cities and counties to deal with the crisis.
“We felt it was incredibly important to help hospitals financially and put an extra $75 billion,” Jones said, also advocating for the state to immediately expand Medicaid, which would give hospitals a financial boost through reimbursement rates. “We knew hospitals were running out of money, and so decisions had to be made and tough choices had to be made. And I think the criticism of Democrats is misplaced because we were pushing very hard.”
Despite its financial challenges, UAB says it will continue to lead on the COVID-19 response. The hospital system has cared for roughly 25 percent of Alabama’s COVID-19-positive in-patient population, by far more than any other hospital in the state, UAB said in a statement.
“In addition to world-class patient care, UAB has provided vital leadership in Alabama’s response to COVID-19 by: collaborating with public health officials; serving on state task forces; leading the state’s COVID-19 research efforts; helping other hospitals with treatment guidelines; consulting with leaders, hospitals and businesses regarding safely opening; promoting public awareness efforts through information campaigns; increasing the state’s testing capacity; and helping the state obtain needed PPE and equipment, among many other activities,” the hospital said.
The hospital said if you want to provide support, continue to stay at home. As of Friday, UAB is caring for 43 COVID-19 patients.
“We’re not going to get a do-over:” Alabama health officer on Thanksgiving and COVID-19
There were 1,427 hospitalized COVID-19 patients in Alabama on Monday, the most since Aug. 11.
Alabama State Health Officer Dr. Scott Harris on Monday pleaded with the public to avoid gatherings over Thanksgiving as COVID-19 continues to surge in Alabama and hospitals statewide are filling with coronavirus patients.
“We don’t want this to be the last ever Thanksgiving for someone in your family, like your parents or your grandparents,” Harris said during a press conference Monday.
Harris said Alabama’s numbers aren’t headed in the right direction and more than 230,000 Alabamians — roughly 4 percent of the state’s population — have been infected by the coronavirus.
“We are adding a couple of thousand new cases a day, at least, that we are aware,” Harris said. “This is a time for people to be vigilant. This is a time to be careful and to think about what you’re going to be doing.”
Alabama added 1,574 new coronavirus cases on Monday, and the state’s 14-day average for new daily cases was at a record high 2,087. In the last two weeks, the state has added 29,223 cases, the most cases in any two week period since the pandemic arrived in Alabama in March.
There were 1,427 hospitalized COVID-19 patients in Alabama on Monday. The last time so many were hospitalized in the state was on Aug. 11, during Alabama’s summer surge.
Harris said that he and his wife will be staying home for Thanksgiving instead of having his family’s regular large, intergenerational gathering. What happens with Alabama’s COVID-19 numbers over Thanksgiving will impact what the state’s December holiday and Christmas season will look like, Harris said.
“Are we gonna be here a month from now trying to have the same conversation? I really, really hope not,” Harris said.
Dr. Mary McIntyre, the Alabama Department of Public Health’s chief medical officer, said during the briefing that her home usually sees between 15 and 20 family members arriving for Thanksgiving. They’ve limited this year’s Thanksgiving to three additional people from out of their household, for a total of seven people, she said.
Everyone must wear masks and have temperatures checked at the door, she said.
Everyone will be seated six feet from one another and a Zoom video conference will be set up for those family members who won’t be attending in person, McIntyre said. They’ll use disposable plates, cups and utensils and have the ability, weather permitting, to eat outdoors.
“If we want to live to see another Thanksgiving, and I do, that it may mean stepping back this Thanksgiving and really limiting the number of people, and some of the things that we do,” McIntyre said. “Now is not the time to get out to do Black Friday shopping.”
Dr. Kierstin Kennedy, UAB’s chief of hospital medicine, in a separate press briefing Monday echoed concern over the possibility of spikes following Thanksgiving and Christmas if the public doesn’t do what’s needed to keep themselves and others safe.
“We are very much worried about the potential spike in numbers. We’ve also seen some of our own staff getting sick,” Kennedy said. “And unfortunately that’s not been at work. It’s been because we are just like you. We’re tired. We’re lonely. We want to try to socialize, and some of us have let our guards down and, as a result, have gotten sick.”
Kennedy said while there’s is concern over future spikes following the upcoming holidays “there is a way for all of us to help prevent that from happening.”
Kennedy said when Gov. Kay Ivey first issued her statewide mask order and social distancing requirements, the public masked up, businesses enforced the orders, and coronavirus numbers improved.
“It didn’t get nearly as bad as we thought, and we are really hopeful that the community is going to come together and do that again for us,” Kennedy said. “Because it’s more than just not having enough space for the COVID patients. It’s also those patients who do not have COVID that have other conditions. They rely on us for routine care, and we want to make sure that we’re available to provide that.”
Kenedy said UAB has an incredible group of staff members, who’ve proven themselves to be quite resilient, but that “the group is tired.”
“We’ve been doing this every single day since March, and so as you can imagine, people are very tired. It’s very emotional, especially as we see younger patients getting sick with this and getting sick in ways that we weren’t expecting,” she said.
Harris again urged the public to make smart decisions that will help slow the spread of coronavirus and save lives.
“Ladies and gentlemen, we’re not going to get a do-over on this,” Harris said. “This is a big national holiday, and we’re in the middle of a pandemic, and our numbers are worse than they have ever been during this entire response. Please be careful. Please be safe. And please try to take care of those people who are most vulnerable.”
Governor allocates $3.6 million in CARES Act funds to food banks
The money is to go to the nonprofit Alabama Food Bank Association, which will administer the funds.
Gov. Kay Ivey on Monday announced that $3.6 million in federal CARES Act money will be used to reimburse food banks for COVID-19-related expenses.
“Alabama is a state where neighbors help neighbors, even in the most difficult times,” Ivey said in a statement. “The Coronavirus pandemic presented significant challenges around the world, as well as here at home in our own state. Food banks in communities across Alabama have been a lifeline for those in need, and I am proud to be able to put these funds toward the Alabama Feeding Initiative. I have told Alabamians that I remain committed to getting these CARES Act funds into the hands of those who need it.”
The funds are to go to the nonprofit Alabama Food Bank Association, according to the memorandum of understanding. The association will administer the funds to eight participating food banks across the state, which can be reimbursed for the following:
- The purchase of food, packaging and related supplies to meet increased demand.
- operational expenses, including fuel and maintenance, incurred due to handling a higher amount for food, as well as open-air distribution events.
- Rental costs of storage space and vehicles to handle increased volumes of food.
- To purchase PPE, screening equipment and decontamination services to prevent the spread of COVID-19.
Unless Congress extends the deadline, Alabama and other states have until Dec. 30 to spend CARES Act funds or the money reverts back to the federal government. Ivey has just under $1 billion left to spend before the deadline.
Alabama Education Association, Board of Medical Examiners meet over excuses to break COVID-19 quarantines
Prior to the meeting, the AEA on Nov. 5 threatened legal action against the board over the matter.
Officials with the Alabama Education Association and the Alabama State Board of Medical Examiners met on Thursday to discuss a concern the association has with doctors who write excuses to allow students to return to school before their mandated COVID-19 quarantine periods expire.
At the meeting between Theron Stokes, associate executive director of the Alabama Education Association, and William Perkins, executive director of the Alabama State Board of Medical Examiners, Stokes learned that the board wasn’t aware of the problem, the AEA said in a press release.
“Both groups agreed to set up a meeting with educational and medical organizations on the front lines of the COVID-19 pandemic in Alabama,” the AEA said in the release. “A meeting should be held before the end of the year and will allow the AEA and the Board of Medical Examiners, as well as other educational and medical organizations, to review existing guidelines issued by the Alabama Department of Public Health and the Centers for Disease Control and ensure conformity in following those guidelines.”
In a letter to Perkins on Thursday, Stokes wrote that it was AEA’s understanding that the board was aware of the problem, but he wrote that during their meeting he became aware that neither the board nor Perkins was aware of the problem.
“It was not the intent of AEA to cause any unnecessary problems for you, the doctors you represent, or your organization regarding this matter,” Stokes wrote.
Prior to the meeting, the AEA on Nov. 5 threatened legal action against the board over the matter.
“It is our firm belief that there exists no medical scenario under which these students could be written out of quarantine and that to do so is violative of ADPH and CDC quarantine recommendations,” Stokes wrote in the Nov. 5 letter.
Stokes in his recent letter notes that both agreed in the meeting to bring together representatives of the other organizations to come up with a uniform procedure for following state and federal guidelines.
“I agree with your plan to conduct this meeting and finalize our goals before the holidays,” Stokes wrote.
Nearly 70 percent of Alabama’s pregnancy-related deaths in 2016 were preventable: report
Most pregnancy-related deaths are preventable, with women of color bearing the brunt of Alabama’s maternal mortality crisis.
A report this month by the Alabama Maternal Mortality Review Committee found that nearly 70 percent of pregnancy-associated and pregnancy-related deaths in Alabama recorded in 2016 were preventable.
Mental health and substance use disorders were identified as key contributors in nearly half pregnancy-associated and pregnancy-related deaths. Patient-, family-, system- and provider-related factors were among the most frequently identified factors involved in pregnancy-associated and pregnancy-related deaths, the report found.
The researchers found cardiovascular conditions were the leading underlying causes in pregnancy-related deaths.
“The Medical Association of the State of Alabama commends the Maternal Mortality Review Committee (MMRC) for its diligence in researching the factors that impact maternal deaths, in hopes to mitigate and prevent future maternal deaths,” said Dr. John Meigs, president of the Alabama Medical Association. “It is very concerning for physicians throughout the state that 70 percent of the deaths reviewed by the MMRC were preventable and that women of color are disproportionately affected. Alabama mothers deserve the best medical care that we can offer.”
According to the report, maternal death and pregnancy-related mortality ratios steadily trended upwards between 2012 and 2015 with the largest increase being in 2016.
Alabama ranks third in the nation for maternal mortality behind only Arkansas and Kentucky.
According to the report, expanding Medicaid could help reduce the state’s high number of maternal deaths and pregnancy-related and -associated deaths.
“Expansion of Medicaid was an underlying, yet significant factor which permeated throughout the case reviews,” according to the committee’s report. “Research has shown that in states where Medicaid expansion was adopted, there were reduced maternal mortality rates and positive maternal health outcomes. Based on the findings of the committee’s review, Medicaid program expansion will allow women to receive needed healthcare before, during, and after pregnancies.”
The MMRC recommends Medicaid expansion up to one year postpartum and improved reimbursement for providers, routine autopsies on maternal deaths, and increased mental health and substance use disorder treatments and services for women.
“Sadly, the Alabama Maternal Mortality Review Committee found that mental health and substance use disorders were identified as key contributors in almost half of pregnancy-associated and pregnancy-related deaths,” said Holly Caraway McCorkle, executive director of the Alabama Council for Behavioral Healthcare. “These deaths are preventable, and Medicaid expansion will offer women who suffer from mental health and substance use disorders life-saving coverage and access to critically needed resources and services before, during and after pregnancies.”