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Advocates warn of “imminent outbreaks” in nursing homes as cases spike

About three-quarters of all cases in U.S. nursing homes have occurred in counties where the 7-day average rate of new cases of COVID-19 was more than 3.59 per 100,000 people. The statewide 7-day average in Alabama was 34.41 new cases per day per 100,000 as of Tuesday.

Micah Danney

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(STOCK PHOTO)

Alabama’s nursing homes face dramatic increases in new novel coronavirus cases if current trends continue, according to two national organizations that are asking governors for “urgent attention and support.”

The American Health Care Association and the National Center for Assisted Living sent a letter to the National Governors Association on Tuesday warning of the danger posed to long-term care facilities in places where new cases are surging.

Given the fact that the level of COVID in the community surrounding a nursing home is a leading indicator of cases in the facility, the major spikes of COVID cases in many states comes at a very challenging time as many states plan the reopening of long-term care facilities and return of visitations from loved ones,” the letter stated.

It cited research by Harvard Medical School, Brown University’s School of Public Health and University of Chicago that showed that a high rate of spread in a nursing home’s surrounding community is the primary factor in whether there is an outbreak at a facility.

About three-quarters of all cases in U.S. nursing homes have occurred in counties where the 7-day average rate of new cases of COVID-19 was more than 3.59 per 100,000 people. The statewide 7-day average in Alabama was 34.41 new cases per day per 100,000 as of Tuesday.

In Jefferson County, which has the most residents of any county in the state, the average number of new cases per day has been more than 200 per day in the last week. Per 100,000 people that is roughly 38.21 cases per day per 100,000 people.

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Two other of the state’s largest counties, Madison and Mobile, also broke 100 average new daily cases last week.

There are 231 nursing homes in Alabama. So far, 195 have reported at least one resident or employee who have tested positive for the virus. Some still have infected residents and others are reported to be COVID-free.

As of Wednesday, 1,183 people in the state have died of COVID-19. The death toll increased by 87 in the last two days alone. Of those who have died from COVID-19 in Alabama, 931 — or 79 percent — have been seniors 65 or older.

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John Matson, director of communications for the Alabama Nursing Home Association, said that his organization is focused on reopening nursing homes to visitors once the state allows it. It will happen at the discretion of each facility, he said, as there is no set number that the rate of spread in the local community would need to drop to.

The letter of concern to governors said that visitation is important to the well-being of nursing home residents. To do it safely, it made three key requests:

  • Expedited lab processing time and on-site testing with reliable and rapid results
  • Additional support for personal protective equipment — especially N-95 masks
  • Close coordination between state officials and long term care providers 

Matson said the ANHA supports the letter and is in a good position to get the support it needs.

“We’re fortunate to have a strong working relationship with Gov. Ivey’s office,” he said.

Micah Danney is a reporter at the Alabama Political Reporter. You can email him at [email protected] or reach him via Twitter.

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AARP Alabama asks for details on $50 million federal COVID-19 aid to nursing homes

Eddie Burkhalter

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(STOCK PHOTO)

The Alabama chapter of AARP is asking the state to ensure federal coronavirus relief funds are spent wisely and in the open. Gov. Kay Ivey on Friday announced $50 million in grants would go to state nursing homes to aid in the fight against COVID-19.

Candi Williams, AARP’s Alabama state director, told APR on Monday that the organization, which advocates for the elderly, wants a better understanding of how that money will be spent and to ensure some is spent for ongoing COVID-19 testing.

A spokesman for the Alabama Nursing Home Association says details on how the money can be spent is already publicly available, however, and Ivey in early June announced the award of $18.27 million in federal CARES Act funds to be spent toward regular nursing home COVID-19 testing.

“What we’re looking for is specifics on how it will be used, and we want those specifics to be made publicly available,” Williams said.

Ivey on Friday said the money is to be administered by the Alabama Nursing Home Association Education Foundation. The Alabama Hospital Association is to administer up to $50 million in grants to state hospitals through another program.

“This allocation of up to $50 million will be for operational costs that are COVID-19 related, such as PPE, cleaning, personnel costs and other costs incurred related to the pandemic,” Ivey’s office said in a press release Friday.

“In partnership with the state of Alabama, the Alabama Nursing Home Association Education Foundation will administer the funds fairly and impartially on behalf of the people of Alabama, for all of Alabama’s nursing home facilities,” the statement goes on to say.

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Williams said the public deserves to know how the federal funds will be used, and said Ivey’s office hasn’t yet signaled whether those details will be made public.

Ivey’s office, through a spokeswoman, declined to comment, and referred a reporter to the Alabama Nursing Home Association.

John Matson, communications director for the Alabama Nursing Home Association, told APR that AARP Alabama need only read the memorandum of understanding published along with Ivey’s announcement about the grants on Friday to see how the money must be spent.

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According to the memorandum, the Alabama Nursing Home Association Education Foundation can only disburse the funds to nursing homes “for the purposes of responding to or mitigating the COVID-19 public health emergency” and details what facilities must do to receive the money.

Among the requirements, nursing homes in their applications must provide supporting documentation, which can include invoices, purchase orders, payroll records and financial records, according to the memorandum. The foundation must also provide the Alabama Finance Director’s Office with a detailed report on the 15th of each month noting how the money was spent, according to the document.

“I think it would be helpful for them to read that,” Matson said, referring to AARP Alabama and the memorandum of understanding.

AARP Alabama is also asking that the money be used for ongoing and methodical testing of all residents and staff in the state’s long-term care facilities.

“We’ve seen across the country that testing can be hit or miss, and testing frequency can vary,” Williams said. “We’ve seen in other states where that has helped curb the loss of life and helps protect residents.”

Matson noted that Ivey in early June also announced a separate $18.27 million in federal CARES Act funds to be spent toward regular nursing home COVID-19 testing and “proactive surveillance” through the end of the calendar year, which is also being administered by the Alabama Nursing Home Association Education Foundation.

Alabama’s long-term care ombudsmen, who are tasked with protecting residents’ rights and investigating health and safety concerns, have been largely banned from entering Alabama’s long-term care facilities since early on in the pandemic when the facilities ended visitations to help prevent the spread of the virus.

Williams said AARP would also like to see the safe reentry of ombudsmen into state facilities and for those details to be included in a publicly-released plan.

“We also have been advocating for transparency and real-time data about the COVID cases and death in Alabama nursing homes and long-term care facilities. That continues to be a struggle,” Williams said.

The Centers for Medicare and Medicaid Services is collecting that state data, but it’s weeks old by the time it’s published on the federal agency’s website, Williams said.

“Having that information would help us protect the residents, staff and surrounding communities, but also making sure families have that information,” Williams said.

The Alabama Department of Public Health has declined to release county-level or facility-level details on coronavirus in long-term care facilities and nursing homes, citing privacy concerns. Many other states do release that information, however.

According to CMS, there have been 3,841 confirmed COVID-19 cases and 562 deaths among residents in Alabama nursing homes as of July 26. AARP Alabama said COVID-19 deaths of nursing home residents make up approximately 42 percent of the state’s total coronavirus deaths.

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Gov. Kay Ivey awards $100 million to state nursing homes, hospitals in fight against coronavirus

Eddie Burkhalter

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Gov. Kay Ivey held an Coronavirus update Press conference Wednesday, July 29, 2020 in Montgomery, Ala. (Governor's Office/Hal Yeager)

Gov. Kay Ivey on Friday announced the award of $100 million in coronavirus relief funds for grants to state nursing homes and hospitals to aid in the fight against COVID-19. 

“While there are many aspects of COVID-19 that we still don’t know, one thing that isn’t in dispute is our seniors and those with preexisting health conditions fair the worst when contracting the virus,” Ivey said in a statement. “Protecting our most vulnerable citizens remains a priority for my administration, and it is incumbent to ensure that our nursing homes and hospitals have every tool possible to mitigate the spread of COVID-19 as well as keep their staff and health care professionals safe as they offer exceptional care to those who are ill.”

One of the two grant programs will provide up to $50 million to be used by Alabama nursing homes for personal protective equipment, cleaning, personnel costs and “other costs incurred related to the pandemic,” according to a press release from Ivey’s office. 

The Alabama Nursing Home Association Education Foundation will administer the funds, according to Ivey’s office. The non-profit previously received $18.27 million in federal coronavirus relief aid to pay for testing and proactive surveillance of COVID-19 for health care workers and nursing home residents. 

“On behalf of Alabama’s nursing homes, I thank Governor Ivey for her continued commitment to assisting the residents and staff in our facilities,” said Brandon Farmer, president of the Alabama Nursing Home Association, in a statement. “Our nursing homes continue to provide high quality, compassionate care despite the challenges posed by COVID-19. These funds will help cover the unexpected and ongoing costs we incur during this pandemic and allow us to focus on caring for those most vulnerable to this virus.”

The Alabama Hospital Association will administer up to $50 million through the other grant program to state hospitals, according to the release. 

“Despite unprecedented challenges and financial strains as a result of the pandemic, Alabama’s hospitals have continued to rise to the occasion in meeting the health care needs of our citizens,” said Dr. Don Williamson, president of the Alabama Hospital Association, in a statement. “Our hospitals thank Governor Ivey and her administration for the continued support and financial assistance. This will go a long way to ensure hospitals are able to care for all patients who need hospital services and protect their employees while doing so.”  

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The two grant programs were funded from the approximately $1.9 billion the state received through the CARES Act. Up to $250 million of that money has been earmarked for the delivery of health care in the state’s battle with coronavirus.

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Judge dismisses lawsuit asking court to loosen voting restrictions amid COVID-19 pandemic

Eddie Burkhalter

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A Montgomery Circuit Court judge on Wednesday dismissed a lawsuit against Gov. Kay Ivey, Secretary of State John Merrill and several Montgomery County election officials that asked the court to expand Alabama’s absentee voting and relax other voting measures amid the COVID-19 pandemic. 

Montgomery Circuit Judge J.R. Gains in his order dismissing the suit wrote that the court lacked jurisdiction to rule on the plaintiff’s complaint because “Plaintiffs present a non-justiciable political question, Plaintiffs lack standing to sue Defendants, and the claims against Defendants are barred by sovereign immunity.” 

The League of Women Voters’ lawsuit asked Gains to order Ivey and Merrill to exercise emergency powers to waive the notary or witness requirement, the requirement to supply a copy of a photo ID and to extend no-excuse absentee voting into the fall. 

“COVID 19 is a very real threat, not only to voters’ physical health but also to the health of Alabama’s electoral process.  We are profoundly disappointed by the judge’s decision, which allows elections to proceed in their current state,” said League President Barbara Caddell in a statement Friday. 

“The League of Women Voters is a non-partisan organization whose mission is to empower voters and defend democracy. This case was filed to do just that. It was filed in the Alabama court system based on the Alabama Constitution and the Alabama Emergency Management Act which protect the right to vote in times of ‘tumult’ and give the Governor and the Secretary of State emergency power to protect citizens during emergencies. This pandemic certainly qualifies as ‘tumult’ requiring additional emergency assistance,” Caddell continued.

Caddell said that since the judge ruled he didn’t have the authority to require Ivey and Merrill to use their emergency powers, the league is appealing to Ivey for help, and detailed eight requests:

  • Suspend the requirement that a copy of the voter’s photo ID be included with the voter’s application for an absentee ballot
  • Suspend the requirement that the absentee ballot be notarized or signed by two witnesses;
  •  Provide adequate personal protective equipment for clerks and poll workers and disinfecting polling equipment;
  • Require in-person voters to wear masks and maintain social distancing;
  • Authorize local election officials to provide early voting at least fourteen days before each election day;
  • Authorize local election officials to provide drive-through or curbside voting where practicable, to establish vote centers and relax restrictions on wrong-precinct voting;
  • Provide local election officials the financial resources to implement these emergency measures; and
  • Adequately notify all Alabama voters of these emergency measures.  This includes either notifying voters that no box need be checked to vote absentee or modifying the absentee application and ballot forms to inform voters explicitly which boxes to check.

“In the past, Governor Ivey has demonstrated her concern for Alabamians in a variety of ways, and we encourage her to address our concerns for election safety by using her emergency power to order such common-sense voter protections,” the league said in their statement.

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Alabama coronavirus cases more than doubled in the last 30 days

The state has averaged 1,605 cases per day in the last 30 days. Thursday’s increase of 1,626 exceeded that average.

Brandon Moseley

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(STOCK PHOTO)

The Alabama Department of Public Health reported an additional 1,626 coronavirus cases on Thursday after several days when new cases increased by less than 1,000 per day.

Through July 7, at least 45,263 Alabamians had contracted the coronavirus, but in the 30 days since, 48,139 more Alabamians have tested positive for the virus and more deaths have followed. The state has averaged 1,605 cases per day in the last 30 days. Thursday’s increase of 1,626 exceeded that average.

The state now has 93,402 confirmed cases of the coronavirus 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.

Through July 7, at least 1,007 Alabamians died from COVID-19. In the last 30 days, another 647 Alabamians have died. That is an average of nearly 22 deaths per day. The Department of Public Health confirmed an additional 15 COVID-19 deaths on Thursday. The state’s death toll now stands at 1,654.

As of Wednesday, at least 1,575 people who have tested positive for COVID-19 were being treated in hospitals statewide. Many hospitals have recently been or are currently near ICU bed capacity. Making matters worse for health care workers, 5,575 Alabama health care workers have tested positive for the coronavirus.

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At least 1,576 of those health care worker cases have come in just the last 30 days.

By Thursday, the state reported 736,594 tests, and 93,402 have been positive. That is nearly a 12.7 percent rate of positive tests since March. Public health officials say anything over 5 percent is bad and an indicator that there are many more people out there with the coronavirus that are not being detected.

In the last two weeks, though, at least 17.5 percent of tests have come back positive, based on 14-day averages of daily case and test increases. In the last week, that positivity rate has been nearly 17 percent.

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At least 37,923 Alabamians are presumed to have recovered.

Some states, including New York, are asking that visitors from Alabama quarantine themselves for 14 days upon arrival. GOP Senate candidate Tommy Tuberville was recently criticized in The Washington Post for defying Washington D.C.’s 14-day quarantine request for visitors from Alabama.

Not all of the news is bad. The seven and 14-day averages of daily case increases 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, and the positivity rate remains high.

The state remains under a “safer-at-home” order through the end of August, issued by Gov. Kay Ivey and State 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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