Reed giving rural healthcare priority in session


(Editor's note: The following is part of an ongoing series of stories from local legislators concerning the upcoming Regular Session of the Alabama Legislature. Prior comments this week can be found at from Rowe (on prisons and other topics) and state Rep. Tim Wadsworth.)

Senate Majority Leader Greg Reed, R-Jasper, says he plans to make rural healthcare a priority in the coming 2020 Regular Session, noting legislators are now more concerned about availability of services in their own counties.

Reed spoke in an interview Thursday in advance of Tuesday's start of the new session of the Alabama Legislature. State Rep. Tim Wadsworth, R-Arley, and state Rep. Connie Rowe, R-Jasper, also noted in recent days that rural healthcare has become important topics in the state. 

Reed made his remarks as a company email obtained by the Daily Mountain Eagle showed Walker Baptist Medical Center's current CEO, Bob Phillips, is leaving. In his place, the head of Princeton Baptist Medical Center in Birmingham, Mike Neuendorf, will serve as CEO both at Princeton and Walker Baptist as of Feb. 1.

The senator said Thursday a public relations official with the Brookwood Baptist Health, the parent group over Walker Baptist, left a message with him Wednesday night, saying that Phillips would be leaving the Jasper hospital and leadership changes would be made, but he wasn't told any details on specific officials taking over. 

In addition, hospitals in surrounding rural counties have recently had a number of changes, including ownership, creating uncertainty in their communities about medical service.

Asked about medical marijuana during the coming session, and whether it or rural health ranked as bigger issues this session, Reed said, "Rural healthcare is much higher as a priority to me than medical marijuana. I think medical marijuana is going to be a significant discussion. It was in the last session, and there will be this time," supplemented with new information and likely media attention.

However, Reed, a medical equipment salesman, noted he has been working closely with Gov. Kay Ivey and senators on rural healthcare topics, sensing a growing concern from other legislators to preserve rural health services. 

"Rural healthcare is one of my priorities during the session," he said, looking at ideas such as recruitment of physicians and giving more opportunities to nurse practitioners in their ability to be involved in patient treatment. 

He also talked about "looking for ways to expand and evolve some of the support from the larger university hospitals in support of the smaller rural hospitals through a program that was in legislation I passed for UAB to have a rural healthcare support center that allows them to, at no cost to smaller rural hospitals, to allow them opportunities to work, help and support with consulting and recruiting services. That has proven to be a positive thing already." 

Reed talked about looking at ways to recruit medical professionals to look at ways to give them incentives for paying off medical school and college debt. 

He said the Legislature will also have to renew job recruitment incentives in the Alabama Jobs Act which he carried in Senate four years. The act "has been an absolute dynamo in being able to recruit industry to our state, even to our own county. That recruitment program was used to attract Yorozu to Jasper," Reed said. 

The incentives were given "sunset" status (an expiration time that calls for renewal, in this case at the end of this year) to force legislators to relook at them at a later date as the state continues to keep pace with other states' recruitment efforts, he said. 

Reed said the push this session to build new state prisons "will be a significant issue," due to pressure from the U.S. Department of Justice and federal lawsuits concerning overcrowding, healthcare and mental health. 

Progress has been made in the past few years, Reed said, noting that the state has gone from 198 percent occupancy in the state prison system to about 165 percent, with a goal of 137 percent set by the Justice Department. To get to that goal, more facilities will be needed, he said.

The Prison Study Commission set up by Ivey, which includes Rowe, has working on the idea, he said. The idea getting the most traction has been for a third party to build the prisons and lease them to the state, allowing the third party "to have complete responsibility for the maintenance and the upkeep of the facility." The state would use and staff the prisons.

Reed said two proposals in that path would have different details. One would allow local entities, such as counties and cities, to float bonds and build the prisons, with no financial responsibility from the state. That would also serve to replace prisons in communities where a prison might close. "That idea makes some sense," he said.

"The other idea is that a third party, which is a national firm that does this in other states, they come in, build the facility, and then lease it back to the state," he said. 

The commission and Ivey have talked about both ideas, he said. While the governor may have some executive standing to enter into agreements for the benefit of the Department of Corrections, but he noted the allocation of funding comes from the Legislature. 

In fact, Reed said he and other legislative leaders were set to talk to Ivey the afternoon of the interview about the prisons, as well as other topics expected for the session. 

The design of the new prisons will have three priorities, including mental and physical health, the staffing requirements and - something he said was important to a number of senators - an increase in job and skills training for inmates, to better help them readjust into society.

On staffing, "the Department of Corrections has had all kinds of issues in hiring guards to be at the prisons because it is a dangerous, difficult job," he said. Technology could reduce the number of retired employees and guards.

The gambling issue that is expected to be a major topic. Reed said he has been in office for nine years and gambling comes up each session. However, he said two new dynamics are now in play.

"Number one, I think the attitude across the board and in the polling I've done and had done for my caucus and so forth, in the neighborhood of 75 to 80 percent of Alabamians, whether they are for it or against it on the lottery, want the opportunity to vote on it," Reed said.

He later added, "I think that drumbeat is going to be as strong this session as it has ever been."

Also, the Poarch Band of Creek Indians have shown "a significant change in attitude" as usually they have wanted to be left alone, as it is federally regulated over its gaming, used to generate revenue for services to its people. 

Reed pointed to recent full page advertising in publications (including the Daily Mountain Eagle) relate a new aggressive lobbying effort (including a website) on an agreement, or compact, the Poarch Creeks say would be mutually beneficial to them and the state. 

"That agreement, or compact, is something that cannot be voted on as a legislative topic by the Legislature," Reed said. "It has to be an agreement initiated by the governor of Alabama with the Indian tribe, and then approved by Indian Affairs and the Department of the Interior. There has to be benefit for the state and there has to be benefit for the tribe for it to be approved at the federal level."

He said if a compact is approved by the governor and federal governments, then the funds coming to the state would be allocated by the Legislature. 

A lottery, as well as changes at other gaming facilities in the state, could be worked on separately by the Legislature without a compact, he said, noting gambling sites in Macon and Greene counties do not pay taxes and could be required to do so in a bill. 

However, Reed said the parties involved seem to be moving to a simultaneous sitation: The state has gaming institutions currently - such as in Greene and Macon counties - where state constitutional amendments allow long-standing bingo halls, while the Poarch Creeks desire a compact, and state residents want a vote on the lottery. 

"With those issues there, I think the theme of some type of comprehensive plan is being discussed. Whether or not that will be palatable for the Legislature or not, I don't know. I do think all of those issues will be on the table, and the dynamics are going to be different than they have been in the past," he said.

Reed noted gaming has usually been discussed when the state's finances are challenged and budgets are stretched thin. 

"Today, Alabama's economy is as strong as maybe it has every been," he said. "We're going to be looking at surpluses in both the General Fund and the education budget for the coming year, and in a lot of ways, that leaves the gaming topic in a place to where people are not as anxious to discuss it because the state is not looking for additional revenues to make ends meet."

If a grand compromise is reached on gaming, Reed feels it all ultimately would be spelled out in a constitutional amendment. "It could be a requirement that the people vote on this issue," he said. "If the lottery were included, information about allocations of resources, if there were tribute from the Indians or taxes paid by some of these other entities, then, whatever would be the case of that, it would ultimately be a decision by the people." 

On the surplus in the education budget, expected to be as much as $500 million, he said the funds could be spent in several ways. Priorities in that area include school security funding for local school boards, mental health issues in schools and solutions in cooperation between state mental health and education departments and salary increases for education staff. Another possibility is a bond issue for K-12 and two-year colleges for deferred maintenance, by way of the surplus and a coming payoff of state indebtedness.