Issue: Health

Alabama would suffer for years to come under no-new-revenue General Fund budget

By Carol Gundlach

Alabamians’ quality of life would suffer for years to come if the no-new-revenue General Fund (GF) budget that the House’s GF budget committee approved Thursday becomes reality. The House is expected to vote Tuesday on the budget, which would slash vital services like health care, child care and public safety. The state’s promising new reforms of Medicaid and prisons would end, and services for low-income children could face devastating cuts.

With the Legislature’s regular session nearing an end, talk of one or more special sessions is running rampant, and the threat of deep cuts to services that make our state a better place to live and work is real. Here is a look at a few of the ways Alabamians would feel the cuts in their everyday lives:

Proposed budget cuts would end new Medicaid reforms and impose severe cuts to other health care programs. The proposed GF budget would reduce Medicaid funding by 5 percent. While the Medicaid agency has not specified what services would be reduced or eliminated, State Health Officer Don Williamson has said the cut would force Medicaid to abandon its new regional care organization model, designed to keep patients healthier while cutting costs.

Williamson said last month that a smaller 3 percent cut would force the agency to end coverage of outpatient dialysis, forcing kidney patients to be admitted to the hospital to receive routine dialysis. Medicaid also would have to eliminate hospice care coverage and stop paying for adult eyeglasses and prosthetics.

In addition, Medicaid would reduce reimbursement payments to doctors, which could mean fewer physicians treating Medicaid patients. Medicaid also would contract with a single provider of prescription services, likely forcing many local, independent pharmacies to close.

The committee’s budget would cut home health services for the elderly and disabled by more than 9 percent. Patients losing these services could be forced to enter much more expensive nursing homes, reducing patients’ independence and increasing costs to the struggling Medicaid program. Funding for life-saving HIV and AIDS medications also would be cut by 50 percent.

Proposed budget cuts would reduce community mental health services. In recent years, the Department of Mental Health responded to budget cuts by closing nearly every public mental health hospital. Many advocates applauded the new focus on less restrictive (and less expensive) community-based services.

But the 2016 GF budget proposal would reduce funding for those very services by 5 percent. Patients unable to receive mental health treatment may be forced into private hospitals, or they may end up incarcerated in local jails without access to needed counseling and medications.

Proposed budget cuts would devastate social services for low-income families and children. Together, the committee’s GF budget and the education budget awaiting House committee approval would reduce Department of Human Resources (DHR) funding by 14 percent.

DHR commissioner Nancy Buckner last month outlined draconian service reductions in the event of major budget cuts. These could include the elimination of the Temporary Assistance for Needy Families (TANF) program, which provides cash assistance and services for extremely low-income families, including more than 30,000 children.

Other cuts could include major reductions in child care assistance for thousands of working families, the elimination of adult day care services, and the elimination of child support collection services for more than 200,000 Alabama families. Because much state DHR funding is matched by federal money, the agency’s total cuts would be much larger than the lost state dollars alone.

The House committee budget would eliminate GF support for the Department of Youth Services (DYS), which provides supervision and services for youthful offenders and their families. The total reduction would be 12 percent, accounting for DYS funds in the education budget.

Like mental health, DYS has moved in recent years toward less expensive and more appropriate community services and has closed expensive residential beds for low-risk offenders. These community services would be cut under the proposed GF budget. With fewer residential beds, juvenile offenders would be left unsupervised or incarcerated in county facilities instead.

Alabama’s network of Community Action Agencies provides nutrition, housing, Head Start and energy assistance services to low-income people. The proposed GF budget would cut state funding for these services by 50 percent.

Proposed budget cuts would end prison reform and could risk a federal takeover of the state prison system. The committee’s GF budget would make devastating cuts to Alabama’s civil and criminal justice system, ensuring that the recently passed (and highly praised) prison reform legislation could not be implemented.

The state’s already reeling trial courts would face a 16 percent cut under the budget, leading to hundreds of layoffs. The budget also would cut juvenile probation services by nearly 40 percent and forensic sciences by 22 percent. These cuts could force courts to close at least two days a week, delay trials and hearings, and delay criminal cases that require DNA and other forensic evidence. The deep cuts also would result in more unsupervised juvenile offenders even as youth services are slashed.

Alabama’s prison system, already operating at nearly twice its designed capacity, would absorb a 5 percent cut under the proposed budget, increasing the risk of federal intervention. The budget also includes major cuts for the very programs needed for prison reform to succeed. The state’s drug court program would be cut nearly 40 percent. Community corrections, the alternative to imprisonment, would be cut by half. And parole services, essential for reducing recidivism, would be reduced by 14 percent.

Bentley has said he plans to sign the prison reforms that the Legislature passed last week into law. But before any of those reforms can be implemented, the governor’s office must certify that the Department of Corrections and the Board of Pardons and Paroles have enough money to move ahead with the changes. The proposed GF budget would derail prison reform by making this certification impossible.

Our state needs new revenue to avoid these cuts. Overall, the committee’s $1.64 billion GF budget falls more than $200 million short of the amount needed to prevent deep service cuts and invest in reforms. Lawmakers thus far have not considered Gov. Robert Bentley’s proposals to raise revenue and avoid those cuts, including increasing the state cigarette tax and automobile sales tax. Other tax bills that won House committee approval last week have stalled.

Alabama faces an important choice that will help determine what kind of state our children and grandchildren will inherit. Do we raise new revenue to protect vital services like health care and public safety? Or do we erode our state’s quality of life with devastating cuts to those services? The House committee’s budget would side with the latter option, and Alabama would suffer the consequences of that choice for years to come.

By Carol Gundlach, policy analyst. Posted May 15, 2015.

Alabama Medicaid long-term care bills head for full House, Senate votes

By M.J. Ellington

Alabama would deliver Medicaid long-term care services in a new way under two identical bills that won legislative committee approval Wednesday. House and Senate committees approved the respective bills – HB 585, sponsored by Rep. April Weaver, R-Brierfield, and SB 431, sponsored by Senate Majority Leader Greg Reed, R-Jasper – without opposition.

State Health Officer Don Williamson said the plan’s goal is two-fold: to enable more people receiving long-term care to remain in the community instead of going to nursing homes, and to slow the growth of health spending for people who need long-term care. At-home care costs $10,000 per year, compared to $60,000 for nursing home care, he said.

The legislation would remove the current state cap on participation in Medicaid home- and community-based services. When fully operational, the plan could save between $700 million and more than $1 billion per year, Williamson said.

The bills would bring Medicaid long-term care services under a provider-led managed care system similar to (and coordinated with) the new Medicaid regional care organizations (RCOs), Williamson told the Senate Health and Human Services Committee. The RCO model, set to take effect in October 2016, is designed to keep patients healthier while cutting costs.

Alabama’s Medicaid Long-Term Care Workgroup recommended the plan to set up integrated care networks. The group has been meeting since February and includes Arise policy director Jim Carnes.

The plan would create citizens’ advisory committees for the integrated care networks that include representatives of Alabama Arise member groups and other health advocates. Committees amended both bills Wednesday to help ensure the membership of those committees and the networks’ governing boards reflects the diversity of the population served. Arise requested the diversity changes.

“Arise and our advocacy partners have been working for years to expand Medicaid home- and community-based service options for long-term care,” Carnes said. “The integrated care network plan is a historic breakthrough that will help Alabama meet looming health care challenges as our senior population grows.”

By M.J. Ellington, health policy analyst. Posted May 6, 2015.

Alabama crossroads: We need new revenue

By Kimble Forrister

We all want to live in a healthy, secure and prosperous state. Alabama is taking important steps toward that goal now, but deep General Fund budget cuts could undo that progress.

Medicaid’s new regional care organizations will keep patients healthier while cutting costs. Prison system improvements will protect Alabamians while lowering costs and helping former inmates transition back into their communities. Investing in these changes now will save money later.

We’re at a crossroads in Alabama. Cutting vital services is the wrong path.

The devastating cuts in the no-new-revenue General Fund budget proposal would force us to abandon our Medicaid and corrections improvements. And without new revenue, Alabama faces deep service cuts that could make the state a worse place to live for years to come.

Cuts to Medicaid, which covers one in five Alabamians, would top $300 million. That would force the program to end coverage of vital services like adult eyeglasses, prosthetics, hospice care and outpatient dialysis. It also likely would lead to even fewer doctors serving Medicaid patients, most of whom are children, seniors, and people with disabilities.

The costs for Alabama’s children would be real. Cuts to the Department of Human Resources (DHR) would make Alabama the first state to end its Temporary Assistance for Needy Families (TANF) program. That would eliminate cash assistance for more than 30,000 children living in deep poverty, as well as uniforms, car repairs and other job readiness assistance for their parents.

DHR cuts also would end child care benefits for 15,000 children. That could hurt our state’s economy by forcing thousands of working parents to quit their jobs. More than $340 million in child support payments would be risk if DHR ends collection services, and hundreds of seniors would lose adult day care services that allow them to live independently.

Mental health funding cuts would harm more than 25,000 Alabamians by reducing or eliminating community-based mental illness and intellectual disability services. That would reduce independence for thousands of Alabamians. The cuts also could cost hundreds of people their jobs by forcing them to stay home to care for family members who lose crucial support services. In addition, severe mental health cuts could land Alabama back in federal court.

Deep General Fund cuts would have serious public safety implications as well. Nearly a fourth of Alabama’s state troopers would be laid off. The prison system, which already operates at nearly twice its designed capacity, would close two facilities. That would mean even more overcrowding and an even greater chance of a federal takeover of the state’s prison system.

More than 1,100 state workers would lose their jobs, including more than 600 court employees. That likely would force courts to close at least two days a week, meaning longer wait times for criminal trials or restitution cases.

This is no way to invest in our state’s future. Alabama needs new revenue to end the chronic budget shortfalls that are holding us back. The General Fund needs a sustainable revenue stream to support Medicaid, corrections, mental health care and other vital services. Raising the cigarette tax and raising the state sales tax on automobiles to 4 percent – the same as we pay on groceries – would be two good places to start.

If we want a better Alabama tomorrow, we need to start building it today.

By Kimble Forrister, executive director. Posted April 23, 2015.

HIV medication redistribution bill wins Alabama House committee approval

By Jim Carnes

Pharmacies that distribute HIV medications for or in HIV clinics could redistribute certain unopened drugs under a bill approved Thursday by the House Health Committee. HB 247, sponsored by Rep. Patricia Todd, D-Birmingham, awaits action in the full House. An identical bill passed the House 99-0 last year but died when the Senate adjourned without voting on it.

Under current law, HIV clinics must destroy unopened medications if patients do not show up for treatment. Todd’s bill would allow pharmacies to redistribute those drugs to other patients and would set controls on handling and oversight of the drugs. Arise recommended this policy change in 2013 to the governor’s Medicaid Pharmacy Study Commission, which sought ways to reduce costs in the state’s Medicaid drug assistance programs.

By Jim Carnes, policy director. Posted April 2, 2015.

Health security for Alabama’s working families

By Jim Carnes

Hundreds of thousands of uninsured Alabamians would qualify for Medicaid if Alabama expanded eligibility to adults with incomes up to 133 percent of the federal poverty level. (That’s about $15,000 a year for individuals and $31,000 a year for a family of four.) Many hard-working Alabamians have no health coverage because they earn too much to qualify for Medicaid and too little to afford private health insurance. This fact sheet examines what’s at stake for Alabama in deciding whether to expand Medicaid under the Affordable Care Act.

Four things to know about Alabama’s 2016 funding challenges

By Chris Sanders

It’s the latest verse of a decades-old song: Alabama faces yet another funding shortfall next year for vital services like Medicaid, mental health care and corrections. Here are four things to know about the budget challenges facing the Legislature during the 2015 regular session that began Tuesday.

(1) Alabama’s revenues for the budgets that fund education, health care and other services still haven’t returned to pre-recession levels.

Alabama has two major state budgets: the Education Trust Fund (ETF), which pays for K-12 and higher education, and the General Fund (GF), which provides a major chunk of the support for vital non-education services, including Medicaid, mental health care, corrections and public safety. The picture that revenue officials painted for each on Tuesday was bleak.

Economic struggles during and after the Great Recession hammered both budgets, and neither has seen revenues return to pre-recession levels. GF receipts last year were down 15.5 percent since 2008, according to the Legislative Fiscal Office (LFO), and ETF appropriations this year are down 12.2 percent from their 2008 level. Alabama’s K-12 cuts since 2008 are the nation’s second worst, while our higher education cuts are the nation’s fifth worst. Alabama’s unemployment rate is improving, but revenues still aren’t growing nearly enough to undo the damage wrought by the Great Recession.

(2) The General Fund shortfall is persistent, and it’s not going away on its own.

The picture is especially bleak for the GF. Alabama’s education budget draws most of its money from state sales taxes and individual income taxes, which grow as the economy improves. But the GF relies on a hodgepodge of other revenue sources, most of which are slow to grow even during boom times.

That leaves the GF with a structural deficit, meaning revenue growth is not strong enough to keep pace with ordinary cost growth for vital services like Medicaid, mental health care and corrections. Without new GF revenue, these services continually will remain at risk of massive cuts.

(3) Alabama needs new revenue to avoid devastating cuts to vital services like Medicaid, mental health care and corrections.

How bad could the cuts for Medicaid, mental health care and other GF services get without new revenue? Perhaps most dramatically, failure to address the GF shortfall could spell disaster for Medicaid, which provides health coverage for one in five Alabamians and already has been cut to the bone of federally required coverage provisions. Even small further cuts could endanger lives.

GF cuts could mean even shorter staffing for the state’s overcrowded prison system, which operates at nearly twice its designed capacity. It also could mean fewer state troopers on the highways, more trial delays, longer lines to renew a driver’s license, or long waiting periods for many families seeking ALL Kids health coverage for their children.

Next year’s GF shortfall will be $264 million, according to Executive Budget Office (EBO) estimates. That would be a 14 percent drop in a perennially underfunded budget that already struggles to fund barebones service levels.

But the funding challenges don’t end there. EBO’s Bill Newton said Tuesday that Alabama also needs an additional:

  • $155 million to maintain current service levels for Medicaid and corrections,
  • $63.5 million to cover public safety costs that now are being covered by a transfer from the state’s road and bridge money,
  • $26 million to pay for expanded community corrections and other recommendations of the state’s Prison Reform Task Force, and
  • $32.5 million to begin repaying the $161.6 million that the state borrowed from the GF’s rainy day account and must restore by 2020. (So far, Alabama hasn’t repaid a dime.)

Add it all up and it comes to $541 million in new GF revenue needs. That’s the amount that Gov. Robert Bentley proposes to raise with a mix of tax increases and loophole closures. “We must break the cycle of budget shortfalls year after year after year,” Bentley said Tuesday night during his State of the State address. “We must have adequate means.”

(4) Taxing low-income Alabama families deeper into poverty is not the way to cure our funding woes.

Alabama’s tax system is upside down. Low- and middle-income families pay twice as much of their income in state and local taxes as the top 1 percent of earners do. It’s an imbalanced structure that makes it harder for low-income families to escape poverty and leaves them with less money for the consumer spending that fuels economic growth. The main driver of this upside-down tax system? High sales taxes, especially on groceries and other necessities that account for a big share of low-income families’ household budgets.

Significantly, Bentley’s plan would not increase taxes on food, clothing or over-the-counter drugs. Instead, the governor proposes to raise more than $400 million by increasing the state’s cigarette tax and sales tax on automobiles. Bentley’s proposal would boost the cigarette tax from 42.5 cents per pack to $1.25 per pack and would increase the state sales tax rate on automobiles (now 2 percent) to match the 4 percent rate that applies to other consumer goods.

The rest of the new revenue would come from a mix of business tax increases and loophole closures. (One proposal is for Alabama to adopt combined reporting, which would treat corporations and their subsidiaries as one corporation for tax purposes. You can learn more about combined reporting here.)

Strong investments in services like education, Medicaid and public safety promote economic growth and improve our state’s quality of life. By funding those investments without raising taxes on necessities like food and clothing, Alabama can give everyone a better opportunity to get ahead in life.

By Chris Sanders, communications director. Posted March 4, 2015.

The State of Working Alabama 2014: Health coverage in Alabama: Where we’ve succeeded and where there’s work to do

By Carol Gundlach

Alabama has enjoyed great success in recent decades in ensuring that children and seniors have the health protection they need, according to a new Arise Citizens’ Policy Project report issued Tuesday as part of The State of Working Alabama 2014. But the state lags behind the nation when it comes to insuring young adults, nearly 30 percent of whom lack health coverage.

“Child care, construction and food service are essential jobs that are often low-paying, and the people who do that important work deserve the protection of health insurance,” ACPP policy director Jim Carnes said. “The Marketplace makes affordable coverage available for tens of thousands of Alabamians. Closing the coverage gap would insure hundreds of thousands more. It’s time for our state to take this important step toward a healthier, more secure Alabama for all.”

General Fund budget, changes to Alabama’s landlord-tenant law enacted

By Chris Sanders

Next year’s General Fund (GF) budget became law Thursday night when the Alabama House ended the 2014 regular session without considering Gov. Robert Bentley’s proposed amendment to it. Bentley’s changes to the $1.8 billion GF budget were enacted automatically when the House adjourned. Check out AL.com’s report to learn more about Thursday’s action.

Bentley still must decide whether to sign the Education Trust Fund (ETF) budget or veto it and order the Legislature to return for a special session. Bentley urged lawmakers to approve a 2 percent pay raise for K-12 teachers next year, but the ETF budget sent to him did not include a teacher raise or bonus. Click here to learn more about the ETF budget.

GF support for the Department of Corrections would fall by about $2 million, or 0.5 percent, next year under the budget, even though Alabama’s prison system is operating at nearly twice its designed capacity. The budget includes $3.5 million for an overflow facility to help house some inmates from the overcrowded Julia Tutwiler women’s prison in Wetumpka. The spending plan also includes $250,000 for a new ombudsman program for Tutwiler prisoners who report mistreatment.

State employees would receive a one-time $400 bonus next year under lawmakers’ GF budget. Bentley’s amendment changed the funding source for those bonuses but did not eliminate them. Medicaid funding would increase by 11.4 percent next year, though the amount would fall short of what State Health Officer Don Williamson said the agency needs from the GF. Williamson said earlier this year that Medicaid could endure at the proposed funding level by cutting costs in the prescription drug program and other areas. Click here to learn more about the GF budget.

Landlord-tenant law revisions, AHIP bill among other enacted legislation

Alabama landlords will have more time to refund a security deposit or give notice of why they are keeping some or all of it under a new law enacted last month. SB 291, sponsored by Senate President Pro Tem Del Marsh, R-Anniston, will increase that window from 35 days to 60 days. The law also will allow landlords to treat a property as abandoned if electrical service is cut off for at least a week.

In addition, landlords will have to provide only a seven-day written notice if they plan to terminate the lease for a violation that does not involve failure to pay rent. That’s down from the previous 14-day timetable. SB 291 gives renters four chances every 12 months to correct problems cited as a lease violation without getting the landlord’s written consent. The measure passed 28-0 in the Senate and 98-0 in the House.

The Alabama Health Insurance Program (AHIP) will come to an end under another law enacted last month. SB 123, sponsored by Sen. Slade Blackwell, R-Mountain Brook, will transfer any remaining unused and unobligated program funds to the GF. Supporters said AHIP, which offers “guaranteed-issue” health coverage, is no longer needed because the Affordable Care Act (ACA) requires insurers to offer coverage regardless of a person’s health history. Blackwell’s bill passed 21-0 in the Senate and 90-0 in the House.

Before the ACA, applicants with pre-existing conditions like cancer often struggled to find coverage. Alabama created AHIP as a high-risk pool to cover certain residents who were turned down by other insurers after Congress passed the Health Insurance Portability and Accountability Act (HIPAA) in 1996.

By Chris Sanders, communications director, and M.J. Ellington, health policy analyst. Posted April 4, 2014.

Alabama Legislature passes ETF budget, goes home without approving bills on payday lending, execution drug secrecy

By Chris Sanders

Alabama lawmakers passed a $5.9 billion Education Trust Fund (ETF) budget without a pay raise for K-12 teachers just before the 2014 regular session ended Thursday night. The House voted 54-45 to agree to the compromise budget that the Senate approved Tuesday. That leaves Gov. Robert Bentley, who urged the Legislature to approve a 2 percent raise for teachers next year, to decide whether to sign the ETF budget or veto it and order lawmakers to return for a special session. Check out AL.com’s report to learn more.

Many other proposals cleared one chamber but did not win final legislative approval before the regular session ended Thursday. Among the subjects of bills that lawmakers did not send to Bentley were:

  • Payday lending. HB 145 would have created a statewide database of payday loans. The bill, sponsored by Rep. Patricia Todd, D-Birmingham, would have made it easier to enforce a current state law that prohibits borrowers from taking out more than $500 in payday loans at any one time.
  • Death penalty drug secrecy. HB 379 would have kept the identities of people involved in carrying out state-sanctioned executions confidential. The bill, sponsored by Rep. Lynn Greer, R-Rogersville, also would have shielded the identities of companies that manufacture or supply death penalty drugs. Sen. Cam Ward, R-Alabaster, sought to amend the bill to allow disclosure of such information under certain circumstances.
  • HIV drug redistribution. HB 138 would have allowed pharmacists at or affiliated with HIV clinics to redistribute unused HIV medications originally prescribed for other patients. The bill, sponsored by Todd, would have set controls on handling and oversight of the drugs.
  • Accountability Act changes. HB 558 would have made it easier for wealthy Alabamians to contribute more money to groups that grant scholarships to help parents of children in “failing” schools pay for private school tuition under the Alabama Accountability Act. The bill, sponsored by Rep. Chad Fincher, R-Semmes, would have removed the act’s $7,500 annual cap on the tax credit that individuals or married couples can claim for contributions to such organizations. The bill would not have changed current law allowing Alabama to provide a total of no more than $25 million of scholarship credits annually.
  • Lifetime SNAP and TANF bans. SB 303 would have ended Alabama’s policy of forever barring people convicted of a felony drug offense from regaining eligibility for food assistance or cash welfare benefits. The bill, sponsored by Sen. Linda Coleman, D-Birmingham, would have allowed otherwise eligible people with a past felony drug conviction to receive benefits under the Supplemental Nutrition Assistance Program (SNAP) or the Temporary Assistance for Needy Families (TANF) program if they have completed their sentence or are complying with their probation terms.

Much discussion, no Senate passage of payday loan database, execution drug secrecy bills

The payday loan database bill reached the Senate floor twice Thursday afternoon. Senators initially delayed action on HB 145 after Sen. Bobby Singleton, D-Greensboro, expressed concern about the security of borrowers’ information in the database. About an hour later, the Senate returned to the measure and added three amendments to it.

One amendment, offered by Sen. Shadrack McGill, R-Woodville, would have doubled the bill’s payday loan cap from $500 to $1,000. Two other amendments came from Sens. Roger Bedford, D-Russellville, and Paul Sanford, R-Huntsville. Immediately after adopting the amendments, senators agreed to postpone action on HB 145, and the chamber did not take it up again before adjournment.

Senators debated the death penalty drug secrecy bill three separate times Thursday afternoon but ultimately did not vote on it. Ward tried to amend HB 379 to allow people injured while handling such drugs to sue, but the Senate did not accept that proposal. “No one in the state of Alabama should ever be granted absolute immunity for negligence or gross negligence they commit against somebody else,” Ward said while arguing for his amendment.

The failure to pass HB 379 could bring lethal injections to a halt in Alabama by making it impossible for the state to buy the drugs used in the process, Ward said. “By opposing this bill and killing this bill, what we’re doing is ensuring is this state will go back to the system of the electric chair,” he said. Alabama began using lethal injection in executions after the state retired “Yellow Mama,” the electric chair used from 1927 to 2002.

The three other bills listed above did not reach the House or Senate floor Thursday. The HIV drug redistribution bill, HB 138, passed 99-0 in the House last month and was on the Senate’s final special-order calendar Thursday, but senators adjourned with several measures still lined up ahead of it. Arise and other consumer advocates last year urged Bentley to support this policy change as his Medicaid Pharmacy Study Commission met to consider ways to reduce costs in the state’s Medicaid drug assistance programs.

By Chris Sanders, communications director. Posted April 3, 2014.

Alabama Senate committee amends execution drug secrecy bill, approves HIV drug redistribution bill

By M.J. Ellington

An Alabama Senate committee Wednesday unanimously approved a bill that would keep the identities of people involved in carrying out state-sanctioned executions secret in most instances. But the Senate Health Committee amended the bill to divulge the names of companies that manufacture or supply lethal injection drugs if a judge orders their release. HB 379, sponsored by Rep. Lynn Greer, R-Rogersville, awaits consideration by the full Senate.

The original HB 379 would have kept secret, in all instances, the identity of people involved in carrying out executions, along with the identity of the maker and provider of drugs used in lethal injections. Greer said states that use lethal injection in executions have difficulty obtaining drugs for that purpose because many companies fear lawsuits.

Sen. Cam Ward, R-Alabaster, is an attorney who chairs the Senate Judiciary Committee and serves on the Health Committee. Ward said he understands the goals of Greer’s bill but has grave concerns about “creating an area of complete immunity” in state law that prohibits divulging the information in every instance. The committee approved two Ward amendments to allow the information to be released under a court order.

Sen. Linda Coleman, D-Birmingham, said the state should not enact a law that effectively could prevent prosecution in all cases. “Somebody could inject Drano and not be prosecuted” under the original bill, Coleman said.

Sen. Billy Beasley, D-Clayton, said decisions about immunity are not easy ones. He pointed to people in the audience from a victim’s advocacy organization. Beasley said the issues gave him an uneasy feeling of protecting “someone who committed the crime of death,” but he voted for Ward’s amendments and the bill.

Randy Hillman, executive director of the Alabama District Attorneys Association, said the law would apply to a very narrow set of circumstances involving a shrinking number of drug providers. Some defense attorneys seeking to stop executions file court challenges related to the drugs used in lethal injections.

Alabama began using lethal injection in executions after the state retired “Yellow Mama,” the electric chair used from 1927 to 2002. Sen. Gerald Dial, R-Lineville, questioned whether the state might have to return to using electrocution to carry out death sentences if HB 379 does not pass.

Bill to allow redistribution of some unopened HIV drugs advances

The Senate committee Wednesday also approved a bill that would enable pharmacists at or affiliated with HIV clinics to redistribute unused HIV medications originally prescribed for other patients. HB 138, sponsored by Rep. Patricia Todd, D-Birmingham, awaits consideration by the full Senate. Committee members amended Todd’s bill to match a similar bill – SB 437, sponsored by Sen. Linda Coleman, D-Birmingham – that won committee approval last week.

HIV clinics now must destroy unopened medications if patients do not show up for treatment. HB 138 would allow pharmacies to dispense those drugs to other patients and would set controls on handling and oversight of the drugs. Arise and other consumer advocates last year urged Gov. Robert Bentley to support this policy change as his Medicaid Pharmacy Study Commission met to look at ways to reduce costs in the state’s Medicaid drug assistance programs.

Lawmakers will return Thursday for the 27th of 30 allowable meeting days during the 2014 regular session, which is expected to last until early April.

By M.J. Ellington, health policy analyst. Posted March 19, 2014.