Investing in Rural Medicine for the Future

Investing in Rural Health Care in Alabama remained a top priority for the Medical Association this past Legislative Session and will be going forward.  Ensuring affordable, high quality and physician-led access to quality care for rural residents not only means a healthier Alabama, but is also a piece of the economic development puzzle for maintaining and improving communities throughout the State. Each year, the Medical Association supports funding for programs like the Rural Medical Scholars Program at the University of Alabama, Rural Medicine Program at Auburn University and the Board of Medical Scholarship Award (BMSA) which grants medical-school-scholarship-loans to pre-med students, medical students and resident physicians to help attract them to underserved parts of the State.    

The Rural Medical Scholars program works to recruit and assist Alabama college students from rural areas who want to become physicians and work in the state’s rural communities.  Since its founding in 1996, more than 200 students have participated in the Rural Medical Scholars Program, and 126 have completed medical school and residency. Of those, the vast majority practice in Alabama, in mostly rural areas, and 65% are primary care physicians.  As well, thanks to the leadership from both Governor Ivey and the Legislature, the Association was able to maintain the total amount for physician-student loans in 2023 via the BMSA at $1.9 million, establishing 8 new physicians in underserved parts of the state through medical school tuition loans.  

The Association also worked on crafting a long-overdue update to the existing rural physician tax credit.  Since its inception in 1993, many things have changed in rural Alabama and the current eligibility requirements are outdated.  The Association worked with the Alabama Department of Revenue on the bill and although it did not pass, much progress was made and the Association maintains updating the rural physician tax credit as a priority for next session.  

Most physicians who come from rural areas and/or begin their careers in rural areas usually stay and practice in those communities.  These programs remain one of the best mechanisms for expanding access to quality, physician-led care and help to attract and keep physicians in underserved communities.  As the Medical Association gears up for the 2023 regular session, the Association looks forward to working with the Legislature to increase access to quality care in rural communities throughout the state and grow the physician workforce in Alabama to better care for citizens. 

Discussions with Decision Makers: Representative Jeff Sorrells

Representative Sorrells is a member of the Alabama House of Representatives from the 87th District, serving since 2018. He is a member of the Republican party and serves on the House Health Committee. Rep. Sorrells was previously the mayor of Hartford, Alabama and is a vice president of the First National Bank of Hartford, Alabama.

What first prompted you to consider running for office?

When I first got involved in public office in 2002, on a local basis, my primary concern was to make a difference in my community. Being from a small rural community, it appeared that everything stayed the same and nothing changed for the better. I felt that the best thing I could do was get involved and work toward improving my community. I firmly believe that the best plan of action you can take to invoke change is to get involved in a positive manner and work toward a goal for the future. Have a plan and then implement that plan for a better quality of life for those people you serve. Being a mayor for 10 of those years served as an opportunity for me to be able to make that change and improve the quality of life for those in our community.

How does your background help serve you in the Legislature?

Being in the banking industry for the past 35 years has helped me to see the value of being able to help people and work with people to achieve the results that are beneficial to them and you. Working together is necessary to be able to achieve these goals and to have the ability to be successful in your role in the Alabama legislature. The satisfaction that you can derive from helping others is a tremendous motivation for me in public service. Banking has taught me the value of helping others in their time of need as well as how to listen when those around you talk.

What are some of your legislative priorities next term?

Being from a rural environment I think it is time Alabama took a hard look into Medicaid expansion. There are too many hospitals and clinics in our rural areas that are closing and these hospitals serve a tremendous purpose in many of our communities. Too many times the older population does not have the means to travel 40 or 50 miles for health care services. Medicaid expansion could possibly be the mechanism that can keep these hospitals and health care clinics open and serving the community. We also must get tough on the Fentanyl abuse in Alabama and our country as well. Way too much of this drug is pouring across our southern border and we need to let those that would distribute and use this drug know that a high price will be paid when you are caught.

What are some health-related issues important to your district and your constituents?

There is little doubt that Covid has been an issue for all Alabamians over the last couple years. This virus has highlighted just how important our rural physicians and hospitals are to our state. We have to keep exploring all options available to help our rural areas maintain and deliver adequate health care.

What do you think people understand the least about our health care system?

The aspect that I think people are most unaware of is the reimbursement of services provided by the health care community. Procedures that are performed are billed at a specific price but the actual funds received are predetermined regardless of what the actual cost may have been. This usually leaves a balance due and ultimately has to be absorbed by the health care provider.

If you could change anything about our state’s health care system, what would it be?

Improving access to health care especially in rural areas. Telemedicine will go a long way toward benefiting people in the areas that currently are underserved. We must make sure our rural hospitals are adequately funded and can survive in rural Alabama.

How can the Medical Association – and physicians statewide – help you address Alabama’s health challenges?

When questions arise, it is imperative that we, as legislators, have the opportunity to seek out information from those that are versed in that industry. My background being in banking is what I am most versed in, so to have the ability seek out professionals in the health care industry and discuss issues is imperative for me as a legislator.

What is the one thing you would like to say to physicians in your district?

THANK YOU!! Thank you for all your dedication and hard work taking care of Alabama during the pandemic. Thank you for working the long hours under difficult circumstances to ensure that all Alabamians were provided with the health care that was much needed during these unprecedented times that we experienced in the pandemic.

Drawing a Line at Pharmacists Prescribing Medicine

For the 5th installment of an in-depth look into each of the Medical Association’s “Top 10 Highlights” from the 2022 regular session, we will look at the Association’s opposition to allowing pharmacists blanket authority to prescribe vaccines and immunizations

At the beginning of the 2022 Regular Session, a bill was drafted and supported by the Alabama Pharmacy Association that would have given pharmacists broad authority to prescribe vaccines and immunizations.  Currently, pharmacists may administer vaccines, but may not prescribe them. The bill would have permitted pharmacists to prescribe any vaccine or immunization that they are already allowed to administer. 

Proponents of the legislation stated their goal was to expand access to vaccines and immunizations and make permanent some of the additional privileges granted to pharmacists via the temporary COVID emergency orders. As the Association discussed possible alternatives to the bill, medicine offered multiple substitutes to the proposed legislation that would have met the stated goal, but these were all rejected by the pharmacy association. With no agreement in place, proponents failed in their attempt to move the bill forward. 

The Association believes strongly in the physician lead health team and does not support fracturing care delivery. Hence, the Association partnered with the Alabama Chapter of the American Academy of Pediatrics, the Alabama Academy of Family Physicians, and the Alabama Chapter of the American College of Physicians in opposition to the bill. The coalition maintained that allowing pharmacists to prescribe vaccines – especially important childhood vaccines – would disrupt the “medical home” and actually hurt children’s access to care. The Association also believed that allowing pharmacists the ability to prescribe was ultimately a “scope creep” style bill that would blur the lines between medicine and pharmacy. The bill “passed” out of the Senate Healthcare Committee on a voice vote from Sen. Jim McClendon despite the absence of a quorum. The bill ultimately failed as it never made it to the Senate floor. The Association fully expects similar legislation to be proposed in the 2023 Regular Session.

Discussions with Decision Makers: Representative Arnold Mooney

Rep. Mooney (R–Birmingham) is a member of the Alabama House of Representatives, serving the 43rd district covering Shelby County. Born and raised in Montgomery, Rep. Mooney is supported by ALAPAC and a member of the House Health Committee. Rep. Mooney has been married to his wife Kelly for 31 years; has three grown children, a grandson, and a granddaughter and is a career Commercial Realtor.

What first prompted you to consider running for office?

I grew up in Montgomery and paged at the Legislature at an early age, clerked for a Montgomery attorney who served in the House of Representatives, interned in the Senate and worked on staff in the Senate after working for an Alabama US Senator in Washington. I actually assisted with running an Alabama House and Senate race, as well as, serving as the Campaign Manager of a US Senate race here in Alabama. I also had the opportunity to be on staff with the Medical Associaton of the State of Alabama for nearly three (3) years. I also have physician son who gives great perspective on healthcare. 

How does your background help serve you in the Legislature?

Continuing to work on free speech issues, adoption improvements, Pro-Life issues, strong reserve funds for our General Fund and Education Trust Fund budgets, as well as, the correct use of State funding , Special Needs education,  harden our schools for safety and security to protect our children from violent attacks and Election Law security legislation and health related issues.

What are some of your legislative priorities this term?

Continuing to work on free speech issues, adoption improvements, Pro-Life issues, strong reserve funds for our General Fund and Education Trust Fund budgets, as well as, the correct use of State funding , Special Needs education,  harden our schools for safety and security to protect our children from violent attacks and Election Law security legislation and health related issues.

What are some health-related issues important to your district and your constituents?

Pro-life and adoption needs, protecting the Physician/patient relationship through informed consent, widening the delivery and efficiency of medical services to Alabamians.

What do you think people understand the least about our health care system?

Quite simply how it actually works and the variety of things that constantly are proposed that could hurt them personally.

If you could change anything about our state’s health care system, what would it be?

Improve the responsiveness of state health related agencies such as the State Health Department and involve more private practice physicians in the decision making process.

How can the Medical Association – and physicians statewide – help you address Alabama’s health challenges?

Continue to support your MASA staff as they identify and communicate issues to the Legislature. Please become active participants in the legislative and political process. Our cooperative efforts will make a great difference for your patients and all Alabamians. 

What is the one thing you would like to say to physicians in your district?

I know many of you and want to know all of you! As our area continues to grow, please call on me to assist you with your concerns and issues. We can make the lives of our people better!

Discussion with Decisionmakers: Gil Isbell

Rep. Isbell (R–Gadsden) is a member of the Alabama House of Representatives, serving the 28th district covering Etowah County. Born and raised in Etowah County, Rep. Isbell is supported by ALAPAC and is running for re-election to represent District 28. He works at Isbell Dental and served as President of Gadsden Kiwanis Club.

What first prompted you to consider running for office?

I wanted to give back to my community, county and state.  In order to make a difference, you must get involved.

How does your background help serve you in the Legislature?

I have a diverse background in business from Airport Consulting, Real Estate, Retail, Recycling and more.  Furthermore, I lived outside the state for 25 years and learned there are all types of people that make up our great nation.

What are some of your legislative priorities this term?

-Help find a suitable industrial occupant for the Goodyear facility.

-Help develop the Megasite and find manufacture(s) to locate at the site.

-Help make the GSCC Advanced Manufacturing and Workforce Development Center a reality.  It will be a regional facility with dual enrollment, supported by all 3 school systems and will help support present and future training for many career tech jobs.

-Make the Southside Bridge the top infrastructure project and help secure funding. 

-Help obtain a 3^rd lane for Rainbow Drive/Hway 411 from Hway 77 to Lumley Road in Rainbow City.

-Help strengthen education and get more qualified teachers in place.

-Work with State leaders to further address Mental Health issues.

-Work on Parental Rights issues.

-Work on protecting individuals regarding Guardianship and Conservatorship.

-Work on reducing flagrant lawsuits.

-Give the Citizens the opportunity to vote for a lottery.  Put the vote in the hands of the people.

-AND MUCH MORE!

What are some health-related issues important to your district and your constituents?

I am working with individuals and the Alabama State Lab to further new born testing.  Also, I want to work on mental health issues. 

What do you think people understand the least about our health care system?

I deal with insurance on a daily basis in my job at a dental office.  Most people do not understand insurance coverage or what procedures are covered.  Also, many people do not understand they need to see doctors on a routine basis.

If you could change anything about our state’s health care system, what would it be?

Develop a more consistent way to communicate with the public.  I know the industry does a good job of educating the public, but I think it could be better.

How can the Medical Association – and physicians statewide – help you address Alabama’s health challenges?

As a legislator, we have to become experts in many fields (which is impossible).  I would like for the Medical Association to continue to present and educate the legislature on issues that the medical association identifies as important to the citizens of our state.

What is the one thing you would like to say to physicians in your district?

Thank them for what you do.  It is harder and harder to take care of patients because of the sheer numbers of patients that must be seen to make ends meet.  Again, thank them for what they do.

Medical Association’s Top 10 Highlights for the 2022 Regular Session

While the Medical Association advocated on and monitored hundreds of bills and resolutions during the 2022 Legislative Session, below is a “Top 10” list of some of the major issues on which the Association was involved.