CullmanTimes.com - Cullman, Alabama

February 2, 2013

TOWN HALL - Lawmakers outline budget challenge; discuss midwifery

By David Palmer
The Cullman Times

Editor’s Note: This is the first of several articles from Thursday’s town hall meeting concerning the 2013 legislative session.

A pre-legislative session town hall meeting in Cullman covered a wide range of issues facing the state, including several that were presented by members of the audience Thursday night.

State Sen. Paul Bussman and Reps. Mac Buttram and Ed Henry, all Republicans, hosted the meeting at Cullman City Hall.

Bussman opened the two-hour meeting with a presentation of the budget issues facing Alabama, particularly in the General Fund, which supports Medicaid, prisons, courts and other services. Along the way, Bussman also noted some positive news, such as the new bridges under construction on Alabama 157 and the eventual four-laning of another section of the highway.

“We should see the bridges completed within a year. In another two years we expect to see the four-laning completed,” Bussman said.

On the economic front, Bussman noted that the state’s unemployment rate has dropped from 11 percent three years ago, to the most recent reporting of 7.1 percent. Cullman County’s unemployment has decline to 5.7 percent.

“The economy is still stagnant, but we are seeing some improvement. Cullman County’s rate is one of the best in the state, and if we can get the state level down to 5.5 percent, Gov. Bentley can start getting paid,” Bussman said.

Gov. Robert Bentley has refused to accept pay until the state’s unemployment rate drops to 5.5 percent.

“One of the problems we’re facing is that the Alabama business confidence index is down. This is small business. They are scared to death of Obamacare and what the federal government is going to do. We are seeing some of our industries doing real well right now, however, and that’s good,” the senator said.

Bussman said states are still uncertain what impact the president’s national healthcare program will have on budgets. Alabama is already struggling to make ends meet in the General Fund, and many lawmakers fear that the federal health plan will only multiply the financial burden on Medicaid, which consumes the lion’s share of the budget.

“Fifty-six percent of the General Fund is Medicaid and prisons, which leaves very little for everything else, and that’s not acceptable. The General Fund has little growth built into it, whereas the education budget relies heavily on sales tax and income tax. So, when the economy is growing that budget does well,” Bussman said.

After fielding a few questions about the budgets, Vinemont resident Alex Jennings asked lawmakers their position on midwifery and their assessment on the chances of passing a bill to legalize the practice in the coming legislative session.

Bussman, who sponsored a bill last year to legalize midwifery, said the proposal has some support but will require those on both sides of the issue to make concessions.

“It’s not my responsibility to tell you where you should have your baby,” Bussman said. “It’s your right to have a baby the way you want to and we should make it safer for natural childbirth. We’ve got to get away from the state telling you how to do everything.”

Henry said concerns about midwifery come from physicians at hospitals who may have to handle emergency cases.

“If a physician is hit with an emergency case and has no background knowledge of the mother’s medical history, then they are worried about legal issues,” Henry said. “I think one solution is to ensure that they would have no liability in those cases.”

Audience member Hannah Ellis said one idea in Alabama is to allow individual credentials for nurses and nurse practitioners who want to practice outside of a hospital environment.

Henry said the state nursing board has opposed efforts to allow nurse practitioners to do more in the medical field. Other states, such as Florida, allow nurse practitioners to operate under the medical board.

After the meeting, Sheree Jennings, the wife of Alex Jennings, said she supports legalizing midwives.

“I was a home birth. To me it makes sense. I know that the rate for C-sections is so high,” she said.

The 2013 session of the Legislature begins Feb. 5.



David Palmer may be contacted at dpalmer@cullmantimes.com or 256-734-2131, ext. 213.