SYLACAUGA -- Gov. Robert Bentley met with doctors, dentists and the Board of Directors of Coosa Valley Medical Center on Monday to discuss the need to increase the number of professionals in rural areas.
He spoke during a lunch meeting at Hickory Street Cafe and then toured the hospital’s Imaging Department, Transitional Care Unit, second floor, Intensive Care Unit, Labor and Delivery, and the emergency room.
Glenn Sisk, chief executive officer for CVMC, thanked the governor for visiting and starting such an ambitious initiative to increase doctors and dentists in rural areas.
Bentley in his State of the State address in February offered his Great State Plan of 2019 to increase the number of health professionals in rural areas.
The governor wants to better the state’s numbers in “America’s Health Rankings” for 2015. Bentley said the rankings were a report from the United Health Foundation.
He said the report indicated Alabamians tended to have access to fewer primary care doctors and dentists than people in most other states. Among the 50 states, Alabama had the third-lowest number of dentists per 100,000 people and the 11th-lowest number of primary-care physicians, according to the report.
Access to care tends to be even worse in many of Alabama’s rural counties. Eight counties – Chilton, Cleburne, Coosa, Henry, Lamar, Lowndes, Macon and Perry – have no acute-care hospital serving the general public, according to the Alabama Hospital Association.
In addition, three counties have no full-time dentist, according to the Alabama Rural Health Association.
Another measure of the lack of access in rural areas comes from the May 2015 report on Primary Care Health Professional Shortage Areas, released by the Alabama Office of Primary Care and Rural Health.
The report showed that all or parts of 36 Alabama counties were geographic shortage areas. Each of these areas had less than one primary care physician per 3,000 residents, and some had less than one per 3,500 residents.
Of those 36 shortage areas, 34 were rural counties or parts of rural counties, as defined by the Alabama Rural Health Association.
“Health care in the state’s rural counties must be addressed,” Bentley said. “Alabama’s rural counties simply do not have proper access to health-care providers.
“The high cost of education for health-care providers is one of the primary reasons for this shortage. To encourage health-care providers to practice in rural counties, I propose the creation or expansion of loan repayment programs for doctors, physician’s assistants, dentists and nurse practitioners.
“Recipients would receive funds to repay student loans if they contract to practice in their fields of medicine for a certain amount of time in specifically defined, low-access areas of the state.
“In addition, my office will analyze and encourage the passage of state and federal tax credits that would create an additional incentive for health-care professionals who are willing to practice in underserved areas.
“I also plan to help Alabama hospitals create 12 residency programs for medical school graduates undergoing on-the-job training. Residents can practice medicine in hospitals under supervision by attending physicians, and many physicians practice near where they worked as residents.
“Thus, creating more residency programs could greatly boost the number of health-care providers in Alabama.”
In talking to those attending the meeting, Bentley said he had heard only good things about Coosa Valley Medical Center. He said the state was going to have to combat the health issues faced by its citizens.
“We are the most obese state in the nation,” he said. “Our infant mortality rate is high in some areas of the state. We must do something.”
Some 1 million state residents receive Medicaid, he said. The program is a hot topic in the ongoing legislative session. The state’s Medicaid Agency is requesting an additional $100 million in next year’s budget, funds lawmakers seem hesitant to provide.
Bentley said he will veto the state’s General Fund budget it if the Legislature does not find the extra funding for Medicaid.
Roland Thacker, chief financial officer for CVMC, said the hospital serves between 50 and 54 percent of patients on Medicaid and faces reimbursement challenges on this daily.
Doctors told the governor something must be done about Medicaid from their point of view. Another doctor said mental health issues needed be addressed.
On the Affordable Care Act, Bentley pulled no punches.
“It is a terrible piece of legislation,” he said. “It has got to be repealed. It is going to cost this state over $710 million over the next six years. We can’t afford it.”
Following the tour of the hospital, Bentley said he was impressed with CVMC.
“I want to tell all rural hospitals,” he said, “to come here and look at what you do.”