The COVID-19 pandemic has revealed the structural weakness in the Alabama Department of Public Health. Unknown to most Alabamians is that the ADPH is not a cabinet agency. It reports to a separate board, not to the governor or the legislature.
By law (Sec. 22-2-1) the Medical Association of the State of Alabama (MASA) is the State Board of Health. MASA is a private association which represents approximately one-third of the licensed physicians in the state, and its members select their own governing board. Alabama is the only state that has turned over its state health department to a private organization.
Alabama is recognized as the leader when dealing with natural disasters, but not so when it comes to healthcare and healthcare disasters. We ranked 46th in 2018 and 47th in 2019 in overall healthcare outcomes. We rank from last to nearly last in COVID-19 vaccine distribution. The most recent audit by the Examiners of Public Accounts has several findings relating to an absence of or a weakness in internal controls. One finding relates to collecting fees, for which they did not have the legal authorization to set, impose or collect.
The Alabama Department of Public Health is outside of the control of the governor and the legislature. A bill before the legislature will create a cabinet level state agency with a secretary of health that will be accountable to the governor and legislature and not to a private organization. Currently, the state health officer reports to the state board of health and does not sit in at the governor’s cabinet meetings. This does not allow for a good coordinated effort in resolving healthcare issues.
The time to restructure is now. The time to move Alabama healthcare to a higher level is now. This issue has been ignored for too long.
State Senator Jim McClendon
See complete story in the Northwest Alabamian.