Alabama Department of Public Health

The strategic plan for the Alabama Department of Public Health outlines its direction from 2024 to 2026. It is guided by five strategic priority areas: Health Outcome Improvement, Financial Sustainability, Workforce Development, Organizational Adaptability, and Data Driven Decision Making. The plan aims to promote, protect, and improve the health of Alabamians by enhancing programs, improving operations, and advancing initiatives to achieve measurable improvements and strengthen public health capacity, ultimately fostering healthy people, communities, and Alabama.

The council received updates on opioid prescribing and regulations. It was announced that Alabama was not selected to attend the National Academy for State Health Policy's 32nd Annual State Health Policy Conference. The council discussed holding a future meeting on a larger scale with guest speakers, focusing on various aspects of palliative care, and agreed to discuss this further at the next meeting. Additionally, a request was made to add website changes as a standing agenda item.

The council discussed opioid prescribing and regulation updates, transportable orders for patient preferences, and an ad hoc workgroup. There were no acute items to present regarding opioid prescribing, but there was discussion about legislation and existing rules for risk education. The council reviewed a revised form for National Physician Orders for Life-Sustaining Treatment and the challenges of its acceptance in nursing homes. The ad hoc workgroup was established to analyze the feasibility of a statewide communication initiative, named the Alabama Conversation Project, to promote conversations around serious illness. The council also discussed the project's composition, promotion, pricing, and potential funding sources.

The council meeting addressed the shortage of IV Dilaudid and its impact on patients, with a call for research into affected areas of patient care. COVID-19's impact on palliative care and hospice patients was discussed, including positive cases in long-term care settings and challenges faced by hospice organizations in accessing nursing homes. The Alabama Nursing Home Association's updated visitation policies were noted. Difficulties in obtaining equipment and the shift in spiritual care services were also discussed. Concerns were raised about Medicare prepayments under the CARES Act and potential funding cuts. The council considered the accountability of assisted living facilities regarding compliance with state rules during COVID-19. A balanced approach to allowing hospice staff into facilities was suggested, and the Alabama Conversation Project was put on hold. The Southeast Innovation Summit was postponed and converted to a virtual format.

The meeting included discussion of opioid prescribing and regulation updates, including the rescheduling of Gabapentin and Medicaid hard edits. Updates were provided on transportable orders for patient preferences and a national form for use in all states. A presentation was given on palliative care and telehealth at the University of Alabama at Birmingham, focusing on community-based virtual access to palliative expertise. The Center to Advance Palliative Care report card was reviewed, showing Alabama's improvement from an "F" to a "D". An update was provided on the Palliative Care and Hospice Education and Training Act bill before Congress, and members were encouraged to contact legislators for support. There was also a discussion about a public awareness survey report from CAPC concerning palliative care versus hospice.