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january 2019

Airbus Breaks Ground on New Assembly Line in Mobile

Groundbreaking for the new Airbus A220 Production Facility on Jan. 16, 2019, in Mobile, Ala. Photo by Mike Kittrell

The first shovelfuls of dirt went flying at the new Airbus Final Assembly Line in Mobile Wednesday morning, followed by a surprise show of fireworks — all celebrating that when the new A220 line gears up, Mobile will be the fourth largest producer of commercial aircraft in the world.

Right now it’s rolling out more than four a month of the aircraft company’s A320 family, on the way to producing five a month. When the new Final Assembly Line is at full production, turning out another four a month, Mobile will move into the world’s fourth ranking.

Only Toulouse, France, and Hamburg, Germany — both Airbus facilities — and Seattle, home of commercial rival Boeing, produce more.

The groundbreaking was an Airbus special — balloons and crowds and speeches and local dignitaries, airline company officials, Airbus leaders from much of the company’s global footprint, employees, construction team members, and several dozen journalists from key air and business publications all over Europe and North America.

There were serious questions during media session. How will Brexit affect Airbus’ ability to complete planes on time? What kind of incentives did the company win from state and local authorities? How is Airbus going after the U.S. Air Force tanker contract this time? What’s the actual demand for the new A220?

And there were serious answers. Airbus is hoping Britain can still avoid an economically disastrous split from the European Union, but is developing contingency plans. The wing, crucial to any aircraft design, is currently built in Britain.

Incentives? Ask the local and state officials, Airbus officials deferred.

The tanker contract? Yes, Airbus is trying again after losing to Boeing. “I still don’t understand why the most powerful Air Force in the world wouldn’t fly the best tanker,” said Airbus CEO Tom Enders, noting that his firm has won contracts from virtually all other major world air forces.

Demand? Airbus has an order book of more than 500 of the new 100- to 150-seat single-aisle craft, and Delta, the company whose order prompted Airbus to take on the Canadian plane and bring production to the U.S., has “topped up” its order, said Jeff Knittel, chairman and CEO of Airbus Americas.

But the event was first and foremost a celebration of Airbus in Alabama.

And, said Enders, while the company enjoys its special relationship with Mobile and Alabama, it’s not here because the people are nice but because the U.S. is the largest market in the world for single-aisle commercial aircraft and it makes sense to bring the production to the market.

Birmingham Scrutinizes its Workforce

Waymond Jackson (left) and Sanjay Singh, of the Birmingham Business Alliance, are working to turn workforce data into positive steps for the region’s workers and economy. Photo by Art Meripol

Last June, Birmingham’s business leaders gathered at the Alabama Workforce Training Center for the release of the “Building (it) Together” report, a thorough, data-based analysis of Greater Birmingham’s workforce needs and potential for growth.

“This is a critical moment in Birmingham’s history,” the report claims. “Birmingham struggled to rebound from the Great Recession, and has an economy built around industries that have limited growth in the 21st century.”

To address this problem, the study offered detailed suggestions for better educating the local workforce, boosting entrepreneurship and investing in diverse, promising industries.

The study was conducted by analytics software company Burning Glass Technologies and the Council for Adult and Experiential Learning (CAEL). More than 125 local representatives participated in focus groups to gather insight on Greater Birmingham’s current economic situation. Members of the Bold Goals Coalition of Central Alabama’s Workforce Action Network funded the study and have spent the last six months analyzing and acting on the results.

When the report was released, business leaders were receptive, but not surprised. “There wasn’t anything completely brand-new to those involved, but it highlighted where the challenges were,” says Waymond Jackson, senior vice president of public policy for the Birmingham Business Alliance. “Now we can come up with attainment goals.”

One of the first issues facing the region’s workforce is the immediate departure of recent graduates. “We need more people with at least a bachelor’s level,” Jackson says. “Everyone knew we needed it, but now we’ve seen the numbers.” According to the study, 43 percent of local college graduates and 53 percent of doctoral graduates leave.

Now the report’s organizers are looking for areas where they can open new internships and co-op opportunities, starting at the high school level, to help students build local connections.

“In other big cities, they all know that you need to engage high schools in work experience,” says Sanjay Singh, vice chairman of workforce development for the BBA. Singh cites Birmingham’s Division of Youth Services’ Kids & Jobs Program as a strong starting point. “Every summer, they place 100 seniors in offices, and you see an impact right away. They get real life work experience, and may even get job offers before they graduate.”

Employers have also found it difficult to recruit professionals with three to five years of experience. “Onboard Birmingham started after in-depth conversations with local HR leaders so that we can attract that talent,” Jackson says. “We’ve seen some success and better retention rates, but that’s not enough on its own. We need more programs like that.”

The Onboard Birmingham program partners with companies across multiple industries, including healthcare, law, education, finance and marketing. While young professionals can build a diverse network and become better acquainted with the city, employers can expect a greater likelihood of their talent remaining in town and investing in the community. The tighter network and local affinity are strategically fostered to keep young professionals in Birmingham.

Management positions also have proven hard to fill. In its research and discussions with IT leaders, the report determined that there are indeed software professionals with the requisite five to seven years of experience, but they are hesitant to leave their current jobs. “There’s been an increase in young professional talent, but it’s been difficult to recruit experienced professionals,” Singh says.

This apprehension has proven particularly harmful to the city’s startup potential. “While the region has taken strides to foster entrepreneurship, employers and entrepreneurial leaders cite a fear of taking risks in new fields as a consistent barrier,” the report states.

While the need for better retention was obvious, the report spells out where education and training should be focused. The region produces almost 12,000 graduates per year, but there’s a misalignment between their degrees and available jobs. “We have an oversupply of graduates in life sciences, so we’re looking at how other cities handle that,” Jackson says. “If there’s a mismatch between healthcare graduates and opportunities, we must determine what companies could we create or connect.”

“The talent supply gap is especially pronounced in jobs related to IT, and our region is already taking steps to educate and train more individuals to fill these positions,” says Suzanne Austin, senior vice provost and senior international officer at the University of Alabama at Birmingham. The need for IT jobs grew by 77 percent from 2010 to 2015, and the supply gap could continue to expand over the next 10 years.

“The Innovate Birmingham Workforce program, funded by an America’s Promise grant, has already trained more than 150 young people for employment in this sector,” Austin says, “and this program can certainly serve as a model for other economic sectors.”

Innovate Birmingham was launched in 2017 to prepare young adults for careers in IT and software development. The previous year, the U.S. Department of Labor awarded Birmingham a $6 million grant to educate the city’s underemployed young adults in those fields. The program was designed with a four-year goal of placing 925 individuals into IT jobs. In light of the Building (it) Together study, Innovate Birmingham also will offer apprenticeship opportunities for hands-on experience.

“Alignment of leadership and resources is key to the successful economic expansion of the Birmingham area,” Austin says. “We must work together to attract new regional investments that will lead to the creation of more mid- and high-skill jobs that pay good salaries to people through the area.”

In light of the imbalance between life science graduates and available jobs, educational institutions, particularly UAB, are adapting to better serve both students and the future of their field.

“At UAB, we took it very seriously,” says Kathy Nugent, director of the school’s Bill L. Harbert Institute of Innovation and Entrepreneurship. “We’re looking at our curriculum to make sure that it still keeps up with industry needs. We want to train those post-docs and PhDs applicable to biotech. For IT, we’re working on coding camps and Innovate Birmingham. That’s all good, but we’ve got to keep building in that area of expertise.”

While unemployment in Alabama has dropped, that progress is not equivalent across all demographics. The region’s African American population faces unemployment rates higher than 10 percent. The report calls for better training for underrepresented groups in fields with potential to grow.

The report also emphasized Birmingham’s overreliance on non-traded industries that only circulate goods and services locally. Traded industries that bring new income into the local economy make up just 28.8 percent of Birmingham’s employment, below the national average of 36 percent.

Growth in Birmingham’s existing traded industries has fallen due to a combination of low-skill work and low pay. Many production jobs in these fields also stand to be automated in the future. “Communities without a robust traded industry mix, and the associated ‘employment multipliers,’ can be harder hit by economic recessions,” the report warns.

Business services and distribution and electronic commerce were identified as the city’s top traded industries. In 2015, business services accounted for 22,592 jobs while distribution and electronic commerce contributed 20,098. However, both fields were down from their 2010 numbers.

The report does credit Honda and Mercedes as exemplary sources of outside income. “The recent growth of automobile manufacturing in Greater Birmingham is a strong signal that it can develop as an advanced manufacturing hub,” it notes.

Singh also suggests increased focus on technology-enabled healthcare, which can be conducted remotely in Birmingham for patients around the U.S. Other technology-enabled services like Shipt and Fleetio already serve clients around the country and globe respectively, and have elevated Birmingham’s image as a viable startup environment.

“Life sciences are our crown jewel,” Nugent says. “We have a big patient population here. We’re in the middle of the stroke belt and see a high rate of diabetes, so it’s a great place for clinical trials. We have promising research and high-profile investigators at the forefront of genomics, precision medicine, cancer and diabetes. Birmingham has the capacity to make a footprint in those fields.”

Although there are several effective workforce development initiatives in place already, Building (it) Together quantified the region’s major issues with informed suggestions for the next steps. The report’s organizers have been working with CAEL to turn the study’s vital insight into a thorough implementation plan for 2019. “The information from this study is actionable,” Jackson says. “We’re taking a data-driven approach to talent retention and growth.”

Tom Little and Art Meripol are freelance contributors to Business Alabama. Both are based in Birmingham.

Winning the Plant, Finding the Workforce

The 1,485 workers on the line at Toyota’s Huntsville engine plant will soon be joined, by 2021, by 4,000 workers at the Mazda Toyota assembly plant across town.

As the state’s automotive manufacturers and automotive supplier companies have rapidly expanded in recent years and their work has become increasingly high-tech, the industry has consistently faced challenges in recruiting and retaining enough qualified workers.

Almost 40,000 employees work in Alabama’s automotive manufacturing sector, and now, with Mazda Toyota Manufacturing USA constructing a new, $1.6 billion joint venture assembly plant in Huntsville, the state’s need for qualified automotive workers will intensify. Construction is set to begin in 2019, and the facility will employ at least 4,000 workers, with an annual production capacity of 300,000 vehicles, says Ed Castile, deputy secretary of the Alabama Department of Commerce and director of the state’s worker training agency, AIDT (Alabama Industrial Development and Training).

“The company has said they will need 4,000 people, so we’re planning for that, but in many cases, Japanese companies are conservative on their numbers, so it could be even more,” Castile says. “Before construction even began, we were laying out a process for how we’ll recruit workers and the skills that will be needed.”

Training automotive workers has been an ongoing project for AIDT and its partners since Mercedes-Benz announced it would build its first U.S. plant in Alabama more than 25 years ago. But the demand for 4,000 skilled automotive workers at Mazda Toyota, as well as expanding workforce needs at Mercedes and other Alabama-based auto manufacturers, adds urgency to the task.

Because Alabama has a history of success in recruiting and preparing an adequate workforce, business and governmental leaders say they’re ready to face the challenge. “Toyota Manufacturing [which already operates an engine plant in Madison County] had a great deal of comfort when selecting this site because of their 15-year history in our area with the engine plant,” says Chip Cherry, president and CEO of the Huntsville/Madison County Chamber of Commerce. “They’ve done five expansions, and AIDT was there to help with workforce needs each time. Also, we have a long history of being able to generate a long list of people to interview.”

Neither the city of Huntsville, Madison County nor the state of Alabama made any guarantees regarding the number of workers that could be secured for the new Mazda Toyota plant. However, “we did guarantee that we’d be available to help as much as possible,” Cherry says.

Harnessing Existing Workforce

While more workers are needed to fully staff the new plant, state leaders are quick to point out that a tradition for a strong workforce was one of the selling points that led Mazda Toyota to select north Alabama.

“One reason this area was popular is that there’s a really good workforce in the [Tennessee] Valley,” Castile says. “A lot of people live in north Alabama and drive to Tennessee to work, so it’s a chance for them to stay home and work. In addition, there are three other automotive plants in the state that have been very successful, so we have a track record of finding and keeping good automotive workers.”

Because Huntsville leaders have “chased large projects before,” they knew that workforce would be an important piece of the puzzle, Cherry says. That’s one reason they hired Deloitte to undertake an updated labor study.

“That study showed that we have the capacity to handle an additional 7,000 employees in the automotive sector over the next five years,” Cherry says.

That means other automotive plants — such as the nearby Toyota engine plant — don’t have to worry about experiencing employee shortages when the new factory comes online. “Our definition of success is not robbing Peter to pay Paul,” Cherry says.

There’s room for more skilled jobs partly because many residents are employed in jobs that do not meet their full potential. “There’s a significant pocket of underemployed individuals in north Alabama and southern Tennessee,” Cherry says. “They may not be unemployed, but they’re interested in improving their prospects.”

For instance, when Polaris opened a plant in Huntsville in 2016, about 10,000 people applied for about 450 jobs, and more than 7,200 were qualified to move to the next stage of the process, Cherry says. Similarly, when Huntsville’s Toyota engine plant announced a need for 100 new workers recently, 10,000 people applied.

John Holley, dean of technologies at Calhoun Community College, explains the basics of a piece of automotive tech equipment to Shyanne Lansdell and Chandler Barber. Photo by Dennis Keim

Preparing New Talent

While north Alabama already has a valuable existing workforce, area leaders are also working to train new workers and students to be prepared for the jobs that will be available at Mazda Toyota now and in the future.

“The automotive industry will look completely different in the next five years compared to today,” says Kim Ogle, manager of external affairs at Toyota Motor Manufacturing Alabama. “It is critical to have a workforce that can adapt to change, solve problems and quickly learn new technologies. Stronger partnerships and collaboration between the industry and educators is key for developing and maintaining a talent pipeline. Educators must understand what the industry needs so they can create programs that help develop students to meet the workforce needs. We also need educators to help us overcome misperceptions of careers in manufacturing to help increase interest in the field.”

To help meet an ongoing need for skilled maintenance technicians, Toyota partnered with Calhoun Community College in 2014 to develop the Advanced Manufacturing Technician Program (AMT), Ogle says. The AMT program is a two-year work and study program that allows students to gain industry work experience that aligns with classroom curriculum, making them ready for employment upon graduation. About 12 partner companies now participate to sponsor AMT students, so graduates help fill the gap for skilled workforce needs across the industry, not just at Toyota.

Toyota is also working with AIDT to develop innovative new hire assessment and training programs, Ogle says. For instance, at Toyota’s request, AIDT is ramping up an apprenticeship program that supplies maintenance technicians and other skilled professionals to several local manufacturers and will now prepare more workers.

In partnership with Calhoun Community College, the Federation of Advanced Manufacturing Education (FAME) provides a two-year technical associate degree, along with paid work experience at a local plant and experience in advanced manufacturing technology. The program has operated successfully for several years, and at Mazda Toyota’s request, AIDT is currently working to expand it. A new FAME center will be located in the Alabama Robotics Technology Park, located in Tanner, adjacent to Huntsville, Madison and Decatur.

Along with the FAME apprenticeship program, local community colleges also offer standalone courses and curricula, such as those that will be available at the new plant. “Calhoun, Northwest-Shoals, Wallace State and Drake State community colleges are all gearing up to offer programs in advanced manufacturing to help provide the workforce we’ll need,” Castile says.

High school technical education programs are also part of the effort. When the Alabama Legislature’s 21st Century Workforce Act passed in 2013, it provided $50 million to equip high schools with high-tech equipment to teach students the skills needed for advanced manufacturing and other jobs of the future.

The investment is paying off, Castile says. “We’re one of only a few states in the country that have high school career tech programs that allow kids to graduate high school with industry certifications,” he explains. “Those students are successfully entering the workforce, or going on to college to become high-level engineers. These programs are supporting a wide range of workforce needs that are all important.”

The Huntsville/Madison County Chamber of Commerce has recently developed a plan “to help people select a career path before they select an education path,” Cherry says. “We want to provide opportunities for people who are interested and share the information with schools. With co-ops available, many students can cover the cost of their education and get out of school without debt.”

Assisting with the Recruiting Process

A highly trained workforce will clearly benefit companies across the Tennessee Valley and the state, not just the new Mazda Toyota plant. But at the moment, the new factory is top of mind.

When Mazda Toyota is ready to begin the process of sourcing new applicants, AIDT will help get the ball rolling, just as it has for other automotive plants when requested. “We’ll craft a process for individuals to apply online for jobs, and those applicants will be reviewed automatically and organized into different buckets based on their experience and expertise,” Castile says. “As closely as we can, we’ll match the applicants to the precise skills the company is looking for. Those who are strong matches will be interviewed and go on through the process.”

As construction continues on the plant, education and training continues to prepare its future workers. “We have the workforce to support this,” Castile says. “We don’t just have warm bodies, but we also have specific skills that have been built into this workforce.”

Nancy Mann Jackson and Dennis Keim are freelance contributors to Business Alabama. Jackson is based in Birmingham and Keim in Huntsville.

Pioneering Private Patient Advocates

Diana McKenzie Photo by Dennis Keim

Krista Hughes and Diana McKenzie have a lot in common.

The two women are Alabama’s first private patient health care advocates, a rapidly growing profession formed to find ways to better cope with a health care system plagued by medical errors, such as misdiagnosis, delayed or missing test results, undecipherable medical bills and overworked medical professionals.

Both Hughes and McKenzie have health care backgrounds and have had first-person looks at the problems. And both are admirers of Trisha Torrey, founder and CEO of the Alliance of Professional Health Advocates, a firm that provides information and support to health care advocates nationwide.

As Congress struggles to address health care issues, the Commonwealth Fund, a think tank, recently rated the U.S. health care system as the worst among the 11 developed nations it analyzed as part of an evaluation conducted every three years.

“I had my own run-in with the health care system,” Torrey says. “I had been diagnosed to the point that it had cost me every penny of my savings.”

Torrey was misdiagnosed as having a rare form of cancer when in fact she had panniculitis, or inflammation of fat cells. She says it took weeks to get the cancer diagnosis and weeks to get an appointment with an oncologist who sent her for blood work and a CT scan, both of which came back negative for any abnormalities.

But the doctor insisted she had symptoms of lymphoma and did not have long to live. She contacted another oncologist, and while waiting to see him, began researching her diagnosis, and “it became very clear to me that I did not have cancer, no matter what those labs and oncologists thought.” Three weeks later, after meeting with the second doctor, she received confirmation that she did not have cancer.

Krista Hughes

Hughes, founder and CEO of Hughes Advocacy in Birmingham, says the doctor’s office of a friend with breast cancer forgot to send a biopsy to the lab for analysis and the woman had to wait several weeks to get the results, “with three small children, right during the holidays.

“And then, at the same time, my dad had a medical error occur, so it just so happened that I had two medical errors going on in my life.”

She says her father had a kidney stone and the physician prescribed 90 tablets of painkiller when he needed a medical procedure.

McKenzie, founder and CEO of  McKenzie Healthcare Advocacy in Huntsville, has been in the health care industry for 23 years, as a nurse, a clinical nursing instructor and a legal nurse consultant.

“I have been on the front line of advocacy during those 23 years, and I have seen from the patient’s perspective how important it is for them to understand all aspects of their health care and be treated with dignity and compassion, and they need to know that there is someone that cares and hears their voice,” McKenzie says.

Private patient advocacy is a relatively new profession, Torrey says. “As a profession, we have only been around for nine years. These things take a long time to grow, and especially in health care, where there was a perception up until a few years ago, that well, that I get my health care for free so why should I pay somebody for it?

“People are just now beginning to understand that they are not getting what they need from the system, and so, as perceptions catch up to reality, that is where advocacy is growing.”

“With the way our health care industry is going right now, with all the unnecessary tests and procedures, patients just don’t know where to go and how to navigate their own health care journey,” says McKenzie, who started her business last April. “I talked to a lot of people in my community…and I found a great need for an individual health care advocate.

“A lot of Baby Boomers have a lot of parents who are aging, and they are lost. They don’t know how to handle their health care, what the insurance companies are going to pay, what doctors to use. I just kind of did my own survey in the community and I got a lot of good feedback that this would be a service people would be interested in.”

While the Hughes and McKenzie programs are the only two private advocacy programs in the state, Torrey says Alabama really isn’t that far behind.

“Everything is relative, of course, but Alabama isn’t like New York, LA, San Francisco, Chicago, and Alabama doesn’t have the same older populations as Florida and Arizona do. In terms of smaller population states, and of course much of Alabama is very rural,” Torrey says.

But, she says, Alabama is not any further behind than anybody else.

“As a matter of fact, I would probably tell you that there are more advocates in Alabama than in some other states, like Mississippi or Louisiana or out in Nebraska or Colorado. I would say Alabama is right in the middle of the pack,” she says.

Most patient advocacy programs are modeled along lines of a law practice or an accounting firm.

“Pricing is done in a variety of ways,” Torrey says. “All these folks are independent, so they do it differently, just like lawyers have different kinds of pricing. The pricing is going to be dependent on the services being provided. They are going to charge something very different to negotiate a hospital bill than they are to sit by your hospital bed and spend time in the hospital or to accompany you on a doctor’s visit to help you understand what the drug side effects might be.

“Certified advocates can charge more than non-certified. Certification is brand new in 2018,” Torrey says. “But I can give you a range across the country. The lowest pricing I have seen is between $75 and $100, and we actually have someone who charges more than $400 an hour, and she’s got a waiting list.”

“I don’t ever discuss my fees,” Hughes says. “When my clients call me, I do it based on their diagnoses. I base it on how much time will be involved, like a lawyer. Some people retain me on an as-needed basis, almost like a retainer.”

“What I try to explain is that the hospitals and insurance companies have their advocate, and they are paid by the hospitals and insurance companies,” McKenzie says. “With me, I am paid directly by my client, so my allegiance is to my client. I have a range. The one to two hour consultation is $250.” Fees are based on the amount of time she expects to spend and the client’s financial situation.

Torrey says a decade ago private patient advocates were not always well accepted by the medical community.

“When we got started, physicians didn’t want an extra person in the exam room, they didn’t want somebody by the hospital bedside,” Torrey says.

“What they have discovered is that we make them look good. In fact, we are not there to get in the way of anything medical they are doing; we are there to facilitate what they are trying to do. So we are the ones who can often get a drug approved; we are the ones who can get the insurance company to pay for something; we’re the ones who can keep the Medicare patients from returning to the hospital before their 30 days are up; we’re the ones that are protecting their patients from some sort of medical error.

“When you need legal help, you call a lawyer. When you need tax help you call a tax preparer. When you need medical help, you call an advocate.”

Bill Gerdes and Dennis Keim are freelance contributors to Business Alabama. Gerdes is based in Hoover and Keim in Huntsville.

UAB’s Intensive Care for Rural Clinics

Greenville Mayor Dexter McLendon at LV Stabler Memorial Hospital in his home city. He credits a management agreement with UAB Health System for helping his hometown hospital survive to provide convenient care for local residents. Photos by Robert Fouts

Health care is ailing in many parts of rural Alabama, as the combination of rising operational costs, dwindling local populations and increasing government regulations makes it difficult for some hospitals to remain open. The University of Alabama at Birmingham is attempting to help with the administrative equivalent of a house call.

In late 2017 and early 2018, the UAB Health System entered into management agreements with three rural hospitals in the state: Bryan W. Whitfield Memorial Hospital in Demopolis; LV Stabler Memorial Hospital in Greenville, and John Paul Jones Hospital in Camden. Through these affiliations, UAB comes in and assists with the overall facility operations, including having two members on each hospital board.

“They help with everything,” Greenville Mayor Dexter McLendon says. “They don’t go in there and manage day-to-day. But they give advice and meet with you on a regular basis with suggestions and recommendations. They set up goals and plans for the board to follow to get us where we need to be.”

That’s important, because many rural hospitals in the state currently are far from where they need to be. “The challenges of a rural hospital in Alabama are so numerous that I probably couldn’t list them all,” McLendon says.

The main issue is financial. Alabama is one of 14 states that has refused to accept Medicaid expansion under the Affordable Care and Patient Protection Act, a move that would have decreased the number of uninsured residents in the state.

Yet the uninsured still receive treatment when they are seriously ill or injured, and those bills often go unpaid. That can be a major problem for rural hospitals, which usually serve a higher percentage of uninsured patients and have a lower financial cushion to absorb those costs.

“When (Alabama) declined to take the Medicaid money, it just destroyed our hospital,” McLendon says. “It made absolutely no sense.”

Other factors include the increasing difficulty of finding young doctors willing to live in rural areas, and the escalating complexity of the overall health care system. Hospitals have to report to dozens of regulatory bodies and handle layers upon layers of documentation.

“Health care has become so complex that there’s no way a small hospital can have the expertise to navigate everything,” Whitfield Memorial CEO Douglas Brewer says.

That is where the UAB Health System is trying to help. Through these management agreements, UAB provides access to its wide array of operational personnel for advice and reduces some costs by allowing the hospitals to purchase equipment through UAB’s supply contracts.

“I have the greatest respect for these rural hospital administrators, because I have hundreds of people who I can pick up the phone and ask them to do something for me, and rural hospitals don’t have that,” UAB Health System CEO Dr. William Ferniany says.

“We have such rich resources here. I have an insurance department, a compliance department, a supply-chain department, a strategic-planning department. They can provide help to these rural hospitals that don’t have all these services.”

This includes assistance with insurance, capital, IT issues and doctor recruitment. UAB analyzes data and conducts community-needs assessments to discover the best areas of focus for each hospital. And perhaps most importantly, UAB simply provides guidance to hospital officials who have been unable to keep up with the rapid change in health care over the past decade.

“A lot of it is strategic, business and operational things. But we also give them somebody to partner with and support them,” says Don Lilly, senior vice president for network development in the UAB Health System. “They’re out there on this island with health care moving so fast around them with all these changes going on. Who do they have to lean on?”

McLendon meets with LV Stabler Memorial Hospital CEO Donny Rentfro.

For UAB, these agreements are partly altruistic and partly self-serving. Lilly says the university sincerely wants to improve health care throughout the state. But it also helps UAB if its hospital, which constantly is at or near patient capacity, handles only the more serious cases and doesn’t become bogged down with ailments that could be easily treated at a smaller, rural facility.

“We approach this as a mission-driven endeavor. We feel like it’s our role to care for people all over the state,” Lilly says. “So we thought it was important to work with some of these rural communities to see what we could do to help them.

“By doing that, the goal is to keep as many patients in their home community as possible. Our hospital is full to the gills. We don’t need generic heart patients from other communities. If we can help them figure out a way to take care of those patients locally, it keeps our resources open for the people who really need to be transferred here.”

Or as Ferniany says, “The more patients we can keep in other hospitals, it’s a win all around. The hospitals win because they get the revenue. The patient wins because they can stay closer to home. And we win because it leaves room for the patients who we should really be treating.”

The other winner is the rural community itself, which keeps its hospital — important not only for health care but also for the local economy and business recruitment.

“When you’re recruiting industry — and I’ve met with hundreds of companies over the years — the first two things they ask about are the schools and the hospital,” McLendon says. “It’s not easy to convince a company to come to your town if your hospital is struggling.

“It’s not like UAB can wave a magic wand and make things perfect. This doesn’t solve all the problems. But it does provide a light at the end of the tunnel.”

Lilly says since the agreements began, there have been “seven-figure improvements” in revenue at the Greenville and Demopolis hospitals, while JPJ Hospital in Camden “has been kind of static.” He says UAB receives a percentage of the “bottom line” if it helps create one for the hospital, but until then, “we’re kind of working for free.”

In this case, however, the bottom line is not necessarily the top priority. By keeping these hospitals open, it ensures that rural residents have quicker access to health care, without having to travel an hour or more to the nearest hospital.

“We recently had an 11-week-old baby brought in who was not breathing. We were able to stabilize the baby and get it to Children’s (of Alabama),” Brewer says. “If this hospital wasn’t here, there’s no question that baby would not be alive. So our link to UAB has definitely saved lives.”

Cary Estes and Robert Fouts are freelance contributors to Business Alabama. Estes is based in Birmingham and Fouts in Montgomery.

Alabama’s Surprise Senator Talks Business

Taking time out during a visit to Mobile’s Mitchell Cancer Institute, Sen. Doug Jones shares insights from his first year on the job. Photos by Mike Kittrell

In an era when politics is dominated by the colorful, the flamboyant and the master of one-line putdowns, Sen. Doug Jones presents a very different style.

Quiet, dignified and all business, Jones talks issues rather than personalities, solutions rather than criticisms.

He’s exactly what you might look for in a U.S. Senator from Alabama, except that he’s got the wrong color-coding — a true blue politician in a deep red state.

On fall trips home to Alabama, he attended the groundbreaking for the new Mazda Toyota plant underway in Huntsville, met with healthcare officials at USA Mitchell Cancer Institute in Mobile, chaired a hearing on helping older workers find a niche in the workforce.

And people recognize him. Here and there, people who see him ask for a chance to take a selfie together, and he’s happy to oblige.

While in Mobile, he led a trade roundtable, bringing together leaders from steel and automotive companies, port officials, other heavy industries and a pair of farmers to talk about the ways that recent tariff changes are helping and hurting their businesses.

Jones sat down with Business Alabama shortly after that trade meeting.

“I think there were a lot of consistencies” in what the diverse segments had to say, particularly about the dangers of uncertainty, Jones says. “I thought they were very candid about what the uncertainty created — it just kind of freezes them a bit.”

Growing up in Birmingham when it was a strong steel town, with family members working at U.S. Steel and even trying it briefly himself, he has an ear for the steel industry. “The steel industry has gotten hammered over the last 10 years, especially since 2014,” he says. “I’ve known the effects of steel dumping, primarily from China, so I knew that the tariffs that the president imposed are helpful to the domestic steel industry. And I have no quibble with that. But you have to balance the healthy steel industry with the other effects it could have. I think George W. Bush tried to do that, and it cost more jobs in other sectors than it helped in the steel industry.”

If you could change one thing?
“Do away with straight ticket voting. Force people to look at candidates and issues and not just simply check one box.” Alabama is now one of just eight states that allows straight ticket voting.

And auto leaders want exactly the opposite — lower tariffs on imported steel so they can build more affordable cars. And they’re tired of being called a possible national security threat, which Jones says simply doesn’t make sense to him.

A trade war “has the potential for really hurting probably the most important sector of Alabama’s economy right now. If the prices of automobiles go up, demand’s going to go down, production will go down — and that affects everybody.” Suppliers, gasoline producers and, eventually, even steel producers will feel the effects.

And the farmers, he says, were voicing “a cry for help. Not in the sense of ‘We want a bailout or a handout’ but in the sense of ‘We want to keep our markets.’

“Farmers have a tough go of it anyway,” he says. “They are susceptible to market fluctuations and weather and just about everything that’s completely out of their control.”

While everyone’s needs seem at odds, they agree on one thing, Jones says. “I think the one thing that they are asking for is certainty. They’d like to see the trade war end.

“Everyone wants to protect our workers, our farms, our businesses. But they also want certainty.”

So trade policy has to be balanced and considered, he says. “Unfortunately, the administration doesn’t seem to really have a coherent strategy.”

Talking just a few weeks after the November election turned control of the House to the Democrats, Jones says he believes that Congress can help but added, “Whether we will or not remains to be seen.”

Congress could, for example, rescind the president’s authority to single-handedly manage the “national security” tariffs. It could turn the responsibility for defining national security to the Department of Defense, rather than the Department of Commerce. It could legislate specific trade issues.

And he hopes the change in the make up of Congress will cause more oversight, rather than less.

If you could wave a magic wand?
Expand Medicaid. “I think that would help the people of this state tremendously. We’ve got federal dollars going out of state to other people; they’re not coming back in. And I think it would help the economy. I think it would add jobs, and it would help our rural hospitals stay open and help our communities.”

While the two parties worked in union on the banking bill and the opioid crisis bill, they didn’t really work together on other key issues, like changes to taxes or to the Affordable Care Act.

“Now, I think that, in order to actually move legislation, the House and the Senate are going to have to talk to each other, and they’re going to have to reach across the aisle to do that,” says Jones, “And I think when that happens, that gives you the best opportunity to really get some things done.

“The big question is whether or not people will continue to play the political games” or retreat to their respective corners and yell at each other, in which case not much happens. “But if they say, ‘Ok, here’s an issue that we want to tackle. How can we best do it?’ and go to the give and take of compromise, I think there are some real opportunities.”

To date, he says, the president hasn’t done much but talk about bipartisan leadership; now, he has the opportunity to demonstrate it.

Jones has high hopes for a better political scene.

“If the Democratic majority in the House gets too aggressive in their oversight, and overreaches, it’s going to hurt; it’ll hurt everybody. But if what they’re talking about is doing their Constitutional duty of oversight — because there hasn’t been any oversight of the administration in two years — if they do that in a measured way, in a Constitutional way, and at the same time propose legislation on issues of the day, they can help the Senate minority work with the Republican majority to try to get things done.”

And, says Jones, there is work that needs doing — healthcare, trade, banking, affordable housing, for example.

“But again, it’s going to take people on both sides of the aisle getting past the politics of it and trying to one up each other and instead try to get some things done for the American people.”

It’s a rosy picture, but Jones believes in it.

He’s known Sen. Richard Shelby — Alabama’s senior senator and for many years now a Republican — since the 1970s, and he respects him.

“We don’t always vote the same way on particular issues, but in terms of the bigger picture — about Alabama and jobs and the economy and trying to do things that will bring a positive economic impact to Alabama — we are pretty much in synch.”

“You don’t hear me out bashing Republicans. Shelby’s not out there bashing Democrats. Our floor speeches are trying to find common ground; trying to put forth things that are going to help people.” And, he says, “there’s a lot more bipartisanship going on in the Senate than people see.”

Jones knows that not every decision he makes will be popular but believes it’s better to educate himself on issues and try to vote for what makes best sense. “If you try to just play purely politics, you might as well just be a robot and take a poll every time you want to vote.”

Even if people didn’t vote for him, he says, “I still represent them” and try to do what’s best for the state.

And he hopes people appreciate that, because “I love the job. I am honored to be here. I am humbled to be here.”

It’s been his dream since he started his career working for the late Sen. Howell Heflin.

And he has no intention of quitting.  You can expect to find his name on the ballot in 2020.

Nedra Bloom is copy editor of Business Alabama, and Mike Kittrell is a freelance contributor. Both are based in Mobile.

Moving Day for The Shoals’ Biggest Hospital

The new NAMC will feature a fully accredited chest pain center and labor and delivery unit with two natural birthing suites, plus an array of new equipment. “Our tech will be second to none,” says COO Mike Howard. Photo by Abraham Rowe

With 358 beds and 1,200 employees, North Alabama Medical Center is the 15th largest hospital in the state and the largest in The Shoals.

When Business Alabama spoke with Chief Operating Officer Mike Howard of NAMC in Florence, in late November, he was seven days out from a big day on the calendar. All he had to do was move everything, including patients, from Eliza Coffee Memorial Hospital 2.2 miles down the road to the new digs.

So what was his mood, given such a Herculean task?

“What keeps me up at night right now is ensuring all the elevators in this old building are working on move day,” he says. The core of the old building was constructed in 1943, with the newest addition added back in 1983.   

Like NASA, Howard had plenty of contingency plans in his back pocket. On Dec. 6, moving day, 30 ambulances stood ready to assist in transporting patients, starting at 8 a.m.

“Along with patients, we’ll also be transporting some equipment on move day. Over the past five years, we’ve made capital investments of $5 million to $6 million each year. Most all of the equipment we purchased is on wheels, like beds and IV poles, because we knew we were going to make the move to NAMC,” Howard says. “Each item will be tagged at ECM Hospital with the exact location it will be taken to at North Alabama Medical Center. This entire process is carefully orchestrated and dictated.”

Happily, some of the old building’s equipment doesn’t have to be moved, because updated equipment has already been installed at NAMC. The two buildings are roughly equivalent in square footage, but the new building uses space more efficiently. There will be 43 more patient rooms and larger operating and recovery spaces.

A convoy of trucks was also on hand for moving day to ferry equipment from each ward as the patients are moved. Mock runs were practiced in November, with a few curve balls thrown into each exercise, such as a simulated broken elevator.

Career Notes, January 2019


Northpointe Bank has added Darryl Richardson to its Alabama lending team.


Jeff Long has joined Royal Cup Coffee & Tea as senior vice president of sales, food service and hospitality.

Coca-Cola Bottling Company United Inc. has named Pamela Cook director of multicultural marketing and community affairs for the Central Region.


Stacey Brewer, executive coordinator for Neil Lamb at the HudsonAlpha Institute for Biotechnology, has been appointed board chair for the International Association of Administrative Professionals Foundation.

Clint Lovette


Clint Lovette, of Lovette Design + Build, was named the Home Builders Association of Alabama Remodeler of the Year for 2018.

Hoar Construction Director of Business Development, Alabama Division Clayton McKinnon was recognized by the International Council of Shopping Centers CenterBuild conference as one of its Rising Retail Leaders Under 40 for 2018.

Economic development

Brian Jennings has joined the Birmingham Business Alliance as vice president of economic development.


Auburn University President Steven Leath has been appointed to a three-year term as secretary of the Council of Presidents of the Association of Public and Land-grant Universities.

Shaik Jeelani, vice president for research and dean of Tuskegee University’s graduate school, has been inducted into North Carolina State University’s Mechanical and Aerospace Engineering Alumni Hall of Fame.

Wallace State Community College Director of Information Technology Kirk Nugent has earned the status of certified in Governance of Enterprise IT.

University of North Alabama Police Chief Kevin Gillilan was selected to attend a 10-week FBI National Academy. Joan Williams, director of the Office of Diversity and Institutional Equity, has received the Louis Dale Diversity Leadership Award, presented by the Alabama Association of Higher Education Diversity Officers. In addition, Michael Pretes, professor of geography, has been elected vice president and president-elect of the Association of Pacific Coast Geographers.

The Newcomen Society of Alabama honored University of Alabama at Birmingham President Ray Watts. Also, James Hill has been named chair of the UAB Department of Nutrition Sciences and director of the UAB Nutrition Obesity Research Center. In addition, Jonathan Wiesen has been hired as UAB’s new chair of the Department of History.


Grandbridge Real Estate Capital has hired Richard Alexander Jr. in the company’s Mobile office as vice president. 


The Alabama Grocers Association honored Curtis Lyons as Vendor of the Year and Danny Babb as Wholesaler of the Year. Lyons has served on the AGA’s board of directors for five years and Babb has served for two years.

Marc Miller


Southeast Health has welcomed Devesh Dahale as director of health system engineering and Patti Taylor as director of graduate medical education administration. In addition, Amith Skandhan, an internal medicine hospitalist, has been named to the American College of Physician’s Top Hospitalist list for 2018.

Marc Miller, chief executive officer of Statera Health, is the recipient of Alabama Regent’s 2018 American College of Healthcare Executives Senior Level Healthcare Executive Award.


Ward Muller is the new president and owner of Hydro Technologies of Mobile, which represents manufacturers of HVAC, plumbing and fire protection products. 


Blue Cross and Blue Shield of Alabama has named Ted Hosp executive director of governmental affairs.


Gov. Kay Ivey appointed Assistant Attorney General Monet Gaines as Montgomery County District Court Judge.

Lauren Smith has been named president of Lanier Ford Shaver & Payne PC. She succeeds Ed Starnes, who was president for 11 years.

George Newton II, a partner with Starnes Davis Florie, has been inducted as an associate of the American Board of Trial Advocates.

Tommie Reese Sr., public safety director with the City of Demopolis, has been named the law enforcement coordinator for the Alabama Attorney General’s Office. In addition, A. Clark Morris has been appointed to lead the Attorney General’s Special Prosecutions Division.

Adams and Reese attorneys were recognized by Mid-South Super Lawyers. Those recognized who serve in Alabama offices were Richard Carmody, Charles Pinckney, Stephen Rowe, Aaron McLeod, Russell Rutherford, Andrew Freeman and April Smith.

Balch & Bingham attorneys Chuck Burkhart and Conrad Anderson IV authored the Alabama Construction Law Manual, the state’s first treatise on legal issues affecting the construction industry to be published in more than a decade.

Bradley Arant Boult Cummings LLP has added seven attorneys in its Birmingham office, who are Kaylee Beauchamp, Rachel Conry, K. Laney Gifford, Claire Johnson, Riley McDaniel, Alexander Thrasher and Davis Vaughn. Also, Partner C. Meade Hartfield has been appointed the inaugural chair and founder of the Women in Law Committee of the Alabama Defense Lawyers Association. In addition, Partners Lela Hollabaugh, Lindsey Boney IV and Tripp Haston have been named by Who’s Who Legal as among the world’s leading life sciences attorneys.

Maynard Cooper & Gale has added Mary Mangan and Claire Martin as associates in the firm’s Litigation and Employee Benefits & Executive Compensation practice groups.

Brandon Clapp and Brian Richardson, of Swift, Currie, McGhee & Hiers LLP, were named Rising Stars in the 2018 Mid-South Super Lawyers listing.

Patricia Ryan


Patricia Ryan, executive director of the Jefferson County Library Cooperative Inc., is retiring after 20 years. Replacing Ryan is Tobin Cataldo, a 13-year employee of Birmingham Public Library.


Carol Aiken, clinical operations administrator and privacy and compliance officer for the Smith Family Clinic of Genomic Medicine, was appointed to the Alabama chapter of the American Academy of Pediatrics Practice Management Association executive committee.


Don Comeaux has been named executive director of the Gulf Coast Exploreum Science Center.


Exchange 202, of Mobile, has added Jason McKenzie as director of community engagement.

Stephen McNair, of McNair Historic Preservation in Mobile, has been appointed by Gov. Kay Ivey to serve on the Southern Rail Commission. His term will expire in July 2022.

Jim Page, president and CEO of the Chamber of Commerce of West Alabama, has been appointed by Gov. Kay Ivey to the board of directors of the Alabama Partnership for Children.

Yolanda Sullivan

Yolanda Sullivan, CEO of YWCA Central Alabama, has retired. Sullivan served as interim CEO in 2014 before being named CEO in 2015. She was the fourth CEO in the organization’s history.

Jimmy Dobbs, executive director of Agape of Central Alabama, is retiring after 33 years of service.

Jimbo Meador, conservationist and owner of Jimbo’s Delta Excursions, has received the Alabama Coastal Foundation’s Lifetime of Conservation Achievement Award.


Talladega Superspeedway Chairman Grant Lynch received the Buddy Shuman Award from the National Motorsports Press Association.

Real Estate

Newcastle Homes has welcomed Terri LoBretto as its sales agent for Camellia Ridge in Pelham.

Janice Harper, of Town Square Realty, has completed the final course of the Alabama Realtor Institute. 


Birmingham Children’s Theatre has added Jessie Kisor as the new director of education.

Alabama’s Largest Hospitals 2019

Sources are the Alabama Hospital Association and facilities surveyed.

Click here to view the complete listing.

University Investment in Football Charges South

Stadium planners at the University of South Alabama visited a number of schools with new stadiums, including Tulane University and Colorado State University, for design ideas.

The University of South Alabama has been fielding a college football team now for 10 years, but the field has never been on its campus in west Mobile.

That looks to finally change, as the school’s board of trustees recently charged USA President Tony Waldrop with building a campus stadium. The school’s dream house should come in at the mid-$70 million range and be ready for play by 2020.

The fourth largest four-year public university in the state will become the seventh to invest in an on-campus football stadium. USA’s team has been playing in 69-year-old, city-owned Ladd-Peebles Stadium, home of the annual Reese’s Senior Bowl. UAB, the third largest university, plays now in Legion Field but will break ground this year on a new campus stadium expected to be finished in 2021. Troy University, Alabama A&M and Alabama State all have campus stadiums.

For USA Director of Athletics Joel Erdmann, there’s no shortage of things on the to-do list. USA promptly launched the Get On Campus campaign, an online crowd-funding effort that gives people a way to donate at any level from a few dollars to a few million. You can follow the progress on the university’s website, southalabama.edu and search for stadium fundraising. Parallel to that is a more behind-the-scenes effort to solicit major gifts based on naming opportunities, suites and other premium offerings.

The Mobile County Commission was near the front of the line with a $2.5 million commitment. “We feel comfortable with where we’re at, and we believe now that the County Commission has sparked it a bit, people will gravitate toward the project,” Erdmann says.

The school will do its own construction management for the project, led by Associate Vice President for Facilities Management Randy Moon. Using USA’s architects and craftsmen will save close to 15 percent off the top of construction, planners say.

“Now that we’ve been able to publicly declare we’re pushing the button, we’ll be shifting to sales mode very quickly,” Erdmann says. “We’ll be unrolling all the opportunities to be involved in this through winter and into the spring.”

Perhaps mindful that Mobile sports fans can sometimes be bargain-minded, planners are being sensitive to fair pricing. Erdmann says time was spent looking at other stadiums in the Sunbelt Conference and Conference USA. Jaguar football prices won’t be the most expensive or least expensive by comparison, but will offer “a quality product on a beautiful campus.”

Playing football on campus will allow for many advantages, not the least of which is welcoming visitors who may not have seen USA lately. “The fruits of this labor will go beyond my time and our time. It will mean graduates who bring children to campus, who in turn bring their children. We want to start to grow those traditions.”

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