When Department of Mental Health Executive Director Wendy Bailey discussed a Mississippi bill to require audits for community mental health centers in January in the Senate Accountability, Efficiency, Transparency committee, she told lawmakers the performance audits would help them learn more about the health needs of the state.

“Issues that are revealed through a performance audit can also help you see what areas of the state there’re gaps in services, and there may need to be more funding or additional things looked at,” she told the Senate committee on Jan. 28. “It really should be a positive thing, not a punitive thing.”

Left out of Bailey’s testimony was that the bill, which passed its first chamber Feb. 12, would simultaneously eliminate a key process designed to ensure Mississippi provides the public with mental health service information and oversight into how Bailey’s agency operates. 

In addition to tasking Bailey’s department with creating performance standards by which to measure community mental health centers at least once every two years, the bill axes an independent mental health state oversight office. Created by the Legislature in 2020, the office operates from the Department of Finance and Administration and is tasked with comprehensively reviewing Missisisppi’s mental health system.

Bill Rosamond has served as coordinator since the office was created. In that role, he publishes reports four times a year about gaps in mental health access and the state of Mississippi’s community mental centers. Current state law gives the coordinator the power to examine and make recommendations on how to improve access to Mississippi mental health, substance misuse and intellectual and developmental disabilities services. 

“It allows investigation into essentially every area of mental health services in our state,” Rosamond said of the legislation that created his position to Families As Allies Executive Director Joy Hogge in a 2020 interview. He did not respond to emails from Mississippi Today asking for his thoughts on this proposed law. 

Hogge, an advocate who has worked with people seeking mental health services for over three decades, said she was initially concerned about Rosamond in that interview. She said she had worried about his past working relationships with the state’s mental health department and how that could impact his oversight of that agency. 

When the federal Department of Justice sued Mississippi in 2016 and accused the state’s mental health system of violating the Americans with Disabilities Act, Rosamond worked at the Mississippi Office of the Attorney General and helped defend the state. 

But Hogge told Mississippi Today that since Rosamond took office, she and other advocates who pay attention to Mississippi’s mental health system have found his reports and monitoring valuable for revealing unmet needs in the state. Recent reports have focused on the lack of public intensive treatment options that don’t involve overnight hospitalization, problems with people accused of crimes being psychologically evaluated for their ability to stand trial and why chancery clerks were reporting inconsistent data as to how many people were jailed while awaiting mental health treatment.

She also didn’t know of any other office tasked with monitoring the Department of Mental Health.

“Every entity needs something outside of itself to hold it accountable,” Hogge said. 

Sen. Nicole Boyd, a Republican from Oxford and the bill’s sponsor, told Mississippi Today the Legislature created the mental health accessibility office because of the 2016 federal lawsuit, and the state in 2023 successfully argued the Department of Justice couldn’t enforce this part of the Americans with Disabilities Act. Because of that, there is no longer a need for the office, Boyd said.

A court transcript from shortly after the Legislature created Rosamond’s office indicates that U.S. District Court Judge Carlton Reeves, who oversaw the case, thought the position would impact the case, but neither he nor the parties asked for it to be created. At one point, he expressed concern that the person who fills the position could “blow up everything” he and the lawyers had worked for.

When former House Public Health and Human Services Chair Sam Mims, a Republican from McComb, spoke about the bill that created Rosamond’s office on the House floor in 2020, he did not bring up the federal lawsuit. 

Instead, he used similar language to how Bailey described this year’s bill; some of Mississippi’s community mental health centers are struggling, and the mental health accessibility coordinator could help the Department of Mental Health better work with the centers. 

“We really believe this is going to help our constituents and really provide the mental health services that our citizens have been needing,” Mims said.

Nearly six years later, Boyd said she and other state lawmakers get similar information to the quarterly reports Rosamond’s office writes from the Department of Mental Health, and it didn’t need to spend taxpayer money for duplicative services. When asked who the independent entity would be monitoring the Department of Mental Health, she said the Legislature would do that. 

“We don’t need to be paying another half-million dollars to another entity,” Boyd said. “We don’t do that for any other agency.”

Other Mississippi agencies, like the Department of Child Protection Services, have independent monitoring because of court appointments for ongoing cases.

Boyd also said that Bailey and the State Board of Mental Health have for years asked for a bill to more formally monitor the community mental health centers. The centers operate independently, but the Department of Mental Health sets standards and allocates funding for them. In budget hearings earlier in the session, the department asked for an additional $4.2 million for the centers for the upcoming fiscal year.

In addition to mandating audits of community mental health centers, the bill would oust some executive staff of centers that don’t meet performance standards six months after a failed audit. Those roles would temporarily be replaced with contractors chosen by the Department of Mental Health. 

When discussing the bill on the Senate floor, Boyd compared it to the state’s ability to take over school districts when issues arise.

“My community mental health center is very in support of this legislation,” Boyd said to the other senators. “Many community mental health centers are in support of this legislation.” 

Melody Madaris, executive director of the community mental health center in Boyd’s district, said she didn’t want to speak directly about the legislation. She said she supports transparency and accountability of mental health services, and she believes organizations like hers already cooperate with strong oversight from organizations like the Department of Mental Health.

The state agency conducts regular site visits to all of its certified providers, including community mental health centers, and requires them to implement quality assurance measures.

“I feel like we have multiple layers of oversight,” she said.

When Mississippi Today reached out to the mental health department about the bill, department spokesperson Adam Moore did not address concerns about the elimination of Rosamond’s office. In an email, he said the agency continues to be committed to transparency even after the state overturned the federal government’s 2016 lawsuit, and it publishes data about programs and services it funds. 

For the part of the bill that calls for additional community mental health center audits, Moore said the proposed language would formalize the department’s oversight of these health services. He pointed out that multiple centers have had to consolidate in recent years. 

Phaedre Cole, president of the Mississippi Association of Community Mental Health Centers and executive director of the center that serves most of the Delta, disagreed with Moore that these types of audits could have saved other organizations from collapsing. In an email, she said it was because of the financial hardships that come with serving Mississippians regardless of their ability to pay for care — hardships that have been furthered by recent funding cuts. 

She echoed Madaris that the state mental health department has broad regulatory power already, and state law tasks local governments with overseeing most community mental health center responsibilities. This bill, she said, does not address the underlying financial reasons why public community mental health services may not reach all Mississippians. 

“If CMHCs are going to continue fulfilling our role as the state’s safety net provider, funding resources will need to match that obligation,” she said.