Abrupt terminations at the Mississippi Department of Health earlier this month removed the directors of about a dozen preventive health programs from their posts, according to staff members who were laid off. 

The layoffs included roughly 20 people in the Offices of Preventive Health and Health Disparities, many of whom were program leaders. Some worked at the health department for nearly two decades. 

Terminated directors included those responsible for leading chronic disease prevention, diabetes, cardiovascular health, cancer, school health, tobacco control, injury and violence prevention, heart disease and stroke prevention, and oral health programs, among others. 

Mississippi has one of the highest rates of preventable diseases in the country, including heart disease, hypertension, obesity and diabetes. These conditions disproportionately affect Black Mississippians, and contribute to the state’s high infant and maternal mortality rates. 

Selma Kelly-Alford is among the agency’s leaders who was fired. The bureau director for language access at the health department, Kelly-Alford was laid off on Oct. 1 after five years working at the agency. 

“We were making a great impact,” she said. “…Not all the work happens in the clinic. You know, in order to educate people, we need to learn how to really target those communities appropriately.”

Staff members were also laid off in the department’s Strategic Planning and Response division, formerly the Office of Emergency Preparedness, amounting to a total of about 30 layoffs, said spokesperson Greg Flynn. 

The decision to lay off staff members was made largely due to federal funding reductions, State Health Officer Dr. Dan Edney said after the Board of Health meeting Oct. 8. 

He also estimated that about 150 contract employees were ordered to stop their work as a result of the ongoing federal government shutdown. Non-essential, federally funded contract workers have since been terminated, Flynn told Mississippi Today. 

The reorganization will save the agency about $20 million, Edney said Oct. 8. That figure includes staff layoffs, termination of contract workers and paused federally funded contracts with subgrantees, according to Flynn. 

The changes will not affect the agency’s core public health work or the Women Infants and Children’s (WIC) Nutrition program, Edney said. 

In spite of the federal funding reductions it faces, the health department does not plan to ask for a funding increase from the state Legislature next year. 

Edney said he hopes the staffing changes will result in the agency’s preventive health division providing more direct services to Mississippians on Oct. 8.

“Our programmatic areas should be there to make things better and improve outcomes,” he said. “When I’m not seeing improved outcomes, there will be changes, and I have not seen improved outcomes.” 

The Offices of Preventive Health and Health Disparities host a range of programs to improve the health of Mississippians and address inequalities in the health department’s policies and procedures, according to the health department’s website. 

Programs the offices administer include providing free rides to county health department appointments, training community health workers, educating the public on chronic disease prevention, and providing interpretive services to people with limited proficiency in English receiving agency services. 

Kelly-Alford said she worries the staffing reductions – which removed the employees most familiar with the agency’s preventive health programs – could undermine the initiatives she and others have developed.

“Will it stand?” she said. “Will somebody else come and pick up the pieces?” 

The agency has no concerns about its ability to continue preventive health work, Flynn said. 

The health department provided few language services in 2019 when Kelly-Aford joined as coordinator for the language access program, she said. 

She said she has spent the last five years “building it up, creating the program and really working to make sure that the community was really obtaining those benefits.”

Organizations that receive federal funds are required to provide people with limited English proficiency “meaningful access” to programs and services under Title VI of the Civil Rights Act. During her tenure, the division established a language line to provide interpretive services to county health departments, certified about 130 interpreters and implemented a language access plan, she said. 

Today, health department providers use about 20,000 minutes of interpretive services each month to serve patients, she said. Interpreters trained by the health department serve their communities in hospitals, social work settings and schools.  

“We’ve come such a long way,” she said, noting that the agency was not in compliance with Title VI regulations when she began.

Kelly-Alford was not given a reason for her termination on Oct. 1. 

About a week before the layoffs, a report published by the Office of State Auditor Shad White alleged the health department failed to properly monitor $290,000 worth of taxpayer funds directed to the Office of Preventive Health and Health Equity.

“The state must stop handing taxpayer dollars to nonprofits with vague goals and then failing to monitor what these nonprofits do with it,” said White in a released statement. “The government is wasting so much money.”

Edney has not named the audit as a reason for the layoffs publicly. But a person outside the department who was briefed on the firings and spoke to Mississippi Today under the condition of anonymity to discuss internal agency decisions previously said the downsizing was partially linked to issues outlined in the report. 

Kelly-Alford said her work did not overlap with the grants mentioned in the report. She said it felt important to speak up to avoid being associated with alleged mishandling of federal funds. 

“I’ve worked hard to build my name,” she said. 

At the Oct. 8 press conference, Dr. Edney said the department should do more to eliminate health disparities and improve population health outcomes than simply process federal grants. 

“The area should be doing a better job taking care of people and not just taking care of grants,” he said.

Health department subgrants are not the responsibility of a single person. Several staff members must approve them before they are signed off by Edney, including those cited in the auditor’s report. 

Kelly-Alford said her termination at the health department does not diminish her commitment to providing language access services to Mississippians. She said she is strategizing on how to continue to provide interpreter training to the bilingual community. 

A huge part of public health is preventive health, she said, which includes educating providers and patients about available resources and implementing programs that deliver services to communities. 

“Without it, you’re kind of going in a circle.”