The Yazoo County Health Department will reopen next week after nearly nine months.
As Mississippi’s health care infrastructure continues to crumble, the reopening could mean more access to health care in Yazoo County.
However, what services will be offered is unclear. The Mississippi State Department of Health’s communications department declined to answer specific questions about the health care services provided at the Yazoo health department, instead directing Mississippi Today to a general list of services offered at county health departments.
Spokespeople did not respond by press time as to whether all of the listed services, which include breast and cervical cancer, domestic violence and rape, and other services for women and mothers, are offered at Yazoo in particular.
Yazoo County is a maternity care desert – it has not had labor and delivery services since the early 1990s, and there are no practicing OB-GYNs. All county health departments stopped accepting maternity patients in 2016.
Spokespeople also declined to answer questions about Yazoo’s staffing levels and how long it was closed, though its website says the Yazoo health department has been closed for renovations since September of last year.
According to the department’s press release, the county health department won’t be open full time — it’ll only operate Tuesdays and Thursdays from 8 a.m. until 5 p.m.
The state health department has closed 10 county health departments in the last decade. Nine of those were closed in 2016, when the state health department’s budget was slashed. In remaining county health departments, hours and services have been reduced.
State Health Officer Dr. Daniel Edney requested money from the Legislature this year to increase nursing staff levels at county health departments across the state, but lawmakers did not appropriate those funds.
County health departments are typically funded through a combination of county, state and federal money, Edney said in an interview with Mississippi Today.
“We utilize all the resources we can from our federal partners to help the county health departments, but the (Centers for Disease Control and Prevention) does not fund public health at the county level,” he said. “It’s up to us to do that, and we just don’t have enough state funding.”
Currently, most nurses at county health departments are paid through federal dollars, which have strings attached, Edney said. He needs state money so nurses have more freedom in the services they can provide.
Though Edney said the need for county health departments has decreased over the decades as health care has improved, Mississippi’s health care infrastructure is in trouble.
A third of hospitals are at risk of closure, one report says, and hospitals have shuttered service lines across the state.
“We need every partner that we can get,” Edney said. “The county health department, it should be an incredibly valuable resource.
“Everybody has this mentality of how it used to be in the 1960s, that every county health department was fully staffed and open five days a week. The funding just isn’t there anymore.”
The renovated county health department has new doors and bathrooms, as well as ADA compliant access and parking. A press release from the Mississippi State Department of Health said an updated lab and clinic areas would allow for better patient flow.
After a ribbon cutting and open house on Monday afternoon, the clinic will officially resume operations on Tuesday.
DeSoto County officials believe they’ll need at least 10 years to move off Memphis’ sewer system, as a federal judge’s decision looms over how and when the connection will cease.
Memphis notified Southaven, Horn Lake, and unincorporated parts of DeSoto County in 2018 that it intended to not renew a 48-year contract between the entities. But it wasn’t until a judge’s ruling earlier this year that the termination process officially began.
Since 1975, the Mississippi towns have sent their sewage to Memphis through a local body called the Horn Lake Creek Basin Interceptor Sewer District. But the sewer district, on behalf of the Mississippi towns, and Memphis have each sued the other in the last few years over whether or not the contract would, in fact, end.
Memphis leaders said in 2018, when it sent the notice, that the city wanted to focus more of its resources towards its own residents’ wastewater, and no longer wanted the burden of assisting the growing suburbs to the South.
The initial 1975 contract says that the agreement “shall remain in effect for forty (40) years from the date hereof and at the expiration of said time shall be subject to review and change agreeable to both parties.” In 1983, the two sides agreed to extend the deal until 2023.
In Southaven, where the population has grown from 15,000 in 1980 to about 55,000 in 2020, Mayor Darren Musselwhite said that the two sides had different interpretations of the contract, and it wasn’t until a judge’s ruling in March that confirmed that the deal will expire this coming September. He said about 75,000 connections in DeSoto County are using the Memphis sewer system.
Southaven Mayor Darren Musselwhite. Credit: City of Southaven
“(The sewer district) disagreed with Memphis in 2018 that the contract would end, they felt like the contract said it would be renegotiated,” Musselwhite said. “So that’s what we’ve been waiting five years on to know.”
Now, after the two sides failed to reach a settlement, U.S. District Judge Mark Norris will issue a final ruling over how many more years, and at what billing rate, Memphis will continue to handle the Mississippi towns’ wastewater.
Memphis is arguing that the new system — which would fall under the already-existing DeSoto County Regional Utility Authority, or DCRUA — could be built within seven years, while Musselwhite and the sewer district believe it would take to 10 to 12.
“I felt like Memphis was very ridiculous in some of their comments,” the mayor said. “It’s a major project.”
He said that DCRUA will have to redirect and pump the water to the new facility. With its current setup, DeSoto County benefits by being on an uphill slope from Memphis, making it easier to send the city its wastewater.
The biggest obstacle, though, is funding. The sewer district estimates it’ll cost $230 million to build the new system.
Sen. David Parker, R-Olive Branch Credit: Gil Ford Photography
So far, the state Legislature has allocated $12 million for the project, Sen. David Parker, R-Olive Branch, told Mississippi Today. Parker said the local entities will put up about $9 million of initial funding. Musselwhite said the district will look for about $50 million in piecemeal federal support, including from recent infrastructure bills, $50 million from the state, and then pay for the rest with bonds and low-interest loans.
Another point of dispute in the ongoing legal battle is how much customers in Southaven, Horn Lake and the other areas should have to pay. Memphis charges other suburbs, such as Collierville, Lakeland, and Millington, a wholesale rate of $3.32 per 1,000 gallons, while only charging the DeSoto County sewer district 96 cents per 1,000 gallons, the Commercial Appeal reported. While Memphis argued the district should pay what the other suburbs are being charged, the district’s attorneys said there’s no reason to change the way the rates have been calculated for decades.
Parker, whose district includes the towns receiving Memphis’ sewer service, recently authored a bill attempting to create a regional utility authority for Jackson, which would’ve put most of the decision-making power in state leaders’ hands.
“I think the Memphis system will miss us… will miss the revenue,” Parker said. “It may not be in my lifetime, but when things degrade over time, as a lot of the metro cities are suffering the same kind of financial strife and having to make major repairs.”
Parker added that lawmakers may try to redirect state money that could have gone to Jackson towards DeSoto County.
“My thought is that since Jackson got $800-plus million (in a recent federal investment), when we were looking at maybe having to give them a large sum from the state, maybe some of that money we anticipated going to Jackson can go to DeSoto County in the future,” he said.
Sen. John Horhn, D-Jackson, said that Parker’s comment ignored the fact Jackson still needs financial support for its wastewater system, a need the city has estimated to be $1 billion.
“I do think it’s ironic that the same legislators who were so against putting resources into Jackson’s wastewater problems are now planning to come to the Legislature for their wastewater woes,” Horhn told Mississippi Today. “If they are successful, I think that would show a double standard exists in the Mississippi Legislature.”
“I think from my standpoint, I’m standing ready to promote funding for Jackson’s wastewater issues even if it means trying to amend legislation for DeSoto County,” Horhn said. “The local government’s failure to prepare for this contract ending reminds me of the local leadership’s decision making in Jackson with the garbage contract.”
A federal lawsuit has been filed saying a new Mississippi law will make it more difficult for the elderly and disabled to vote.
Republicans sponsors of Senate Bill 2358 say it is designed to prohibit what they refer to as “ballot harvesting.” The bill prohibits anyone other than election officials, postal workers, commercial carriers, household members or caregivers from providing voter assistance and submitting an absentee ballot. Under Mississippi law, only certain people, including the elderly and disabled, can vote early or via mail. But to vote by mail, a person has to go through multiple steps, including requesting a ballot application before receiving the actual ballot.
“Voters — especially those with disabilities — depend on the assistance of community groups, friends, and neighbors,” Peg Ciraldo, co-president of the League of Women Voters of Mississippi, said in a statement. “Now these neighborly efforts are being criminalized, and Mississippi voters in need of assistance are being silenced. Democracy in Mississippi cannot be whole when these voters are disenfranchised.”
The lawsuit was filed in federal court in the Southern District of behalf of a group of Mississippians and the League of Women Voters of Mississippi by the Southern Poverty Law Center, Mississippi Center for Justice, American Civil Liberties Union, ACLU-Mississippi and Disability Rights Mississippi.
“Mississippi voters with disabilities will be barred from receiving assistance from the people they trust – and some are likely to be disenfranchised,” the lawsuit reads.
The lawsuit is timely, those filing it say, because state and local elections are slated later this year, with party primary election set for August.
A violation of the new law is punishable by up to one year imprisonment and a fine of $3,000. The lawsuit says the new state law violates federal elections law.
When he signed the bill into law, Reeves said, “Mississippi is taking another step toward upholding the absolute integrity of our election process by banning ballot harvesting across the state. This process is an open invitation for fraud and abuse and can occur without the voter ever even knowing.”
The Republican leadership of the Legislature passed multiple bills during the 2023 session they said were designed to maintain “the integrity” of the election process. Others argued the bills would make it more difficult for Mississippians to vote. One required local election officials to purge voter rolls if people do not vote during a a specified time.
Under the bill, people who do not vote in one of two presidential elections in a four-year period or in any other election between those national elections would be mailed a card asking them to confirm they still live at the same address. If they do not respond to that card, they would be required to vote affidavit in the next election.
People who vote by affidavit — with their vote accepted as still residing in the voting district — would be considered a voter in good standing. But if they do not return the card or take no voter-related action over a period of two federal elections they would be removed from the registered voter list.
Democratic 2nd District U.S. Rep. Bennie Thompson and his Louisiana counterpart are requesting data about the massive layoffs at Ochsner Health System to ensure Black workers and other minorities were not disproportionately impacted.
Thompson and U.S. Rep. Troy Carter of Louisiana penned a letter to Ochsner CEO Pete November last week. The layoffs, which represented about 2% of the health system’s workforce, spanned both Mississippi and Louisiana.
“While only you can make your business decisions, historically these types of actions have disproportionately affected women, and minority communities including Black, Asian, and Hispanic individuals,” the letter stated.
Rep. Bennie Thompson (D-Miss.) departs a House vote at the U.S. Capitol July 14, 2022. (Francis Chung/E&E News/POLITICO via AP Images)
“We write today to ensure that the actions taken align with the rights guaranteed by the Constitution, including Equal Protection under the Fourteenth Amendment, Title VII of the Civil Rights Act of 1964, applicable labor practices and fundamental fairness.”
Thompson and Carter requested specific data, including demographics of the layoffs sorted by race, gender and age; parish of laid off employees; and downsized positions by number, classification and salary.
November on Thursday wrote back to Thompson assuring him that the decision-making process was “deliberate, organized and thorough” and included “ … significant input from legal counsel – to ensure that all our workforce reduction decisions were based on legitimate and objective criteria tied to the business needs of the organization, and that there were no improper disparities in our workforce reduction based on race, gender, or age.”
November also repeated what he said in a memo announcing the layoffs: the positions primarily affected were management and non-direct patient care roles, and employees with clinical credentials were offered frontline patient care roles with an incentive package.
He referenced the current nationwide nursing shortage and said he is hopeful that employees who were laid off will move into “full-time frontline roles.”
“We are already working with many clinical employees who have expressed interest in continuing their career at Ochsner, and we have rehired a significant number of affected employees to bedside positions,” he wrote. “ … We are hopeful that many impacted employees who have been in largely administrative roles will move into full-time frontline roles, and we continue to recruit for several hundred unfilled frontline nursing roles across our system.”
At the end of the letter, November said his team is willing to meet to discuss the specific information Thompson requested.
When the layoffs were announced last month, a spokesperson for Ochsner Health declined to answer Mississippi Today’s question about how many of the affected positions were in Mississippi.
Ochsner Health has dozens of operations in Mississippi, many of which are in the southern part of the state and on the Gulf Coast.
The cuts are expected to save between $125 million and $150 million a year, according to NOLA.com, and is the largest such reduction in the hospital system’s history.
Thompson referred to the “significant federal assistance” Ochsner received in the form of federal pandemic funds and said that constituents have been reaching out to his office.
“The letter was sent in response to the layoffs. They have received significant federal assistance, and we want to ensure that through this phase of reduction, they are fair to all employee concerns,” he said in an emailed statement to Mississippi Today. “As these layoffs occur, we want to ensure that they are fair to the employees. Constituents have reached out to our offices numerous times.”
He did not answer whether he has asked for similar information from companies in the past.
Carter’s office did not respond to questions and a request for comment from Mississippi Today.
Read the full letter from Thompson here. Read November’s reply here.
The University of Mississippi Medical Center will dissolve the LGBTQ+ clinic that came under lawmakers’ scrutiny last fall because it offered gender-affirming care like hormone therapy and puberty blockers to trans minors.
About 67LGBTQ+adults who have received services at the clinic this year, from routine check-ups to gender-affirming care, will be affected. It’s unclear if trans adults will be able to receive gender-affirming care at other UMMC clinics.
The co-director of the center that oversees the TEAM clinic said he felt “completely blindsided” by the decision to close operations on June 30, which was made without him, and worries about the ethics of suddenly closing a specialized clinic for a marginalized group of patients.
“This is an institution responding in fear not responding in reason,” said Alex Mills, a tenure-track professor of pharmacy at University of Mississippi and the co-director of the Center for Gender and Sexual Minority Health. He oversaw operations at the TEAM clinic. “It’s demoralizing and dehumanizing to the LGBTQ community.”
The surprise decision is “based in part” on a legislative committee report released last month that included recommendations for steps UMMC could take to shutter the pioneering TEAM, or “Trustworthy, Evidence-based, Affirming, Multidisciplinary,” clinic, wrote Dr. Alan Jones, the associate vice chancellor for clinical affairs, in an email Thursday morning.
“UMMC will cease operations of the clinic at the end of this academic year, June 30, 2023, read Jones’ email to clinic providers. “All patients who are currently scheduled will be contacted by phone in the coming days about this change. Please work with your department chair to ensure a smooth process during this change.”
UMMC did not respond to questions about the future of clinic patients’ care by the time this story published.
Services for trans kids have been limited at UMMC since executive leadership decided the clinic should stop seeing minors after lawmakers complained, according to emails obtained by Mississippi Today. Then the Legislature passed House Bill 1125 earlier this year, banning gender-affirming care for trans youth entirely.
By Thursday afternoon, the webpages for TEAM Clinic and the Center for Gender and Sexual Minority Health had been taken down from UMMC’s website.
“They are erasing us,” Mills said.
He has several new patients scheduled for their first appointment at TEAM clinic tomorrow — now he doesn’t know what he’s going to tell them.
Immediately after receiving the email, Mills wrote to Jones’ assistant requesting a meeting, hoping to ask if UMMC could postpone the shutdown for 90 days to give patients a smooth transition.
Mills got an email back from Brian Rutledge, Vice Chancellor Dr. LouAnn Woodward’s chief of staff, Thursday afternoon. His request was denied.
“Dr. Jones is not able to meet, but UMMC will be handling everything regarding the UMMC TEAM clinic and its patients,” Rutledge wrote. “After this point, I would encourage you to work directly with your UM School of Pharmacy chair or dean on how this impacts your practice responsibilities within your faculty role there.”
Mills said his department chair’s request to meet with Jones was also denied.
Since the decision was made without him, Mills said he doesn’t know what leadership’s transition plan entails.
He’s planning to write up a letter to give to patients tomorrow, but he doesn’t know if UMMC leadership has already made one. He doesn’t know who will be notifying his patients, what they will be told or the kind of care UMMC will give them once the month is up — or even who will be their providers.
He doesn’t know what will happen to the clinic space or to the three grant proposals he just submitted.
“Why isn’t that being communicated to the people who run the damn clinic?” Mills said.
The legislative committee report, published by the Joint Committee on Performance Evaluation and Expenditure Review, or PEER, recommended that UMMC could dissolve the TEAM clinic by “integrating services” back into the medical center’s regular care setting and offer “optional LGBTQ training courses to all staff and students.”
Even if UMMC fully follows PEER’s recommendation and continues to provide gender-affirming care for trans adults, Mills said he doesn’t know if it will be done in a respectful and dignified manner. What made the TEAM clinic unique, Mills said, is that it is a dedicated space where LGBTQ+ patients could be assured that every employee, from the receptionists to the nurses, believe trans people exist and would use the right pronouns.
That’s why the clinic was cofounded in 2015 by Dr. Scott Rodgers, who is now UMMC’s associate vice chancellor for academic affairs: To try to help LGBTQ+ Mississippians overcome one of the biggest barriers to care they face, which is finding providers who respect their sexual and gender identity.
A 2019 press release from UMMC emphasized the clinic’s unique mission: to “ensure every Mississippian has access to accepting, high-quality and holistic primary health care” regardless of their gender identity or sexual orientation.
Mills feared this was going to happen ever since UMMC leadership decided the clinic should stop providing care to trans youth after lawmakers complained last fall. When that happened, Mills said he at least had some input.
“Mind you, it was secretive, but we had a meeting to discuss a plan, at least, that was appropriate and ethical,” he said. “But this is just not how leaders should work. It’s not how you should be conducting yourself in any workplace. It’s just a really big slap to the face.”
Now he is concerned that even if the TEAM clinic is shut down and its services are dispersed across the medical center, it still won’t be enough to appease lawmakers.
“They are trying to erase a group of people,” Mills said. “If they find out it’s going to be throughout other clinics, people are now going to complain and say all of UMMC is doing this.”
RAYMOND — Gov. Tate Reeves refused to answer a question Wednesday about why he has not fulfilled a pledge to give away campaign donations from people who have pleaded guilty to multiple state charges involving Mississippi’s massive welfare scandal.
The first-term Republican governor running for reelection told reporters at a Hinds County event that he will eventually donate at least $6,000 that he received from Nancy and Zach New, two central figures in the scandal, to a charity once the ongoing criminal and civil cases involving how federal welfare funds were misspent have concluded.
But Reeves, at the same event, ignored a question from Mississippi Today seeking to clarify why, exactly, he’s waiting for the litigation to conclude to return the funds when the News pleaded guilty to multiple criminal charges at the federal and state levels more than a year ago.
“… You don’t get to follow around and ask the governor questions,” Reeves said in a tirade about Mississippi Today, refusing to answer the original question and several follow-ups.
Note: Audio of Reeves’ full response can be found at the bottom of this article.
In April 2022, the News brokered a plea deal with federal and state prosecutors, where the two defendants pleaded guilty to counts of bribing a public official, fraud against the government and wire fraud in exchange for cooperating with federal investigators.
The ongoing investigations by state and federal officials are unlikely to change the News’ guilty status.
The impetus for lingering questions about their donations to the governor stems from a 2020 press conference Reeves conducted, where he promised to place the contributions in a separate bank account from his primary campaign accounts.
But Reeves admitted on Wednesday that he had not transferred that money into a separate account, and it remains stowed away in his campaign coffers that total more than $9 million.
“It currently continues to be in the same account,” Reeves said in response to a WJTV reporter’s question. “We have probably five or six different accounts situated through Friends of Tate Reeves as well as Tate for Governor, and those monies, $9,000 or somewhere in that range, will be refunded at the appropriate time.”
The News also pleaded guilty to separate federal charges that involved bilking millions in taxpayer funds for their now-shuttered private school — the same private school Reeves showcased in a 2019 campaign ad.
Reeves’ campaign has reused the 2019 campaign footage in recent ads for his current bid for the Governor’s Mansion.
The governor on Wednesday criticized the press for asking why he would continue using footage from a school previously operated by people who have pleaded guilty to several crimes. Still, he ultimately said his campaign decided to include the video because it made for “a good picture.”
“I presume that the fact that those videos were shot over five years ago, and for whatever reason, I guess whoever did the editing decided that it was a good picture,” Reeves said. “And that’s the reason they put it in the campaign ad.”
Democratic gubernatorial candidate Brandon Presley has continued to attack the governor for his connections to people caught up in the scandal and for failing to adequately provide oversight to the state’s welfare agency during the eight years he served as lieutenant governor.
Presley again criticized Reeves at a campaign event in Tupelo on Thursday, though the governor has not been charged with any crime and has denied taking any part in the scandal.
Note: Click below to listen to the audio of the May 31 interview with Gov. Tate Reeves. WJTV senior political reporter Richard Lake and Mississippi Today’s Taylor Vance were the two reporters asking questions.
Mississippi spends more annually on beaver control — $1.1 million — and regulating cosmetologists — $1 million — than it does on monitoring ethics in state government, at $730,000 a year.
Penalties for leaking info about a Mississippi Ethics Commission complaint against a politician or filing one with false info carry jail time and hefty fines.
But actually violating most of Mississippi’s ethics, conflict of interest, open meetings, public records and campaign finance laws carry no jail time or felony charges. Fines start as low as $50 and can be waived.
How can you tell it’s statewide election time in Mississippi?
Because there’s talk of reform, ethics, transparency, preventing corruption and getting to the bottom of the latest mega-thievery scandal plaguing the Magnolia State. This time it’s tens of millions of welfare dollars meant for the poorest of the poor that were stolen or misspent.
But corruption is like the weather in Mississippi — lots of people talk about it, but nobody ever seems to do anything, unless it’s the feds doing one of their once-a-decade or so roundup operations. State lawmakers have been loathe to enact meaningful reform, transparency or oversight of the intersection of politics and money. This leaves the door wide open for corruption.
Mississippi’s campaign finance and lobbying laws are extremely confusing, conflicting and lax, but that’s almost beside the point. Alleged violations are seldom investigated or enforced. The attorney general’s office appears to be the only state agency with clear authority to investigate and enforce, but it almost never does. AG actions on campaign finances or lobbying over the years have been so rare that, when they do happen, they bring outcry of selective enforcement.
Mississippi allows politicians (except some judges) to take unlimited campaign contributions from individuals, LLCs and PACs. Unlike some other states, Mississippi has no general “pay-to-play” prohibition on campaign contributions from people or companies doing business with government.
Unlike many other states, Mississippi has no “gift law” banning or limiting how much money lobbyists or others can spend on “gifts” for lawmakers.
Mississippi politicians are supposed to at least accurately report the money they receive, but this is enforced with the same fervor and similar penalties as jaywalking laws. And unlike most other states, Mississippi politicians’ reports are not electronically searchable. Transparency has never been Mississippi government’s strong suit.
Bribery of a politician is, ostensibly, illegal in Mississippi, but the state has a long-running tradition of leaving any enforcement of that up to the feds.
This statewide election cycle has already brought allegations of campaign finance law violations.
Mississippi’s campaign finance laws are aimed at providing transparency to the voting public and limiting the corrosive influence of big money in politics. But the laws are a confusing, often conflicting patchwork that’s been piecemealed into the state code books without providing clear authority. The secretary of state’s office is responsible for receiving campaign finance reports, but serves mainly as a repository, with no real investigative or enforcement authority. The Ethics Commission, after some changes to laws in recent years, appears to have some authority, but it’s really unclear.
“It’s a mess,” state Ethics Commission Director Tom Hood said of Mississippi’s campaign finance laws. “Changes have been made multiple times over multiple years, and it’s like trying to put together a jigsaw puzzle that doesn’t fit.
“For instance, (state code) 23-15-803 says the Ethics Commission can impose penalties on political committees,” Hood said. “But then it refers to another section of law that doesn’t appear to apply, and it doesn’t say what our authority is or give us a process.”
In other states, ethics commissions have more authority, funding and staff. In Alabama, for instance, its Ethics Commission receives more than $3 million a year in funding, and has about 20 employees. Mississippi’s has six employees — including only one investigator for the whole state — and for the coming year was budgeted at $730,000.
Alabama in the mid-1990s reformed and revised its ethics laws and gave its commission clearer authority. Violations of that state’s ethics laws carry prison sentences up to 20 years. Over many years, Alabama has seen numerous public officials and employees who run afoul of its laws fined, removed from office and-or jailed. For example, former Gov. Guy Hunt was convicted and removed from office for using $200,000 from his inaugural fund for personal use. Former Gov. Robert J. Bentley pleaded guilty to campaign finance violations, resigned, was given a suspended sentence and agreed to a lifetime ban on running for office in Alabama.
Hood said he’s not pushing lawmakers for large increases in funding or authority for the Mississippi’s Ethics Commission. But he would like for laws and responsibilities to be clearer, particularly with campaign finance issues.
“Somebody needs to have clear authority and responsibility to enforce the law — that would be a good first step,” Hood said. “… If you want to prevent somebody from stealing, then you should promote transparency. I feel like our laws do a pretty good job of that, except for campaign finance.”
What should have been a lifeline for Mississippi’s struggling hospitals is proving to be out of reach for the facilities that need it the most.
State lawmakers approved sending millions of dollars to save Mississippi’s struggling hospitals during the session, but now many hospital leaders are running into difficulties trying to access that money.
A third of Mississippi’s rural hospitals are at risk of closure — many of them were counting on the state grants to survive the year.
Legislators in February established the grant program, part of Lt. Gov. Delbert Hosemann’s plan to “save rural hospitals,” in lieu of expanding Medicaid. A month later and just days before the end of the legislative session, they decided on the amount: $103 million to be disseminated among the state’s struggling health care providers.
It was millions less than the Mississippi Hospital Association had advocated for — despite a $4 billion surplus in the state budget — but health care leaders said they would take what they could get.
Hospitals were allocated varying amounts through a formula that accounted for bed counts, hospital designation, emergency rooms and other factors.
But there was a hitch — the money wouldn’t come from the state general fund. Instead, it would come from American Rescue Plan Act funds, federal money meant to ease the financial hits taken by the pandemic.
Timothy H. Moore is the President/CEO of the Mississippi Hospital Association. Credit: Vickie D. King/Mississippi Today
MHA director Tim Moore, whose organization helped craft the program, said it wasn’t clear then how much the source of the money would affect hospitals’ ability to access it.
“I think the Legislature felt that it would not be a problem … to get the money out,” he said. “We were looking at them actually cutting grant checks to the hospitals. When ARPA money was applied, that changed the whole thing.”
ARPA funds can only be used to cover COVID-related expenses, and many hospitals have already claimed those federal pandemic reimbursement dollars. Expenses claimed through ARPA cannot have been claimed under any other federal and state reimbursement programs, rendering the grant money useless to many Mississippi hospitals.
According to Paul Black, CEO of Winston Medical Center in Louisville, that makes the grant bill more of a reimbursement bill.
“I don’t know who came up with the bright idea to use ARPA money. If they did, they definitely did not understand what that meant to this program,” he said.
“It’s just extremely frustrating that one of the pieces of the legislation … is one thing and the appropriations is something completely different. I don’t understand how they can do that, I really don’t.”
Gov. Tate Reeves, who sent out a release emphasizing his role in the program’s passage, declined to comment about the grant situation.
In a statement sent to Mississippi Today after this story published, Hosemann said, “Our intention was to provide $103 million to hospitals based on a formula related to type of operation and bed count to help stabilize them. If any hospital is shorted because of complications with the federal ARPA structure of the grant, I will support legislation at the beginning of the Session to make up the difference.”
House Public Health Chair Sam Mims, author of House Bill 271 which funded the program, did not respond to a request for comment.
Senate Medicaid Chairman Kevin Blackwell, author of Senate Bill 2372 which established the program, deferred questions about hospitals’ issues with the grant program to state Health Officer Dr. Daniel Edney.
The state health department is tasked with distributing the funds, and because it’s now tied to federal ARPA funds, has to work with the state department of finance and administration to do so, Edney said.
During the bill process, Edney said the health department pointed out the pitfalls of using the ARPA money.
“Federal money … doesn’t take up state resources from other places,” he said. “The downside is it has to follow federal guidelines versus state general funds.”
One of those downsides has already become clear: The allocation based on hospitals’ number of licensed beds has been struck, on account of federal guidelines. That means hospitals, if they get money at all, will definitely be getting less than expected.
Sen. Hob Bryan, D-Amory, expresses his concerns about a potential state lottery during a special session of the Legislature at the Capitol in Jackson Thursday, August 23, 2018. Credit: Eric J. Shelton, Mississippi Today/ Report for America
Senate Public Health Chair Hob Bryan said he’s received questions about the grant program from hospital officials and others, and that he still doesn’t have all the answers.
“I’ve asked questions, and I’m still confused,” Bryan said. “I talk with A, and A says one thing, then I talk with B, and B says something else.”
“I think there’s a lot of confusion over whether a hospital would have to have already spent money on COVID expenses and can be reimbursed, or whether they can spend in the future. One of the things I’ve been told is that if you are improving things at your hospital to deal with COVID, or to prepare for the next COVID, then you will be eligible under the regulations.
“Hospitals’ reactions appear to be, ‘That’s all well and good, but I’m going broke and this says I can spend more money and get reimbursed, but that doesn’t help me right now,’” Bryan continued.
Bryan said he believes questions and confusion about the program are in part because of the hasty, secretive process Mississippi legislative leaders have used to set budgets in recent years.
“We do everything in secret, and then put it all together at the last minute,” Bryan said. “Transparency, like say, in conference committees and the rest of the process might help, in that issues like this could be identified and addressed before it’s passed. Discussing these things more in the open could provide better results … Of course, we had the House refusing to negotiate on this or anything else because they were holding out for tax cuts, then they tried to do everything in the last 36 ½ minutes.”
Black agreed that hammering out funding details at the last-minute likely contributed to this oversight — an oversight that’ll have grave consequences for state’s hospitals.
“We got all these legislators that are patting themselves on the back for doing something for the hospitals,” Black said. “When it comes out, they didn’t do anything. At least for us to get what was promised in the Senate bill is not what is taking place now.”
Some of the state’s larger hospitals might be able to get their hands on some of the money. But it’s less likely that the state’s smaller, rural hospitals, who are in much more dire financial straits, will be able to.
“The whole intent of this was to help small rural hospitals,” Moore said. “That’s going to be much more of a challenge.”
Winston Medical Center was set to receive a little less than a million through the grant program. Because of the funding complications, the hospital actually won’t get anything at all.
“Unless the Department of Health comes up and finds out some way to get around some of the issues … as things sit right now, there’s no avenue for us to claim any money,” Black said.
The money would’ve been enough to cover about a month’s worth of payroll, Black said, but in the larger scheme of things, it would’ve helped Winston stay open until the end of the year and staunch the “slow bleed.”
Winston, though, is in a far more stable financial state than many other rural hospitals.
Before the grant money and a big credit line approval, Greenwood Leflore Hospital was weeks from shutting down. It’s not clear how the new developments will affect its financial viability.
Greenwood Leflore Hospital’s interim CEO Gary Marchand discusses the challenges facing the hospital at Greenwood Leflore Hospital in Greenwood, Miss., Tuesday, February 14, 2022. Credit: Eric J. Shelton, Mississippi Today
Gary Marchand, the hospital’s leader, said it was too early in the process to answer Mississippi Today’s questions, but said he believes the complications caused by the ARPA funding will just slow down when the hospital will receive its allocation.
“We understand MSDH is moving quickly,” Marchand said.
Hospitals can apply for the money during a one-month window that starts June 1. Edney said once a hospital’s application is approved, he’s hoping to get the money over immediately.
However, Black is more cynical about the reality of the situation.
“That’s what they said when they passed the bill back in April, and now it’s the end of May going into June,” Black said. “If anybody gets it by September, it’ll be a miracle.”
Unless a special session is called to address the funding issue, Moore and Black are looking toward the next legislative session for help. They’re hoping that most hospitals survive until then and that state leaders come around to seeing the economic advantages to expanding Medicaid in Mississippi, which would bring millions of dollars to the state’s hospitals.
“The analogy I keep thinking about is Charlie Brown, Lucy and the football,” Black said. “Lucy holds the ball for Charlie Brown to kick, and at the last minute, she pulls it back. He falls on his rear end.
“That’s what this has been like.”
Reporter Geoff Pender contributed to this story.
Editor’s note: This story was updated after publishing with a statement from Lt. Gov. Delbert Hosemann.
