Amtrak, freight rail companies and the Port of Mobile have struck a deal that will bring back passenger trains to the Mississippi Gulf Coast, connecting Mobile to New Orleans.
A joint statement from all parties – Amtrak, CSX Transportation, Norfolk Southern Railway Company and the Port of Mobile – says they “collectively reached an agreement” that supports both freight trains and passenger trains running in the Gulf Coast Corridor.
“This is going to happen,” said Southern Rail Commissioner Knox Ross. “Everybody has to do what they said they’d do, but this will be a tremendous boost for the Gulf Coast.”
The settlement agreement was filed Monday. The federal board tasked with deciding the route’s future was scheduled to vote on the years-long dispute in December. The board had asked the parties to first attempt mediation.
The proposed route would run two trains daily with stops in Bay St. Louis, Pascagoula, Gulfport and Biloxi. Amtrak hasn’t run a Gulf Coast route since Hurricane Katrina.
Ross said the details of the agreement are confidential and he doesn’t have a timeline of what to expect. A copy of the settlement agreement filed with the Surface Transportation Board had specifics redacted but stated the settlement terms will “completely resolve the dispute” after “several conditions are met in the coming weeks and months.”
Amtrak first filed its complaint with the Surface Transportation Board over a year ago, asking the body to step in to settle the dispute over access to the freight-owned tracks.
In the joint statement, the parties ask the board to pause the case as they work through the agreement.
Board members have sat through days worth of testimonies about the track’s ability to support both passengers and freight trains over the last several months. Had the parties not settled, the board’s Dec. 7 vote would have determined the route’s future.
Amtrak had always maintained the route could handle the added passenger train traffic, freight companies and the Port of Mobile worried it could negatively affect business.
The debate largely pitted Alabama officials against Mississippi leaders who have long championed the return of a passenger route to the Gulf Coast as an economic boon.
“Since Katrina, these downtowns have been rebuilt and become very attractive,” Ross said, referring to the Mississippi cities on the proposed route. “And this will bring people right to their front door.”
The State Board of Education has named a North Carolina educator and Mississippi native as the next state superintendent.
Robert Taylor, a native of Laurel, will serve as the next state superintendent of education. Credit: Mississippi Department of Education
In a press release, the department announced Robert Taylor as the new leader of Mississippi’s 140 public school districts. His appointment ends a monthslong search after former State Superintendent Carey Wright stepped down from the position in June.
Taylor was most recently a deputy state superintendent for the North Carolina Department of Public Instruction. Originally a native of Laurel, he earned his bachelor’s degree from the University of Southern Mississippi and has worked in North Carolina schools since 1992. He has served as a teacher’s assistant, classroom teacher, school administrator, and in various district leadership positions before becoming the superintendent of Bladen County Schools in 2011. He served in this role until 2021 when he became a deputy state superintendent.
During his time in North Carolina, Taylor also helped to draft legislation restructuring state testing in public schools and served on multiple public education advisory boards, according to the release.
“The opportunity to return home to Mississippi and work hand in hand with all stakeholders to improve education is perhaps the pinnacle of one’s career,” Taylor said in the MDE statement. “This opportunity has been afforded to my family and I and we look forward to our homecoming.”
He will start the position in late January 2023, according to the Department of Education release. Until then, Interim State Superintendent Kim Benton will continue to serve.
Taylor is the state’s second Black superintendent; the first was Henry L. Johnson, who also came to Mississippi from North Carolina in 2002.
The Mississippi Department of Education told Mississippi Today Taylor will be paid $300,000 annually, the same amount his predecessor, Wright, was paid.
The state board selected McPherson and Jacobson, a national superintendent search firm based in Nebraska, to conduct the search. The firm received $51,200 for its services.
“Dr. Taylor possesses all the qualities the Board sought for the next state superintendent of education,” Rosemary Aultman, chair of the State Board of Education, said in a statement. “Mississippi has become a national leader for improving student outcomes. The Board is confident we selected the right person to lead our state to achieve at even higher levels.”
The bleak outlook for hospitals across the state, especially those in rural areas, was highlighted Monday during a hearing of the Senate Public Health Committee.
While possible solutions were discussed, senators indicated that long-term fixes might not be coming during the upcoming 2023 session.
State Health Officer Daniel Edney told committee members that 38 rural hospitals across the state “are in danger of immediate closure or closure in the near term.” Some of those hospitals are larger regional care centers, such as Greenwood Leflore Hospital.
Edney said nearly all of 111 hospitals across the state are facing financial difficulties with many areas – particularly in the Delta and some parts of southwest Mississippi – becoming “health care deserts.” Edney, representatives with the Mississippi Hospital Association and others have been warning of the crisis facing health care in Mississippi for some time caused in part by rising costs and changes in the structure of health care in the nation – all of which have been exacerbated by the COVID-19 pandemic.
The Public Health Committee met Monday to be updated on the crisis and to hear possible solutions.
The Hospital Association offered six possible steps that could be taken to help the hospitals survive – ranging from increasing the state-federal Medicaid supplemental payments to hospitals, to eliminating the taxes hospitals pay to expanding Medicaid. Of those steps, the one that would not require legislative action and is most likely to occur would be the state Division of Medicaid seeking federal approval to increase payments to hospitals.
Tim Moore, chief executive officer of the Hospital Association, said all of those steps are needed to increase the financial viability of the state’s hospitals. But according to a Hospital Association chart handed out to senators, expanding Medicaid is the options that would provide the most benefit. Medicaid expansion would provide a financial boost to the hospitals, while improving the state economy, based on multiple studies. It also would benefit Mississippi citizens by providing health care to primarily the working poor.
During the committee hearing, Sen. Brice Wiggins, R-Pascagoula, said Medicaid expansion would not solely fix the problem facing the hospitals. Richard Roberson, vice president for policy with the Mississippi Hospital Association said, “it might not solely fix it, but I would argue it would go a long way.”
Wiggins replied, “It would go a long way because it would provide a revenue stream for hospitals, but 10 years down the road could be another situation.”
But Roberson said in the meantime, people, primarily the working poor, would have access to health care other than a hospital emergency room. Under current law, hospitals are mandated to provide emergency services regardless of a patient’s ability to pay.
Medicaid expansion would cut down on more expensive emergency room care while providing Medicaid expansion beneficiaries the opportunity for preventive care from primary care physicians, Roberson said. In addition, Medicaid expansion would substantially cut down on the amount of uncompensated care – about $600 million a year and increasing – that hospitals currently incur because there would be fewer uninsured patients being treated.
After the meeting, Sen. Dennis DeBar, R-Leakesville, when asked about the possibility of expanding Medicaid in the upcoming 2023 session, responded, “Why are you asking me about that?” DeBar then added it might be pointless for the Senate to try to take up the issue while the House leadership and Gov. Tate Reeves are entrenched in their opposition to Medicaid expansion.
Sen. Kevin Blackwell, R-Southaven, who chairs the Senate Medicaid Committee, said after Monday’s Public Health Committee hearing that he remains opposed to Medicaid expansion. He said Medicaid provides less money to medical providers for the services rendered than private insurance. He said he would prefer other options, such as helping poor people purchase private insurance.
The federal government pays 90% of the health care costs for those covered by Medicaid expansion – those earning up to 138% of the federal poverty level or about $19,000 annually for an individual. Whether the state could develop a Medicaid expansion substitute where the federal government pays the bulk of the cost for private insurance is not known.
At any rate, Blackwell said it probably would be the 2024 session – after 2023 statewide elections – before such options are considered.
In the meantime, Edney pointed out there is a growing area in the state where there is no hospital to deliver babies. He said that only worsens Mississippi’s position as the state with the nation’s highest infant mortality rate.
Edney said the state Department of Health would try to step in as a last resort “safety net” in those areas lacking adequate health care.
Mississippi’s growing health crisis threatens to close at least a dozen hospitals across the state and puts Mississippi in the lead nationally for rates of uninsured people.
Mississippi Today launched an ongoing series looking at the impact of the health care crisis on the people and institutions of the state.
As part of that project, Senior Political Reporter Geoff Pender answered readers’ questions on Reddit about Medicaid expansion (or the lack thereof) in the state. Here’s a recap:
Q: Thank you for doing this and continuing to push on this topic.
As I sit here seeing the Greenwood hospital closing while the governor touts tax breaks for companies and the state government refuses this aid… I just do not get it.
Unless I think of all of the non-rational reasons for it.
A: Unfortunately, we are hearing from many corners that Greenwood may be the canary in the coal mine right now. We have heard some dire predictions of late from state hospital and other officials. State Health Officer Dr. Edney recently warned that we’re looking at at least half a dozen hospitals on the brink, and others are saying our entire system is troubled. I don’t know that Medicaid expansion would be the panacea for all that, but most experts are saying the influx of billions of federal dollars for health care would stave off many of these problems.
Q: As the Q&A article describes, there are political and economic arguments against expansion, but what in your opinion are the underlying motives for the stance? Are the politicians perhaps more driven by financial incentive from opposition groups in addition to maintaining their political platforms for the sake of the party? And as for general people, do you think it’s related to a mentality of being against handouts and of “pulling yourself up by your bootstraps”? What do you think are the underlying feelings and motivations to these stances?
And lastly, how do you think these underlying reasons can be negotiated with to make progress towards achieving expansion?
A: As far as the current drivers of opposition to expansion, I would say they are now more political than economic, and have been so for quite a while. For one thing, we have empirical evidence from other states, including now Louisiana and Arkansas, that show expansion isn’t the budget-buster our leaders once feared.
We also have reams of studies and evidence from other states showing we would see net positive benefits – thousands of jobs created, savings of double-digit percentages in uncompensated care for hospitals, more workforce participation (ours is typically lowest in the country), net GDP growth and even projected growth in population. Also, we’ve seen firsthand over the last two years that Mississippi, with our economy so heavily dependent on federal spending, sees booming state budget growth when there is an influx of billions of federal dollars. We’re sitting on more than $2 billion in basically surplus state money right now, largely the result of the influx of federal pandemic spending.
And again, this expansion is aimed primarily at the “working poor,” people in the gap between being poor enough for other help or being able to afford private insurance or pay medical bills out of pocket. As many have pointed out, a lot of the folks we’re talking about with this are working more than one job. As for pulling one’s self up by bootstraps, too many folks are one ER visit away from not having any bootstraps, and once someone gets a chronic illness because of lack of preventive care, it costs taxpayers anyway (and more).
No, the opposition now would appear to be more purely political (partisan) and philosophical – not wanting expansion of “Obamacare,” and opposition to expansion of a government program, even if in the long run it’s projected to benefit the workforce and private sector.
That opposition to government programs, however, appears to be selective among state leaders. One recent anecdote struck me in particular. Gov. Reeves recently held a press conference to trumpet the state’s work on expanding broadband internet across rural Mississippi. This is being funded with federal tax dollars. Instead of lamenting such government largesse, Reeves vowed to see that “we not only get our fare share, but that we get more than our fair share.” It would appear it’s OK to take hundreds of millions of federal dollars for internet service to areas where the private sector won’t do it, but not OK to take federal money to help keep people alive and well and working.
As for how this opposition might be overcome – I don’t know that anyone has a simple answer to that. One thing I hear all the time, though, even from some who have opposed expansion, is time. I have heard over and again in recent years that it’s probably just a matter of time before Mississippi expands Medicaid. Polling in recent years would indicate the populace may already be a bit ahead of our politicians on this policy … and, of course, look at other states relenting, such as Arkansas, Louisiana.
We attempted to delve into some of this opposition, past and present, here.
Q: Can Medicaid expansion prevent local hospitals from closing?
A: It’s unclear if it definitely would — rural hospitals in particular are facing major headwinds with personnel shortages and costs, supplies, inflation, uncompensated care. But most projections by experts have shown net benefits, and we’ve seen in other states that expansion helped. Particularly, in Louisiana, rural hospitals saw reductions in uncompensated care costs in the 55% range. This alone could give struggling rural hospitals some breathing room.
This study indicates hospitals in expansion states are less likely to close.
Q: With Medicaid expansion costing far more than initially predicted in other states, it delivering consistently poor health outcomes for those on the program, and it failing to ultimately help save rural providers as seen in Colorado and Indiana…why advocate so intensely for expanding a program that’s heading toward insolvency besides the fact that it will pad the pockets of and expand profits for big hospitals?
A: As for costing more than predicted, as I understand, this has not truly been the case at least on the state level. Some states have seen more people than initially predicted, but that has also been offset by people shifting from their traditional Medicaid to that with the higher match rate from the feds, and other non-direct economic benefits.
As for Colorado, I just recently read a report that rural hospitals there are “about 6 times less likely to close than hospitals in non-expansion states, according to a study by researchers at the University of Colorado Anschutz Medical Campus.” I’m not sure what you are looking at, but would like to see it if you can forward a link.
As for poor health outcomes, I’m not sure Mississippi would have anywhere to go but up. Mississippi Medicaid has had poor health outcomes, but that has been primarily because only the sickest of the sick, so to speak, are on its adult population. Proponents say that the working-poor expansion population would receive more preventive care and improve outcomes — but you are right, that has been one major argument against expansion in Mississippi.
I don’t know that expansion would pad the pockets and profits of big hospitals. It would help ameliorate the $600 million or so in uncompensated care that is hammering, in particular, smaller rural hospitals.
In Belhaven on Sunday night, members of Mississippi’s LGBTQ community solemnly placed roses on a blue, pink and white flag as they read aloud the names of 70 trans people killed in the last year in the U.S. – a figure that’s almost certainly an undercount.
Gatherers flipped through a booklet with pictures of those who had been killed, including including four Black trans and gender non-conforming people in Mississippi: Mel Robert Groves, 25, from Jackson; Kesha Webster, 24, from Jackson; Shawmaynè Giselle Marie McClam, 27, from Gulfport; and Jimmie “Jay” Lee, 22, from Oxford.
“That weighed heavy on me,” Jensen Luke Matar, a trans community organizer, said after the final name was read aloud. “You look at those names, you look at those ages, you catch those cities – the ones you have connection to, the ones you were born in. Some right here in Jackson, in our backyard.”
“This is real y’all, this is real lives,” he continued. “You recognize how many trans and non-binary people are in this space right now? That could’ve been any of us.”
The emotional ceremony was organized by several Mississippi-based LGBTQ organizations and nonprofits as part of Transgender Day of Remembrance, an annual, international vigil to highlight violence experienced by the community. For more than two hours, gatherers laughed, cried, shared resources and sought not just to mourn but to celebrate their trans community members who are still living.
Across the country and in Mississippi, trans people face an epidemic of violence, the brunt of which is borne by Black trans women. This violence is rooted in a web of anti-trans forces, experts say, including an increasingly hostile political environment, widespread misconceptions about trans people and prescriptive cultural and religious beliefs – all of which are present in Mississippi.
At the vigil, four faith leaders spoke, including Reverend Lance Presley from Broadmeadow United Methodist Church.
“I want you to understand this: If there’s no way to understand scripture or tradition or anything else as affirming and celebratory of trans identity, of trans lives, of trans people, then the scripture is wrong, then the tradition is wrong,” he said.
Last week, Tate Reeves’ unveiled priorities for next year’s legislative session include a “Parental Bill of Rights,” which he described enabling parents to determine what pronouns their children should be called in public school.
A report by the National Center for Transgender Equality notes that just over 25% of trans people killed this year lived in Texas and Florida, two states that have passed prominent anti-trans legislation.
Following the service, there was a reception with cupcakes made by Tayla Carey, a trans woman whose brother, a well-known Black, LGBTQ student at Ole Miss named Jay Lee, was murdered earlier this year. Several of Lee’s friends drove down from Oxford for the vigil.
Carey shared a poem she had written for Lee, tearing up because it was the first time she’d read it aloud.
“Your spirit will be with me always,” she said. “When I see a bird chirping on a nearby branch … I will know it’s you singing to me. When a butterfly brushes so gently by me and so carefreely, I will know that it is you assuring me that you are free from pain. When a gentle fragrance of a flower catches my attention, I will know that it is you reminding me to appreciate the simple things in life.”
Some of the resources that were shared at the memorial included: Sarah Schnaithman, a trans lawyer in Amory, Miss.; the TRANS Program, which advocates against anti-trans legislation, assists with gender marker change applications and provides peer support; Grace House Services, a transitional home for individuals with HIV/AIDS; the ACLU of Mississippi; Capital City Pride; and Awakening Love, a trans-led nonprofit that provides short-term financial assistance.
Transgender Day of Remembrance was started in 1999 to honor Rita Hester, a Black trans woman whose murder still has not been solved. In a 2020 article about Hester’s life, NBC News noted that “for many in the trans community, the day is the only annual gathering they have.”
On Friday, Sept. 9 – the 11th day of the water crisis in Jackson, Miss., and weeks into a citywide boil water notice – I went to brush my teeth.
I was at my apartment in Belhaven, one of the oldest and wealthiest neighborhoods in the majority-Black capital city. With the day off work, I had planned to drive to a suburb of Jackson to wash my clothes, thinking the laundromats in town were still affected by the crisis. Getting ready to leave, I turned on my bathroom sink faucet; for a second, the stream of water ran normally before it sputtered, lost pressure and turned a shockingly dark, coffee-colored brown.
My reaction was to turn off the faucet.
Earlier that week, I had seen a picture on Twitter of a bathtub, supposedly in Jackson, that was full of opaque, black water. Without more context, I had dismissed it as fake, but I wasn’t doubting anymore. I turned on my shower – it also sputtered before the water turned the same dark brown. I tried my sink again. Still brown. Then I flushed my toilet; it lurched away from the wall. I opened the lid to see chocolate-colored water slowly filling the bowl.
I took a video and posted it on Twitter with the caption, “My water just now in Jackson, MS.”
Within minutes, I was getting hundreds of retweets. That turned into dozens of direct messages, emails and phone calls from reporters around the world requesting to play the video on TV that night, and literally thousands of replies all asking the same question: What was in my water, and why was it that brown?
I had the same questions. Like all of my coworkers at Mississippi Today, I had been covering the crisis since it began on Aug. 29, but I wasn’t reporting on the condition of the water system or treatment plants.
Still, I thought I’d be well-suited to get the answers as a journalist. But more than two months later, I still don’t know what, exactly, was in my water, or why it turned brown. I’ve talked with experts in water quality and city officials – they gave different answers. The experts say that discolored water is a natural phenomenon in aging water systems, though the pipes in my building could’ve contributed. City officials are adamant my brown water was “an isolated incident,” but we obtained records showing people across the city had experienced similar brown water during the height of the crisis.
The city also said they were going to test my water, but after weeks of back and forth with me, they admitted they never did.
But the first call I made that day was to my landlord’s front office. I wanted to know if other properties in Belhaven were affected or if my unit, a 1940s quadruplex, was the only one.Though the pipes in Belhaven are decades old, much of the neighborhood is downhill and nearby J.H. Fewell, the city’s secondary water plant – as a result, the homes here are often better able to weather water-related crises than those in other parts of the city.
The office manager answered the phone. Multiple properties were affected, she said. The water in Nejam Properties’ office in Belhaven Heights, a sister neighborhood on the hill across Fortification Street, was the color of “weak coffee.”
“That’s all to do with the city of Jackson and the boil water notice and stuff like that,” she said in a way that seemed intended to be reassuring.
Even before Gov. Tate Reeves declared the water emergency in a late-night press conference on Aug. 29, there was widespread confusion in Jackson about whether the water was safe to drink. Despite months of on-again, off-again boil water notices, many people, including myself, had been using the water normally. The mayor, Chokwe Antar Lumumba, had repeatedly questioned if the most recent boil water notice, which had been imposed by the state in July, was necessary.
This lack of clarity from both the city and the state continued throughout the crisis, making it hard for many Jacksonians to know what to trust. Reeves’ initialpress conference did not include Lumumba or anyone from the city – and the very next day, Lumumba disputed several of Reeves’ comments, including an alarming statement that raw flood water had entered the O.B. Curtis treatment plant and was flowing into people’s homes.
In my apartment, the first clue as to what happened came a few hours after I posted the video. That afternoon, I learned my neighbor directly beneath me on the north side of the buildinghad been getting brown water in his kitchen sink for a week if he used hot water. But on the south side, my neighbors still had clear water, albeit with low-pressure. An expert later told me this could indicate an issue with the pipes inside my section of the building – something my landlord, not the city, would be responsible for.
My water cleared up the day after I posted the video on Twitter, but it continued to gain views. By Monday, it had been watched more than 10 million times. That afternoon, I looked through my Twitter DMs.
One message stood out. It was a request from the City of Jackson’s account. They asked for my address so they could come test the water.
I could send it, I replied, but I wanted to know why they were asking.
“… If the water is that brown… we want to get the address to Public works and the health department to find the reason why,” they responded.
“Gotcha!” I wrote back before sending my address. Since I work from home, I said the city could come by any time.
“Ok…,” they wrote. “I’m going to give that address to our public works person… and hopefully they’ll be able to determine what the heck is going on.”
After some back and forth, the city’s Twitter account asked if my water was still brown.
“Can we get a sample of it? (I’m asking per our public works director)”
The next morning, I ran into three city contractors on the sidewalk outside my apartment. They weren’t there to test my water but to install new meters.
I showed them the video. Gesturing down at the water meter, one of the contractors remarked that their work wouldn’t prevent the discolored water from happening again.
Jackson, he said, needs to re-pipe the whole city.
The exchange prompted me to check in with the city’s Twitter account.
“When do you think y’all will send someone over?” I asked at 9:42 a.m.
Six hours later, the city replied, “Hey Hey!!!! I think they went out there this morning…”
That was my last exchange with the city’s Twitter account, but I would learn – when I reached out to the city a month later – that Public Works never tested my water.
Meanwhile, at Mississippi Today, we were trying to do our own test of my water – an effort that proved fruitless.
Our health editor, Kate Royals, had been researching how to test water and found a private lab in Ridgeland, a suburb of Jackson, called Waypoint Analytical. We ultimately submitted three tests to Waypoint over the course of a month, for a total of $137.
The first sample, which I took the same day I posted the video, had puzzling results. That Friday afternoon, I talked to the lab manager who told me I needed to collect 100 milliliters of water and could put it in Tupperware, the only clean container I had at home. We had decided to test my water for E. coli and “total coliform,” a type of bacteria used to indicate the presence of pathogens.
The water was still dark and turbid when I turned it into the lab, but the results they sent us a few days later showed the water was too dark to test.
“The sample could not be read for Total Coliform due to the dark coloration of the sample interfering with the Reading,” the results said.
So six days later, the day the boil water notice was lifted, we tried again.
The second test came back with high levels of total coliform but no E. coli. But I had committed two possible user errors. One, my Tupperware container might’ve introduced bacteria into the sample. Two, I didn’t flush out the line by running the bathroom sink faucet before taking the sample, the water-testing protocol generally recommended by the Environmental Protection Agency.
Nearly another month passed before we could get a third and final test. This time, I got more guidelines from the lab and followed them to a tee, cleaning my faucet with bleach (which yielded more brown sediment) and running the water for one minute before collecting it in a sterile container and placing it in a bag of ice.
It came back with no bacteria detected. But that’s not the full story.
One expert I later consulted, Francis de los Reyes – a professor of environmental engineering and microbiology at North Carolina State University – suggested that because the lab’s test required re-growing bacteria, the bleach I had used on the faucet could’ve lingered in the water, killing any organisms that might’ve been present. He said I should’ve run the tap for longer than one minute to clear the bleach.
So what was in my brown water, and why did it happen? Other experts I talked to could only speculate. De los Reyes’colleague, Detlef Knappe, who specializes in water quality and treatment, told me that because there was likely no E. coli in my water, the brown color was probably the “natural” result of a drop in pressure in the old pipes.
In a functioning water system, Knappe explained, generators push water from the plant to homes, where it stays suspended in the pipes until a faucet is turned on. But in old water systems like Jackson’s, lined with cast iron pipes, a drop in pressure can cause accumulated sediment to collapse into the disrupted water stream and turn it brown. The water isn’t leaving the plant a dark brown color, Knappe said, but becomes discolored somewhere along its journey to the faucet.
Christine Kirschoff, a professor of civil and environmental engineering at Penn State University, had another perspective. Though she agreed that the brown water was likely caused by a drop of pressure in the pipes, she said it could’ve been exacerbated by the routing of the pipes in my building. That scenario would explain why my downstairs neighbor also had discolored water but my neighbors to the south never did.
The last week of September, I went on vacation and promptly got food poisoning. I would later learn that as I was laid up on my couch – subsisting on chicken nuggets and Uncrustables and using up the last of the bottled water I’d bought the first week of the crisis – the mayor had commented on my water at a town hall the same week.
A recording of the town hall at the New Jerusalem South Church on Sept. 27 shows Lumumba, microphone in hand, standing in front of poster boards of graphs, pictures of O.B. Curtis and a spreadsheet labeled “IMMEDIATE NEEDS.” He starts talking about my water around the 12-minute mark in a tangent about re-watching an interview he gave on national TV.
By now, my tweet had helped shape the national perception of Jackson’s water crisis.
“I was upset, because I did an interview,” Lumumba said. “And y’all know when I do these interviews, I can’t see the packages they’re running, I can’t see the images that they’re running in the background – all I see is a blank screen. And they keep showing this black water coming out of a faucet, right?”
My water, Lumumba went on to say, represented an “extremely rare situation” issue at “one isolated building.”
“That is not what is coming out of your water treatment facility, right?” he said. “You’re not having black water going to every resident. Y’all – y’all live in Jackson. Y’all – how many times have you seen a black water come out of your faucet? Right? I have residents tell me time and time again that they don’t know where that was, right?”
For me, this raised several new questions. Did the city actually send anyone to test my water? How were they able to determine the brown water was isolated to my building? What other discussions did they have about my water? Why didn’t the city reach out to me with their conclusion?
On Oct. 13, I sent an email asking if the city had tested my water to Melissa Faith Payne, the city’s public information officer.
“I believe the discolored water at your building was an isolated incident … and not indicative of the water that actually comes from the plant,” she responded the next day. “I think it had more to do with the lines/pipes at your building. I’ll Loop our public works team in to get more information for you.”
I followed up. What was the mayor’s basis for his comments at the town hall? If it was easier, I suggested, I would be happy to talk with the Public Works employee that tested my water.
“I briefed the Mayor just before the town hall,” Payne replied, adding that she was still waiting on an answer from Public Works.
About a week later, I got a statement from Jordan Hillman, the interim director of Public Works. The department could not make any employees available for an interview, she said, due to the workload of maintaining the water system, but Hillman did explain why the city thought my water was an isolated incident.
“This incident was indicative of a local pipe issue for a variety of reasons including knowledge of water condition leaving plants, water color at nearby fire hydrants, and experience with similar issues,” Hillman said. “There were extremely limited reports of similar water discoloration through our report tool.”
The tool that Hillman is referring to is an online survey the city created for residents to report the color of their water. My coworker Alex Rozier, who has been covering the crisis closely, recommended I fill it out the same day I posted the video.
I asked the experts what they thought of Hillman’s reply.
Knappe, the NC State professor, told me that the water from a fire hydrant isn’t necessarily representative of the color of water inside a home, because the pressure and speed at which water comes out of a hydrant is much greater than a faucet. Kirschoff said that it depends on where the fire hydrant that the city examined was located relative to my apartment.
Unsatisfied, I put in several public records requests. I asked for copies of any communications about my water, which the city has only partially fulfilled.
After a few more days of inquiries, Hillman finally told me that “no samples were taken from your specific home or area at that time.”
I also asked for responses to the report tool. Despite the fact that the mayor said my experience was an “extremely rare situation,” the submissions from other Jacksonian detailing discolored water seem to say otherwise. Out of 565 responses, including mine, to the form since Aug. 29, 423 – or 74% – reported discolored water. The submissions came from across the city but about a third were concentrated in northeast Jackson. (We did not filter duplicates from this count.)
Responses from more than 20 people, a little more than 4%, contained descriptions of brown, gritty water that matched what I had seen in my home. Though far more people used the word “brown” to describe their water, I couldn’t tell if their report matched my experience because the city was supposed to send me pictures that had been uploaded in response to the form but hasn’t.
“Reddish brown water in both toilets strong enough to leave a brown ring,” one person wrote.
“When I boil my water it turn my pot brown inside my bath water have dirt in it,” another person said.
“My water is brown and leaves deposits of dirt..” a third submitted.
I asked Hillman and Payne why the city thought these responses were “extremely limited” on Nov. 4 but I haven’t heard back.
More than two months after my water turned brown, I haven’t had an issue. I’ve gone back to using my water to cook, wash my dishes, and brush my teeth, but every morning, I see reminders and warnings – representations of what could happen again. The grainy water left permanent, hair dye-like splotches on my toilet bowl, bathtub, and sink basin. Now, I always run my water for one minute before I use it.
The city and state seem to have returned to the contentious relationship that preceded the crisis, with both sides accusing the other of providing incorrect information, which only further weakens public confidence in the system.
There’s no sign this will change. As winter sets in, raising the possibility that another freeze could shut down the system, the state is considering if it will lift the emergency declaration. Multiple lawsuits have been filed. And though it’ll become public soon, just last week, the city inked an agreement with the federal government to fix the water system – in secret.
Hundreds of thousands of Mississippians fall within what’s called the “coverage gap” — they work lower-paying jobs that do not offer health insurance, but they also do not qualify for traditional Medicaid coverage.
Although the Children’s Health Insurance Program (CHIP) covers uninsured children up to age 19 whose family income does not exceed 200% of the federal poverty level, some children in Mississippi remain uninsured. There are 41,203 Mississippi children enrolled in CHIP as of October, according to the Division of Medicaid.
Numerous studies have shown that expanding Medicaid — lawmakers choosing to opt into an expanded version of the federal-state health coverage program — would guarantee health care for at least 200,000 primarily working Mississippians who don’t currently have it. It would also cover these currently uninsured children.
But a handful of state political leaders have rejected expansion for more than a decade, ignoring the nonpartisan, reputable experts who have thoroughly studied the effects of expansion.
Below is an interactive, county-by-county map showing the Mississippi children who would qualify for Medicaid if state leaders chose to expand.
Advocates are urging the Mississippi Department of Education to include the disability rights movement in the state’s social studies standards.
Late last year, MDE officials were accused of removing civil rights content from the standards, which then became a focal point for numerous frustrations with social studies education.
The revised social studies standards were first presented to the State Board of Education in December 2021. The proposed changes removed many specific names, events and details in lieu of more broad descriptions. During the first public hearing in January 2022, education department officials walked back this change to the satisfaction of several groups present. Still, other people expressed concern that officials were adding critical race theory to the standards. MDE officials have repeatedly stated the theory is not taught in K-12 classrooms.
At the hearing Friday, seven of the eight speakers advocated for the inclusion of the disability rights movement in U.S. History and minority studies courses, as well as broader education about disabled individuals in earlier grades.
Davonda Ferrell, whose seven-year-old daughter has Down syndrome, felt that the exclusion of the disability rights movement sends the message to her daughter that she is not important.
“It’s only right that when students first start school, they learn about all of the diverse groups that are within our school and community,” Ferrell said. “It is vitally important to start early and often to promote inclusion of all students.”
Scott Crawford, of the Mississippi Coalition for Citizens with Disabilities, said that one in three Mississippians have a disability, but few know how the struggle to be included benefits them today. Crawford mentioned sit-ins led by Judy Heumann, transportation boycotts in Denver, and the “Capitol Crawl” as important examples of activism that led to the passage of the Americans with Disabilities Act.
“This didn’t just happen,” Crawford said. “People put their bodies on the line.”
Other activists said that the representation of the disability rights movement shows disabled children that it is possible for them to lead productive lives.
“All civil rights movements matter, and all should be included in the curriculum,” said Christy Dunaway, a disability rights activist.
Jean Cook, spokesperson for MDE, said they plan to bring the final version of the standards before the State Board of Education at its Dec. 15 meeting, where any changes in response to these comments will be noted.
During her 14 years working as an OB-GYN in Greenville, Dr. Lakeisha Richardson has seen five patients diagnosed with breast cancer during their pregnancies.
Most of them did not have health insurance prior to pregnancy, so going to the doctor for annual checkups was neither affordable nor routine. They missed out on clinical screenings and the chance to learn whether they were at higher risk of breast cancer.
Pregnancy does not cause breast cancer, but it can make it grow and spread more quickly, and breast cancer associated with pregnancy has a lower survival rate. For Richardson’s patients without health insurance, pregnancy brought Medicaid coverage that allowed them to go to the doctor for prenatal visits, and that was when their cancer was diagnosed.
One of Richardson’s patients died from breast cancer a few weeks after giving birth.
“Legislators think, women are healthy, they’re going to have a baby, and they can come off Medicaid,” Richardson said. “They don’t think that other illnesses and disease processes can exist in pregnant women.”
Mississippi doctors like Richardson see thousands of patients every year who have no health insurance, and thus limited access to affordable health care, until they become pregnant and qualify for Medicaid. If the patient has a chronic condition like diabetes or hypertension, getting treatment during pregnancy is critical – but not necessarily sufficient to prevent problems like preterm delivery, low birth weight, birth defects, and even stillbirth.
Access to routine care prior to conception increases the chance a person can have a healthy pregnancy and delivery. But in Mississippi, where one in six women of reproductive age is uninsured, preconception health care is far from universal. Under current Medicaid eligibility policy, adult women can get coverage only when they are pregnant or have kids at home and very low household income.
“If they have a preexisting disease like diabetes or hypertension, if they’re uninsured they’ve probably been off their meds for a while, so they’ll come in with elevated blood pressure, elevated glucose that have been uncontrolled for months or years,” Richardson said. “If it takes them a while to get their Medicaid and they’re already late to prenatal care, they have growth restrictions for the baby.”
But perhaps nowhere are the consequences of sickness – sickness that is largely preventable – more evident than in the unnecessary suffering of Mississippi’s mothers and babies.
Nationally, the leading cause of infant mortality is birth defects. But in Mississippi, the causes are more preventable: premature birth and pregnancy or delivery complications as well as sudden infant death syndrome (SIDS).
Within each of these statistics, Black women and babies suffer much more than their white counterparts.
Expanding Medicaid would not on its own solve Mississippi’s maternal and infant health crisis, which State Health Officer Dr. Daniel P. Edney has identified as a top priority. Health insurance is not the same as access to health care, and access to health care alone is not enough to ensure all Mississippians have healthy food, opportunities to exercise, and safe neighborhoods.
But OB-GYNs interviewed across the state said that lack of access to health care prior to conception is a problem they see every day. They may see a patient get her diabetes or hypertension under control when she has Medicaid coverage during her pregnancy, only to lose coverage and return to self-managing her conditions. They won’t see her again unless she gets pregnant again, and then the process of treating her chronic condition must start all over again.
“We work really hard and optimize their diabetes during pregnancy, and then they’ll be a gap in care between and patients come back for the next pregnancy and it’s like we’re starting from square one again,” said Dr. Sarah Novotny, a maternal-fetal medicine specialist at the University of Mississippi Medical Center.
An analysis by the consulting firm Manatt found that expanded Medicaid eligibility to adults with incomes below 138% of the federal poverty line would likely cut enrollment in pregnancy Medicaid by about half – meaning that it would provide more consistent coverage and access to care for about 10,000 women each year who can currently have health insurance only during and right after their pregnancies.
Dr. Jaleen Sims has worked as an OB-GYN at Jackson-Hinds Comprehensive Health Center since 2019. The federally qualified health center offers services on a sliding scale, so it’s affordable for people without insurance.
“I serve the underserved population that experiences the most suboptimal outcomes, the highest comorbidity rates, the highest mortality rates – those are my patients,” she said.
She estimates that more than half of her patients who are pregnant with their first child have not had health insurance as adults before getting pregnant.
Medicaid offers full coverage for pregnant women with incomes 194% of the federal poverty level, or $4,603 monthly for a family of four. That ensures that low-income and working-class women can get health care during their pregnancies. About 60% of births in Mississippi are covered by Medicaid, the second-highest percentage in the country, after only Louisiana.
Hinds County has both the state’s largest number of Medicaid-covered births, at an average of 2,300 annually from 2016 to 2020, and one of the state’s highest per capita rates of pregnancies covered by Medicaid. Some people with pregnancy Medicaid have another form of insurance, too, but generally the rate of Medicaid coverage during pregnancy gives an indication of how many people lacked insurance before they conceived.
Sims sees patients with hypertension, diabetes, obesity, lupus – “those chronic medical conditions that you really want to have under very, very good control before you get pregnant.”
Diabetes is a good example of a condition that can cause problems during pregnancy – but doesn’t have to.
Sometimes Sims sees patients who got treatment for diabetes during a previous pregnancy, but stopped seeing going to the doctor when that coverage ended. Instead, they’ve tried to manage it on their own.
“Then before you know it, they’re out of the medication, they’re just kind of living,” she said. “They’re like, ‘Well, I don’t check my finger sticks, I don’t have my insulin, I don’t have my medicine. Now I don’t really know where I am at this point.’”
During pregnancy, doctors try to keep blood sugar tightly controlled. That becomes harder to accomplish when the patient’s condition isn’t well managed when they arrive for their first prenatal visit.
If blood sugar is elevated during the first 10 weeks when the fetus’s organs are developing, the risk of birth defects is higher, Novotny said, even if blood sugar is controlled later in the pregnancy.
“A lot of times women haven’t been in care, they find out they’re pregnant, sign up for Medicaid, and by the time they come to us, it’s often the end of the first trimester, when damage may already be done,” she said.
Spina bifida and heart problems are the most common birth defects associated with diabetes. People with diabetes are also at risk for preterm delivery.
Dr. Emily Johnson, an OB-GYN in the Jackson area, said it’s important for people to know that chronic conditions and risk factors during pregnancy can be managed with very good outcomes. Early communication between provider and patient is critical.
“I think them knowing that information helps them have a little autonomy that they can be responsible for their blood pressure and they know what they’re supposed to call me for,” she said. “Communicating about the risk can help them take a little ownership of it and in some way provide some reassurance.”
For many uninsured women in Mississippi, getting signed up for Medicaid is one of the first rituals of pregnancy. But getting approved is a hurdle that for some people can delay their prenatal care by days or weeks.
Providers said they largely see patients get approved within a month or so. A mistake on the paperwork, however, can delay approval.
Matt Westerfield, spokesperson at the Division of Medicaid, told Mississippi Today that according to a recent analysis by the Office of Eligibility, the average approval time for pregnancy Medicaid from Aug. 2021 to Aug. 2022 was about 24 days. That’s slightly higher than the average approval time in 2021 for all eligibility categories of 20 days, according to documents Mississippi Today obtained through a records request.
Even a delay of a few weeks can make a difference, given the importance of early prenatal care. Dr. Kushna Damallie, an OB-GYN at The Woman’s Clinic in Clarksdale, said he would like to see a patient as soon as she misses a period. But that often doesn’t happen.
“One of the biggest hurdles we have in our practice is late prenatal care, no prenatal care, or insufficient prenatal care,” Dumallie said.
Westerfield told Mississippi Today that the Division of Medicaid doesn’t track when women go to their first prenatal visit or what percentage take place during the first trimester of pregnancy.
Richardson said early prenatal care is particularly important for women with a condition called an incompetent cervix, in which weak cervical tissue can cause very early delivery. Black women are more at risk for this condition. One treatment to help ensure a successful delivery is a cervical cerclage, in which providers stitch the cervix closed, usually around 12 to 14 weeks of pregnancy. If that doesn’t happen in time, the risk of miscarriage is higher.
In August of this year, Richardson had a patient who was in the hospital because her water had broken well before viability. The patient had known she needed to get treatment for her incompetent cervix but had not been able to get an appointment early enough.
“She moved from another state, so she didn’t have her Mississippi Medicaid and so she couldn’t get in anywhere to be seen,” Richardson said.
OB/GYN Dr. Nina Ragunanthan poses for a portrait inside of Delta Health Center in Mound Bayou, Miss., Thursday, July 14, 2022. Credit: Eric Shelton/Mississippi Today
While Medicaid expansion is a taboo topic among Republicans in the Legislature, extending Medicaid coverage for postpartum women has bipartisan support. A measure to extend coverage from 60 days to 12 months postpartum passed the Senate resoundingly in the last session, before House Speaker Philip Gunn killed it.
Today, Mississippi is one of just two states that has neither expanded Medicaid eligibility nor extended postpartum coverage.
Senate Republicans including Sen. Kevin Blackwell, R-Southaven, who sponsored the measure, have vowed to reintroduce the measure in the next session, though Gunn still opposes it.
Gunn recently said he believed postpartum Medicaid extension would help only a few thousand women in Mississippi, referring to his calculation that only 60% of the 5,000 new births expected annually after the state’s abortion ban would be covered by the program and dismissing the 21,000 people already covered by pregnancy Medicaid each year.
When discussing crisis pregnancy centers, which already get a $3.5 million tax credit from the state and which Gunn wants to expand to $10 million, he offered no information about the number of people they serve and how, probably because that data is not being collected by the state.
Providers largely say they’d welcome any opportunity to lengthen the amount of time their patients have health insurance. Novotny, the maternal-fetal medicine specialist, said 12 months of coverage postpartum would give her patients a chance to control their diabetes for a longer period before becoming pregnant again.
“They’ve been able to continue the management of their chronic diseases so that when they’re ready to get pregnant again, they are in a good place,” Sims said.
But postpartum Medicaid does nothing to improve access to health care before conception.
Some advocates are concerned that the conversation about postpartum Medicaid could distract from the need to address Mississippi’s health care crisis more broadly.
Nakeitra Burse, a public health consultant and advocate focused on maternal health, said some of the discussion of postpartum Medicaid seems to reflect a belief that pregnancy can be separated from the rest of a life.
“A person’s already experiencing obesity, diabetes, high blood pressure, and then you add pregnancy on top of that, then pregnancy also becomes a condition,” Burse said. “So you’re trying to treat all these things at one time, when people don’t even just have the opportunity to make the healthy decisions for themselves because they don’t have access to care.”
When patients do get access to care during pregnancy, making it to a doctor’s appointment isn’t as easy as it sounds.
“A lot of that decision making means: Do I miss work to go to the doctor? Do I go to the doctor over my child? It’s a lot of push and pull and give and take for the decision making that shouldn’t have to happen, if we had opportunity or access to quality health care.”
Dr. Nina Ragunanthan, an OB/GYN in Mound Bayou, pointed out that the focus on pregnancy and postpartum coverage, rather than expanding access to health care for everyone, implies that women are more deserving of care if they are giving birth than if they are not.
“I think it’s really important not to just pigeonhole a woman as a child bearing vessel,” she said. “Access to care for that woman as an autonomous, independent person, regardless of whether she plans to get pregnant or not, is very important.”
State Sen. Hob Bryan, chairman of the Senate Public Health Committee, joins Mississippi Today’s Adam Ganucheau and Bobby Harrison to discuss the state’s growing hospital crisis. Bryan’s committee is hosting a hearing to discuss potential long-term solutions.
