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The post Marshall Ramsey: Delays appeared first on Mississippi Today.

To reach Gunnison, Mississippi, from Cleveland, the quickest path – though not the route with the best-paved streets – takes you off Highway 8, down miles of narrow roads slicing through some of the most fertile land on earth. In early December, the fields are still but not empty. Silvery water pools in gashes in the dirt, and cardinals settle on shoots of electric green gleaming in the gray light of winter.

When you reach Highway 1, you’ve arrived in Gunnison, with a population of 425 and only two businesses: a gas station and Healthy Living Family Medical Clinic, opened by Gunnison native Wyconda Thomas in 2019. The squat brick building is decorated for the season, with a wreath on the door and letters out front spelling “Merry Christmas.”

When Thomas decided to open her own practice, she chose the place where she saw the greatest need, which also happened to be the community that raised her. 

Despite the town’s small population, the clinic is full every day.

“The statistics– it pointed to these areas,” Thomas said. “The Delta, the lack of resources– if you look at who suffers the most, it’s always these areas. That’s the place you should be treating.”

No region of the state has been harder hit by the decimation of Mississippi’s health infrastructure than the Delta. Kings Daughters Hospital in Greenville closed in 2005, and Patient’s Choice Medical Center in Belzoni followed in 2013. Now, Greenwood-Leflore Hospital is scrambling to find funding to stay open through the legislative session, when it hopes to persuade lawmakers to help. 

Even if the money comes through, there is no long-term plan to ensure Delta residents have access to health care. The predominantly Black region is one of the poorest in the country, and like the state as a whole, it has high rates of diabetes, hypertension and heart disease. Earlier this year, state health officer Dr. Daniel Edney said the region’s health infrastructure is “very fragile” and six Delta hospitals are at risk of closure.

“No one’s coming to the rescue,” he said. 

No one, that is, except for Thomas and people like her: Delta natives who have chosen to open their own small clinics close to home. People like Mary Williams, who runs Urgent and Primary Care of Clarksdale; Juliet Thomas, Antoinette Roby and Desiree Norwood of the mobile clinic Plan A; and Nora Gough-Davis, who operates clinics in Shaw and Drew. 

They face policies that seem almost designed to punish them for trying. Nurse practitioners are reimbursed by Medicaid just 85% of what physicians receive for providing the same services. State regulations require them to have a collaborating physician, to whom they must pay a monthly fee that can reach over $1,000. The state’s failure to expand Medicaid means more of their patients lack insurance, and they may never see a penny for treating them. 

“You have to give yourself,” said Gough-Davis, who trained Thomas and 25 other Delta nurse practitioners at her clinics. “It’s really like community service. We have patients with low, low health literacy. So our typical visit is going to require much more education than a visit with someone who doesn’t have health literacy issues. Education takes time.”

And payment structures don’t account for that time. 

“It never comes close” to full compensation, Gough-Davis said of the typical reimbursement.

Owning her own practice, Thomas has had to learn how to handle paperwork and billing and dealing with reimbursement from Medicaid and insurance companies. She works from 8 a.m. to 6 p.m. most days, and spends weekends and evenings attending trainings and seminars. She sees everything from the flu and COVID-19 to anxiety and depression to birth control requests. 

WIth the health department presence in Bolivar County shrinking and hospitals closing, clinics like Healthy Living are under pressure.

“The struggles are there,” she said. “Everything is being put onto family practice now.”

And yet Thomas struggles to imagine working anywhere else.

“The people here get me and I get them,” she said. “It’s rewarding to make a difference and to do this. I feel like I have God’s favor because of that.”

‘A personal connection to her patients’

Just before 9 a.m. on a recent Thursday, Thomas prepared to see her first patient of the day: a 3-year-old boy at the clinic for a well-child exam. 

She wore black scrubs, with a matching scarf and shiny shoes, and a tidy red manicure. The clinic’s rooms radiated the same warmth and cheerful competence that she did: In the lobby, posters advertise free sports physicals and family planning services. A Christmas tree was decorated with hot pink ornaments. 

Clutching a clipboard, Thomas walked into the first exam room to see her patient, accompanied by his mom and grandfather. 

“Come on, hop up here,” she said to him, gesturing to the table. “I think he might need some help.”

She lifted him up and he sat calmly on the table, his hands folded in his lap and his sneaker-clad feet dangling several feet off the floor. 

Thomas told his family that he needed to be in a booster seat and wearing a helmet when riding a bike. She confirmed he had recently seen a dentist, and would need a vision screen today.

“How’s his diet?” Thomas asked. “Does he eat a lot of foods like rice, cereal, cheeseburgers?”

“That’s about the only thing he’ll eat,” his mom answered.

Thomas laughed. She checked the boy’s ears. He gazed calmly around the room, never fidgeting or whining. 

“You such a good little patient!” she exclaimed.

She told his family that he had some fluid in his ears, so she would send a prescription over to their pharmacy. 

Then her time with the boy was over. The visit hadn’t been complicated, but Thomas had been able to confirm the 3-year-old was healthy and growing well, and his vision was good – a particularly important finding as he approached kindergarten, which most Mississippi kids reach without ever having had a developmental screening. 

A few hours later, a 57-year-old woman named Arlesia Mobley sat in a different exam room. She complained of a headache and dizziness.

“Been around anybody sick?” Thomas asked.

“My grandbaby,” Mobley said. “She had the flu.”

Thomas checked her ears and saw fluid, which she explained was probably causing Mobley’s dizziness. She asked a nurse to conduct a flu swab but went ahead and ordered Tamiflu for her patient. She advised her to drink plenty of fluids, eat chicken noodle soup, and rest as much as possible. 

A few days later, Mobley said she was feeling better, but still drained. 

She had had to find a new doctor earlier this year because of her insurance. She lives in Rosedale, so Thomas was close by. She already feels like Thomas knows her. 

“When she step into the room, she’s got that smile,” Mobley said later. “When she pass by you and you (are) sitting out in the waiting room, she got that smile. That makes me feel good, ‘cause I mean most doctors… especially in the waiting room, their mind wouldn’t be on you nowhere. But it seem like she got a personal connection to her patients.”

Opening a clinic in her hometown

Thomas is a daughter of the Delta, raised in Gunnison and Rosedale. Her parents both coached basketball, and she grew up in the gym. She was a star player at West Bolivar High School and then played for Delta State. 

Her mom and dad, both Bolivar County natives, too, had high expectations for their daughter. 

“When she was growing up, she couldn’t bring no C’s into my house,” said her mother, Will Ethel Hall. “I don’t want nothing but A’s, but we’ll talk about a B, because you was playing sports and maybe you didn’t get it that way. No C’s were allowed, and she knew that.”

“I was real hard on her,” said her father, Willie Thomas, who coached her at West Bolivar. 

A few weeks ago, he ran into a woman in the store who was remembering how he had pushed his daughter. Thomas told her that looking back, he felt it had been too much, and he would do things differently if he could.

“She said, ‘Look how she turned out,’” Thomas said. “I said, ‘You right. I’d do it the same.’”

After college, she spent a year teaching biology before deciding she wanted to go into nursing and going back to school. She knew she’d like to open her own practice eventually, so she made a point of working in as many areas as she could – postpartum care, pediatrics, nursery, neonatal intensive care unit, home health and intensive care. 

“You own your own practice in the Delta, you gotta be everything – resources are very, very limited, you know,” she said.

The Greenville NICU where Thomas trained closed earlier this year, leaving the Delta with no NICUs at all. 

As soon as Thomas became a nurse practitioner in 2015, she started working on plans to open her own clinic. Her grandfather had owned the little building in Gunnison that had once been a county health facility, and the family left it to her for her business. 

When she approached Gunnison leaders about opening a clinic there, they were elated. 

“Our area is really underprivileged, and we just needed a clinic here in town to help our citizens,” said Mayor Frances Ward, who has known Thomas since she was born. “A lot of them don’t have transportation, and they had to pay people to carry them to Cleveland to the doctor. It’s really a blessing that she is here. And we’re very proud of her being from Gunnison, to come back and help her fellow people.”

Thomas opened Healthy Living on Jan. 2, 2019. 

Gunnison residents like 70-year-old Ruby Hall, who works for Thomas as a nurse at the school-based clinics she runs in Rosedale, can’t recall a doctor or nurse coming back to the town in the last 60 years.

Tina Highfill, executive director of the Mississippi Association of Nurse Practitioners, said that’s a common trajectory for Mississippians in their field. 

“Even though I had moved to several other parts of the state, when I came back to open a clinic it was in my hometown,” she said. “Those NPs have already established relationships… And so the patients know them, they trust them.”

And Thomas knows her patients, often personally as well as through her work. That’s part of what drives her.

Her mother remembers missed lunch appointments because the clinic was so busy, and detours during drives to check up on patients at their homes or drop off medicine. 

“It’s just a tie that I have here,” Thomas said. “They need me so bad. At least I feel like they do. That makes me stay here. 

From 13 county health department clinics to one

At the only other business in Gunnison, Bassie’s Service Station, Charlette Brady slices cold cuts, makes sandwiches and rings up bottles of soda and beer. 

“Really don’t much go on here,” she said.  

The opening of Thomas’s clinic was a rare event. Before, Brady and her children traveled to Cleveland for doctors’ appointments. Now, the whole family goes to Healthy Living.

Inside the lobby of the clinic, a plaque commemorates the building’s history. Preserved in the cinderblock wall, the black sign with silver lettering reads: “Bolivar County Branch Health Center. Gunnison, Mississippi. 1960.”

The plaque also hints at how rural Mississippi’s health care resources have shrunk over the last several decades, because the Gunnison county health department site closed sometime in the 1980s. Before Thomas opened her clinic in 2019, it served as a polling location and a small restaurant before sitting vacant for years. 

In 1975, Bolivar County boasted 13 satellite clinics in addition to the main county health facility in Cleveland.

“We try, especially in the Cleveland office, to offer general health services every day of the week,” county health officer Dr. Dominic Tumminello, a Gunnison native, told the Clarion-Ledger that year. “When a person walks into our health clinic, we want to serve that person.”

The county health department building in Rosedale, a 10-minute drive away, closed in February 2016, along with eight other such facilities around the state. Today, there is only one county health department site in Bolivar, in Cleveland, and it is open only four days a week, with limited walk-ins and family planning services requiring a call ahead of time. 

Rosedale’s pharmacy closed recently, too, when its owner retired. 

The nearest hospital is 30 minutes away, in Cleveland. 

The Delta’s population is declining and has declined dramatically since 1940– part of the reason why large hospitals built early in the 20th century are struggling. 

In Bolivar County, 29% of adults lack health insurance. Thirty-six percent of county residents live in poverty, compared to 20% statewide.

The combination of poverty, lack of insurance, serious health needs and a small, spread-out population makes health care in the Delta a puzzle that is only becoming more complicated. 

Yet Thomas has found a way to make it work, by winning federal and state grants that allow her to offer services on a sliding scale, so that patients without insurance can still afford to see her. Healthy Living Family Medical Center was designated a Rural Health Clinic by the health department, which means the federal government reimburses the clinic for primary care services. Thomas also offers family planning services through the Title X grant, participates in a tobacco cessation program through the Institute of Minority Health, and offers free COVID-19 testing and vaccines. 

Her husband, Jervis McGee, sees how hard she works, taking calls from patients after hours and reading up on health issues in her free time.

“A lot of people forget that she’s a normal person, too,” he said. 

For Thomas, it feels critical to offer as many services as possible to a community that needs them. But it’s also exhausting to participate in so many programs, each with its own paperwork requirements, and to try to develop expertise in so many areas. 

She noticed that many of her patients struggle with anxiety and depression, though they don’t always use those labels for their symptoms. She tries to refer them to psychiatrists, but availability is limited. Efforts to bring a psychiatric nurse practitioner to the clinic one day a month or to offer telemedicine haven’t panned out. So now she’s planning to go back to school to earn certification as a psychiatric nurse practitioner.

Nora Gough-Davis, the nurse practitioner and clinic owner who helped train Thomas, said operating an independent family practice clinic is no easy task. After a decade in business, Gough-Davis is hoping to sell the clinics and focus on her work teaching nursing at Delta State. She wants to make sure any buyer keeps them open. 

“I’m tired,” she said. “I want to make sure that access doesn’t leave.”

And all around independent family practice owners in the Delta, the walls are closing in, as hospitals flounder and county health departments cut hours and offices.

One of Thomas’s patients that Thursday was a woman named Jennie Usry. Usry has had headaches and memory loss ever since a fall on the job in June, and she needs to see a neurologist. A specialist in Clarksdale didn’t take her insurance. And when she tried to make an appointment at Greenwood Leflore, she told Thomas, it was impossible. 

“The hospital closing down, so they not taking new patients,” Usry said. “But you a doctor, so you call, it might be different.”

“I don’t know,” Thomas said. “I don’t know if that will… but I will try.”

(A spokesperson for Greenwood Leflore said the hospital’s neurology clinic is still open and accepting new patients. During negotiations with the University of Mississippi Medical Center, the clinic did not make new appointments because it was unclear whether any deal with UMMC would allow neurology services to continue. Negotiations have ended with no deal and Greenwood Leflore hopes the legislature will approve funding that will allow it to stay open.)

This article originally misstated the last name of Tina Highfill, executive director of the Mississippi Association of Nurse Practitioners. It has been corrected.

The post As health infrastructure shrinks, a daughter of the Delta cares for her community appeared first on Mississippi Today.

Cold weather, long a nemesis to the struggling Jackson water system, once again causes problems. Cold water and brittle pipes don’t make for a good combination.

The post Marshall Ramsey: Leaks appeared first on Mississippi Today.

Mayor Chokwe Antar Lumumba said Tuesday, a day after issuing a local state of emergency, that the city’s crews were working with contractors in searching for leaks in Jackson’s water system as residents still deal with little to no pressure coming out of their taps.

The city issued a citywide boil water notice, the third one this year, around 10 a.m. Christmas morning. The mayor said Tuesday that pressure had improved the last two days, but is still low because of unidentified leaks throughout the city’s water lines.

Lumumba said there are five crews of workers roaming the city to find those leaks, but also called upon the help of residents, asking Jacksonians not to assume the city already knows the locations of all the leaks.

The boil water notice impacts the over 170,000 people who drink from Jackson’s surface water system. Lumumba clarified that the city’s well system customers should also boil their water.

“We’ve heard from residents who have not had water for days, I’ve spoken to residents who were scrambling to fix Christmas dinner with little to no water,” Lumumba said Tuesday. “I’ve spoken to residents who are tired of apologies.”

The recent calamity comes just days after Congress announced a historic $600 million investment towards the city’s water system, and just a few weeks after the federal government and Jackson reached an agreement over a temporary third-party takeover.

When asked about solutions, the mayor said part of the answer will be adding new gauges throughout the city to help more quickly identify leaks. But he also emphasized the need to weatherize the pipes, as well as the treatment plants.

The O.B. Curtis treatment plant was at the root of the last cold weather shutdown of the city’s water system in 2021, when exposed equipment at the plant broke down in the face of frigid temperatures. The city has since started to cover parts of O.B. Curtis, but the weatherization of the plant is incomplete.

City officials first told residents about the lack of pressure on Saturday, Christmas Eve, and said the city’s crews were working to determine the cause as both plants were functioning. A news release later that night said many parts of south and northwest Jackson had low water pressure, and that some residents reported losing running water altogether.

Officials said Monday that it was getting “more and more” reports of little to no water pressure in west and south Jackson, as well as in Byram.

The cold weather, a constant foe to Jackson’s aging distribution system, dropped as low as 16 degrees on Saturday.

The recent federal aid to Jackson largely came as a result of the last citywide boil water notice, which ended in September after state and federal intervention. While the short-term support helped stabilize the system, Jackson has issued over 50 boil water notices to different parts of the city since then, showing the persisting fragility of its distribution system.

Declaring the local emergency helps the city distribute resources such as potable water as quickly as possible, said Lumumba, who added that he’s requested additional help from the state emergency agency.

To help identify water leaks from ruptured pipes around the city, officials ask that residents report information to 311 or 601-960-1111 during business hours, or 601-960-1875 after business hours.

Residents can refer to the state Health Department’s list of what to do during a boil water notice, which includes using boiled water to brush teeth, make ice, and wash food with.

Lumumba added that residents should stop letting their faucets drip as the weather warms up to help reduce water demand.

Jackson officials are working with the Mississippi Rapid Response Coalition to distribute water. Elderly or disabled residents can call 311 to have water delivered. The city listed the following sites for water distribution on Tuesday:

South Jackson:

2 p.m.

Candlestick Plaza off Cooper Road, Jackson, MS

Northwest Jackson:

2 p.m.

Corner of Northside Drive and Manhattan Road near Smillow Prep

West Jackson 

2 p.m.

Metro Center Mall near old Dillards Loading Dock

Byram

2 p.m.

Davis Road Park 

2515 Davis Road

For updates on future water distribution, residents can call 311 or 601-960-1875 for information.

The post Jackson declares emergency over Christmas water woes appeared first on Mississippi Today.

The leader of conservative advocacy group Empower Mississippi is launching a new nonprofit news organization in 2023 — and will absorb the assets and work of conservative blog Y’all Politics.

Russ Latino, president of Empower, wrote in a Dec. 27 email to his friends and family that he will launch a new venture, called Magnolia Tribune, which was founded in response to “a significant gap in the current (media) marketplace.”

“Mississippi has a positive story to tell. We will tell it,” Latino wrote. “Faith in traditional media has been undermined by blatant bias and often by careless reporting of complex issues. We will work to restore trust.”

Leaders of the new organization have been developing the concept for months, pitching it to their allies across the political spectrum and in nonprofit circles since the fall. Latino, an attorney who previously worked for the Koch Brothers-funded conservative advocacy group Americans for Prosperity, has never worked in professional journalism.

Latino has long served as a conservative voice at the Capitol and in Jackson. He has advocated for conservative causes at numerous press conferences at the Capitol over the years. In 2021, he was selected by Republican legislative leaders to testify at a hearing in favor of eliminating the individual income tax. He has also served as a fill-in host on SuperTalk Radio, a conservative network that broadcasts across the state.

On a webpage soliciting donations for the news outlet, Latino writes that Magnolia Tribune will be a “non-profit, non-partisan newsroom.” In his Tuesday email to colleagues, he writes that “our commentary will often appeal to conservatives.” Latino did not clarify in his email whether the newsroom will be a 501(c)(3) tax-exempt nonprofit under IRS guidelines, which bar partisanship.

“The concept is to be an in-state Wall Street Journal, with reliable straight news, unique business and culture coverage, and thoughtful perspective,” Latino wrote to his friends on Tuesday. “Our goal will be to balance the media ecosystem to ensure that all points of view are heard. While our commentary will often appeal to conservatives, we will not shy from providing a platform for divergent viewpoints. We believe that people benefit from hearing the whole story and being able to make their own decisions with good information.”

The new outfit will absorb the assets and work of Y’all Politics, a political blog founded in 2004 by Alan Lange. Lange has boasted his cozy relationships with Republican elected officials, long amplifying their perspectives and even attacking traditional media in the state seen as too critical of his colleagues.

Y’all Politics employs a small staff of reporters who closely cover legislative sessions and major statewide political interest stories. Y’all Politics, Latino wrote on Tuesday, will cease operation in January 2023. While Y’all Politics staff will reportedly move over to the new organization, Lange has told people he’s close with that he will not be directly involved with Magnolia Tribune.

Empower Mississippi, which Latino said on Tuesday he will leave, actively lobbies lawmakers at the state Capitol for conservative causes and champions specific legislation. In recent years, Empower has pushed for increased funding for charter schools and other “school choice” initiatives, tax reforms like eliminating the individual income tax, and criminal justice reforms.

Latino said he is raising money for Magnolia Tribune and will build the team “over the next several months and beyond.”

“The news media serves a vital function in a thriving democracy,” Latino wrote on the fundraiser page. “When healthy, it informs citizens, presents a robust marketplace of diverse ideas, and holds leaders accountable. Unfortunately, upheaval in the media landscape has resulted in news that is often agenda-driven, intentionally negative, and hostile to alternate viewpoints. Mississippi is not immune from this trend. It doesn’t have to be this way, though.”

Clarification: This article has been updated to reflect that Russ Latino will leave Empower Mississippi to launch the Magnolia Tribune. “I formed it separately from Empower and am leaving Empower to run it. This is not an outgrowth, but a new venture,” Latino said.

The post Conservative group leader to launch nonprofit news outlet appeared first on Mississippi Today.

State Senate Medicaid Committee Chair Kevin Blackwell, R-Southaven, is not the first politician to look to Arkansas as an example of how to provide health care coverage to more Mississippians.

“No, I don’t believe in it,” Blackwell said of Medicaid expansion after a recent legislative hearing on the financial crisis facing Mississippi hospitals and their possible closure. Blackwell was echoing the positions of many Republican politicians in Mississippi who say they oppose Medicaid expansion that would provide health care coverage for primarily the working poor.

But then Blackwell went on to say that “there might be some alternative to Medicaid expansion for the state to consider.”

The alternative that Blackwell described was taking the federal funds the state would receive through the expansion of Medicaid to help Mississippians purchase private health insurance coverage.

The private health insurance route is what was taken in 2014 by neighboring Arkansas. Instead of expanding Medicaid to provide health insurance to primarily the working poor – up to $18,500 per year for an individual – with the federal government paying 90% of the costs, Arkansas draws down those funds to help people purchase private health insurance policies.

At the time the program was enacted, Democratic Gov. Mike Beebe believed the Republican-controlled Legislature would be more willing to go the private insurance route. The program was approved on the federal level by the Democratic administration of President Barack Obama.

The program was left intact by Republican Gov. Asa Hutchinson, and Gov.-elect Sarah Huckabee Sanders, a former spokesperson for President Donald Trump, has given no indication she plans to repeal the program.

As a matter of fact, Hutchinson recently revamped the program to provide additional preventive care for newborns and mothers. The program also includes incentives to try to help recipients reach economic independence.

A 2018 study found that the Arkansas program would be a net gain to the state’s coffers through at least 2021 because of the decrease in the amount of uncompensated care that hospitals had to provide. A search for more recent studies has not been successful.

In Mississippi, Blackwell pointed out information developed by the Hospital Association indicated that a major factor causing the current financial crisis is that hospital costs have skyrocketed because of inflation and other factors and their revenues have not kept pace.

Still, the Hospital Association has said expanding Medicaid either through the traditional route or through the Arkansas model would be a big help to hospitals by significantly decreasing the amount of uncompensated care they provide. The Hospital Association has said their members provided almost $600 million in uncompensated care in 2021 — twice the amount provided in 2010.

Blackwell said he would be willing to consider a program where the state helped to purchase private insurance for those who qualify for Medicaid expansion. But he said he would not consider such options until the 2024 legislative session.

Arkansas is the only state that currently helps its poor citizens purchase private health insurance while 38 other states have taken the more traditional route of Medicaid expansion. Originally, Iowa and New Hampshire were helping poor people purchase health insurance, but changed because officials believed the more traditional Medicaid expansion route was more cost efficient, according to healthinsurance.org.

The post Arkansas plan of insurance for poor more agreeable than Medicaid expansion for key lawmaker appeared first on Mississippi Today.

Alison Lanthrip, a school attendance officer for Webster County, was puzzled when a particular student stopped showing up to school last year.

She wasn’t the typical student to end up on a truancy list. Lanthrip could have sent a letter to her parents and continued through the tall stack of referrals on her desk. Instead, Lanthrip visited the home in person.

When she got there, Lanthrip found that the family’s washing machine had stopped working. The student had gone through all her clean clothes.

“And she didn’t want to come to school with dirty clothes,” Lanthrip said.

Lanthrip connected the family to a local service organization who replaced the washer. “She was in school within a week,” Lanthrip said.

This is how the often overlooked Office of Compulsory School Attendance Enforcement, established to comply with state statute, should ideally function. 

“Our job is to not just enforce that state law that says you have to come to school, but our job is to work with every agency to make sure that the child does have an opportunity,” said April Brewer, the school attendance officer for Lamar County. 

Sitting in a courtroom after bringing a truancy case before the local county court judge, Brewer clutched the intimidating gold metal and black leather attendance officer badge hanging around her neck, as if to hide it. She says she doesn’t usually wear it on student visits. Brewer doesn’t want them to think she’s there to get anyone in trouble. 

“I am there to really help and I really want them to open up because there are lots of reasons why you don’t go to school and I really want to know what the reason is,” Brewer said.

But lately, the office has been in disarray as the workers have been experiencing higher workloads and stagnant pay, according to several school attendance officers who spoke with Mississippi Today.

The Mississippi Department of Education, which oversees school attendance enforcement, has systematically understaffed the office, they said, creating unmanageable caseloads, as high as 10,000 students per officer in some counties.

“When you are basically considered a paper pusher, you can’t get in and counsel these students,” Lanthrip said. “… All you have time for is paperwork.”

Lanthrip and Brewer are part of a coalition of school attendance officers who are organizing with the help of the Mississippi Alliance of State Employees workers union to lobby and introduce legislation this coming year for better conditions in their office.

Until recently, MDE hadn’t even been providing paper, ink and stamps in order to send the required letters, they said, forcing the officers to pay out of pocket for materials. Because of the conditions, there is too much turnover, contributing to the understaffing. Officers also said MDE has failed to approve their travel and mileage reimbursement, discouraging them from making home visits.

“If you’re not able to do that and get in those households like that, you don’t know what resources they need to try to help these families,” Lanthrip said.

And some haven’t received a pay raise in over a decade.

Terri Hill from Jones County has been working as a school attendance officer for 26 years. After taxes, she takes home about $28,000. She said her last raise was about 15 years ago.

“It’s ridiculous and everybody looks over us,” Hill said.

Brewer, a mom of 7, has been at the job for 11 years, but with a $30,000 salary, she’s had to consistently work two additional jobs.

The bill they drafted would raise baseline pay by about 70%, bringing the floor up from $24,500 to $41,500 – exactly the current starting pay for public school teachers in the state. The 2023 legislation does not yet have a sponsor, but they say at least four lawmakers have expressed interest.

School attendance officers must have at least a bachelor’s degree and their salaries are set in statute. After 17 years, an officer with a bachelor’s degree can earn $31,182. With a master’s degree, they can start out making $26,000 and cap out at $37,000 after 21 years. These state workers were left out of the realignments and teacher pay raises that the Legislature has passed in recent years.

Mississippi Department of Education officials denied that the department has deprived the officers of resources, but acknowledged concerns about the stagnant pay.

“We’ll keep working at it to make sure that we hear the voices of our attendance officers to try to address their needs and work alongside our districts to make sure that if there are things there that help our school attendance officers better serve students, then that is 100% what we’re focused on,” Kim Benton, interim state superintendent of education, told Mississippi Today.

Hill estimates she’s responsible for overseeing between 4,000 to 5,000 students.

“It makes you just wanna pick up your purse and clock out and go home,” Hill said. “… The workload has increased, as far as getting referrals. Like in our county, Jones County, we used to have four PIN numbers (budgeted positions) and they took one away from us, so now there’s only three of us working this county instead of four.”

At one point, there was a cap in the law that allowed for caseloads of no more than 2,500 students per attendance officer. But lawmakers removed that requirement when they rewrote the law in 1998. Now, MDE is authorized to employ a set number of 153 attendance officers. The state currently has 125 filled positions and 20 vacancies, Mississippi Department of Education told Mississippi Today.

The proposed new legislation would remove the limit on attendance officers and reinstate a student-officer ratio of no more than 2,000 students to one officer.

The officers are supposed to make contact with students after 5, 10 and 12 unexcused absences. At 12, the officer may choose to petition the court. These cases are handled differently across the state. Some counties utilize the county and youth courts while others take the cases to justice court, where the parents can face fines or even jail time in severe scenarios. 

Lamar County Court Judge Brad Touchstone, a former lawmaker, said he aims to take the less punitive route and uses court hearings oftentimes to check in on the progress of students far after their initial truancy. He said school attendance officers like Brewer play a critical role in child welfare.

“They’re another layer of protection that we have out there to identify kids that are in crisis. I’ve had children come in here that, at first blush, you just think they don’t want to go to school, but then you identify there’s a lot deeper issues there, depression, a whole host of issues that we need to know about,” Touchtone said. “And we don’t always get a CPS report every time there’s a kid in crisis. So April is able to sometimes identify these kids so we can put services in the home to address the real root problem, which is not truancy. It’s that the child’s in crisis.”

Just recently, Touchstone had a case where the student on his docket brought her school-aged friend to support her during the hearing. Touchstone recognized that if the second girl was there in court during the school day, she was absent, too. The court eventually identified the girl as a runaway from a foster family and “were able to secure her and get her back where she needed to be,” Touchstone said.

Last year, one of the schools Brewer covers called her to tell her that one of the students she had been working with – “she had been doing so well,” Brewer said – had not shown up to school.

Brewer went out to the home to find that the family’s electricity had been cut off. The mom had lost her job and didn’t seek help, fearful that she would have Child Protection Services called. 

“She was scared that that would make them take the children into custody. And I said, ‘No.’ I said, ‘We’re here to help you. I will help you,’” Brewer said. 

After some dead ends, Brewer found an agency that would pay to return power to the home.

“Now what if I didn’t go out and do the home visit?” she asked.

When kids went virtual during the pandemic, it only increased the challenges for attendance officers.

“Because of the pandemic in 2020, thousands of children across the state did not return to school resulting in an exceptionally large number of “missing children,’” the officers said in a letter to lawmakers in support of two bills during the 2022 legislative session. “SAO’s (school attendance officers) spent many hours, on top of their regular duties, to locate these children and ensure they were enrolled in school and receive an education.”

One of the bills would have raised attendance officer pay in statute, while the other would have removed the officers from MDE, placing them at the individual school districts. 

Both died last session after receiving little attention. The chairmen of the house and senate education committees did not respond to Mississippi Today’s request for comment.

For Brewer, who spent her youth in foster care, the work is especially personal. 

“This is not just a job to me,” Brewer said. “I come from a very rough background with foster care and everything. I learned when I was about 14 or 15 that education was my way out. I see this job as an opportunity to reach kids that were basically me.”

“I try to be for them what somebody should have been for me,” she said.

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Gun and domestic violence research at the University of Mississippi Medical Center is seeking to better understand the causes of both and find ways to help those scarred by their impact.

Two federal grants awarded in September totaling $7.5 million from the National Institutes of Health and the U.S. Department of Health and Human Services are funding the research. 

“Each grant will enhance the other,” Dr. Lei Zhang, professor and associate dean in UMMC’s School of Nursing, said in a statement. “Gun violence and intimate partner violence are deeply interconnected.” 

Mississippi has the highest firearm mortality rate in the country (28.6 per 100,000 population), according to the Centers for Disease Control and Prevention, and the highest prevalence of domestic violence, based on data from 2009-2015 collected through the Pregnancy Risk Assessment Monitoring System. 

One grant will establish the Mississippi Violence Injury Prevention Program at UMMC to address gun violence involving 11 investigators from multiple departments, including emergency medicine, psychiatry and preventative medicine. 

Zhang said the program represents a mindset change in how gunshot victims are treated. The focus will be more holistic and community based and on prevention. 

Dr. Matthew Kutcher, an associate professor of surgery, trauma and critical care, said another focus is addressing underlying conditions that lead to violence such as poverty, structural racism, housing insecurity and more. 

“(W)ithout addressing the root causes that keep our state at the top of the list for gun violence, we’re chasing the problem from behind,” Kutcher, the co-principal investigator, said in a statement.

Examples of community-based resources can include the dispatch of credible messengers to prevent violence retaliation, mentorship from community members who have experienced violence and treatment for post traumatic stress disorder. 

Rukia Lumumba,  executive director of People’s Advocacy Institute and community outreach organizer of the program, said hospital-based violence intervention programs have been proven to improve public safety. 

The oldest such program was developed in Oakland, California, in 1994. A 10-year evaluation by Giffords Law Center found that participants in the program were 70 percent less likely to be arrested and 60 percent less likely to have criminal involvement than a control group and produced a cost savings to hospitals of $1.5 million annually.

The next grant will train substance use disorder providers about domestic violence and how those issues intersect during pregnancy and after birth.

Mississippi has the highest prevalence of physical domestic violence before pregnancy and the second highest during pregnancy, according to the PRAMS data. 

Dr. Michelle Owens, professor of obstetrics and gynecology, said one of the goals is to strengthen the ability of providers to identify and help people who are at risk of domestic violence or are experiencing it. 

She said an integrated approach and community partnership will help bridge gaps and provide wraparound support for survivors of domestic violence and substance use disorder. 

The goal is to “(empower) them to take the steps to secure their health, safety and a better future for themselves and their families,” Owens said in a statement. 

The Mississippi Coalition Against Domestic Violence is a partner on UMMC’s grant and will develop training, said Executive Director Wendy Mahoney.  

Those who experience trauma and coercion from domestic violence often turn to substance use as a coping mechanism, she said. 

“(The research) is a great thing because of the intersectionality of domestic violence,” Mahoney said. “It intersects with almost every aspect of life. I don’t think people look at it that way, but the intersectionality is quite vast.”

She said it is great that this research is happening in the state, and she hopes to see others look into other ways domestic violence intersect with other issues including gun violence, housing, other health issues and mental health. 

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Bo Eaton of Taylorsville says he still has the swizzle stick that he drew after his tie election with Mark Tullos of Raleigh in their 2015 bid for the House District 97 post. Eaton drew the winning stick in the unusual process that is spelled out in state law to decide tie elections, but the Republican majority seated their fellow party member, sending Eaton a five-term House veteran home. Eaton catches up on politics with Mississippi Today political reporters Geoff Pender and Bobby Harrison.

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Armed teachers, keycard locks, and lockdown buttons — these are just a few of the ideas and facility updates school districts are exploring as a way to protect campuses from the rising threat of school shootings.

School shootings have been on the rise nationally over the last decade, with 93 incidents in the 2020-2021 school year. Mississippi’s most notable school shooting occurred in 1997 at Pearl High School. More broadly, the Clarion Ledger reported there have been at least 25 incidents involving guns and students in Mississippi over the last 40 years. 

Government officials and school leaders interviewed by Mississippi Today agree that additional school resource officers are one of the best ways to respond to this threat, but acknowledge that without the funding to do so, arming educators could be a worthwhile secondary solution. At least nine states — Idaho, Florida, Kansas, Missouri, Oklahoma, South Dakota, Tennessee, Texas and Wyoming — have a provision or program for arming educators, a list that some in Mississippi hope to join.

A recent survey by Mississippi Professional Educators showed 64% of its members supported having properly trained educators or school staff respond to active shooter situations, a proposal that was also suggested by the governor in his recent legislative budget recommendations. 

Gov. Tate Reeves proposed the creation of a “Mississippi School Safety Guardian Program” that would train and arm nominated school employees through the Department of Public Safety. The program was developed with recommendations and input from the newly formed School Safety Alliance. 

Borne of concerns regarding student mental health and the frequency of school shootings, Mississippi Department of Education officials convened a group, launched in July of this year, to review existing school safety law and make recommendations for updates. The group consists of representatives from the Department of Public Safety, the Department of Homeland Security, the State Attorney General’s office, local school district employees and several advocates. 

Earlier this year, the State Board of Education voted to update its weapons policy to conform with state law, which allows enhanced concealed carry permit holders to carry weapons on school campuses. Once the policy was adopted, MDE Director of Safe and Orderly Schools Brian McGairty said districts had concerns about the added liability of more guns on campuses and struggled to find an insurance carrier who would be willing to take it on, leading to discussions about creating a standardized guardian program. 

READ MORE: Guns have been allowed in Mississippi schools (for some people) since 2012

While the training required to receive that enhanced permit is “very credibly issued,” McGairty said it “… doesn’t take into account that you may have rounds being fired back at you when you’re forced to make those decisions.”

“You may have moving targets that are not the offender coming towards you. When you have 25 kids running down a hallway, can you make that shot?” McGairty said.” 

Erica Jones, president of the Mississippi Association of Educators, said teachers have voiced concerns about the training process and the possibility of the gun ending up in the wrong hands. 

“Many of our educators do not want this added responsibility,” she said. “They feel as if they have enough duties as it is.”

 For districts that opt-in to the potential guardian program, Public Safety Commissioner Sean Tindell is proposing a two-week training academy that specifically focuses on responding to active-shooter situations. The training will cover how to use firearms, self-defense, and communications training. The two week academy would also include background checks and mental health assessments, and the certification granted by this program would need to be reauthorized once a year. 

Tindell said in the legislation his office is drafting, the firearms would be issued to school employees by DPS and would be standardized across the state, and the “guardians” would receive a $500 a month stipend. He added the department hopes the bill will have liability protections for districts and teachers in the case that an active shooter event does occur to help get buy-in from insurance companies.

READ MORE: School chiefs prepare for possibility of facing active shooter

Officials from the Department of Education and the Department of Public Safety agreed that having a school resource officer on every campus would be the best solution, but that sometimes the funding or local personnel may not exist to make that happen.

“I know some people are very wary of teachers carrying guns, but under the (policy) changes, they can do this anyway, and all we’re trying to do is provide an additional level of training … to give (districts) more comfort in the choice their making,” Tindell said. 

Phillip Burchfield, Director of the Mississippi Association of School Superintendents, agreed that the guardian program could be a good substitute measure in districts that can’t get a school resource officer on every campus, but he is still concerned about the additional liability and stress it places on teachers. Burchfield also said he is not convinced the program is more cost effective than just hiring school resource officers once supplies, training time, and increased liability costs are factored in. 

Some districts are also modifying their facilities to make them safer, should an active shooter event occur.

Fred Butcher, superintendent of the Natchez-Adams School District, said the district placed keycard locks on the exterior fencing at the newly renovated high school. Buildings were also renovated so that students don’t have to go outside as often to move between classrooms. The district has also added more cameras and created a lockdown feature that will shut down the campus in sections at the push of a button. 

In Covington County, a federal grant allowed the district to install an access control system, which placed keycard locks on exterior doors, and cameras similar to Ring doorbells that secretaries can use to buzz in parents. Only staff have the keycards to open exterior doors from the outside, but a motion sensor on the inside of the door unlocks it for any person exiting. 

“You don’t want to ever have a situation where a school is not welcoming, so it’s a really fine line and a balancing act,” said Superintendent Babette Duty. 

Duty said she prefers school resource officers to the guardian program — she hired two more resource officers when she first became superintendent, and she would like to add more to ensure there’s one on every school campus. 

“If you fully fund (the Mississippi Adequate Education Program), I can make decisions to keep our kids safe without somebody having to have a pistol,” she said. 

“That person chose law enforcement. That is their field and that’s their skill set, and so that’s the person that I feel most confident about carrying a gun on campus rather than an educator.”

Clarification 12/26/22: This story was updated to clarify that government and school officials touted the benefits of the additional resource officers.

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