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The state’s legislative watchdog committee has issued a report critical of the Mississippi Board of Barber Examiners, and suggests lawmakers consider dissolving it and the separate cosmetology board and put regulation of both under the Health Department.

Findings of the report by the Joint Legislative Committee on Performance Evaluation and Expenditure Review, or PEER, include:

• Mississippi has more restrictive requirements for a barber’s license than 40 other states.

• The board’s exam practices “are not effective in evaluating a candidate’s preparedness for licensure.” In the last year, only 39% of candidates taking barber exams passed.

• In the last year, the board inspected only 191 of the state’s 2,134 barber shops and schools.

• The board last year paid its members improper per diem and travel reimbursement, including paying board members for days they did no board work and paying travel expenses without proper documentation. It also improperly paid staff members at a lower mileage rate than that set in state policy.

• The board lacks internal accounting controls, which puts it at risk for mismanagement and fraud.

• The board’s “lack of knowledge and expertise related to required retirement contributions” cost the board and its licensees nearly $20,000 in delinquent interest payments. And, “the board might have extended its current lease with terms that are not in the state’s best interest.”

• The board’s records are hard to decipher and not easily accessible to staff. The board is not located in a state-owned office building and not easily accessible to licensees or the public.

• Lawmakers “should consider dissolving the Barber Board and the State Board of Cosmetology to create a Barbering Advisory Council and a Cosmetology Advisory Council within the Department of Health’s Professional Licensure Division.” Also, lawmakers should consider making age and education requirements comparable to those of surrounding states and consider prohibiting board members from administering exams.

Lawmakers and other state politicians have for years discussed and debated consolidating or eliminating many of the states scores of small agencies, boards and commissions and reigning in bureaucratic red tape in professional licensure and regulations. They are run by appointed boards, mostly members of the industry they regulate, which raises questions of fairness and competition.

But efforts to reduce or consolidate such boards have had minimal success. They have legislative and political clout. For instance, no elected leader relishes the prospect of thousands of barbers or cosmetologists mad over consolidation come election time.

The barber board refutes many of the PEER report’s findings and “does not agree or concur with dissolving (barber and cosmetology) boards under any circumstances.”

In a written response, the board said it does agree some changes need to be made, but “Dissolving boards does not address the issues of the industry. You will lose the knowledge, history and expertise of the current professionals attempting to streamline or effect cost savings over time.”

The board said it has tried but has not received support from the Legislature in updating current laws. It says it lacks funding to find a third party to administer exams and that its inspectors are part time and limited to working 60 hours or less a month, which limits the number of inspections annually. It said it also lacks funding for a records management system.

The board said, “All board members, inspectors and staff have been provided a copy of the state travel policy rules and regulations. All board members, inspectors and other staff will have training.” But it said it was not asked by PEER to provide documentation of travel and expenses and has since provided them. It also said the state has failed to provide help for the agency to secure better office space.

The post Watchdog report slams state barber board, recommends axing it appeared first on Mississippi Today.

PASCAGOULA – Aaliyah Jackson almost didn’t make it to her job interview at Ingalls Shipbuilding on a recent Monday morning. 

The 18-year-old St. Martin High School senior was pumping gas when a faulty latch sent gasoline spraying all over her only professional dress. Panicked and shaking, she took out her phone and dialed the one person she knew would know what to do: Mrs. Marvin.

That’s her high school career coach. The one who helped her prepare for Ingalls’ first-ever high school career fair. Jackson hopes to land a job sandblasting ships. 

“I don’t have a lot of professional clothes. So I texted her, having a panic attack, covered in gas, asking what I should do,” she said.

Brittini Marvin, per usual, knew what to say. She told Jackson to go home and clean up. She reminded her it would be ok, even if she missed the school bus taking students to the interviews. 

After quickly washing her dress at home, Jackson made it on the bus on time to ride with her coach to the Ingalls offices. And Marvin wasn’t far during the whole process: cheering Jackson on between a written test, physical test and interview.

“I love her,” Jackson said. “I didn’t even know what a resume really was before I went to her office.”

Jackson County has one of the most thorough career coaching programs in the state that goes by the name “P3,” short for “purpose, passion, and paycheck.” The first iteration of a similar program launched about six years ago in northeast Mississippi, funded by grant money from Toyota. 

The programs use career coaches hired from outside the school system — but stationed within a high school — to help students develop a post-grad plan. P3, for example, focuses on its students having one of “three Es”: enrollment (into higher education), employment, or enlistment. 

Meanwhile, a statewide career coaching program has been steadily unrolling as a way to confront Mississippi’s ongoing struggles to increase the workforce participation rate and get young Mississippians into high-paying and in-demand jobs. Last session, the Legislature designated $8 million in American Sovereignty Restoration Act Funds for the statewide version of the program.

Now that funding could double. Gov. Tate Reeves’ legislative budget proposal included the recommendation to up the program’s funding to $16 million through general state funds. 

The statewide program is run by the workforce development office, Accelerate Mississippi. The state had 25 coaches — including those in Jackson County — before last year’s funding. By mid-January, there will be 140 coaches, according to the workforce development office. 

“We’ve been watching what’s happening in Jackson County and what had already been going on in the northeast part of the state,” said Garrett McInnis, Accelerate Mississippi’s deputy director of external affairs. “It was the right place and right time to expand the concept and now we have something that has the potential to positively impact a lot of people and make us more competitive as a state.” 

The access to career coaches was vital for students like Jackson, who graduated early with a last day of school on Dec. 16. Without help to form a plan and set up a job for after graduation, Jackson worries she could have felt stuck at her current job at Taco Bell. 

She is confident enough that she’d start training for a new job at Ingalls come January; she already put her two-weeks notice in at the fast-food joint. 

Jackson County’s success over the last two years, with help from its local chamber of commerce and economic development office, has set a roadmap for the budding statewide program to follow. Career coaches say their advice is catered to every type of student — not just those looking for guidance for in-demand trades like at the Ingalls career fair.

“As career coaches we work with the private and public sectors,” said Amanda Stubbs, a coach at Gautier High School. “We have brought in Ingalls, Chevron, health care workers, counselors, attorneys. We take students on tours and to meet CEOs. The more our students know, the more they can grow.” 

Ava McRaney, 17 and a senior at Vancleave High School, may be her class’ valedictorian but she still felt lost when it came to sorting out how to set up a path to become the first physician in her family. She wound up making an appointment with the school’s career coach, Kim Wiley. 

“I don’t know if I would have been applied to colleges already if it wasn’t for her,” McRaney said.

Wiley set up for McRaney to talk to a medical student about exactly what steps to take during undergraduate college — even carving out what time of year to study for the MCATs — in order to make her dreams a reality. 

“She walked away feeling confident, knowing this is exactly what I need to do,” Wiley said. “She has a plan in place and knows how to move forward.” 

Through the program’s connections to the community, McRaney was able to meet Singing River hospital’s CEO and shadow surgeons in November. 

“I loved every second of the surgeries and I couldn’t take my eyes off what was happening,” McRaney said. “I got to be in the actual operating room. It was just an awesome experience and if I didn’t have that, I’d probably still feel unsure of everything.” 

McRaney already received an acceptance letter from the University of Mississippi. She hopes to one day be an orthopedic surgeon. 

Valerie Jerde, 18 and an early-graduate senior at Pascagoula High School, was at Ingalls’ recent job fair applying to work as a joiner, or a ship’s craftsman. Jerde recently found out she is pregnant. She wants a well-paying career to provide for her new family.

“I could see myself growing at Ingalls,” she said. “But I have always been taught not to keep my eggs in one basket.”

That’s why she’s grateful for the strong connection she’s built with career coach Shunda Williams. Jerde says she knows the coach will be there if she needs career or life advice even when she’s no longer a student. 

“She’s a role model,” Jerde said. 

Unlike high school counselors, the career coaches salaries aren’t paid by the school district. They can’t get called in to proctor a test or substitute teach a class. Their schedule is fully dedicated to helping students plan career paths. 

The American Schools Counselor Association recommends a ratio of 250 students to one counselor. In reality, the national average for that ratio is more like 415-to-1. The career coaches add to a student’s team to ensure fewer are leaving Mississippi high schools without a job or pathway to a job in place. 

The coaches say they’re often intervening to help break cycles of poverty, whether that means buying interview clothes for a student who cannot afford their own or helping a family fill out a Free Application for Federal Student Aid (commonly called FAFSA) so a student can enroll in community college. 

McInnis with Accelerate Mississippi said by January, 51 of Mississippi’s 82 counties will have career coaches in their schools. 

“It’s not nearly enough,” he said. “We need more.

The post Mississippi is investing millions of dollars in high school career coaches. Here’s how it works. appeared first on Mississippi Today.

A challenge to a decades-old federal law that aims to keep Native American children and their families together is before the U.S. Supreme Court, and it has the potential to impact tribes around the country, including those in Mississippi. 

The Indian Child Welfare Act governs child custody of Native children. If a child is removed from their parents, the act sets preferences to place the child with another family member, another member of the tribe or a different tribe. 

The case Brackeen v. Halaand before the Supreme Court challenges these preferences. Three pairs of non-Native foster parents and three states are suing the federal government and five tribes, arguing the act discriminates against non-Native people based on race. 

Tribes including the Mississippi Band of Choctaw Indians are watching the case and see more at stake than adoption. 

“As the only federally recognized tribe in the State of Mississippi, our 11,000 plus members are descendants of those members who chose to remain here in Mississippi to preserve our cultural heritage on our ancestral homelands,” the tribe said in a statement. “Today, just as in the past, the preservation and security of our tribe, and our tribal children and families are of utmost importance.”

The Supreme Court heard oral arguments in November and is expected to make a ruling next year. 

ICWA was created in response to the mistreatment of generations of Native American people by the government, including the enrollment of children in boarding schools where they were forced to abandon their religion and culture and the adoption of children out of tribes. 

When the act passed in 1978, between 25% and 35% of all Native children were taken from their families and put in foster homes, up for adoption or into institutions, according to surveys by the Association on American Indian Affairs. They were often placed with non-Native and white families.

ICWA gives tribes the opportunity to be notified about cases involving Native American children and to intervene. It established a process for transferring child custody cases to tribal court. 

The act recognizes that tribes have sovereignty and exclusive jurisdiction over their members who live on tribal land or are domiciled there. The act’s standards also apply to Native child custody proceedings in state court for those who don’t live on tribal lands. 

During Senate committee hearings about Indian child welfare in the late 1970s, then Choctaw Chief Calvin Isaac testified that raising Native children in non-Native homes reduces tribes’ chances of survival. 

The tribe still holds a similar view and says ICWA helps tribes maintain sovereignty by ensuring they have the opportunity to protect and preserve the wellbeing of their children.

“Children are tribal communities’ most valuable resource since the language, culture, and traditions that make those communities unique are passed down from generation to generation,” the Mississippi Band of Choctaw Indians said in a statement.

The Mississippi Department of Child Protective Services, which oversees foster care and adoption in the state, recognizes ICWA and has developed policies and procedures for how to handle cases with Native children and follow the act. 

This includes giving the Mississippi Band of Choctaw Indians or any tribe that a child belongs to the right to assume jurisdiction of the child. The department also signed a memorandum of understanding with the tribe in 2020. 

In the Supreme Court case, two couples from Texas and Nevada were successfully able to adopt Native American children, even after challenges from the tribes where the children were eligible for membership. 

Another plaintiff, a Minnesota couple, tried to adopt a child who was placed with her grandmother, who is a member of the White Earth Band of Ojibwe. The grandmother eventually adopted the girl.

During oral arguments in November, attorneys representing the plaintiffs challenging ICWA argued a number of issues with the act, including that it violates equal protection through racial discrimination and goes beyond the powers given to Congress to regulate Native American affairs. 

Another issue challengers brought up is whether Native Americans should be classified politically through tribes or racially through their ancestry. 

Ian Gershengorn, the attorney representing the five tribes in the Brackeen case, told the justices during oral arguments that tribal self-government is at the core of ICWA. All federally recognized tribes and members of those tribes have a common political relationship with the United States, which he said is why a political classification is more appropriate than a racial one. 

In court documents, defendants have expressed concerns that a challenge to the act could reduce the legal rights of tribes in issues including environmental regulations, land and gaming. 

Ashley Landers is a professor in the human development and family science program at Ohio State University who studies child welfare of Native children. She wonders what protections for Native children will remain if ICWA is overturned or drastically changed. 

“What are the protections in place to try and right this historic wrong?” Landers said. “We need to have ownership of what we’ve done to Native families.” 

Some researchers and advocates want to shift the focus from adoptive parents to adoptees by having the Supreme Court consider the impact on Native American children in foster care and adoption.  

Sandy White Hawk, an adoptee from the Sicangu Lakota Tribe in South Dakota, is founder of the First Nations Repatriation Institute in Minnesota. She is also research partners with Landers.

The institute serves as a resource for Native people impacted by foster care or adoption, and it supports family and cultural reunification and community healing and offers technical assistance, research, education and advocacy. 

“It’s still happening,” White Hawk said about the adoption of Native American children out of their tribal communities. “Children are still being taken.”

She was placed with a white missionary couple who she said saw her adoption as a way of saving her. In that family, White Hawk endured physical and sexual abuse and grew up hearing her Native American heritage spoken about negatively. 

White Hawk and Landers have researched the experiences of Native Americans, including mental health outcomes of Native adoptees and the kind of abuse they experience in foster care and adoptive homes. 

In one of their papers submitted to the Supreme Court in Brackeen v. Haaland, they found that Native American adoptees are more likely to report self harm and suicidal ideation compared to white adoptees. Their research found Native adoptees have the unique context of historical trauma, assimilation and systemic child removal that suggests their mental health outcomes would differ from adoptees of other races. 

“Adoption is complex and has grief and loss and it impacts everyone, but the person who gets the least support and resources is the adoptee,” White Hawk said, adding that adoptees are often expected to feel grateful about their adoptions. 

Landers said it’s a false narrative that taking Native children from their homes will result in them living a better life. Instead, resources should be allocated to help families stay together and prevent removal, Landers said. 

This isn’t the Mississippi Choctaws’ first Supreme Court case. Over 30 years ago, the tribe brought a case that helped interpret ICWA and define tribes’ role in the custody of Native American children. 

In Mississippi Band of Choctaw Indians v. Holyfield, the court ruled that through the ICWA, tribal courts have the power to hear adoption proceedings for Native children. 

The case started when the tribe appealed the adoption of twins born to Choctaw tribe members who lived on reservation land in Neshoba County. The children were born hundreds of miles away in Harrison County, and the children’s parents agreed to their adoption by a non-native couple, the Holyfields. 

The U.S. Supreme Court ruled in 1989 that tribes have jurisdiction over children domiciled on a reservation based on tribe membership or eligible membership, even if they aren’t physically present there. As a result, the Harrison County Chancery Court didn’t have the jurisdiction to approve the adoption for the twins. 

“MBCI was party to the first U.S. Supreme Court case to uphold ICWA and has continued to support Congress’s constitutional duty to uphold the sovereignty of Indian tribes by joining a brief supporting the tribes involved in the latest U.S. Supreme Court case challenging ICWA,” the tribe said in a statement. 

The post Choctaws fight to preserve authority over Native American adoptions appeared first on Mississippi Today.

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Read this story in English: State health department braces for impending hospital crisis

A medida que la crisis de atención médica de Mississippi empeora y amenaza con cerrar de manera inminente los hospitales en el delta del Mississippi, el Departamento de Salud del estado está tomando medidas para prepararse para el desastre inminente.

El Departamento de Salud del Estado de Mississippi, una agencia que ha sido destruida por los recortes presupuestarios y los servicios debilitados durante la última década, no tenía personal ni fondos para asumir la carga total de reemplazar los servicios de atención médica que se pierden si los hospitales cierran.

Pero el Oficial de Salud del Estado, el Dr. Daniel Edney, dijo recientemente a los legisladores que el departamento, en previsión de un aumento de los desiertos de atención médica en el Delta, ha comenzado a evaluar cómo puede ayudar.

“Estamos estudiando dónde están surgiendo desiertos de atención médica o creemos que van a estar”, dijo Edney a los miembros del Comité de Salud Pública del Senado el 21 de noviembre, y agregó que el aumento de los servicios del Departamento de Salud “generalmente no es algo bueno”.

“Somos el proveedor de último recurso”, continuó. “Estamos allí para la salud pública. Cuando nos ve en atención perinatal, hipertensión, control de diabetes, eso significa que estas comunidades no están siendo atendidas”.

Si bien más de 38 hospitales en todo el estado corren el riesgo de cerrar, el delta del Mississippi, la región más pobre del estado con resultados de salud ya sombríos, es más susceptible a la crisis. En agosto, cerró la única unidad de cuidados intensivos neonatales de Delta en Greenville. Greenwood Leflore Hospital ha eliminado el trabajo de parto y el parto y otros servicios importantes en los últimos meses. Hoy, el futuro del hospital de Greenwood es incierto después de que las negociaciones con el Centro Médico de la Universidad de Mississippi para celebrar un contrato de arrendamiento fracasaron abruptamente el mes pasado.

Además, el Hospital Sharkey Issaquena y varios otros hospitales de Delta se encuentran en una situación financiera desesperada.

Un informe reciente del Center for Healthcare Quality and Reform muestra que más de la mitad de los hospitales rurales en Mississippi, o 38, corren el riesgo de cerrar. El estado tiene el porcentaje más alto de hospitales rurales en riesgo inmediato de cierre en la nación, y los hospitales en su conjunto tienen un déficit de más de $200 millones en 2022, según la Asociación de Hospitales de Mississippi.

Un informe de 2019 de la consultora Navigant reveló una estadística similar a la de 2022: la mitad de los hospitales rurales también corrían el riesgo de cerrar. Pero la diferencia ahora es la gravedad de la situación, dijo Ryan Kelly, director ejecutivo de la Asociación de Hospitales Rurales de Mississippi.

“Los hospitales que sangraban lentamente ahora sangran más rápido”, dijo Kelly. “Pero el problema subyacente sigue siendo el mismo”.

Sin soluciones claras a la vista, Edney dijo que el Departamento de Salud hará todo lo posible para fortalecer la “red de seguridad” en estas áreas desatendidas.

“Ya tenemos un plan de acción”, dijo Edney a los legisladores.

Pero cuando Mississippi Today hizo un seguimiento con el Departamento de Salud del estado y presentó una solicitud de registros para ese plan, los funcionarios del departamento respondieron “… a partir de ahora no tenemos ningún plan en papel”.

Mississippi Today luego pidió aclaraciones y detalles del plan al que se refirió Edney. Un portavoz del Departamento de Salud envió por correo electrónico una declaración de Jim Craig, diputado principal y director de protección de la salud.

“Nuestros próximos pasos en el desarrollo del plan serán reunirnos con los líderes del Centro de Salud Comunitario Delta y coordinar las necesidades y los esfuerzos con nuestra oficina de Servicios de Campo que coordina la atención en los departamentos de salud del condado en todo el estado”, se lee en el comunicado.

Mississippi Today luego solicitó una entrevista con Craig o con alguien más del departamento, y se le dijo a la reportera que podía enviar preguntas por correo electrónico.

El departamento dijo que está “evaluando actualmente” qué servicios podrían ser necesarios al responder a una pregunta sobre si el enfoque primero estaría en el Delta y la atención de maternidad e infantil.

“Los servicios maternos e infantiles son una de las áreas de servicio que estamos evaluando”, dijo Craig en el correo electrónico.

El Departamento de Salud del estado cerró 10 departamentos de salud de condados en la última década, nueve de los cuales cerraron en 2016. También redujo las horas en “varios” departamentos de salud de condados en todo el estado, aunque los funcionarios del departamento se negaron a proporcionar un número específico.

En 2016, anunció que ya no brindaría servicios de maternidad en los departamentos de salud del condado.

La misión del Departamento de Salud es promover y proteger la salud de los habitantes de Mississippi. La agencia vigila enfermedades como el virus del Nilo Occidental, la gripe y las infecciones de transmisión sexual, ofrece programación e información para la prevención de enfermedades y lesiones y otros esfuerzos de salud pública. También supervisa las pruebas de agua potable, los permisos e inspecciones de restaurantes, la regulación del sistema de alcantarillado y aguas residuales en el sitio. Es responsable de otorgar licencias y regular las instalaciones de cuidado infantil, hogares de ancianos y otras instalaciones de atención médica.

No hay un cronograma para la implementación de la red de seguridad a la que se refirió Edney, dijo el departamento.

Andrés Fuentes

Andrés Fuentes es periodista de FOX8-TV en Nueva Orleans y traductor de Mississippi Today. Antes de que el nativo de Nueva Orleans regresara, era periodista para WLOX-TV en Biloxi, Mississippi.

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Blue Cross and Blue Shield of Mississippi dropped its defamation lawsuit against the University of Mississippi Medical Center, one day after the two parties signed a contract agreement to bring the hospital back in network with the state’s largest insurer.

James McCullough II, an attorney representing the insurance company, dismissed the lawsuit Friday with prejudice — meaning these complaints cannot be refiled again in court — and asked that no answer or motion for summary judgment be filed in court. 

In the July lawsuit filed in Rankin County Circuit Court, Blue Cross alleged that UMMC’s public relations campaign was “designed to disseminate false and defamatory statements about Blue Cross to the public.”

The company took issue with the campaign’s advertisements and public statements made by UMMC employees that allege Blue Cross ended its contract with the hospital and the insurer “excluded” UMMC from the network of providers as a result. The insurer claimed the campaign was defamatory and harmed its reputation and business. 

In response to the July filing, Blue Cross filed for a subpoena of UMMC’s communications with news outlets Mississippi Today and SuperTalk Radio, which both closely covered the contract dispute between the private insurer and the state’s largest hospital. 

The subpoena also specifically asked for communications between UMMC officials and Kate Royals, Mississippi Today’s community health editor who worked as a writer/editor at UMMC between stints at the news organization. 

Neither Mississippi Today nor any of its employees has been subpoenaed or been named as a party in any lawsuit related to the contract dispute.

UMMC had received deadline extensions for their response to the lawsuit, according to court documents. 

The lawsuit was against UMMC employees Vice Chancellor for Health Affairs and Dean of the School of Medicine Dr. LouAnn Woodward, Associate Vice Chancellor for Clinical Affairs Dr. Alan Jones,  Executive Director of Communications and Marketing Marc Rolph, and other unnamed UMMC employees.

UMMC itself was not named as a defendant in the lawsuit because state law grants UMMC immunity for defamation committed by its employees.

Editor’s note: Editor’s note: UMMC, through an ad agency, has placed paid advertisements about the BCBS dispute on Mississippi Today’s website. Advertisers have no input in the editorial process. Kate Royals, Mississippi Today’s community health editor since January 2022, worked as a writer/editor for UMMC’s Office of Communications from November 2018 through August 2020.

The post BCBS drops defamation lawsuit against UMMC appeared first on Mississippi Today.

Mississippi’s new broadband expansion agency is asking the public to help with data on internet speeds and availability across the state, for mapping that will be crucial to receiving federal funding for broadband infrastructure.

The federal government is pumping billions of dollars into expansion of internet service in rural areas nationwide. Inaccuracy of service availability mapping has been a long-running problem in determining unserved and underserved areas.

Over the next few months, the Mississippi Office of Broadband Expansion and Accessibility for Mississippi (BEAM) will be using data collected statewide to challenge inaccuracies on the current federal map. This map will be used starting in July to divvy funding among all states from the federal Infrastructure Investment and Jobs Act.

Any Mississippian lacking adequate internet service is asked to visit www.broadbandms.com. Those with no service at all can call or text “Internet” to 601-439-2535 to report locations with no service.

“Our office has been compiling data and working with a mapping consultant to prepare for the release of the FCC map in November,” said Sally Doty, director of BEAM. “We knew the initial map would not show a true picture of broadband service in Mississippi and our office is ready to engage in the challenge process so Mississippi will be fairly represented.”

While past data and mapping has been spotty, there have been estimates that 40% of Mississippi lacks internet access, and it has ranked near the bottom among states on access to service. The effort to extend it has been likened to providing electricity to rural Mississippi in the 1930s, and officials have said it should have similar life-changing impact.

Beam has been taking applications from internet providers and doling out $162 million in federal American Rescue Plan Act money earmarked for broadband expansion. The state is expected to receive from $500 million to $1.1 billion for expansion from the Infrastructure Act.

The state has received hundreds of millions of federal dollars for broadband expansion in recent years. It received $495 million from the Rural Digital Opportunity Fund and lawmakers earmarked another $75 million from the first round of pandemic relief the state received. Most of this money went to rural electric cooperatives who have extended internet service to thousands of homes so far.

Public Service Commissioner Brandon Presley has been a staunch advocate for expanding broadband service to small towns and rural communities across Mississippi, and led the effort to change laws to allow electric co-ops to provide service.

“Whether it be telework, telemedicine, or online education, broadband accessibility will promote economic investment and enhance quality of life for countless rural Mississippians,” Presley said. “I will not rest until every last house at the end of every rural dirt road in Mississippi is connected.”

The post Poor or no internet service at your home? State wants your help with data, mapping appeared first on Mississippi Today.

Health professionals and emergency responders participated in a training called STORK, Stabilizing OB and Neonatal Patients, Training for OB/Neonatal Emergencies, Outcome Improvements, Resource Sharing, and Kind Care for Vulnerable Families, at Mississippi Center For Emergency Services in Jackson, Miss. 

With delivery services becoming more scarce, rural hospitals struggling to stay open and the state’s infant and maternal mortality rates ranking among the highest in the country, those in the medical industry without special obstetrics training are in demand to help recognize and handle obstetric emergencies. This training, which was open to all medical professionals and first responders, was created by University of Mississippi Medical Center doctors and staff. It equipped participants with the knowledge to handle emergencies like high blood pressure and hemorrhage to save lives.

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Matt Greer of Brookhaven was driving home from his shift at the Mississippi Center for Emergency Services, where he works as a flight nurse, when he got a call from his younger sister. A few days earlier, she had given birth to a healthy baby girl after an uncomplicated pregnancy. Now, she told him she had a headache. 

He asked her to check her blood pressure: 140/90. 

For most patients, that reading isn’t concerning. For a pregnant or postpartum woman, however, it’s an indication of preeclampsia. Greer told her to go to the hospital and eventually she did, getting treatment to prevent seizure and stroke. 

But Greer thinks things might have gone very differently had he not completed a new training run by the Mississippi Center for Emergency Services just a few weeks before his sister called. 

The STORK Program equips first responders and medical professionals without specialized obstetrics training – including emergency room doctors and nurses – to handle pregnancy and delivery complications like hypertension and hemorrhage. Doctors at the University of Mississippi Medical Center recognized that in a rural state with dwindling options for obstetrical care, women are likely to deliver outside of dedicated labor and delivery wards, and to need care from people who don’t see pregnant patients every day. So they created the STORK training. 

Greer has years of experience as a nurse, and his sister is a nurse, too. But without STORK, he would not have known how to interpret her blood pressure reading. 

“I would have blown it off,” he said. “Without that fresh on my mind … I would have said, ‘that’s not too bad. You’ll be alright.’”

Chronic health conditions like obesity and diabetes plus poor access to prenatal care contribute to Mississippi’s worst-in-the-nation outcomes for moms and babies, and can’t be treated during a single interaction with a health care provider. But potentially lethal hypertension and hemorrhage are not complicated to manage – if a provider knows what to watch for and what to do. 

And even inside hospitals, that can be a big “if.” 

“Obstetrics is most people’s kryptonite,” said Dr. Rachael Morris, associate professor of maternal fetal medicine at UMMC, who created and leads the training. “Unless you’re an obstetrician, even a well-trained E.R. physician or mid-level provider is going to tell you that you bring a pregnant lady into my E.R., and everyone’s going to freak out.”

The STORK Program’s half-day training includes lectures and simulations to change that dynamic. (STORK stands for Stabilizing OB and Neonatal Patients, Training for OB/Neonatal Emergencies, Outcome Improvements, Resource Sharing, and Kind Care for Vulnerable Families.) The training is funded with a grant from the W.K. Kellogg Foundation, which also allows participants to receive a bag of supplies they can use during deliveries. The program is run by MCES, a division of UMMC that houses critical care transport services – including helicopter teams – and the state’s communications system for hospitals and first responders, Mississippi MED-COM.

“In Mississippi, infant and maternal mortality rates for people of color are among the highest in the nation and many families have to travel considerable distance to access care, creating obstetric emergencies,” said Wesley Prater, Kellogg Foundation program officer. “Our support of UMMC ensures providers across the state have the proper training to stabilize mothers and babies who need critical care.”

So far, about 150 people from around the state – a mix of registered nurses, physicians, medical residents, firefighters and paramedics – have completed the training over 11 classes since it launched in June. The team has 18 more trainings on the calendar.

With the state likely to tally an additional 5,000 births annually thanks to the abortion ban that took effect in July, obstetric services in the state are actually shrinking. The labor and delivery ward at Greenwood-Leflore Hospital closed in the fall. The Delta lost its only neonatal intensive care unit this summer. The NICU at Merit Health Central, which serves predominantly Black and low-income Jackson neighborhoods, also closed. 

Already, more than half of the state’s counties are maternity care deserts: No labor and delivery ward. No OB-GYNs. No certified nurse midwives. 

Women in rural areas face long drives to the nearest labor and delivery ward. Sometimes, that means they can’t make it there at all. Instead, they may give birth in an emergency room, at home while waiting for first responders to show up, or on the side of the road. 

The STORK program staff hope training participants will be able to handle those situations effectively, saving lives along the way. 

“These patients are going to be coming into really small hospitals and delivering or having problems,” said Dr. Tara Lewis, assistant professor of emergency medicine at UMMC and a former labor and delivery nurse.

Lewis joined the program to help tailor it to the needs of emergency room staff in small, rural hospitals. 

“If providers don’t know how to make the diagnosis of what problem is going on, then they’re not going to know how to take care of them.”

PHOTOS: First responders trained on how to deliver babies 

“You look like a really good uterus,” Morris told a burly Flowood firefighter and paramedic who had joined three of his colleagues to attend a STORK training at MCES on a recent Wednesday morning. 

She had just given a presentation on managing hypertension and hemorrhage, and now it was time to demonstrate how to assist during a delivery.

The paramedic held a rubber baby as Morris demonstrated how a baby’s head will generally turn to one side as it leaves the birth canal, and how to use a finger to gently loosen the umbilical cord if it has looped around the neck. 

In addition to the Flowood firefighters, attendees included a pediatric emergency room nurse at UMMC, a women’s health nurse in Meridian, and an emergency room nurse at Magee General Hospital who has assisted with three deliveries in the last year alone.

“That’s a lot considering it’s a small hospital with no labor and delivery resources,” she said. 

There are regular STORK trainings at MCES open to people from all over the state. But the free training is also conducted at hospitals, so participants don’t have to travel and can see how to apply what they learn where they work. 

After Morris finished her presentation, Emily Wells, a nurse practitioner and member of UMMC’s neonate transport team, explained how to care for newborns in the moments after birth. Since Jan. 1 of this year, the team has transported 390 babies to higher levels of care, and participated in 20 emergency room deliveries. 

She described the recent delivery of a “rest stop baby,” who was born in a Toyota Camry en route to a hospital during a cold snap. 

“Cold babies die,” she said, so the team had cranked up the heat inside the car and done everything they could to keep the baby warm.

In a hospital, the baby would be placed in an incubator. But in a pinch, any kind of plastic bag – maybe one that had been used to hold supplies now in use – could be placed around the baby’s body to conserve heat. 

A woman had just delivered a baby at 26 weeks in her car, and now both had made it to the emergency room of their small-town hospital. She had delivered the placenta, too, but was still bleeding. 

What should happen next? Half of the training participants gathered around their patient – a life-size mannequin lying on a hospital bed shouting “I’m bleeding” – and discussed what to do.

“At 26 weeks, I think the placenta abrupted,” Morris explained. 

Blood trickled from the mannequin’s vagina, soaking a pad underneath her body. This was an important lesson, Leslie Cannon, now an educator with STORK after 25 years as a labor and delivery nurse, pointed out: In patients who aren’t pregnant, life-threatening hemorrhage often looks like a dramatic gush. 

“Hemorrhage postpartum, it’s this trickle,” she said. “It’s a huge deal, because that trickle just keeps going.”

That’s important to keep in mind especially because it’s often not obvious when a woman is at serious risk because of bleeding. 

“A young, healthy pregnant lady is going to look really good — until she’s about dead,” Morris had warned of hemorrhaging patients. 

The students administered tranexamic acid to slow the bleeding. 

As Morris had explained during her lecture, a student reached an arm into the uterus to sweep for pieces of retained placenta, which can cause life-threatening bleeding. (“It’s not a comfortable thing to do,” Morris warned.) Another student massaged the mannequin’s belly to cause the uterus to contract. 

Eventually, the trickle slowed and stopped. Morris estimated the patient had lost a liter of blood.

Before everyone left, Morris and Wells gave out their cell phone numbers. Kace Ragan, project manager for STORK, explained that participants get supply bags that include QR codes they can scan to request refills — as long as the grant funding holds out — and report their experiences during deliveries. 

Morris urged the attendees to text or call her with questions any time. Morris treats some of the most challenging pregnancies in the state and serves as obstetric COVID director at UMMC, meaning she’s spent the last two years witnessing devastating loss. 

And yet, she told the training participants, she has “the luxury” of working in a hospital with plenty of resources and specialized training. 

“Y’all are in the trenches doing things that I have to do, too, but with so much less,” she said. 

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