OurTupelo

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

Many people who experience “conference weekend” at the Mississippi Legislature have the same takeaway: There’s got to be a better way to set a state budget. Some phrase it in more colorful or profane language.

It’s a harried, hurried couple of days in which a handful of selected negotiators haggle out a multi-billion dollar budget. Most members of the 174-member Legislature twiddle their thumbs for hours on end, then are hastily called into session to pass dozens of budget bills under deadline, with most not knowing exactly what’s in the bills on which they are voting.

Some lawmakers have asked in vain for more information — such as spreadsheets — before voting. Often, such info is not available because of the last-minute nature of Mississippi budget setting. Public transparency? It goes right out the window in this process.

READ MORE: Lawmakers end 2022 session with historic spending spree

Politicos over the years have likened it to a game of whack-a-mole, lemmings following each other off a cliff, college students scrambling on a term paper after procrastinating and a goat rodeo. Others have been less flattering.

In this frenzied affair, mistakes get made. Sometimes, big ones. Like when lawmakers accidentally spent $57 million more than they had because of a “staff error” in 2016. Or when 10,000 teachers (and $18.5 million) got left out of a teacher pay raise because of a “clerical error” in 2019. Other times, things get sneaked into spending bills that would otherwise never pass muster if more legislators or the public knew they were in there.

One might assume that this budgeting scramble plays a role in lawmakers and budget staff not uncovering some of the multi-million dollar malfeasance, embezzlement and bribery scandals that have rocked the state in recent years. More time and eyes spent on agency budgets and spending certainly couldn’t hurt.

At times lawmakers have vowed to change the process, provide more deliberation on budgeting. This was the case years ago during a push for “performance-based” budgeting. Lawmakers vowed to more deeply analyze what bang taxpayers are getting for their bucks with state agency spending and programs. But these efforts fizzled out. Otherwise, there appears to be very little long-range planning in the Legislature’s budget work.

Instead, Mississippi’s state government budgeting appears to have become even more hurried and the power over the purse strings more concentrated among fewer top lawmakers. And some policy changes have provided rank-and-file lawmakers less input and scrutiny of budgets.

For instance, the House and Senate Joint Legislative Budget Committee holds fall budget hearings, ostensibly for state agencies to make budget requests and justify their spending, and for lawmakers to ask questions. A couple of decades ago, these hearings — open to the public and media — lasted about a month and provided fairly in-depth insight. But over time, the hearings became shorter and more proforma. In recent years, the hearings have become a one-day affair with only a handful of agencies showing up and giving quick-hit superficial overviews.

READ MORE: Spending billions, cutting taxes, fear and loathing: The 2022 legislative session wasn’t pretty, but it was historic

Some lawmakers have pushed, usually to little avail, for policy and structure changes to address these issues. Rep. Hank Zuber, R-Ocean Springs, has for years filed such bills. One would have limited general legislative sessions — where lawmakers offer non-budget or general bills — to every other year. This would help weed out superfluous legislation and allow more vetting and contemplation of state spending and major issues.

Senate Accountability, Efficiency and Transparency Chairman John Polk, R-Hattiesburg, has recently suggested a programmed pause in budgeting. Once budget conference reports, or agreements between House and Senate negotiators, are filed, Polk suggested, instead of rushing a vote on them, the Legislature could recess for a week or two to allow all lawmakers — and even the public — time to scrutinize the proposals.

“It’s an idea,” Polk said. “That way, no one could say they didn’t have a chance to read them.”

In some states, major budget decisions are subject to more public scrutiny — even public hearings — before being passed into law. In Arizona, for instance, the public can speak on the budget at joint House and Senate appropriations hearings. A joint committee in Wisconsin travels the state holding town hall meetings for citizen input on state spending.

Lt. Gov. Delbert Hosemann, serving his first term in that position, said, “I do not like conference weekend.”

Hosemann said he had planned this year to move up budget negotiations and not have a big scramble at the end. But he said that because of a standoff over tax cuts, the House “refused to enter into negotiations until a tax cut was passed.”

This resulted in negotiations being even later and more hectic than usual, in part because lawmakers not only had to set a $7 billion state budget, but decide how to spend $1.8 billion in federal pandemic stimulus from Congress.

“It is my goal that we do not go through that process, at that speed, again,” Hosemann said. “… Certainly, we are open to look at ways to make it better, more positive. We need to do it over a longer period of time, and more eyes on things would always be better.”

The post Mississippi legislative budget process: There’s got to be a better way appeared first on Mississippi Today.

As Jennifer Garner spoke about growing up and her family’s narrow escape from poverty in West Virginia, a C-SPAN camera panned over to then-Mississippi Gov. Phil Bryant. 

From across the room, Bryant held up his cellphone with both arms, capturing video of the “13 Going on 30” actress on his device.

Garner and Bryant were together at a panel on early childhood education at the 2017 National Governors Association meeting in Washington.

As many politicians do, Bryant liked to leverage his proximity to celebrities like country music singers, star athletes and even a reality TV personality to advance his agenda. 

When it was his turn to speak, Bryant began by name-checking a low-income grandmother Garner had recently met in the Mississippi Delta town of Mound Bayou. Tracy Price’s grandchildren attended the nearby elementary school where Garner read to students during her visit.

“I hope Tracy Price is doing good,” Bryant said. “We sent Tracy a selfie yesterday so Jennifer could tell them she’s gone to the top of the government in Mississippi to make sure Tracy gets help.”

Garner beamed, nodding her head. Bryant’s comment suggested that Garner – the kind of “elite Hollywood liberal” that conservatives often mock – had some pull with the governor, that someone with her stardom wielded influence in the Magnolia State.

But like many low-income parents who were systematically denied government benefits during Bryant’s administration, Price did not, in fact, “get help.” 

“Jennifer came to my house,” Price, 62, told Mississippi Today when the publication found her in January. “But I have gotten nothing from anybody since then. I have not received a thing. … Nothing. I had my grandkids here and I was losing my house and everything. They never reached out to me.”

When Garner arrived at her home, Price added, “I had no idea who she was.”

A few months after Bryant and Garner’s exchange in Washington, Bryant’s office arranged for the Mississippi Department of Human Services to start awarding welfare money to the international nonprofit that Garner represented in the meeting. The organization would later give Bryant a shiny award.

Save the Children, a century-old and well-regarded humanitarian organization, has received about $2 million in funding from Mississippi’s Temporary Assistance for Needy Families grant since then.

TANF, the subject of a sprawling fraud investigation in Mississippi, is an anti-poverty program best known for providing direct cash assistance to poor families.

When Save the Children came on the welfare scene, the state was denying more than 98% of poor families applying for the cash benefit while investigators say officials were misspending and embezzling millions from the program. On Bryant’s watch, more than $70 million that the welfare agency passed through two private nonprofits was misspent, according to independent auditors.

Unlike the more conspicuous welfare contractors, Save the Children received its welfare funding directly from the welfare agency for legitimate literacy, after-school and summer programs. Auditors did not find any of its funding was improper. 

But a deeper look at Save the Children’s connection to the welfare program reveals how Bryant used the group to project an image that his administration was implementing innovative approaches to battling chronic poverty and nationally recognized early childhood development, even though the plan never got off the ground. Mississippi remains near the bottom of most national rankings dealing with early childhood development and well-being.

Price said she was initially turned off by Save the Children’s involvement in Mississippi, since the international group is best known for using private donations to aid and educate children in war-torn countries and after natural disasters.

“My whole thing was I kept asking, ‘Why do we have to save the world?’” Price told Mississippi Today. “We can start saving stuff right here. We’ve got a need here. … Charity starts at home.”

But less prominently, Save the Children also operates as a government contractor across the United States.

Save the Children says it has served people in Mississippi for more than 80 years, and former officials and advocates told Mississippi Today the organization really elevated its state presence in 2005 during the aftermath of Hurricane Katrina. It most notably raised private money to build a new child care center on the Coast. The group also took over the federally funded Head Start Center in Sunflower in 2014 after it won the federal grant over the local organization that ran it before.

Ever since, Save the Children has received funding from the Mississippi Department of Education to provide literacy, nutrition and fitness programming in Mississippi’s notoriously underfunded public school system. Reports show it also runs a home-visiting program to coach parents on the best early childhood practices. Save the Children says it matches the public funding it gets with private dollars, almost 2-to-1 in Mississippi, to boost its state programs.

In 2020, Save the Children reported that 91% of 3-year-olds who spent at least one year in its “Early Steps” program had an average or above average vocabulary.

“I have never met a parent that didn’t want to give their child the best possible start in life, but many that just don’t know how. So that’s why these programs are so important,” said Yolanda Minor, Save the Children’s Mississippi State Director. “… We go in and assess the parent, build their self-confidence, provide those age-appropriate activities.”

Current Gov. Tate Reeves awarded the charity more than $460,000 from the Governor’s Emergency Education Response (GEER) pandemic relief funds in 2021. Since current MDHS director Bob Anderson took over and promised to clean up the agency, Save the Children is one of the few welfare grantees introduced during the scandal who is still receiving TANF grants through a newly implemented competitive bid process. In its 2020 application for TANF funding, Save the Children said it employs 160 people in Mississippi and serves 7,529 children and parents.

Save the Children fits as a TANF recipient because in addition to the “welfare check,” states may use the federal dollars for a variety of services including child care, workforce training, transportation, parenting classes and aid to children at risk of abuse and neglect.

Mississippi Today examined Save the Children’s introduction into the welfare landscape, and like all subgrantees at the time, the charity did not have to win a competitive bid to receive funding. They just had to have the governor’s ear.

Emails show Bryant and his education policy adviser Laurie Smith had a hand in channeling welfare funds to Save the Children for the first time in 2017.

Smith, originally from Arizona, was a public school teacher who eventually served as director of Mississippi Building Blocks, an early education and child care center training program launched in 2008 by former Netscape CEO and philanthropist Jim Barksdale’s reading institute.* 

Gov. Bryant’s publicly stated policy preferences – “school choice” and resistance to fully-funding public schools – were opposite those Barksdale endorsed. Yet the governor eventually tapped Smith as his education policy adviser in 2012. 

Smith, who led both the State Early Childhood Advisory Council and the State Workforce Investment Board for Bryant, had great control and decision-making power in her position in the governor’s cabinet.

They seemed to take a special interest in keeping tax dollars flowing to Save the Children. 

“The Governor, through Laurie’s advice, helped us obtain some TANF funding the past year or so and have been able to use those funds to sustain programs as legislative appropriations have decreased over time,” a lobbyist for Save the Children wrote in an email to former MDHS director Davis in November of 2018. 

Save the Children had been receiving a $150,000 direct allocation within the Legislature’s annual education appropriations bill, but in 2018, it was reduced to $50,000.

Trevor Moe, Save the Children’s Managing Director of Partnership Development, told Mississippi Today that it is not unusual for the organization to press leaders to find the funding so it can keep providing services to kids in need. While Save the Children does refer families to other resources, they keep a narrow focus on kids.

“Our approach to dealing with governors, elected officials, is … we’re very zealous about advocating for rural kids – unabashedly so,” he said.

Price said Save the Children selected her as a parent advocate in 2016 because of her involvement at one of the schools it served. 

Years later, during a particularly difficult time in her life near the beginning of the COVID-19 pandemic, Price sent an email to the organization.

“I would love to do more but I am struggling to hold my life together,” Price wrote. “I have nobody to help me … Jen said that she would never forget me yet I knew that we would never meet again. Who helps us in our own country? … I am rich at heart but struggling to make ends meet. I have never reached out to anyone. Can your world wide organization help me?”

Price said she never received a response.

Garner has served as an ambassador for Save the Children for more than a decade, with a focus on early childhood development, an area of special concern in Mississippi. Science shows that the first five years of a child’s life is the most critical for brain development. Experts say that supporting development in a child’s earliest years, even before pre-K, is an effective way of interrupting generational poverty. 

Today, more than one in four Mississippi children live in poverty, the highest rate in the nation. For Black children, the poverty rate is 43%. 

There are several agencies that operate public programs for the youngest Mississippians: the health department has an early intervention program; Medicaid provides health insurance and case management; some public schools offer pre-K through what are called Early Learning Collaboratives; and local community organizations operate federally funded Head Start programs for low-income families.

But the state’s private child care industry, which does not receive a direct allocation in state or federal budgets, is an often overlooked avenue for helping the tens of thousands of babies and young kids it impacts on a daily basis.

The Mississippi Department of Human Services, which saw massive misspending and theft allegations during the Bryant administration, is in charge of the federal fund that props up these private child care centers in low-income areas.

The fund, the Child Care Development Fund, provides vouchers to working class parents so they can afford the child care that allows them to keep a job. The agency’s child care division also grants some of the money to centers that qualify so they can make improvements in accordance with a state plan and quality rating system the division develops.

During his administration, Bryant acknowledged the importance of early education and claimed Mississippi was making progress in that arena. He singled out Save the Children as a key player in making it happen.

At that 2017 governor’s meeting, he held up an orange and fuschia booklet with a wordy title in white letters across the front: “Family Based Unified and Integrated Early Childhood System.”

“The great thing about Save the Children is, we have a statewide plan,” he said, pamphlet in hand. “We worked three years on this, for early childhood learning in the state of Mississippi and this program fits exactly into this plan. It was almost as if, through fate, perhaps divine intervention, that Save the Children came to be a part of this.”

The plan included several components but the main objective was two-fold: To usher in a new child care quality rating system, replacing an old controversial policy, and to increase training opportunities in private child care centers so the employees can appropriately educate, not just supervise, the kids in their care. The less-than-novel concept mirrored the Building Blocks program Smith previously ran. They called this new training effort Early Childhood Academies, which purported to partner with Families First for Mississippi, the program that was misspending tens of millions of TANF funds.

“We’ve been creative in the funding,” Bryant said in the meeting. “We use TANF. Delta Regional Authority has been a part of this. Private funds. Wherever we can find funds, we go and do so.”

The previous quality rating system, which rated centers one through five stars and provided higher reimbursement rates to centers who scored higher, had proved unsuccessful. Fewer than half of centers participated, and advocates complained that the policy worsened racial inequity and offered few resources to actually help centers improve. A 2016 U.S. Commission on Civil Rights investigation into Mississippi’s child care voucher program found that “far too many eligible children are not serviced by the subsidy program, and that the money that should support this eligible population of children is redirected elsewhere.”

The new system was to rate centers either “standard” or “comprehensive.” Standard centers would meet minimum guidelines, plus additional training and professional development, while comprehensive centers would provide more staff coaching and conduct child assessments, among other requirements. Centers would have to rate as standard to participate in the voucher program while comprehensive centers would receive higher reimbursement rates. 

Mississippi received a federal $10.6 million Preschool Development Grant at the end of 2018 to implement the plan. 

But the idea, concocted by Laurie Smith and data scientist Mimmo Parisi of the governor-appointed State Early Childhood Advisory Council, barely materialized. The former council’s website, along with the reports and information it published at that time, was eventually wiped from the internet.

“Everybody interested in participating in the comprehensive plan was invited to a luncheon,” said Amy Berry, director of Little Saints Academy, which received $5,000 through the grant to buy a laminator among other equipment. “They served really nice food, gave us little plaques, gave us all kinds of little trinkets and stuff. They were just spending the money, in essence.”

State leadership placed the grant under the Mississippi Community College Board. The board then hired Austin Smith, the nephew of then-MDHS director John Davis, to serve as the program manager.

Austin Smith (no known relation to Laurie Smith) was also hired to develop a “coding academy” for Families First for Mississippi, the MDHS-funded program that perpetuated the welfare scandal. A forensic audit of the department showed that his employment history included restaurants, a canoe rental company and his father’s landscaping business and suggested he was not qualified to conduct this work. Austin Smith received an auditor’s office demand to repay the state almost $380,000.

His uncle, Davis, also a Bryant appointee, is currently awaiting trial in what officials have called the largest public embezzlement case in state history.

The FBI also investigated the board’s spending of the preschool grant in 2020, former Mississippi Community College Board Director Andrea Mayfield told Mississippi Today, but have not made any public allegations surrounding it.

Behind the scenes of the preschool grant, communication shows Laurie Smith was calling the shots with a particular interest in Save the Children. Mayfield, who chaired the governor’s workforce board that Laurie Smith directed, worked closely with Smith to carry out her vision.

“Hi- will you continue with save the children funding?” Laurie Smith texted Davis on June 21, 2019, just a few days before investigators would administer his first polygraph test and he would be forced out of office. “I’m going to have pdg (Preschool Development Grant) pay for some additional work.”

Mississippi Today requested all expenditure documents, invoices and receipts pertaining to the Preschool Development Grant funding. Save the Children does not appear as a direct subgrant recipient. The organization said it never received this funding.

Under the grant, the community colleges sent trainers out to participating child care centers to work with the staff and read to the children, but Berry said the training her center received was too sporadic and short lived to result in meaningful progress. Much of the money also went to private day care centers to buy equipment like printers and laptops or supplies like ink and markers. 

About $190,000 went to Mississippi Community Education Center founded by Nancy New, a key figure in Mississippi’s unraveling welfare scandal. Records show the nonprofit used most of the money to purchase commodities and equipment for child care centers. 

Overall, Mississippi spent only about 60% of the preschool funds it was awarded, the final expenditure report shows, leaving about $4.2 million unspent.

“There was nothing beyond giving child care centers furniture,” Deloris Suel, owner of Prep Company Tutorial School in Jackson, said of the grant. “That was the biggest part of it.”

Near the end of Bryant’s last term in October of 2019, then-President Donald Trump appointed Laurie Smith to lead the U.S. Department of Labor’s Women’s Bureau. Now, she’s a partner at Bryant’s lobbying company; her work with Building Blocks is absent from her staff profile on the firm’s website. 

Laurie Smith declined to interview for this story, but she sent the following statement: “Although I wasn’t there at the time, once the decision to not move forward with the comprehensive model was made, returning federal taxpayer dollars seems like a responsible decision.”

By the end of the grant period in early 2020, the department had still failed to designate any centers as “comprehensive,” and the rating system was soon abandoned. The state was relying on an additional $10 million federal grant it applied for in late 2019 in hopes of keeping the plan intact. Save the Children representatives said they had discussed working under this grant with state leaders, and even assisted Mississippi with its application.

In a recent interview with Mississippi Today, Bryant said that the state secured $50 million for this early childhood program – which records show is not true. Laurie Smith also told Mississippi Today in 2019 that the state would be going after a $50 million grant, but it only applied for $10 million.

The government eventually rejected Mississippi’s application and the whole operation collapsed. 

“It was a complete failure to launch,” said Debbie Ellis, owner of Greenwood child care center The Learning Tree and leader of a coalition of providers in the Mississippi Delta. “And it set us back years.”

Today, there is no child care quality rating system in Mississippi.

Yet, Bryant was still touting the defunct program as recently as December 2020. 

“When I was governor, I helped create the Family Based Unified and Integrated Early Childhood System, which connects and integrates resources and services for both parents/caregivers and their children,” Bryant said well after the grant was over and the program ceased to function. “This system was expanded as Mississippi secured a $10.6 million federal Preschool Development Grant. This grant funding is helping to strengthen the state’s early childhood systems and improve access and quality for Mississippi families with children age five and under.”

Mississippi Today informed Bryant that no centers ever received the comprehensive designation. “If you’re telling me some government program didn’t work properly, I’m not saying that they always do,” Bryant told Mississippi Today.

Bryant did characterize the program as a success because, he said, “I was told that it was.”

“Dr. (Laurie) Smith managed that and from every report I got was doing a very good job,” Bryant said.

Asked how he knew, during his administration, if reports he received about the efficacy of his programs were honest, he responded, “You don’t. It’s impossible.”

Bryant also said he didn’t know that the community college board had placed Austin Smith, who according to the forensic audit had little experience in this kind of programming, over the management of the grant or that the state failed to spend 40% of the funding.

Ellis said the early childhood development plan’s purpose was little more than to make Mississippi politicians and bureaucrats look good, “to look like they were doing something no one else had been able to do.”

“And they were not,” she said. “They actually did nothing but print beautiful brochures and tout a program throughout the nation that never launched in Mississippi.”

In October of 2019, Save the Children awarded Bryant the “Champion for Children Award” for being a leader in child advocacy.

In an email to Mississippi Today, Save the Children said Bryant’s efforts with the Early Childhood Academies made him the right candidate for one of their awards. 

The organization also praised Bryant for the reduced caseload at Child Protection Services, an agency that remains out of compliance with a federal settlement due to underfunding; reading gains ushered in after the controversial “third grade reading gate”; and the Early Learning Collaboratives, public pre-K programs set up by the Legislature in 2013.

The state most recently ranked 39th in the nation for preschool access for 4-year-olds and 42nd for state spending in early childhood education, according to the The National Institute for Early Education Research annual preschool report.

Mississippi ranked last in the nation for overall child well-being in The Casey Foundation’s 2021 KIDS COUNT report. 

But there is some hope for progress today. In 2021, the state doubled its investment in pre-K. MDHS also recently announced it is developing a new curriculum for child care centers with a $5 million grant to Mississippi State University, calling it the “first step in a strategic partnership for early childhood development.”

Back at the 2017 governor’s meeting in Washington, Garner told stories about visiting the homes of poor families and encouraging often stressed-out moms to talk, read and play with their babies. This is the cornerstone of the work Save the Children has been doing in the Mississippi Delta.

Garner described the homes as having “not an ounce of sound or joy in the place.”

“When we walk into these homes, you would be suffocated by the silence in the rooms,” she said.

Mississippi Today shared the video with Price, who had no idea that Mississippi’s governor had mentioned her in a national broadcast. She said she never received a “selfie” from the governor or Garner. 

Price also said Garner is mistaken when it comes to the Mississippi homes and families she knows. 

“Jen missed the mark. Said too much incorrect fluff that leads any reader or listeners to the wrong conclusion,” Price wrote in a text message. “We struggle to survive but proudly. There is a lot of talent here but no opportunity.”

Save the Children told Mississippi Today that Garner was not available for an interview for this story.

Price was born in Jackson but grew up and went to college in California. There, she spent 29 years working for the same telephone provider until the company abruptly laid her off in 2008. A single mom of a teenager, Price moved back to Mississippi to be with family and wound up in Bolivar County, a particularly economically ravaged part of the Delta.

Now, Price takes care of her two grandchildren, 15 and 13, while their mom finds work elsewhere.

Price said she almost lost her home a few years ago due to a squabble with the previous owners. She now owns the house, which is situated on an isolated piece of property out in the county.

But with the little income she pulls from disability payments, she’s struggled to afford upkeep. The house needs plumbing and siding repairs, but as Mississippi Today has previously reported, home rehabilitation programs for low-income families are sparse in Mississippi.

Price had to take out high interest debt that she would like to consolidate and refinance, but she said lenders have locked her out of opportunities. She said she worked to get her credit score well into the 700s, then a recent $9,000 medical bill for one of the children caused it to drop again. She started a trucking business in 2017 but said she’s been unable to get business loans to purchase the necessary equipment to keep it running. The company didn’t qualify for any of the pandemic relief, either.

“Society has suppressed me economically and reduced me to a credit score,” Price told Mississippi Today. “If you don’t know somebody, you ain’t getting nothing here.”

Price may struggle, but she said that’s what strengthens her faith and the bonds in her family.

In a picture taken with Garner at Price’s home, peeling beige paint near the ceiling is visible. So are colorful curtains, a display cabinet that held a series of Black figurines passed down to her daughter, and Price’s wide, infectious smile. 

Her home is not joyless.

“I go down to the projects, I go down to the low-income places, it’s more joy down there than I see anywhere else,” Price said. “My grandkids are happy, you know? They smile all the time, laugh. They normal; they fight and cuss at each other, too. But they got a roof over their head. They got food in their mouth. They got clothes on their back.”

“They know – beyond a shadow of a doubt – they know their grandma got them.”

*Editor’s note: Jim Barksdale is a Mississippi Today co-founder and major donor.

This is Part 4 in Mississippi Today’s series “The Backchannel,” which examines former Gov. Phil Bryant’s role in the running of his welfare department during what officials have called the largest public embezzlement scheme in state history.

The post Phil Bryant’s star-powered selfies and slick brochures didn’t Save the Children appeared first on Mississippi Today.

Gov. Tate Reeves on Wednesday signed into law the “Broadband Expansion and Accessibility of Mississippi Act” and appointed former state senator and current Public Utilities Staff Director Sally Doty to run the new BEAM office.

The new office will direct hundreds of millions in federal dollars to expand broadband internet access across Mississippi, where some have estimated 40% of the state lacks access. The effort has been likened to providing electricity to rural Mississippi in the 1930s.

“It is my strong belief that one’s zip code should not limit access to these technologies,” Reeves said as he signed House Bill 1029 into law and announced Doty’s appointment. “… Mississippi needs someone who gets up every single day and asks, ‘What can we do to improve and increase access to broadband for our entire state.”

The new BEAM office, under the state Department of Finance and Administration, will take applications from internet providers and dole out $162 million in federal American Rescue Plan Act money earmarked for broadband expansion projects. Mississippi also is expected to receive from $500 million to $1.1 billion for broadband expansion from the infrastructure bill Congress passed late last year.

Doty, as public utilities staff director appointed by Reeves in 2020, has already been helping oversee broadband expansion work in Mississippi. 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.

READ MORE: Cable giants, Mississippi electric cooperatives battle over federal broadband dollars

Doty said electric co-ops and small rural phone companies that received the earlier round of funds have laid thousands of miles of fiber optics and hooked up thousands of households.

“We want to allow all Mississippians to participate in the digital economy we are all part of now,” Doty said. She said Mississippians need access to telehealth, higher education, remote working and other online opportunities to compete and “all of these opportunities depend on connectivity in today’s world.”

House Public Utilities Chairman Scott Bounds, R-Philadelphia, author of the act, said 40 other states have such an office overseeing broadband expansion as the federal government pumps billions of dollars into the efforts nationwide. He said the new office and legislation will be invaluable for future state and federal efforts.

Reeves said the new office will help with “accountability and transparency” of Mississippi’s deployment of hundreds of millions of federal dollars for broadband. But he was also questioned at a press conference after signing the bill about exemptions in the new law for BEAM from public records and open meetings laws. The new law says BEAM records are “confidential, proprietary, and subject to exemption from disclosure.”

Reeves said there are “accountability measures in place,” for the new office and that it will be accountable to him and thus taxpayers. He said the public disclosure shield measures are needed so that internet providers will be candid about their work and service area maps. Nationwide, there is a problem coming up with accurate internet service maps.

The post Reeves signs bill creating Mississippi broadband office, appoints Sally Doty to run it appeared first on Mississippi Today.

The post Marshall Ramsey: Life’s Constants appeared first on Mississippi Today.

When Dr. Jonathan Buchanan moved home to practice family medicine in Carthage in 2017, he was the first physician to come back to Leake County in 26 years.

Many residents had avoided going to the doctor unless it was “dire straits,” Buchanan said. They drove to Jackson or Meridian if they had to. Elderly patients would pay for someone else to take them. 

The community was glad to see him.

“It was absolutely an amazing welcome,” he said. “My parents still live there, like a lot of people I grew up with, who raised me or taught me, those kinds of things. To be gone for a while for college, medical school, residency, and then come back, it was very exciting.”

Buchanan is one of the 55 practicing alumni of the Mississippi Rural Physicians Scholarship Program. The scholarship launched with 10 awardees in 2008, aiming to tackle the state’s shortage of medical providers, one rural doctor at a time. 

Half of all Mississippians live in medically underserved counties, where there are more than 2,000 people for every primary care physician. In four counties – Benton, Carroll, Kemper, and Tallahatchie – there were no such doctors at all as of 2021, according to the health department’s Primary Care Needs Assessment. To close the gap, the state needs 323 more primary care physicians in underserved areas. 

Just shy of 90% of program alumni who have completed their service requirement are still practicing in Mississippi. And the scholarship is still ramping up. Behind the 55 alumni  are 64 people in residency, 64 in medical school, and 67 still completing their bachelor’s degrees. 

“It takes a long time to grow a doctor– a minimum of nine years,” said Wahnee Sherman, executive director of the scholarship program. 

The program awarded 65 scholarships this year, spread across four years of medical school. Recipients are required to spend one year practicing in Mississippi for every year they take the money.

Sophomores in college can apply to join the program’s two-year “nurturing phase.” They get academic support, Medical College Admissions Test (MCAT) preparation and guidance on applying to medical school. If they maintain their grades and score well on the MCAT, they can earn admittance to the University of Mississippi Medical Center or the William Carey University College of Osteopathic Medicine (WCUCOM), with annual funding of $35,000. (Current or admitted medical students who didn’t participate in the undergraduate program can also apply for the scholarship.)

The undergraduates participate in “medical encounters,” where they learn about the profession. On Monday, about 20 of them traveled to William Carey for a day of classes. Most scholarship recipients study at the University of Mississippi Medical Center, but a handful each year enroll at WCUCOM, which was founded about a decade ago with a focus on training primary care physicians. 

Christian Hollis and a University of Mississippi classmate, Taylor Lampkin, stood in a small exam room on Monday morning. Both wore white lab coats embroidered with the motto of the scholarship program in green: “Growing our own physicians.”

Hollis was born with a heart condition. About twice a year, his family made the two-hour round-trip drive from his home in Morton to Jackson so Hollins could see his heart doctors. The experience showed him how geography can become a burden and barrier to patients in need of care. 

Now a junior, Hollis dreams of practicing medicine close to home. He also wants to own a farm like his grandfather, who keeps chickens, cows and donkeys.

“I still go out there now,” he said of his grandfather’s farm. “I want a lot of land and to put animals on it. You can’t do that in, like, California or a big city.”

Hollis and Lampkin’s patient – an artificially intelligent knee joint – lay on the table between them. Dr. John Gaudet, a longtime Hattiesburg pediatrician and now a full-time instructor at the school, showed them how to palpate the knee and insert a needle into the joint to withdraw fluid.

It reminded Hollis of the time his mother had gone to the doctor with a knee swollen with fluid. 

“I saw the doctor do what we just did,” he said. 

Mississippi ranks 49th in primary care physicians per capita, behind only Utah, according to a 2021 report on the physician workforce by the Association of American Medical Colleges. 

There’s both a national and local explanation for this trend. First, around the country, specialists are better paid. On average, they earn about $150,000 more than primary care doctors. 

Dr. Italo Subbarao, the dean at WCUCOM, said specialty care, like neurology and plastic surgery, is “what’s glamorized in medicine.” 

“We try to show people the power of what a family doctor can do,” he said. 

The school is ranked number one in the country for the percentage of graduates who practice in rural areas. (UMMC ranks third.)

Second, people with higher education tend to leave Mississippi. In 2020, only half of recent graduates of public universities were working in the state, according to a recent study by the state auditor. 

Steven Smith, a second-year student at WCUCOM, grew up in Terry. His parents were both volunteer firefighters, and as a kid he went with them to car wrecks and fires because they didn’t have a babysitter. 

He would play with hoses on the firetruck, and when his parents were done working he would ask them what happened to the people after the ambulance took them away. They told him the people went to the doctor, who made them better.

“Well, if the doctor is who makes ‘em better, that’s what I want to do,” Smith thought. He has never really considered leaving Mississippi, but he knows many people with his education do. 

“A lot of people use that as their way out,” he said. 

“We’re doing the opposite,” said his classmate and fellow scholarship recipient, Ti Smith, from Okolona. 

Steven Carter, associate director of the scholarship program, said the COVID-19 pandemic highlighted the importance of family doctors rooted in their communities. While state leaders like health officer Dr. Thomas Dobbs became the highly visible face of Mississippi’s pandemic response, scholarship alumni were intubating patients in their rural hospitals’ tiny ICUs, then rushing to interviews with the local TV station to share public health guidance.

During the pandemic, Buchanan saw patients at the clinic and did hospital rounds, too. He advocated for masking and offered telehealth services. After the vaccines became available, Buchanan started conversations about them whenever he saw a patient.

“My patients trust me with their medical care,” he said. “They trust that I know what’s most up to date and available and what’s been proven versus what’s not. A lot of patients did not even have the thought of vaccination until they had a visit with me to go into detail. They saw how adamant I was about vaccination, that they felt good about receiving it.”

Mississippi’s sheer need for physicians is daunting. It would take hundreds of new doctors to fill the gap. Does one make a difference? 

Sherman believes the stories of Buchanan and his fellow alumni make the answer clear. 

“When you go into these communities that haven’t had a new doctor in 20, 25 years, you see that impact immediately,” she said. 

When talking to Mississippi students and alumni involved in the scholarship program, the state’s data on brain drain seems perplexing; no one seems to have given much thought to leaving. 

“I always wanted to stay in Mississippi after I graduated,” said Kayla Redmond, a junior at Mississippi University of Women. “I’m a country girl. I’ve traveled out of state. It’s not hospitable.”

Most of the participants are from rural areas themselves. And though they’re from all over the state, they share the perspective that the people in their communities deserve the best health care the country can offer. 

In between activities Monday, Khadeejah Franklin, a University of Mississippi junior from Vancleave, and Lauren Sumrall, a Mississippi College junior whose parents live in Poplarville and Purvis, talked about their goals. Franklin would like to practice back home, so people in Vancleave don’t have to travel so far for care. Sumrall wants to open labor and delivery clinics serving rural communities. 

“I don’t feel like anybody should have to drive 45 minutes in labor,” she said. “Where you live should not determine—”

“The level of care you receive,” Franklin nodded.

The post Mississippi needs hundreds of doctors. This scholarship program is ‘growing our own physicians.’ appeared first on Mississippi Today.

Attorneys at the Mississippi Center for Justice filed a formal ethics complaint on behalf of Mississippi Free Press reporter Nick Judin, who was barred entry from a House Republican Caucus meeting in March.

Mississippi Today first reported the journalist was barred from the March 14 meeting in an article chronicling what occurs inside the meetings. Major pieces of legislation authored or supported by Republican leaders, including Speaker of the House Philip Gunn, are often discussed and debated inside the backroom meetings.

Those private deliberations about policy often mean lawmakers will ask few or no questions during public committee meetings and on the House floor. In caucus meetings in recent years under Gunn’s leadership, Republican members have been asked to vote on specific bills, several lawmakers told Mississippi Today.

READ MORE: Speaker Philip Gunn uses secret Capitol meetings to pass his bills and restrict public debate. Is it legal?

Many people inside and outside the Capitol — including Republican lawmakers in both the House and the Senate — question whether the caucus meetings violate the state’s Open Meetings Act because the caucus consists of well more than half of the entire House body.

“The law is clear, yet for years the Speaker and the Caucus have violated it, conducting their business in secrecy and ignoring the rights of the public,” Mississippi Center for Justice attorney Rob McDuff, who filed the complaint, said in a statement.

The caucus meetings had never been challenged before the Ethics Commission or state courts. But several past opinions — including a 2017 Mississippi Supreme Court ruling — indicate the meetings could be illegal because the House Republican Caucus represents much more than a majority of the entire House of Representatives and is deliberating public policy in private.

State Sen. Sollie Norwood, a Democrat from Jackson, asked for an Ethics Commission opinion about the controversial meetings in early March, but commission leadership directed the senator to either file an official ethics complaint or ask the attorney general’s office for an opinion.

Gunn’s staff maintains that the House Republican Caucus is not obligated to adhere to the Open Meetings Act because it is not a “public body,” as defined by state law.

“The House Republican Caucus is not a public body under the Open Meetings Act,” Emily Simmons, Gunn’s communications director, told Mississippi Today last month. Trey Dellinger, Gunn’s chief of staff, shared the same justification.

Senate leaders do not agree. When Lt. Gov. Delbert Hosemann became lieutenant governor and presiding officer of the Senate in 2020, second-term Republican state Sen. Mike Seymour inquired whether caucus meetings were legal under the Open Meetings Act. After Senate staff did some research, Hosemann decided that he would not convene Senate Republican Caucus meetings because the staff advised him the meetings could very likely violate the Open Meetings Act.

The decision is now before the Ethics Commission, an eight-member body appointed to four-year terms by the governor, lieutenant governor, speaker of the House, and chief justice of the Supreme Court.

Several members of the commission have close ties to the state’s political apparatus or the officials who appointed them. Spencer Ritchie, appointed to the commission in 2018 by then-Lt. Gov. Tate Reeves, was executive director of the Mississippi Republican Party for more than two years.

Erin Lane, an attorney appointed to the commission in 2020 by now-Gov. Reeves, is the wife of one of Reeves’ closest friends, college fraternity brother and campaign donor Colby Lane.

Hosemann appointed Ben Stone, a Republican donor and longtime friend of Hosemann’s, to the Ethics Commission in 2021. Stone has been reappointed to the commission by every lieutenant governor since 1981.

One of Gunn’s two appointees currently sitting on the Ethics Commission is Sean Milner, who is president of the Mississippi Baptist Children’s Village. Milner and Gunn have both been leaders at Morrison Heights Baptist Church in Clinton. It is unclear whether Milner will recuse himself from the commission’s deliberations of Norwood’s opinion request regarding Gunn’s private meetings.

Editor’s note: Vangela M. Wade, president and CEO of the Mississippi Center for Justice, is a member of Mississippi Today’s board of directors.

The post Ethics complaint filed after reporter barred from House GOP Caucus meeting appeared first on Mississippi Today.

Southern Miss, ranked as high as No. 11 in the nation in college baseball polls, is led by a pitching staff that ranks in the top three in virtually every major statistical category, including third in earned run average and second in strikeouts to walks ratio. Associate head coach and pitching coach Christopher (Oz) Ostrander, the wizard behind the numbers, joins the podcast this week.

Stream all episodes here.

The post Podcast: Christopher (Oz) Ostrander: This guy knows his stuff appeared first on Mississippi Today.

Read Auditor Shad White’s thoughts here.

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

One day in early 2020, a Madison man noticed blood in his mouth. His symptoms escalated, and by the end of that week, he was in the intensive care unit at Merit Health Madison. When he woke up from a procedure, the gastroenterologist told him his liver was in bad shape.

He had end-stage liver disease, and the only treatment option was a liver transplant. 

The next two years consisted of a double hip replacement, numerous procedures on his esophagus and visits with an array of specialists, including psychologists. He started a special diet and followed the rules his doctors gave him. He did all of this to become eligible as a transplant candidate at the University of Mississippi Medical Center, which houses the state’s only organ transplant program.

In January of this year, he got the bittersweet call: his liver had worsened, and he was now on the transplant list.

“The liver problem is not something that is linear, it’s exponential. It doesn’t just progressively get worse – it’s one day you’re toddling along doing pretty well, then boom, you can fall off the cliff, and the liver goes bad overnight,” said the man, who did not want his name printed over fear of retaliation and privacy concerns. 

But after all that work and waiting, he, along with all Mississippians with Blue Cross & Blue Shield insurance who are on the transplant list at the University of Mississippi Medical Center, is now ineligible to receive an organ as long as the hospital is out of network with the insurer. 

UMMC, the state’s largest hospital and only academic medical center, went out of network on April 1 with Blue Cross & Blue Shield of Mississippi, the state’s largest insurer. UMMC asked for higher reimbursement rates for its services and disagreed with the company’s quality care plan, which measures hospital performance and whether services provided to patients are adequate.

Mississippi has the lowest reimbursement rate from commercial insurance companies for inpatient services in the nation, according to a 2021 white paper by the actuarial and consulting firm Milliman. The outpatient reimbursement rates are also low compared to the rest of the country. 

Blue Cross balked at the hospital’s proposal, and tens of thousands of Mississippians were left to face higher out-of-pocket medical expenses or find care elsewhere. UMMC has the state’s only organ transplant center in addition to the only children’s hospital, Level I trauma center, Level IV neonatal intensive care unit and other advanced specialties.  

Adults and children with Blue Cross insurance represent about 10% of the transplants done each year, according to UMMC officials. They are not considered under the “continuity of care” obligation, which requires the hospital to honor in-network insurance rates for certain patients until June 30. UMMC officials say this is because a transplant recipient’s care extends far beyond 90 days and requires a lifelong prescription of expensive immunosuppressant drugs.

“We’re still looking at the legal issues and the authority we have to try and bring a settlement about between the parties,” said Mike Chaney, the state commissioner of insurance, when asked about the dispute’s impact on organ transplant candidates. 

READ MORE: UMMC goes out-of-network with Blue Cross Blue Shield

The liver transplant candidate moved to the metro area in 2019 to access better medical care for problems stemming from a serious car accident. He was diagnosed with liver disease in 2020 and found out UMMC’s program was listed in the top three in the country by the Scientific Registry of Transplant Recipients. He was relieved he’d be able to access this life-saving care from a nearby – and esteemed – provider. 

The call that a liver was ready could come anytime of the day or night, and he needed to have a bag packed and always stay within a one-hour drive of the hospital, his care team told him. He should self-monitor and report any changes or issues to his doctors immediately. 

But the first week of this month, the transplant coordinator called him. 

“They said, ‘Your insurance is not willing to pay,’” he recalled. He first understood them to say he had been removed from the list entirely, but later clarified he had been put on “hold” – meaning if his perfect organ became available, he wouldn’t be getting it at UMMC. 

Marc Rolph, executive director of communications and marketing at UMMC, said the process of placing potential transplant recipients on hold, or marking them as “inactive,” due to insurance changes is not new. 

“There are cases where somebody has insurance (we accept), they get on the (transplant) list and change their insurance to one that we’re not in network with,” he said.

Rolph said if and when UMMC returns to being in network with the insurance company, the hold on the patient is lifted.

“So you’re still on the list, you haven’t lost your spot,” he said.

When an organ becomes available — a rare occurrence in itself because of the small percentage of people who are on ventilators before they die — a match is found through a complex database of candidates maintained by the United Network for Organ Sharing. The match is based on a variety of characteristics of both the donor and the recipient, including blood type, medical urgency and the location of the transplant hospital.

But as long as UMMC remains out of network with Blue Cross, patients with Blue Cross who are only on UMMC’s transplant list won’t be notified if a compatible organ becomes available. Instead, it would go to another candidate, or potentially no one at all.

Officials at Blue Cross & Blue Shield of Mississippi call the move “heartless” and say transplants is one of the areas where it offered UMMC an increase in reimbursement when the hospital and insurer were attempting to negotiate their contract.

“Most of these patients have been treated by UMMC for some time and their relationship with their UMMC physician is being disregarded by these tactics,” said Cayla Mangrum, manager of corporate communications for Blue Cross & Blue Shield of Mississippi. “UMMC’s reimbursement for transplants is fair and equitable and based on regional data.” 

But Dr. Alan Jones, associate vice chancellor for clinical affairs for UMMC, said Blue Cross is not telling the whole story. The insurer did offer a minimal increase in transplant, but it was offset by reductions in other areas, he said. 

Details of existing contracts and negotiations between insurers and hospitals, even those that are state-funded, are not public record. 

Chuck Stinson of the Mississippi Organ Recovery Agency, the state’s organ procurement agency that raises awareness about organ, eye and tissue transplantation, declined to comment on the issue.

The UMMC patient scrambled to find a solution after getting the call. He talked to Blue Cross & Blue Shield of Mississippi representatives, who he says are encouraging him to get on the list at Methodist Transplant Institute in Memphis. 

The insurance company doesn’t seem to understand the complicated, involved process of getting evaluated and the challenges of getting care three hours away, he said.

“She (Blue Cross adult case manager) just said ‘Oh, you’ll just go up there and get evaluated,’ and I said, ‘Ma’am, it’s not that simple.’ It was four months (of evaluation) at UMMC,” he said. “And who’s going to pay for me to go back and forth to Memphis? I don’t know a soul in Memphis.”

And because transplant programs have differing criteria for candidates, there’s no guarantee he would be accepted there. Some require a certain MELD (Model for End-Stage Liver Disease) score to qualify. Others only allow a candidate to be on the transplant list at one facility, while others allow candidates to be on multiple lists.

“What if I don’t qualify after I go to Memphis and spend all that time and money? What if, for some reason, they just don’t like a guy that looks like me?” he said. 

And because some insurance plans have coverage limits, people who go through multiple evaluations at different hospitals may exceed their limit and face expensive medical bills.

He is waiting on a cost estimate from UMMC of what the transplant would cost in hopes Blue Cross agrees to pay some of it. But because UMMC has said it will not accept any payments from Blue Cross, it’s unknown whether any payment agreement can be reached.

The average total cost of a liver transplant is $878,400, including costs of care the month before surgery and six months’ of care post-surgery, according to a summary of estimated organ transplant costs for 2020.

“If a Member wants the UMMC Network benefit payment to be made to the Member, they can direct BCBSMS to do so by not signing a Written Direction of Payment,” said Cayla Mangrum, manager of corporate communications for the insurer, when asked about the patient’s situation. “In this situation, the Member would not be guaranteed that UMMC would not balance bill them for amounts greater than their Network benefits.”

Balance billing is illegal under a state law passed in 2013. The law states that if a health care provider accepts payment from a health insurance company on behalf of a patient, the provider is prohibited from collecting any amount from the patient above their deductible, co-pay, or co-insurance amount.

For example, if a patient is billed $10,000 by their hospital the health insurance company pays the hospital $5,000, and the hospital cannot then try to collect the remaining $5,000 from the patient.

If the payment is made directly to the patient, however, it is not considered balance billing for the hospital to charge the patient the difference.

Officials at the hospital and insurance company each point the finger at the other when asked about the sometimes life-and-death effects this contract dispute is having on UMMC patients.

“We understand that some Members may not want to go out of state for their transplant – but it is UMMC that is refusing to care for them,” Mangrum said.

Jones said he hopes Blue Cross “sees the value” of the state’s only organ transplant program and UMMC as a whole.

“We are disheartened that patients with whom we’ve already established a relationship may have to make the difficult decision to get on a transplant list at another facility. We certainly wish they weren’t faced with that process, which can sometimes take multiple in-person visits with a hospital’s transplant program coordinators and surgeons,” said Jones. “We believe it is best for Mississippians who need a life-saving organ transplant to receive it here in their home state.”

This patient said while the situation has been stressful, he’s been able to remain calm. What really gets to him, he says, is thinking about children in his same predicament.

Liver transplant recipients can live a good 30 years, he’s heard.

“At my age, I probably don’t have 30 years left, even with a great liver. But a child that is sick and has a bad MELD (Model for End-Stage Liver Disease) score – a transplant could create 30 more years of healthy living (for them),” he said. “They’ve got their whole lives in front of them. It’s just sad to try to even comprehend that any person or organization would stand in the way of that.” 

The post Need an organ transplant in Mississippi? You may be out of luck thanks to an insurance dispute. appeared first on Mississippi Today.