‘Get out the shot’: This is what vaccine outreach looks like in rural Mississippi

BEAUMONT — Sheran Watkins watched families drift past her tent under picked-clean pecan trees at Fulmer’s Farmstead and General Store. Watkins waved and said hello to attendees at the Mississippi Pecan Festival, but mostly she waited for someone, intrigued by the red-white-and-blue sign next to her, to approach.
Before long, a man walked up to her table. He inspected the shiny blue buttons and the stack of flyers that said: “Get the facts. Get the vaccine. Be a hero!”
“Hey, I’m vaccinated,” he said as he reached for a pamphlet. “Can I take some of these if I need information? I’m trying to get these guys at work vaccinated.”
“As many as you need,” Watkins replied.
When it comes to tabling at Mississippi festivals, Watkins is a seasoned pro, having worked for 26 years as an extension agent for Mississippi State University. In that role, she taught adult canning programs and cooking classes, and went to local high schools to teach food safety courses or host 4-H club meetings.
Watkins had been retired all of five months when, in July of this year, David Buys, the state health specialist at MSU Extension, gave her a call. MSU had received nearly $1 million in grant money to do vaccine outreach in 32 counties in eastern Mississippi. Buys needed someone who could hit the ground running, and he wanted Watkins to come on board to work on vaccine outreach.
“It’s so important because every one of us knows somebody that has passed away from COVID-19,” she said. “There has been nothing in my adult life that has affected the closing of the church in this way — it affects every aspect of our lives. If I can do one thing to try to help someone, I want to be on the frontline.”
Public health experts say it’s “abundantly clear” that vaccination is the only way out of the pandemic. In Mississippi, 44% of the population is fully vaccinated, and the vast majority of COVID deaths in the state were of people who did not receive a shot.
But it’s not that simple. The Centers for Disease Control and Prevention estimates that between 25-32% of Mississippians are hesitant or unsure of the COVID-19 vaccine, with an earlier study conducted by the Mississippi State Department of Health finding most were concerned about the vaccine’s safety, potential side effects and effectiveness.
MSU’s efforts are part of the Mississippi RIVER Project, a larger endeavor by DHA to increase vaccination rates among rural and low-income communities, and communities of color (“RIVER” stands for recognizing important vaccine and education resources). With about $10 million in funding from the U.S. Health Resources and Services Administration, a federal agency focused on expanding health care for rural and low-income communities, the Mississippi RIVER Project is working with colleges and universities around the state.
For MSU’s part, its work is operating from the premise that people who are vaccine hesitant can be convinced: The more accurate information people get, the more likely they are to get vaccinated. Watkins, one of eight organizers on the project, is not a health worker, but she’s worked in rural Mississippi for decades. Buys hopes that Watkins and other organizers can leverage their ties to rural and agricultural communities to reach vaccine hesitant communities and convince them to get the shot.
“We have a special focus and concentration on agricultural-related work in the state, so the health and safety of our farm families is of utmost concern for us,” Buys said. “We try to stay in our lane but do some education where we can, reach the folks we have trust with and leverage our trust to get them science-based information so they can make the best decision for their family.”
Other universities in the state are utilizing similar partnerships to do COVID vaccine education. At the University of Southern Mississippi, Susan Johnson, an associate professor of public health, spearheaded an initiative called the “Community Engagement Alliance Against COVID-19 Disparities,” also known as “CEAL.” With funding from the National Institutes of Health, Johnson created a six-week curriculum to train people interested in becoming community health advisors, or CHAs.
At the end of the course, the newly minted CHAs organized events to spread vaccine awareness. In Hattisburg, a CHA whom Johnson trained held a “vaccination block party” at DeWitt Sullivan park where volunteers gave out popsicles and watermelon.
“In every community, there are people who naturally, when they tell you something, you just believe them,” Johnson said. “With this initiative, we were looking at people who you know in your family, in your neighbor, in your churches, at your workplace — if we can get (them) the right information, (they) will naturally share that information with other people and help to dispel those myths.”
Community health workers sometimes have to tread carefully, though, because the vaccine “is so politicized in Mississippi,” Buys said.
That’s why Buys turned to retired extension agents, like Watkins, as opposed to agents actively working in the field.
“We’re having to be very cautious,” he continued. “We’ve already got relationships built, people that trust us, that we trust, and that we work with, and we recognize that our relationships in those cases are of high, high, high importance. If we burn those bridges, those relationships, then what do we have?”
Rather than run away from politicization, DHA decided to tackle vaccine outreach like it is a political campaign.
“Political campaigns focus on GOTV, ‘get out the vote,’” Buys said. “Well, this is ‘get out the shot.’”
And just like with political campaigns, there’s a script, which DHA based on research from the World Health Organization, the De Beaumont Foundation, the Kaiser Family Foundation, and other health groups. It goes like this: First, educators are instructed to open the door to a conversation with an open-ended question, such as “You may be hearing a lot about COVID vaccines. Tell me what you think about them?” Then, validate their concerns — without playing into misinformation. That’s done by utilizing what’s called the “truth sandwich” approach: Start with the truth, acknowledge misinformation, then return to reality. DHA advises COVID educators to emphasize the benefits people will gain from getting vaccinated, such as the ability to gather safely with family.
Finally, educators help people make a plan to get vaccinated, much like a canvasser would help a voter identify their polling place.

At the Pecan Festival in Perry County, Watkins didn’t have time to walk people through her script. In that kind of environment, her work was more about listening to the folks who chose to come up to talk to her, like one family of five, who asked about taking some of the pamphlets home.
“We’re trying to get my parents to get vaccinated,” the dad told Watkins.
“Make sure they know it’s ‘cause you love them and you want them to be around,” Watkins said.
“Yeah that’s what I say,” he replied.
As the family walked away, one of the kids told Watkins, “You have a good time and I hope you don’t get corona!”
On Saturday, just one person who wasn’t vaccinated came up to Watkins, a woman who wanted to say that she wasn’t going to get vaccinated. “That’s your choice,” Watkins told her.
“That was the right thing to say,” she replied before walking away.
Watkins shrugged off the encounter: Her goal is to provide information, not judge people who don’t want to get vaccinated.
“Sometimes people just don’t know,” Watkins said. “To me, you can’t blame them for those things they just don’t know.”
“Being an extension agent for so many years,” she continued, “you learn that you’re gonna hear a lot, you’re gonna deal with a lot. There’s no reason for me to get upset at someone who got themselves in a financial mess — they’ve still got to take that class to get out of that mess.”
Watkins knows her job is not without risk. She is in communities weekly meeting new people where the risk of transmission is high, and she worries about bringing the disease home to her husband who has heart stents. Still, Watkins wants to help.
“It does still make you nervous because COVID is real and people have died,” she said. “Sometimes you have to put that in the back of your mind to try to share the information and let people know there are resources.”
“But again, it is about being safe,” she added. “I put on a seatbelt and think nothing about it, because it’s for my good. … We’ve been vaccinated all our lives. What’s one more?”
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Gov. Reeves says he’ll call medical marijuana special session ‘sooner rather than later’

Gov. Tate Reeves on Wednesday said he’ll call lawmakers into special session on medical marijuana legislation “sooner rather than later,” but would not speculate a date or whether he’ll also let legislators tackle pandemic pay for nurses or other COVID-19 measures they’re proposing.
Reeves said there are still details — such as funding for a medical marijuana program — to be worked out, and indicated a session would be in coming weeks, but not this week as lawmakers had requested.
READ THE BILL: Mississippi’s long-awaited medical marijuana draft
“There is no update on exactly when, but I do anticipate we are going to have one sooner rather than later,” Reeves said at a press conference on workforce training on Wednesday. He said he spoke on Monday with Lt. Gov. Delbert Hosemann and House Speaker Philip Gunn.
“We are a long way towards getting a final agreement, but not all the way there yet,” Reeves said. “At this point it’s jut a matter of working out the final details … things such as funding, an appropriation bill, what that would look like.”
After months of negotiations, Gunn and Hosemann announced a House-Senate agreement last week on a medical marijuana program to replace the one adopted by voters last year but shot down by the state Supreme Court on a constitutional technicality. Gunn and Hosemann said they have the votes to pass the measure and asked Reeves to call a special session for Friday.
The draft medical marijuana bill legislative leaders have agreed to would levy the state’s sales tax, currently at 7%, on marijuana, and a $15 per ounce excise. But the bill does not specify funding for the Departments of Health, Revenue and Agriculture to run and regulate it. The bill routes the marijuana revenue into the general fund. This has prompted concern from state health and agriculture leaders that lawmakers would not adequately fund the agencies to stand up such a program.
Agriculture Commissioner Andy Gipson, who said he opposes his agency being involved in marijuana regulations, said the Legislature is “notorious” for creating new programs or duties for agencies without providing extra funding or staff. State Health Officer Dr. Thomas Dobbs expressed similar funding concerns this week.
Reeves has sole authority to call lawmakers into special session and set the agenda.
Hosemann and Gunn have also asked Reeves to allow lawmakers to tackle COVID-19 issues in a special session.
They want to give federal American Rescue Plan Act money to hospitals to pay nurses extra to help with what some health officials said is a shortage statewide of 2,000 nurses during the pandemic.
Gunn and Hosemann also want to change wording in a law that would allow families of first responders to receive death benefits if the first responder dies from COVID-19. Public safety officials have determined that a 2016 law that provides $100,000 in benefits to families of those who die in the line of duty does not cover COVID-19 deaths.
Hosemann and Gunn also want to provide emergency funding from federal ARPA funds to child abuse and domestic violence shelters and programs, who have lost regular sources of funding due to the pandemic, while cases of abuse have increased.
Reeves has had a rocky relationship with the Legislature, and has clashed particularly with his fellow GOP legislative leaders over control of spending federal pandemic stimulus money. Reeves has also said he doesn’t want lawmakers tied up at length in a special session, which would cost taxpayers tens of thousands of dollars a day.
READ MORE: Summary of the long-awaited medical marijuana deal.
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Podcast: It’s Golf Week in Mississippi

Golf professional and Mississippi Sports Hall of Famer Randy Watkins joins the Cleveland boys to discuss the Ryder Cup and the Sanderson Farms Invitational, which is played this week at the Country Club. As it happens, all-time Ryder Cup match-winner Sergio Garcia will defend his title, coming off the American’s record-setting victory over the Europeans at Whistling Straits. Watkins, an Ole Miss man, also has an opinion on Saturday’s Ole Miss-Alabama football showdown. You know the Cleveland boys do, too.
Stream all episodes here.
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Mental Health chief says agency will comply with federal order despite appeal by attorney general

Mississippi Mental Health Executive Director Wendy Bailey said she will work to carry out a federal order to place more of an emphasis on treating people suffering from mental illness even as the office of Attorney General Lynn Fitch prepares to appeal the ruling.
When asked recently by legislative leaders about a possible appeal of a final remedial order handed down earlier this month by U.S. District Judge Carlton Reeves, Bailey said, “I feel we are on track to make great progress even over the next 24 months in this area.
“We will comply with the judge’s order and do everything that we need to do as a state agency,” she continued. “As far as the appeal, that would be a question for the Attorney General’s office.”
Last year, Reeves ruled in favor of the U.S. Department of Justice, which had sued the state of Mississippi on allegations it violated federal law by not prioritizing treating mental health patients in community settings when possible instead of placing them in hospitals.
Reeves issued his remedial order earlier this month putting in place a monitor and specific guidelines on how the state should achieve the goal of treating people in community settings. On Monday, Fitch’s office filed a motion asking Reeves to stay portions of his order while it was appealed.
Fitch argues the order would mandate the state spend money not yet appropriated by the Mississippi Legislature and it should be up to the state, not the judge, to determine how to meet the mandates of moving toward providing care in community settings.
“The balance of equities tilts strongly in favor of partially staying the remedial order pending the outcome of the appeal,” the AG’s office wrote in its motion to Reeves.
Reeves’ order provides the state 120 days — until Jan. 5, 2022 — to develop a draft plan, and until March 6 to craft a final plan.
“I can tell you we are committed to providing services in the community and to expanding that,” Bailey said. “We know where we need to go. As the Department of Mental Health, we are going to continue to do that.
“There is still progress to be made and still goals we need to meet. We are dedicated to doing that.”
Bailey, speaking on Sept. 24 at a hearing of the Joint Legislative Budget Committee as it works to develop a budget for the new fiscal year beginning July 1, said the $40 million her agency has received from the federal government as part of COVID-19 relief packages will be used in part to move more toward community treatments.
In addition, Bailey said she anticipates going to the Legislature in January after her agency crafts its draft plan to respond to the judge’s order to request the Legislature appropriate at least a small portion of the $1.8 billion it has received in federal COVID-19 relief funds to help address the issue of moving more mental health care to community settings.
Lt. Gov. Delbert Hosemann agreed with Bailey, saying, “we need to do the right thing” regardless of the Department of Justice lawsuit.
Since fiscal year 2012, as the U.S. Department of Justice investigation ramped up, Bailey said the state has reduced spending on institutional care by $70.8 million and increased community-based care by $88.8 million as of fiscal year 2020, which ended on June 30, 2020. For the current year, Bailey said, the agency will divert another $5.8 million from institutional care to the community setting.
The DOJ alleged that the state system often denied patients the opportunity to receive care in their communities and increased the risks of long-term hospitalization of people suffering with mental health issues. In ruling for the federal government, Reeves conceded that the state was moving in the right direction in terms of community care, but that there were still gaps in the state system.
“Mississippi now has intensive community support services in all 82 counties,” Bailey said, adding that 85% of the people now being served are receiving that treatment in the communities.
She said “the continuum of care” provided by mental health hospitals must be maintained for those who need it. But she added, “Most anything and everything we can do to divert from state hospitals and provide services in the community, that is what we are going to do.”
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Legislative Black Caucus holds medical marijuana hearing, may draft its own bill

As the state’s Republican legislative leadership waits for Gov. Tate Reeves to call lawmakers into special session for medical marijuana, a special committee of the Mississippi Legislative Black Caucus on Tuesday held a daylong hearing on the issue.
“The hearing will help us meaningfully evaluate legislation that has been crafted in the event of a special session,” said Black Caucus Chairwoman Sen. Angela Turner Ford, D-West Point. “And should the session not materialize, the caucus will use the information provided during the hearing to prepare its own medical marijuana bill.”
The caucus on Tuesday heard from medical experts, including state Health Officer Dr. Thomas Dobbs, on the pros and cons of medical cannabis and from patient advocates, policy and industry experts.
WATCH: Mississippi Legislative Black Caucus holds hearing on medical marijuana.
Mississippi’s GOP legislative leadership last week announced House and Senate negotiators had reached a deal on draft legislation to create a medical marijuana program. This would replace a program passed by voters last year through a ballot initiative, but struck down by the state Supreme Court on a constitutional technicality.
Lt. Gov. Delbert Hosemann and House Speaker Philip Gunn on Friday requested Reeves call the Legislature into special session to address the legislation, and other issues. But Reeves, who has sole authority to call a session and set the agenda, has not responded to the request, although he had previously said he would call a medical marijuana session if lawmakers could reach agreement. Both Hosemann and Gunn last week said they believe they have the votes to pass the measure.
The Black Caucus on Tuesday heard from Karmen Hanson, with the National Conference of State Legislatures, who outlined some of the medical marijuana policies, tax and fee structures of other states. She noted how varied they are.
“If you’ve seen one state’s cannabis regulatory program, you’ve seen one state’s cannabis regulatory program,” Hanson said.
The caucus also heard testimony from Agriculture Commissioner Andy Gipson, a day after Gipson held a press conference to reiterate his opposition to his agency helping oversee a medical marijuana program, as the draft legislation proposes.
“I disagree with the assumption that just because it’s a plant, it should be with the Agriculture Department,” Gipson said. He thanked the caucus for allowing him to participate in the hearing, and said he was not allowed to participate in similar hearings the legislative leadership held drafting the bill.
Gipson said that, among other concerns, his agency doesn’t have the staffing, experience or funding to oversee cannabis growing, processing and transportation. He said this would cost an estimated $3.5 million to $4 million a year, and legislative leaders have not said how it would be funded.
House Minority Leader Robert Johnson III, D-Natchez, said, “We need to make sure everybody involved in this has the proper funding and staffing.”
Gipson said he believes the Health Department should be solely responsible for regulating medical marijuana, but that his office would provide any advisory or consulting help it needs.
“I know there’s going to be a medical marijuana program in Mississippi,” Gipson said. “This is the opportunity to get it right.”
Caucus members during the Tuesday hearing questioned many particulars of the bill drafted by the GOP legislative leadership.
READ MORE: Mississippi’s long-awaited medical marijuana draft. Read the bill.
Rep. Omeria Scott, D-Laurel, questioned the proposal allowing only indoor growing, in lock-and-key facilities of at least 1,000 square feet, in a state with some of the richest farming land in the world, and with many struggling small farmers.
“We are precluding Mississippi farmers in this bill from even being allowed to participate,” Scott said.
The caucus heard from minority farming advocates and university research experts, including the head of the Black Farmers and Agriculturalists Association, who said the country has seen “virtually the extinction of the African American farmer” in recent decades. Cannabis could help “attract African Americans back to the land” for farming, he said. But allowing only indoor growing, he said, would prevent many Black farmers with small landholdings and less assets from participating.
But research experts noted that most states require indoor growing for medical marijuana to help improve the safety and standardization of products. Others noted that some states have used their land grant universities to help run medical marijuana programs and to help farmers get involved. Mississippi’s land grant universities are Alcorn State University and Mississippi State University.
A Mississippi patients advocate at the hearing Tuesday told harrowing stories and showed photos and video of children with debilitating conditions that could be treated with medical cannabis. Some Mississippi families have had to become “medical refugees” and leave the state for treatment, lawmakers heard.
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Accelerate Mississippi funds Gulf Coast diesel tech program, flexing its new authority over job training dollars

Mississippi’s brand new workforce development office has awarded nearly $1 million to a Gulf Coast college program that trains diesel technicians, marking the first time Accelerate Mississippi has publicly flexed its authority over state job training funds.

The award signals a shift in how the state is spending workforce training dollars under the guidance of Ryan Miller, Accelerate Mississippi’s executive director. Miller’s office oversees tens of millions of dollars, including a $25 million pot collected via an unemployment insurance tax on businesses for the state’s 15 community colleges. But that oversight just began in July.
“We are trying to be more targeted and specific toward the areas where we are focusing funding and resources,” Miller said. “Where are there industry sectors that appear to have a large amount of vacancies with a large need that are also professions that pay above the average wage?”
Mississippi Gulf Coast Community College, which will use the money to grow the capacity of its diesel technician program from 20 students to 40, is the first program to make a proposal to Miller’s office and be awarded money. Miller has designated $10 million of the $25 million pot for the office’s grant program to target in-demand jobs.
That money is part of the state’s Workforce Enhancement Training — or “WET” — fund. It had previously been the charge of the state’s Community College Board, which is still involved in processing the funds.
Miller’s new office, however, was given freedom and flexibility under legislation passed in 2020 to direct those funds in ways the college board could not when it manned the money alone.
The board’s former director, Andrea Mayfield, told Mississippi Today last year that the fund’s guidelines favored those already working and relied upon employers making requests. That’s no longer the case.
“In essence, we’ve taken the position that, in addition to direct requests from employers, we need to focus our WET fund resources upon those career opportunities in which there is a discernible need and could result in increased wages for Mississippians,” Miller said.
A Mississippi Today report last year found that a quarter of the roughly $23 million spent through the Community College Board covered businesses’ Occupational Safety and Health Administration training. In most cases employers are required to provide such training, which doesn’t typically result in new skills.
Miller said as his office looks over past expenses in its new role, it will have to ask hard questions.
“Does stand-alone safety training meet the requirement of enhancing productivity?” Miller posed. “In most cases, probably not.”
Kell Smith, the interim director of the Community College Board, said the body has welcomed Miller’s direction.
Mississippi Gulf Coast Community College’s grant totals $941,701. The grant will cover $500,000 in new equipment and $288,000 in scholarship money among other expenses to train technicians to maintain and repair diesel engines.
Mississippi graduated 106 diesel technicians per year during a four-year period ending in 2020, according to state data. Yet, the average number of positions open per year in the state during that period was 526.
The Gulf Coast college created the program in spring 2020 in direct response to businesses that were grappling with the gap in qualified candidates to fill open technician jobs. The college reported in its application that every student in the first cohort found a job in the field.
“Our college is thrilled to take on this challenge and in return create economic opportunity for residents of the gulf coast,” Mississippi Gulf Coast Community College President Mary Graham said in a statement.
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Agriculture commissioner bashes medical marijuana bill, says he won’t participate

State Agriculture Commissioner Andy Gipson said lawmakers are not following the will of voters with a medical marijuana proposal and reiterated his vow that his agency will not participate in regulating it.
“Who is going to operate this expansive program?” Gipson, a former longtime state legislator, said at a press conference on Monday. “Who is going to pay for it? How much is it going to cost? Standing here today, I don’t think anyone can answer these questions … The Mississippi Legislature is notorious for passing massive government programs and expanding bureaucracy without providing any way to pay for it.”
“This agency is not designed nor equipped, nor is this agency funded for such an expansive and expensive program as this proposes,” Gipson said. “… This is not what people voted for … This is not what people elected me to do, be a marijuana kingpin.”
READ MORE: Mississippi’s long-awaited medical marijuana draft
Lt. Gov. Delbert Hosemann and House Speaker Philip Gunn last week announced that legislative negotiators had reached agreement on a draft bill to create a medical marijuana program to replace the Initiative 65 program passed by voters last year but shot down by the state Supreme Court. Hosemann and Gunn have asked Gov. Tate Reeves to call lawmakers into special session on Friday for the Legislature to pass the measure.
The proposal calls for the program to be regulated by the Mississippi State Department of Health, the Department of Agriculture and the Department of Revenue. Initiative 65, briefly enshrined in the state constitution by voters before being struck down by the high court on a constitutional technicality, would have had MSDH solely in charge of regulating the program.
But Gipson, who said he had no input in the bill and only saw the draft on Friday, has said for weeks that he does not want to regulate growing, processing or transportation of marijuana as the bill provides. He initially said marijuana remains federally illegal, so he would be violating his oath of office to uphold U.S. laws if he participated. On Monday he listed numerous other problems he has with the proposal, although he said he believes the state will ultimately join more than two dozen others in having a medical marijuana program.
For starters, Gipson said, the legislative proposal doesn’t follow the letter or spirit of Initiative 65.
READ MORE: Summary of the long-awaited medical marijuana deal.
Gipson said he estimates it would cost his agency $2.9 million a year to oversee cultivation and processing of medical marijuana, and he doesn’t yet have an estimate how much it would cost to regulate transportation and disposal the draft bill tasks his agency with. He noted lawmakers tasked his office with overseeing hemp growing two years ago, but have twice denied his request for $500,000 in additional funding for it and have “not appropriated one copper penny for the Hemp Cultivation Act.”
“That $2.9 million would be a 41% increase in the budget of this little agency,” Gipson said.
Gipson said the Health Department should handle all regulation of the program, as Initiative 65 outlined. He said only one other state, Florida, has its agriculture department regulating it. He said having one agency, the Health Department, regulating marijuana would provide “efficiency” and less expansion of government and bureaucracy.
Gipson said Initiative 65 would have been self-funded, “by the industry” through fees, but that lawmakers are now planning to tax it and all the money “is sucked up and going into the state general fund” with no clear plan from lawmakers on how to fund the program.
“This proposal is not what people voted for,” Gipson said.
Gipson said the bill would have his agency providing oversight within 60 days of its passage and that timeframe “is unworkable.” He noted that Alabama’s newly created medical marijuana program gives agencies 18 months to stand up a program.
Neither Gunn’s nor Hosemann’s offices immediately responded to a request for comment on Gipson’s press conference on Monday. But legislative negotiators have noted that they provided Gipson with an out in the proposal. It would allow Gipson’s agency to contract out its oversight in the legislation to another agency or private contractor.
Gipson, who had previously said he might sue if lawmakers tried to force his agency to regulate medical marijuana, said, “If this passes the way it reads now, we would have to consider farming it out.”
“But if they put that in the bill, why not let the Department of Health farm it out, too?” Gipson said, saying that having three agencies involved is a recipe for inefficiency, red tape and high costs. He said he is also concerned the legislation “has no real role for law enforcement” such as the Department of Public Safety or Mississippi Bureau of Narcotics.
Gipson said he’s willing to work with lawmakers on drafting a better program and believes “at the end of the day this can be fixed very simply with modest changes, and make it look more like Initiative 65.”
READ MORE: Gov. Reeves noncommittal as lawmakers ask him to call special session on marijuana, COVID-19
Reeves, who has sole authority to call special legislative sessions and set the agenda, has not said when, or if, he would call lawmakers back to Jackson to deal with the proposal, but he had said he would call a medical marijuana session if lawmakers were in agreement on a program.
Hosemann and Gunn last week said they believe they have the votes to pass the proposal.
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