Legislators, working with an unprecedented amount of money thanks to record state tax collections and $1.8 billion in federal coronavirus-relief funds, are slated to return to the state Capitol Monday morning with hopes of finalizing a state budget.
House Speaker Philip Gunn said the goal is to complete the task and end the 2022 legislative session by Tuesday.
Legislators were scheduled to complete the budgeting process early last week, but twice have had to extend the session to complete the process.
“We have a few little details to take care of” to finalize a budget agreement, said Senate Appropriations Chair Briggs Hopson, R-Vicksburg.
The budget is likely to be about $300 million more than the $6.56 billion overall state support budget passed during the 2021 session. That will include the $246 million already committed for a pay raise averaging $5,145 for teachers and a 3% raise for state Highway Patrol troopers and for Mississippi Bureau of Narcotics officers. Money also will be set aside to provide raises for some state employees to get their salaries closer to regional averages.
Hopson said the final budget agreement that will be offered for legislators to vote on also will likely include additional funds for early childhood education and for the school building fund.
It is not clear, though, whether the budget will include additional money for the Mississippi Adequate Education Program, which provides the state’s share of the basics to operate local school districts. Early budget projections had MAEP about 10% short of full funding.
Negotiators said they are likely to commit to spending $1.5 billion of the $1.8 billion in federal COVID-19 funds this session. The bulk of those funds will be used to help local governments with their water and sewer infrastructure needs.
The funds also will be used:
To provide funds to the departments of Corrections, Mental Health and Child Protection Services to deal with lawsuits or pending lawsuits based on substandard conditions.
To enhance tourism efforts.
To shore up needs in the health care system highlighted during the height of the COVID-19 pandemic.
Senate Finance Chair Josh Harkins, R-Flowood, said the state will be able to save about $30 million this year by not passing a bond bill. The Legislature often incurs debt for the state by issuing bonds to finance various construction projects. Instead, this year the projects will be funded through the more than $1 billion in surplus funds the state has because of the unprecedented revenue collections. Those funds are expected to be used for state building construction, construction at the universities and community colleges and for road and bridge needs.
Those funds also could be used for local construction projects approved by the Legislature.
Katina Spaulding’s daughter started walking at 15 months. Spaulding thought that was normal: This was her first child, and she had no one to compare her to.
But when Spaulding enrolled her daughter in the Head Start program in Biloxi, a developmental screening revealed she wasn’t learning at her age level. Additional tests showed the little girl couldn’t hear properly because her eardrum was full of fluid.
“That made her walk late, talk late– she wasn’t connecting the dots,” Spaulding said.
The screenings revealed the problem and pointed the way to solutions. Spaulding’s daughter, now 16, was able to get treatment.
“I would haven’t been able to get any of that without the screening,” said Spaulding, who now works as a family health service specialist at the Moore Community House Early Head Start Program in Biloxi. “My baby would have been worse off.”
But the experience of Spaulding’s family is not typical in this state. In 2016, only about 17% of Mississippi kids under three years old completed a developmental screening, according to a national survey– the lowest rate in the country and well below the national average of 30%. That means Mississippi kids often aren’t able to access services and treatments to help them catch up to peers.
Early childhood experts say the picture is improving. Funded by a $17 million federal grant, the Mississippi Thrive Child Health and Development Project has spent the last five years working to improve children’s developmental health, including by increasing screenings. In recent years the share of kids completing screenings has put Mississippi closer to the middle of the pack nationally– but that still means most kids aren’t getting screened, said principal investigator and University of Mississippi Medical Center pediatrician Dr. Susan Buttross.
And with an estimated 15% of all kids experiencing a developmental delay, many Mississippi children start school with developmental delays still unidentified and untreated, affecting their ability to learn and shaping how their teachers and peers relate to them.
Spaulding worries about what that means for them as they grow and try to learn in classrooms that aren’t always designed to give them individualized attention.
“If your shoes ain’t tied like Johnny’s shoes, your shoes ain’t right,” she said. “That child gotta find their way. So where are they? They’re lost. They’re labeled.”
Franklin Head Start students practice identifying colors during class at Franklin Head Start in Bude, Miss., Thursday, March 31, 2022. Credit: Eric Shelton/Mississippi Today
Developmental screening involves reviewing a checklist to see whether a child has reached milestones for their age. At the center where Spaulding works, the screener for babies under three months asks caregivers to answer questions like: “Does your baby smile when you talk to him? When your baby is on her back, does she kick her legs?”
The screenings can identify early whether a child has a developmental delay, and research shows intervention before a child is 5 years old improves long-term outcomes.
More than 20 years later, though, screenings are far from universal. The study that found less than 20% of Mississippi kids under three years old had been screened in 2016 also found rates varied widely across the country, with the highest figure in Oregon, at about 60%.
In Mississippi, Buttross said, many children don’t have a primary care pediatrician. About half of Mississippi’s population is rural, and some counties don’t have a single pediatrician. Kids without a pediatrician get medical care when they need it at an emergency room or an urgent care center, but they don’t have a “medical home” where a doctor tracks their development and health over time.
And some pediatricians working in the state were trained years ago, before universal developmental screening was the goal and before evidence-based tools were widely used.
“Many times children who had milder delays were not discovered,” Buttross said. “Some of it was education, some of it was lack of resources.”
A joint project of UMMC and the Social Science Research Center at Mississippi State University, the Mississippi Thrive initiative has focused on educating pediatricians, nurse practitioners, social workers, childcare providers and parents on the importance of developmental screenings and how to conduct them.
“Healthy children mean a healthy future, and so the better we take care of our kids early on and the more we link them to needed services, the better off they will be, the better off their families will be and the better off our state will be,” Buttross said.
Franklin Head Start students practice identifying colors during class at Franklin Head Start in Bude, Miss., Thursday, March 31, 2022. Credit: Eric Shelton/Mississippi Today
Given Mississippi kids’ patchy access to pediatricians, child care providers can play an especially important role in screenings. And for decades, Head Start has shown how this can work.
The federally funded child care centers serve infants and toddlers from low-income families, and their operating rules require them to provide developmental screenings. Though Head Start centers comprise only about 10% of the state’s childcare centers, they completed 30% of all developmental screenings by child care providers, according to a 2021 study by the Children’s Foundation of Mississippi.
More than half of all childcare centers in the state did no screenings.
Nita Norphlet-Thompson, executive director of the Mississippi Head Start Association, called developmental screenings “a cornerstone” of Head Start programming. With centers in all 82 counties, Head Start serves 23,000 pregnant moms, infants, and toddlers. Every child enrolled gets a physical, a dental exam, and screenings for speech, vision, and overall development.
If a child fails his hearing screening, for example, the center will refer the family to an audiologist who can start treatment. If a family can’t afford the costs, Head Start steps in to cover the expenses.
The results guide the center’s instruction and goals for each child.
“How do you know where to go with a child if you don’t know where the child is?” Norphlet-Thompson said.
Cathy Gaston, executive director of Friends of Children of Mississippi, which runs Early Head Start programs serving about 3,500 children across 20 counties, said that when a child leaves Head Start and begins kindergarten or first grade, the program coordinates with their school to make sure they get services right away.
“[The screenings] also give you an opportunity to start really early,” she said. “Many times, you find by the time they reach school age you’ve kind of worked through those things.”
Tricycles are in place for students at Franklin Head Start in Bude, Miss., Thursday, March 31, 2022. Credit: Eric Shelton/Mississippi Today
What will it take to continue increasing developmental screenings in Mississippi?
Head Start leaders suggest screenings could be mandatory for all child care providers. But Buttross said conversations with child care directors suggested that mandated developmental screenings could be burdensome for the centers, potentially affecting their ability to operate.
“If child care is needed, the worst thing we could do is set up a barrier,” she said.
One possibility could be to create a “gold star” to reward child care centers that do provide developmental screenings.
Gaston said Head Start and other programs can partner with local organizations in underserved communities to set up free screening events. Incentive programs for parents and more mobile services could help, too.
“You’ve got to be really willing to go to those rural areas where you know there’s a challenge,” she said.
Buttross’ team has also documented another problem: When a developmental delay is discovered, parents aren’t always able to find specialists who can treat the issue. Some private health insurance plans don’t cover key services like speech therapy.
Families of kids with developmental delays are supposed to be able to access free developmental services through the state’s Early Intervention Program. But families often face delays in accessing services because of staffing and funding issues, Head Start leaders said.
Norphlet-Thompson, who has worked for Head Start since 1988, said she and her colleagues have always seen the importance of developmental screenings. In recent years, she’s seen more discussion of the topic across the board in Mississippi.
“We’re so glad that everybody else is catching up,” she said.
Mary Harrington, Early Head Start director; Katina Spaulding, family health service specialist; and Margaret Crawford, education specialist stand outside their office at the Moore Community House Early Head Start program in Biloxi.
So much going on in the sports world, including on the golf course, where Chad Ramey of Fulton became the first native born Mississippian to win on the PGA Tour in 52 years. This week, we’ve got both the men’s and women’s Final Fours and so much high level college baseball. The Cleveland boys talk about it all in this episode.
Senior political reporter Bobby Harrison sat down with State Economist Corey Miller to talk about Medicaid expansion at the third and final Mississippi in the Know: Legislative Breakfast on Thursday, March 24. Miller, alongside Senior Economist at the Mississippi Institution for Higher Learning Sondra Collins, has recently published a study from the University Research Center analyzing the effects of Medicaid expansion on the state.
Watch the full conversation:
Editor-at-large Marshall Ramsey took the stage during the conversation to complete a live drawing that referenced the role Miller’s research has played in the tense 2022 legislative session.
Mississippi’s largest hospital went out of network with the state’s largest insurer on Friday, meaning thousands of Mississippians will now face higher out-of-pocket costs for their health care or be forced to leave the state for certain specialty care.
This is the first time the state’s only academic medical center has officially gone out of network and not had an active contract with Blue Cross Blue Shield of Mississippi, according to UMMC officials’ knowledge.
Even though representatives for both sides have been meeting in person each week since January, the two entities were not able to agree to a new contract before the March 31 deadline.
UMMC is asking Blue Cross for substantial increases to inpatient, outpatient and professional reimbursement rates, some as large as 50%. UMMC maintains it’s asking for below market rates for academic medical centers, while Blue Cross officials say that steep rate hikes would necessitate a substantial increase in customer premiums.
“We are disappointed that Blue Cross doesn’t value the Medical Center enough to agree to a fair contract and keep us in its network,” Dr. LouAnn Woodward, vice chancellor for health affairs and dean of the UMMC School of Medicine, said in a press release. “We know that patients are disheartened and frustrated. We must – for the health and wellness of all Mississippians – stand firm in our resolve that Blue Cross should agree to pay us at fair market rates.”
The two sides have also sparred over Blue Cross’ quality care plan, which measures hospital performance and whether services provided to patients are adequate across 15 different categories. UMMC leadership has said that the complexity involved in the care the hospital provides means it should have an individualized quality care program, while Blue Cross maintains that UMMC should be held to the same standards as its other network providers.
“It is unfortunate we have not been able to reach an agreement,” said Cayla Mangrum, corporate communications manager at BCBSMS, in a statement. “Unreasonable demands by UMMC for increased payments, along with their unwillingness to agree to Network Hospital quality requirements, are not in the best interest of our Members and Groups as we seek to provide access to quality, cost-effective health care. We will continue to work to reach an agreement with UMMC, but until then, our primary goal remains our Members’ health.”
There are certain services and facilities UMMC has that cannot be found anywhere else in the state. These include Mississippi’s only Level 1 trauma center, Level IV neonatal intensive care unit and children’s hospital, among other critical care services.
Insurance Commissioner Mike Chaney told Mississippi Today this week that he questions whether BCBS could meet the state’s Managed Care Plan Network Adequacy Regulation without UMMC in its network. The regulation requires health insurance providers to “maintain a network that is sufficient in numbers and types of participating providers to assure that all devices to covered persons will be accessible without reasonable delay.”
Cheney also said his office would get involved if the two parties didn’t strike a deal by Friday.
This week, Mississippi Today spoke to parents whose children have been receiving specialty care at Children’s of Mississippi. Few have received answers about what the future holds and some are scrambling to find an alternative provider for their children.
“The truth is we can’t go anywhere else,” said Lanier Craft, whose son has Pompe disease, a rare genetic condition that affects the muscles. “This is all there is for us. Batson has been there since I walked in the door in February eight years ago with my child. They have done everything for us, and to just completely lose that within a day because of an agreement over money is unimaginable.”
There are three groups of Blue Cross Blue Shield customers that UMMC’s out-of-network status won’t apply to:
Those enrolled in the Mississippi State and School Employees’ Health Insurance Plan. Though that plan is administered through BCBS, only commercial insurance plans are affected.
Patients who come into UMMC’s emergency room or are transferred from another hospital.
Patients for which UMMC has a continuity of care obligation. UMMC can’t stop caring for, say, a pregnant woman in her last trimester of pregnancy or a cancer patient who is in round two of 12 rounds of chemotherapy. For these patients, this period of coverage will expire 90 days from April 1.
Mike Feder arrived in Jackson in 1979 to become general manager of the Class AA Jackson Mets, which was the Class AA affiliate of the New York Mets from 1975 until 1990.
The historic Easter Flood decided to tag along. When the Texas League season began, Smith-Wills Stadium was submerged under Pearl River floodwaters.
“I’ve never seen so much rain,” Feder said. “It almost seems as if it never stopped raining. I’ve still got scars on my knuckles from pulling that tarp. We set a Texas League record for rainouts.”
Rick Cleveland
Nevertheless, Feder spent the next nine years running the Jackson team.
“We had a lot of great players, a lot of great managers and coaches who came through on their way to the Big Leagues,” Feder said. “We won some championships and we had some fun.”
Those times will be re-lived this weekend when former players, coaches and managers will travel back to Mississippi for a Jackson Mets reunion. They’ll play some golf, wine and dine, tell some stories and have a meet and greet with fans Saturday morning at the Mississippi Sports Hall of Fame Museum (10 a.m.).
More than 30 former players, including several who made the Major Leagues, will attend. Those include Darryl Strawberry who as a 19-year-old Jackson Met slugged 34 home runs. That figure is especially impressive when you consider Strawberry played all his home games in a cavernous, often humid ballpark where home runs elsewhere were fly ball outs.
The ball sounded different coming off Strawberry’s bat – take it from someone who would go to the ballpark just to watch him take batting practice. His home runs often soared high into the pine trees beyond the right field fence, an area that became known as “The Strawberry Patch.”
In 1982, Strawberry, Billy Beane and Terry Blocker often manned the three outfield positions in the Jackson Mets lineup. All three were former No. 1 draft choices. Strawberry and Beane, who went on to become General Manager of the Oakland A’s and subject (played by Brad Pitt) of the hit movie “Moneyball,” are both expected to attend the reunion.
Strawberry went on to hit 335 Major League home runs. If that home run number surprised anyone who watched him in Jackson, it was only because he did not hit more.
Mike “Mad Dog” Howard.
One former Jackson Met who won’t have to travel far is Mike Howard, who lives in Gluckstadt. Howard met his wife here during his Jackson Mets days (1979-80) and returned to the Jackson area when his playing days ended. Any Jackson baseball fan from that era will fondly remember Howard, known as “Mad Dog” because of his relentless playing style. Mad Dog Howard ran to first base even after he walked or was hit by a pitch.
“People asked me why I would run to first after a walk,” Howard said. “I’d tell them I was just warming up so I could steal second and third base.”
Howard stole 55 bases over his two full Jackson Mets seasons. In 1980, when he was the Jax Mets MVP for a Texas League championship team, he hit .291 with 29 doubles and eight triples and seemed on a fast track to Shea Stadium in New York.
Howard did make it to New York but the stay was short. “You’ve heard of getting a cup of coffee in the Big Leagues?” Howard said. “I had time for two cups of coffee and a bagel.”
He played parts of the 1981, ’82 and ‘83 seasons for the New York Mets. On opening day of the 1983 season, Howard started in right field against the Philadelphia Phillies. Hall of Famer Steve Carlton was on the mound for the Phillies. Hall of Famer Tom Seaver was on the mound for the Mets. The Mets won 2-0. The switch-hitting Howard knocked in the winning run. As cups of coffee go, that one was sweet. And it got sweeter.
“So the next day it’s raining, and I go to the batting cage underneath the stadium to get some B.P., and somebody was already there. It was Pete Rose getting in some swings,” Howard said. “Well, Pete Rose was my childhood idol. So I introduced myself to him and he said, ‘Oh, I recognize you. You kind of have my playing style.’ I could have died and gone to heaven right then.”
Not nearly all the former Jackson Mets returning for the reunion made it to the Major Leagues. One who did not is Kurt Lundgren, who pitched three seasons (1985-87) at Smith-Wills. In ’85, Lundgren, a New York native and lifelong New York Mets fan, won eight games, lost four and had a 3.29 earned run average and was named the Mets’ most outstanding pitcher.
But Lundgren was not your typical professional baseball pitcher. For one thing, he was only 5 feet, 10 inches tall and weighed all of 170 pounds with his spikes on. He did not throw hard. What’s more, Lundgren was an Ivy Leaguer, a graduate of Columbia where he majored in English. He was a voracious reader, who would just as soon talk about William Faulkner and Eudora Welty as how he had pitched that evening. I know. That’s often what we talked about in the Jax Mets club house.
When his baseball career ended in 1987, Lundgren, who had no money, had to decide how to make a living. He chose to become a lawyer and enrolled in the Mississippi College School of Law.
“I loved it in Mississippi,” Lundgren said Thursday after arriving in Jackson Wednesday night. “I loved the food and the people. I loved how laid back the lifestyle was. In three summers, I had made some good friends here. It seemed like the thing to do. No regrets here.”
After law school, he moved back to New York where he has become a successful litigator, a partner in a successful firm. When he heard about this weekend’s reunion, there was never a doubt.
“Of course I was coming,” Lundgren said. “I can’t wait to see all the guys and see all my Mississippi friends, both from baseball and law school. It’s funny, you know, when I walked off that plane last night, I think my blood pressure went down 20 points.”
House and Senate negotiators say they are still working to reach an agreement to restore the state’s initiative process that allows Mississippians to bypass the legislative process and place issues on the ballot for voters to decide.
Most of the focus as legislators strive to conclude the session either this weekend or early next week has been on developing a state budget and spending the bulk of $1.8 billion in federal COVID-19 relief funds. But negotiators said they are still working on fixing and restoring the initiative process that was ruled invalid this past May by the Mississippi Supreme Court.
When asked if a deal was still possible, Sen. John Polk, R-Hattiesburg, the lead Senate negotiator, replied “absolutely.”
Still, it appears the two sides are far from reaching agreement.
Both Polk and Rep. Fred Shanks, R-Brandon, the lead House negotiator, said the primary disagreement centers on the number of signatures needed to place an issue on the ballot. The House position is that the number of signatures should be equal to 12% of the people voting in the last gubernatorial election.
The Senate wants the number of signatures needed to place an issue on the ballot to be equal to 12% of the registered voters (not those voting) on the day of the last presidential election.
The required number of signatures of registered voters needed under the House plan would be about 100,000 while under the Senate proposal it would be about 240,000.
“I don’t see how a grassroots organization would be able to get that number of signatures,” Shanks said of the Senate proposal.
Polk said he supported the high number of signatures because “it makes sure more Mississippians (at the ballot box) care about the issue being presented.”
The state’s previous initiative process that was struck down by the state Supreme Court required the signatures equal to 12% of the voters from the last gubernatorial election. The Supreme Court struck down the proposal because the process required the mandated number of signatures to be gathered equally from the five congressional districts as they existed in 1990. The state lost a congressional seat in 2000.
The new language pending before the Legislature would require the signatures to be gathered equally from ever how many congressional districts the state has.
Both sides agree that the new proposal should allow voters to place issues on the ballot to change or amend general law. The initiative adopted in the early 1990s and that was struck down by the Supreme Court last year allowed voters to amend the state Constitution.
Legislative leaders said they would prefer the process be used to amend general law because it is more difficult to change the state Constitution. Changing the Constitution requires the approval of voters.
It is likely that any agreement also would prohibit legislators from changing any initiative approved by voters for two years except by a two-thirds vote of both chambers of the Legislature. Any compromise also might include language requiring initiative sponsors to detail how to pay for any proposal that will cost the state money.
The initiative process was struck down at the same time the medical marijuana initiative that was approved by voters in November 2020 was ruled invalid by the Supreme Court.
At the time House Speaker Philip Gunn asked Gov. Tate Reeves to call a special session the restore the initiative process. Reeves did not. Earlier this session legislators passed a bill legalizing medical marijuana but have been unable to agree on how to restore the initiative.
Any proposal passed by the Legislature to restore the initiative also must be approved by voters.
A Tupelo couple is suing a north Mississippi hospital and its affiliates over an alleged balance-billing scheme that cost them nearly $50,000.
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.
Though balance billing is illegal in Mississippi, it still happens, as many are still unaware of the state law.
In 2017, Chastity Woods needed dozens of non-elective medical treatments, including blood and iron transfusions, according to the lawsuit. She received these treatments from North Mississippi Medical Center (NMMC) in Tupelo and local clinics also owned by the hospital’s Delaware-based parent company, North Mississippi Health Services, Inc.
After receiving payment from Chastity’s insurer Health Cost Solutions, the providers returned to the Woods to demand nearly $50,000 in additional payments in 2018.
Unaware of Mississippi’s ban on balance billing, the Woods accepted a special “tax time deal” from the debt collectors in March 2019 that would reduce their bills by 20%. They then paid the bills by taking out a home equity line of credit, the suit states.
The Woods allege that the debt collector came back in October 2019 to demand an additional $8,936.05 – even after the Woods paid nearly $42,000 to the hospital and debt collector. The Woods allege that the debt collectors continued to harass them until they filed their lawsuit in Feb. 2020.
Chastity declined to speak to Mississippi Today for the story. Calls to their attorney were not returned. Bruce J. Toppin, chief legal officer at North Mississippi Health Services, told Mississippi Today that the company does not comment on pending litigation.
Though balance billing is against the law in Mississippi, some hospitals haven’t updated their business models since the law was passed, according to Roy Mitchell, executive director of the Mississippi Health Advocacy Program.
“We (Mississippi) have the highest rate of medical debt in the country. We have for years … And (balance billing) is all based on a business model that, unfortunately, some providers are still clinging to,” Mitchell said.
The ban on balance billing is largely toothless, with Insurance Commissioner Mike Chaney and Attorney General Lynn Fitch claiming they lack the statutory enforcement authority to take action against hospitals that break the law. This leaves patients like the Woods with no alternative to lengthy and costly lawsuits.
A legislative attempt to strengthen the balance billing law in 2019 would have required the attorney general’s office to enforce the law and establish binding arbitration to resolve any balance billing disputes between providers and patients. Though it was authored by then House Insurance Chairman Rep. Gary Chism, the bill never made it out of committee.
Chism told Mississippi Today in 2019 that lawmakers who were also medical professionals opposed the bill.
“They want to be able to get their money,” Chism said.
Because Chastity’s health insurance plan is not in NMMC’s network, the hospital would have received a higher reimbursement if she had used Stanley’s insurance, attorneys for the hospital say.
“The Woods took the cheap way out and wound up with significantly higher out-of-pocket costs as a result,” the attorneys wrote.
The Woods chose to use Chastity’s Health Cost Solutions plan instead of Stanley’s state employees plan because the former had a lower deductible. But Mississippi’s anti-balance billing doesn’t distinguish between types of networks. According to the law, as long as the provider accepts payment from the insurer, “the payment shall be considered payment in full to the provider, who may not bill or collect from the insured any amount above that payment, other than the deductible, coinsurance, copayment or other charges for equipment or services requested by the insured that are non-covered benefits.”
The Woods attorneys have argued that if the providers believed the reimbursement rates offered by Chastity’s insurer weren’t high enough, they could have refused to provide the non-emergency treatment or insisted the Woods find another way to pay. Instead, NMMC accepted at least 48 different payments from Chastity’s insurer, at 140% of the rate Medicare would have paid, the lawsuit alleges.
In addition to damages, the Woods are seeking a permanent injunction against NMMC issuing or attempting to collect balance bills.
