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Millions were supposed to go to Mississippi’s hospitals. Getting that money will be difficult for most, and impossible for others

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What should have been a lifeline for Mississippi's struggling hospitals is proving to be out of reach for the facilities that need it the most. 

State lawmakers approved sending millions of dollars to save Mississippi's struggling hospitals during the session, but now many hospital are running into difficulties trying to access that money.

A third of Mississippi's rural hospitals are at risk of closure — many of them were counting on the state grants to survive the year. 

Legislators in February established the grant program, part of Lt. Gov. Delbert Hosemann's plan to “save rural hospitals,” in lieu of expanding Medicaid. A month later and just days before the end of the legislative session, they decided on the amount: $103 million to be disseminated among the state's struggling providers.

It was millions less than the Mississippi Hospital Association had advocated for — despite a $4 billion surplus in the state budget — but health care leaders said they would take what they could get.

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Hospitals were allocated varying amounts through a formula that accounted for bed counts, hospital designation, emergency rooms and other factors.

But there was a hitch — the money wouldn't come from the state general fund. Instead, it would come from funds, federal money meant to ease the financial hits taken by the pandemic. 

Timothy H. Moore is the President/CEO of the Mississippi Hospital Association. Credit: Vickie D. King/Mississippi

MHA director Tim Moore, whose organization helped craft the program, said it wasn't clear then how much the source of the money would affect hospitals' ability to access it.

“I think the felt that it would not be a problem … to get the money out,” he said. “We were looking at them actually cutting grant checks to the hospitals. When ARPA money was applied, that changed the whole thing.”

ARPA funds can only be used to cover COVID-related expenses, and many hospitals have already claimed those federal pandemic reimbursement dollars. Expenses claimed through ARPA cannot have been claimed under any other federal and state reimbursement programs, rendering the grant money useless to many Mississippi hospitals.

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According to Paul Black, CEO of Winston Medical Center in Louisville, that makes the grant bill more of a reimbursement bill.

“I don't know who came up with the bright-eyed idea to use ARPA money, if they did, they definitely did not understand what that meant to this program,” he said. 

“It's just extremely frustrating that one of the pieces of the legislation … is one thing and the appropriations is something completely different. I don't understand how they can do that, I really don't.”

Both Hosemann and Gov. Tate Reeves, who sent out a release emphasizing his role in the program's passage, declined to comment about the grant situation.

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House Public Health Chair Sam Mims, author of House Bill 271 which funded the program, did not respond to a request for comment.

Senate Medicaid Chairman Kevin Blackwell, author of Senate Bill 2372 which established the program, deferred questions about hospitals' issues with the grant program to state Health Officer Dr. Daniel Edney. 

The state health department is tasked with distributing the funds, and because it's now tied to federal ARPA funds, has to work with the state department of finance and administration to do so, Edney said.

During the bill , Edney said the health department pointed out the pitfalls of using the ARPA money.

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“Federal money … doesn't take up state resources from other places,” he said. “The downside is it has to follow federal guidelines versus state general funds.”

One of those downsides has already become clear: The allocation based on hospitals' number of licensed beds has been struck, on account of federal guidelines. That means hospitals, if they get money at all, will definitely be getting less than expected. 

Sen. Hob Bryan, D-Amory, expresses his concerns about a potential state lottery during a special session of the Legislature at the Capitol in Jackson Thursday, August 23, 2018. Credit: Eric J. Shelton, Mississippi Today/ Report for America

Senate Public Health Chair Hob Bryan said he's received questions about the grant program from hospital officials and others, and that he still doesn't have all the answers.

“I've asked questions, and I'm still confused,” Bryan said. “I with A, and A says one thing, then I talk with B, and B says something else.”

“I think there's a lot of confusion over whether a hospital would have to have already spent money on COVID expenses and can be reimbursed, or whether they can spend in the future. One of the things I've been told is that if you are improving things at your hospital to deal with COVID, or to prepare for the next COVID, then you will be eligible under the regulations.

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“Hospitals' reactions appear to be, ‘That's all well and good, but I'm going broke and this says I can spend more money and get reimbursed, but that doesn't me right now,'” Bryan continued.

Bryan said he believes questions and confusion about the program are in part because of the hasty, secretive process Mississippi legislative leaders have used to set budgets in recent years.

“We do everything in secret, and then put it all together at the last minute,” Bryan said. “Transparency, like say, in conference committees and the rest of the process might help, in that issues like this could be identified and addressed before it's passed. Discussing these things more in the open could provide better results … Of course, we had the House refusing to negotiate on this or anything else because they were holding out for tax cuts, then they tried to do everything in the last 36 ½ minutes.”

Black agreed that hammering out funding details at the last-minute likely contributed to this oversight — an oversight that'll have grave consequences for state's hospitals.

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“We got all these legislators that are patting themselves on the back for doing something for the hospitals,” Black said. “When it out, they didn't do anything. At least for us to get what was promised in the Senate bill is not what is taking place now.”

Some of the state's larger hospitals might be able to get their hands on some of the money. But it's less likely that the state's smaller, rural hospitals, who are in much more dire financial straits, will be able to.

“The whole intent of this was to help small rural hospitals,” Moore said. “That's going to be much more of a challenge.”

Winston Medical Center was set to receive a little less than a million through the grant program. Because of the funding complications, the hospital actually won't get anything at all.

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“Unless the Department of Health comes up and finds out some way to get around some of the issues … as things sit right now, there's no avenue for us to claim any money,” Black said.

The money would've been enough to cover about a month's worth of payroll, Black said, but in the larger scheme of things, it would've helped Winston stay open until the end of the year and staunch the “slow bleed.”

Winston, though, is in a far more stable financial state than many other rural hospitals.

Before the grant money and a big credit line approval, Greenwood Leflore Hospital was weeks from shutting down. It's not clear how the new developments will affect its financial viability.

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Greenwood Leflore Hospital's interim CEO Gary Marchand discusses the challenges facing the hospital at Greenwood Leflore Hospital in Greenwood, Miss., Tuesday, February 14, 2022. Credit: Eric J. Shelton, Mississippi Today

Gary Marchand, the hospital's leader, said it was too early in the process to answer Mississippi Today's questions, but said he believes the complications caused by the ARPA funding will just slow down when the hospital will receive its allocation.

“We understand MSDH is moving quickly,” Marchand said.

Hospitals can apply for the money during a one-month window that starts June 1. Edney said once a hospital's application is approved, he's hoping to get the money over immediately.

However, Black is more cynical about the reality of the situation.

“That's what they said when they passed the bill back in April, and now it's the end of May going into June,” Black said. “If anybody gets it by September, it'll be a miracle.”

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Unless a special session is called to address the funding issue, Moore and Black are looking toward the next legislative session for help. They're hoping that most hospitals survive until then and that state leaders come around to seeing the economic advantages to expanding Medicaid in Mississippi, which would bring millions of dollars to the state's hospitals.

“The analogy I keep thinking about is Charlie Brown, Lucy and the football,” Black said. “Lucy the ball for Charlie Brown to kick, and at the last minute, she pulls it back. He falls on his rear end.

“That's what this has been like.”

Reporter Geoff Pender contributed to this story.

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This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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Mississippi Today

Veiled accusations fly in hearing over disappearance and death of Jackson man

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mississippitoday.org – Mina Corpuz – 2024-04-30 16:18:14

Following a contentious hearing Tuesday in the disappearance and of a Jackson man, a Hinds County judge said he intends to keep an injunction in place until the state can complete an autopsy. 

Chancery Court Judge Dewayne heard arguments Tuesday morning in a to determine who will decide what happens to the remains of Belhaven Heights resident Dau Mabil and whether an independent autopsy can happen. 

Mabil, 33, disappeared March 25, and three weeks later, his body was found over 50 miles away in the Pearl in Lawrence County. 

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The day that a preliminary autopsy determined that the body was that of Mabil, his brother, Bul, filed the lawsuit against Mabil's wife, Karissa Bowley, and state investigators: the Capitol Police and the State Lab. None of the defendants said they were notified of the April 18 hearing when Thomas entered the emergency temporary restraining order and preliminary injunction. 

Lisa Ross, Bul Mabil's attorney, right, answers questions from the media after a court hearing about Dau Mabil's death investigation at the Hinds County Chancery Court in Jackson, Miss., on Tuesday, April 30, 2024. Credit: Eric Shelton/

Bul Mabil and his attorneys have raised suspicions about what led to Dau Mabil's death, and they argue that an independent autopsy is the only way to be certain there was no foul play – contrary to what the Lawrence County sheriff has said. U.S. Rep. Bennie Thompson has requested the Justice Department investigate.

On Tuesday, that led to pointed questions by Bul Mabil's attorney Lisa Ross to Bowley, who testified for nearly two hours. 

Ross' questions included implications about whether Bowley or some of her family members  had something to do with Mabil's disappearance, introduction of text message evidence showing that the had fought and spent a few days apart in the weeks leading up to him going missing. 

The questioning culminated when Paloma Wu, who is representing Bowley, asked if she killed Mabil or knew who did, and Bowley said no.

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Karissa Bowley, left, is consoled after a court hearing concerning the investigation of the death of her husband, Dau Mabil, at the Hinds County Chancery Court in Jackson, Miss., on Tuesday, April 30, 2024. Credit: Eric Shelton/Mississippi Today

Ross also asked Bowley other reasons why her husband went missing, including past arguments they had, money, whether Mabil was suicidal and why she didn't accompany him on March 25. 

Throughout testimony, Wu made multiple objections to Ross' questioning, asking about how they were relevant, saying they were hearsay and they should be stricken from the record. Judge Thomas most of the questions. 

“This has become a performance for free-wheeling defamation,” Wu said about the attorney's questioning. “This is not a murder trial against Karissa.” 

To date, there has been no evidence of foul play and nobody has been criminally charged. 

Bowley said she would have agreed to an independent autopsy if Bul Mabil had just asked, and she would have preferred the family to have a conversation rather than having to go to court.  

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Multiple times, Ross asked Bowley if she would agree to make the results of the state's autopsy public and to allow an independent autopsy on Mabil's body.

“I have no reason not to,” Bowley replied. 

In court filings, Bul Mabil argued he should be considered the next of kin who can make decisions about his brother's body rather than his brother's wife. Wu said the state is clear that a surviving spouse takes precedence as next of kin over siblings and other descendants. 

After the hearing, Ross said her questions highlight how there is no Mississippi case law that defines who counts as a surviving spouse. In other states, she found that courts have ruled that an estranged or separated spouse does not count as next of kin. 

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A motion by Capitol Police and the State Crime Lab filed late last week asks the judge to dismiss the temporary restraining order and lawsuit complaint. 

Thomas said he plans to issue an order Thursday to address pending motions and issues raised in the hearing, and he said he will release a separate order addressing Bowley's request to be added as a plaintiff. 

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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Mississippi Today

The Pulse: Mississippians rally for full Medicaid expansion

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Rev. Reginald Buckley joined hundreds of , clergy, and from over 35 communities at the Capitol in for a “Full Expansion Day” rally, urging legislators to expand coverage under the federal Affordable Care Act on Tuesday, April 16, 2024.

READ MORE: ‘A matter of life and death': Hundreds rally at Capitol for full Medicaid expansion

Mississippi health news you can't get anywhere else.

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This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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Mississippi Today

Senate ushers in new college board appointees with few questions asked about higher education

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mississippitoday.org – Molly Minta – 2024-04-30 11:53:38

Hearings for new members of the governing board of Mississippi's public universities last week were in a small, out-of-the-way room on the fourth floor of the Capitol that does not have live-streaming capabilities. 

Senate committee meetings are usually on YouTube, a point of pride for the chamber where lawmakers occasionally mock the Mississippi House for not doing the same. 

But the failure to broadcast the hearings for Gov. Tate Reeves' nominees to the Institutions of Higher Learning Board of Trustees means there is no way for students, faculty or staff who could not make it to to observe the proceedings to know what occurred, even as, according to multiple senators, the meeting was standing-room-only. 

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This is noteworthy because the IHL Board meetings are pro forma; the 12 trustees almost always vote in lock-step and rarely discuss policy proposals during regular open meetings in Jackson. The Senate has advise-and-consent power on the governor's nominees, so its confirmation hearings are one of the few times trustees, who serve nine-year terms, must take questions from representatives of the public. 

Though Reeves' four nominees were asked by Sen. Nicole Boyd, R-Oxford, the chair of the Senate Colleges and Universities Committee, about why they wanted to serve on the IHL board, multiple senators told Mississippi Today they could not recall, or did not ask, the appointees any questions about higher education issues. The nominees were confirmed by the full Senate with no questions on Sunday afternoon. 

The committee hearing occurred on April 23 at 1 p.m. in room 407, a small room tucked away in a corner of the fourth floor observation balcony, behind a scanner, a security guard, an assistant's desk and a sign that says “NO ADMITTANCE Senate Staff Only.” 

Room 407 on the fourth floor of the Capitol Building where a Senate committee spoke with Gov. Tate Reeves' four nominees to the Institutions of Higher Learning Board of Trustees on April 23, 2024. Credit: Molly Minta/Mississippi Today

“I really don't think I thought about how it didn't have live-streaming capabilities,” said Boyd, who is also a Senate conferee embroiled in the contentious Medicaid expansion negotiations. “There wasn't anything sinister about it.” 

Boyd added that before the committee hearing, she and the chair of the House Colleges and Universities Committee had interviewed the four nominees. She said she was excited about the different experiences the new trustees would bring to the board. 

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“Our committee really wants to work closely with the college board and the community college board,” Boyd said. “I wish there were cameras in there because it's more of an intimate setting. I would like to have more meetings in there … just because the room is small and you're around the table.”

New IHL board member Jerry Griffith, a retired IRS agent who previously served on the Gaming Commission, said he was even confused if the hearing was public or private when he was contacted by Mississippi Today. 

“Please forgive me, I'm not trying to be ugly or anything, but I'm so new to the board,” Griffith said. “I'm not sure if I can share anything.” 

Griffith said he would be happy to chat with Mississippi Today after he made some calls, but he did not respond to further inquiries. Charlie Stephenson, the president of the Mississippi Bulldog Club Board of Directors, and Don Clark, an attorney at Butler Snow, did not respond to Mississippi Today's requests for comment. 

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The final new board member, Jimmy Heidelberg, an attorney from , said he did not know all the committee members, but that Boyd and several other senators asked him about his education and professional experience. 

“She just said we've all got your information and your background, is there anything else you want to add or ask me and I said, ‘well, it was pretty thorough,'” Heidelberg recalled, adding that he told the committee he was also concerned with Mississippi's declining population of college-aged residents. 

“I said, ‘we need the best universities that we can have to keep kids home,'” he added. 

Heidelberg was not asked about any policies he would support to achieve that goal, and he said he wouldn't speak on that because he is not yet familiar with the board's inner workings. 

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Mississippi Today asked if he supported the proposal from State Auditor Shad White to defund college degrees that don't contribute to the state's

“I don't know specifically what you're talking about, but I think everybody would share if you go to college and study and achieve a degree, hopefully you will out to be a contributing citizen with a skill that you can support yourself and your on,” he said. “That's the point of education.” 

This session, a failed effort to rename Mississippi University for Women threw a spotlight on the ailing enrollment of the state's regional colleges. Lawmakers introduced several controversial proposals to reduce the number of public universities in the state, prompting outcry, particularly from supporters of Mississippi's historically Black public universities — Jackson State University, Alcorn State University and Mississippi Valley State University. 

Now, just one graduate of those three universities will sit on the IHL board after the Senate confirmed Reeves' nominees. Griffith's background report shows he graduated from Delta State University and had attended Jackson State, Boyd said. 

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But senators barely, if at all, asked the nominees questions about higher education, multiple sources told Mississippi Today. 

“I really didn't have that many questions, and I don't remember that many questions being asked of really any of them,” said Sen. Scott DeLano, R-Biloxi. 

That's not the purpose of these hearings, DeLano added. He noted Room 407 was so packed, extra chairs had to be brought in. The presidents of Mississippi State University and Delta State University were in attendance.  

“Generally speaking, we don't get into that kind of stuff,” DeLano said. “It's very rare, unless it was a reappointment, but other than that, you don't want to catch somebody off guard or flat-footed on an issue they do not have … background information to understand why we're asking.” 

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The hearings are more about affirming the nominees' backgrounds, multiple senators said, after an investigation by the legislative watchdog. Boyd asked the nominees why they wanted to be on the IHL board. 

Sens. Nicole Boyd, R-Oxford (left) and chairman Kevin Blackwell, during discussions on the cost of Medicaid expansion at a public meeting held at the state Capitol, Tuesday, April 23, 2024. Credit: Vickie D. King/Mississippi Today

“We got a really good sense of who they are and what they're going to bring to the college board, and I'm appreciative of people of that caliber, who could go sit and retire, giving back because the college board takes a ton of time,” Boyd said. 

The last time the Senate used its power to reject an IHL appointee was in 1996 when it repeatedly turned down four of Gov. Kirk Fordice's nominees: Hassell Franklin of Houston, Ralph Simmons of Laurel, John McCarty of Jackson and Tom McNeese of Columbia. The four nominees were later confirmed in a special session.

“We want to have some general idea of where someone stands,” DeLano said, “but for the most part those boards are supposed to be independent, and they're supposed to be subject-matter experts.” 

Sen. Briggs Hopson, R-Vicksburg, said he couldn't recall much of the meeting because it is the busiest time of year for him. Like other senators who spoke with Mississippi Today, he complimented the accomplishments of two of Reeves' nominees: Clark, the attorney for Butler Snow, and Heidelberg, the Pascagoula attorney, who both graduated from University of Southern Mississippi before attending the University of Mississippi School of Law. 

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“I don't remember exactly, and I don't know what questions were asked,” Hopson said. “I know I complemented two of the nominees that I've known … My experiences with them have always been positive.”

DeLano said that he had worked with Heidelberg on insurance policies affecting the Mississippi Coast. Boyd recalled that Clark and Griffith discussed the enrollment cliff that will uniquely affect the regional colleges. 

“We've got to make sure that we're progressively and actively managing that and that we're helping our regional universities make sure that they have strong enrollment numbers and growing enrollment numbers,” Boyd said. 

Ultimately, the meetings are more about jumpstarting a working relationship than they are fact-finding missions, DeLano said. After the committee wrapped, he said he spoke with Clark about public-private partnerships, because it is relevant to a bill this session that would authorize IHL to enter into a long-term lease agreement on behalf of the University of Mississippi. The bill died in conference yesterday.

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“It just gives me a good to shake hands with whoever those people are and look them in the eye and tell them I look forward to working with them in my role,” DeLano said. “I've seen some committee meetings where they might get partisan on this issue. I don't care about partisanship as much as I care about their willingness to dive deep into the issues and try to understand the totality of the duties that they have.” 

Sen. Sollie Norwood, D-Jackson, concurred. He said he did not ask the new trustees any questions but that he hopes to meet with them later this summer to discuss issues pertaining to the HBCUs, mainly the end of the Ayers settlement, which was meant to redress the IHL's historically underfunding of those institutions, and IHL's presidential selection process. 

“I want to let them get a chance to get in and get familiar with it and then we can have those conversations,” he said. 

Multiple committee members did not return inquiries from Mississippi Today or declined to comment, : Sen. John Polk, Sen. Daniel Sparks, Sen. Josh Harkins,Sen. Alfred Butler and Sen. Tyler McCaughn. 

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“I am away from the Capitol and I suggest you call the committee chairwoman Senator Nicole Boyd,” Sen. Walter Michel wrote in a text. 

“I wouldn't be the one to talk to,” wrote Sen. Joel Carter, also over text. “I was late due to negotiations on a conference report. I know there weren't very many questions.”

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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