Mississippi Today
‘Mississippi chose to fight’: Court overturns Justice Department efforts to overhaul state’s mental health system
A dozen years after the Department of Justice first sent Mississippi a letter detailing shortcomings in its mental health system, the state may have finally beaten the federal agency.
A federal appeals court ruled Tuesday that a district judge erred in determining that the Mississippi mental health system violated the civil rights of adults with serious mental illness and in imposing a remedial order that required the state to expand a range of services, from crisis response to supported housing.
The Department of Justice sued the state in 2016, arguing the failure to provide mental health services that people could access in their communities resulted in them being involuntarily committed to state hospitals for treatment over and over again. U.S. District Judge Carlton Reeves sided with the DOJ in 2019, and in 2021 approved the remedial order and appointed a monitor to evaluate the state’s compliance.
The conservative three-judge panel at the United States 5th Circuit Court of Appeals overturned all of that. The panel found that the DOJ’s claim that adults with serious mental illness in Mississippi were “at risk” of institutionalization was not sufficient to prove discrimination under the Americans with Disabilities Act.
“The possibility that some un-named individual with serious mental illness or all such people in Mississippi could be unjustifiably institutionalized in the future does not give rise to a cognizable claim under Title II [of the Americans with Disabilities Act],” Judge Edith Jones wrote for the panel. “Nor does such a vague and standardless theory license courts under the ADA to rework an entire state’s mental health system.”
In a statement, Wendy Bailey, executive director of the Department of Mental Health, said the agency would continue working to expand community services and decrease hospitalizations.
Credit: Eric Shelton/Mississippi Today
She said that over the last decade, the department has shifted legislative funding from the state hospitals to the community mental health centers. The state’s 11 regional centers are supposed to provide routine therapy and medication as well as intensive outpatient services for people with very serious mental illness. They also operate crisis stabilization units that can provide short-term inpatient treatment instead of state hospitals.
The department plans to use federal American Rescue Plan Act funds to continue expanding services. All of those funds must be spent by the end of 2026.
Bailey also said the department would continue to share data on the new services, which had been required by the remedial order.
A spokesperson for the Department of Justice declined to comment. It’s unclear whether the agency will appeal the decision.
Megan Schuller, legal director at the Bazelon Center for Mental Health Law, said other federal appeals courts have agreed that people who are “at risk” of unnecessary institutionalization can bring a claim under the ADA (the Fifth Circuit panel also cited those decisions in a footnote).
“It’s sort of a perverse approach, to say that… if you know that you are at serious risk of institutionalization, that you can’t challenge that until you’re already institutionalized and have suffered the harm,” she said of the Fifth Circuit panel’s ruling.
Are community services available?
In recent years, the state rolled out additional mobile crisis services and intensive treatment teams across the state. These services are run by the community mental health centers, which are certified by DMH but operate independently.
The most recent report by the court-appointed independent monitor, Michael Hogan, concluded that “foundational elements” like funding of services and data reporting were in place, but people were not always able to access care when they needed it and some still wait in jail without charges for treatment.
“The structural aspects of change have been addressed, but the system is not yet working for all people the way it should,” Hogan wrote.
Some of the data DMH has gathered so far indicates wide variance in services across the community mental health centers.
For example, some of the intensive treatment teams served fewer than half the number of clients they had capacity to treat in the first three quarters of fiscal year 2023, according to data Mississippi Today obtained through a public records request. One with the staff to serve 90 people actually treated just 36.
The services are supposed to help people access treatment so they don’t need to be hospitalized through the civil commitment process.
A recent Mississippi Today/ProPublica investigation found that from 2019 through 2022, at least 2,000 people were jailed without charges while they awaited evaluation and treatment through the state’s civil commitment process. Local chancery court officials and law enforcement said they wanted to place those people in crisis stabilization units for treatment, but that the facilities are often full or reject people because they are too “violent,” have a medical issue or need a higher level of care.
The state has expanded Crisis Stabilization Unit beds from 128 in 2018 to 180 today, with plans to open more.
Adams County Sheriff Travis Patten, who testified during the 2019 trial, said the CSU that opened in his area in 2021 hasn’t reduced the number of people held in his jail during the civil commitment process because the facility refused to admit them except in rare circumstances.
In late August, Lacey Handjis, a 37-year-old mother, died in Patten’s jail while detained there – with no criminal charges – during civil commitment proceedings. Her death is under investigation by the Mississippi Bureau of Investigation.
Patten said the Fifth Circuit ruling was “disheartening.”
“I’m not pointing the finger at anyone saying it’s their fault, but I am saying that you are judged by how you treat the least of them, and this state can do a lot better in terms of the treatment that is offered and supplied to our mental health consumers,” he said.
Advocates in Mississippi expressed disappointment with the ruling.
Polly Tribble, executive director of Disability Rights Mississippi – the state’s protection and advocacy agency for people with disabilities – said in a statement that Mississippians with mental illness are still unnecessarily institutionalized.
“If Mississippi was making improvements to its mental healthcare system, as the state has claimed, in conjunction with the order, why did the state feel the need to appeal?” she said. “Shouldn’t it be everyone’s hope that people with mental illness are receiving the care they need in the best environment for positive outcomes, no matter who is dictating it?”
Melody Worsham, a certified peer support specialist who lives with a mental illness and testified at the 2019 trial, said she worries that without federal oversight, the Legislature won’t be willing to continue funding expanded mental health services.
“My educated gut right now talking to you is that that’s what they’re gonna do in the Legislature: ‘We don’t have to do this anymore,’” she said. “‘The court case isn’t here anymore, so we can do whatever we want. I don’t want to fund that anymore. We’re just going to reduce the budget and you’ll just have to figure it out.’”
National implications?
The Department of Justice suit in Mississippi was one of dozens of actions the agency has taken to enforce the “integration mandate” of the ADA established by the U.S. Supreme Court in Olmstead v. L.C. In that case, the nation’s highest court ruled that institutionalizing people and depriving them of the chance to live in their communities constitutes discrimination. The Justice Department has relied on that precedent to sue states to force them to provide community services for people with mental illness.
At the Fifth Circuit, Mississippi argued that the remedial order “raises fundamental federalism problems by permitting the district court and the United States to micromanage a State’s mental-health system.”
Mississippi Department of Mental Health Board Chairman Stewart Rutledge said in a statement that those lawsuits had overstepped.
“Mississippi chose to fight,” he said. “And we fought for our citizens who desperately need mental health services. Conversely, the US Department of Justice spent the last twenty years bleeding mental health systems nationwide in bare pursuit of a win. Mississippi took a huge risk standing up to this bullying, but with this victory, Mississippi – and the rest of the states – can put their full resources back toward serving our fellow citizens in need.”
The Attorney General’s Office, which argued the case at the Fifth Circuit, said the lower court’s ruling “gave the federal government the ability to dictate the way Mississippi provides mental healthcare to its citizens” and cheered its overturning.
Joy Hogge, executive director of Families As Allies, pointed out that the district court’s requirements for the Department of Mental Health were substantially similar to what the department proposed. The state’s response to the lawsuit “was about Mississippi making it clear that the federal government can’t tell it what to do,” she said.
“That being said, there are more services in place than there were, and DMH has set up a system to monitor them,” she said. “I hope all that continues.”
Schuller, the legal director for the Bazelon Center, pointed out that the ruling is controlling only in the Fifth Circuit.
The Department of Justice could request a rehearing by all the judges of the Fifth Circuit.
It could appeal to the United States Supreme Court, but a loss there could have major ramifications for the enforcement of the ADA around the country.
“There’s a danger in any litigation and I would certainly say looking at the court right now, disability rights advocates and Olmstead litigators would oppose DOJ appealing that to the Supreme Court,” Schuller said. “I would certainly hope that they would not.”
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
Hospitals see danger in Medicaid spending cuts
Mississippi hospitals could lose up to $1 billion over the next decade under the sweeping, multitrillion-dollar tax and policy bill President Donald Trump signed into law last week, according to leaders at the Mississippi Hospital Association.
The leaders say the cuts could force some already-struggling rural hospitals to reduce services or close their doors.
The law includes the largest reduction in federal health and social safety net programs in history. It passed 218-214, with all Democrats voting against the measure and all but five Republicans voting for it.
In the short term, these cuts will make health care less accessible to poor Mississippians by making the eligibility requirements for Medicaid insurance stiffer, likely increasing people’s medical debt.
In the long run, the cuts could lead to worsening chronic health conditions such as diabetes and obesity for which Mississippi already leads the nation, and making private insurance more expensive for many people, experts say.
“We’ve got about a billion dollars that are potentially hanging in the balance over the next 10 years,” Mississippi Hospital Association President Richard Roberson said Wednesday during a panel discussion at his organization’s headquarters.
“If folks were being honest, the entire system depends on those rural hospitals,” he said.
Mississippi’s uninsured population could increase by 160,000 people as a combined result of the new law and the expiration of Biden-era enhanced subsidies that made marketplace insurance affordable – and which Trump is not expected to renew – according to KFF, a health policy research group.
That could make things even worse for those who are left on the marketplace plans.
“Younger, healthier people are going to leave the risk pool, and that’s going to mean it’s more expensive to insure the patients that remain,” said Lucy Dagneau, senior director of state and local campaigns at the American Cancer Society.
Among the biggest changes facing Medicaid-eligible patients are stiffer eligibility requirements, including proof of work. The new law requires able-bodied adults ages 19 to 64 to work, do community service or attend an educational program at least 80 hours a month to qualify for, or keep, Medicaid coverage and federal food aid.
Opponents say qualified recipients could be stripped of benefits if they lose a job or fail to complete paperwork attesting to their time commitment.
Georgia became the case study for work requirements with a program called Pathways to Coverage, which was touted as a conservative alternative to Medicaid expansion.
Ironically, the 54-year-old mechanic chosen by Georgia Gov. Brian Kemp to be the face of the program got so fed up with the work requirements he went from praising the program on television to saying “I’m done with it” after his benefits were allegedly cancelled twice due to red tape.
Roberson sent several letters to Mississippi’s congressional members in weeks leading up to the final vote on the sweeping federal legislation, sounding the alarm on what it would mean for hospitals and patients.
Among Roberson’s chief concerns is a change in the mechanism called state directed payments, which allows states to beef up Medicaid reimbursement rates – typically the lowest among insurance payors. The new law will reduce those enhanced rates to nearly as low as the Medicare rate, costing the state at least $500 million and putting rural hospitals in a bind, Roberson told Mississippi Today.
That change will happen over 10 years starting in 2028. That, in conjunction with the new law’s one-time payment program called the Rural Health Care Fund, means if the next few years look normal, it doesn’t mean Mississippi is safe, stakeholders warn.
“We’re going to have a sort of deceiving situation in Mississippi where we look a little flush with cash with the rural fund and the state directed payments in 2027 and 2028, and then all of a sudden our state directed payments start going down and that fund ends and then we’re going to start dipping,” said Leah Rupp Smith, vice president for policy and advocacy at the Mississippi Hospital Association.
Even with that buffer time, immediate changes are on the horizon for health care in Mississippi because of fear and uncertainty around ever-changing rules.
“Hospitals can’t budget when we have these one-off programs that start and stop and the rules change – and there’s a cost to administering a program like this,” Smith said.
Since hospitals are major employers – and they also provide a sense of safety for incoming businesses – their closure, especially in rural areas, affects not just patients but local economies and communities.
U.S. Rep. Bennie Thompson is the only Democrat in Mississippi’s congressional delegation. He voted against the bill, while the state’s two Republican senators and three Republican House members voted for it. Thompson said in a statement that the new law does not bode well for the Delta, one of the poorest regions in the U.S.
“For my district, this means closed hospitals, nursing homes, families struggling to afford groceries, and educational opportunities deferred,” Thompson said. “Republicans’ priorities are very simple: tax cuts for (the) wealthy and nothing for the people who make this country work.”
While still colloquially referred to as the One Big Beautiful Bill Act, the name was changed by Democrats invoking a maneuver that has been used by lawmakers in both chambers to oppose a bill on principle.
“Democrats are forcing Republicans to delete their farcical bill name,” Senate Democratic Leader Charles Schumer of New York said in a statement. “Nothing about this bill is beautiful — it’s a betrayal to American families and it’s undeserving of such a stupid name.”
The law is expected to add at least $3.3 trillion to the nation’s debt over the next 10 years, according to the most recent estimate from the Congressional Budget Office.
This article first appeared on Mississippi Today and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.
The post Hospitals see danger in Medicaid spending cuts appeared first on mississippitoday.org
Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.
Political Bias Rating: Center-Left
This article reports on the negative impacts of a major federal tax and policy bill on Medicaid funding and rural hospitals in Mississippi. While it presents factual details and statements from stakeholders, the tone and framing emphasize the harmful consequences for vulnerable populations and health care access, aligning with concerns typically raised by center-left perspectives. The article highlights opposition by Democrats and critiques the bill’s priorities, particularly its effect on poor and rural communities, suggesting sympathy toward social safety net preservation. However, it maintains mostly factual reporting without overt partisan language, resulting in a moderate center-left bias.
Crooked Letter Sports Podcast
Podcast: The Mississippi Sports Hall of Fame Class of ’25
The MSHOF will induct eight new members on Aug 2. Rick Cleveland has covered them all and he and son Tyler talk about what makes them all special.
Stream all episodes here.
This article first appeared on Mississippi Today and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.
The post Podcast: The Mississippi Sports Hall of Fame Class of '25 appeared first on mississippitoday.org
Mississippi Today
‘You’re not going to be able to do that anymore’: Jackson police chief visits food kitchen to discuss new public sleeping, panhandling laws
Diners turned watchful eyes to the stage as Jackson Police Chief Joseph Wade took to the podium. He visited Stewpot Community Services during its daily free lunch hour Thursday to discuss new state laws, which took effect two days earlier, targeting Mississippians experiencing homelessness.
“I understand that you are going through some hard times right now. That’s why I’m here,” Wade said to the crowd. “I felt it was important to come out here and speak with you directly.”
Wade laid out the three bills that passed earlier this year: House Bill 1197, the “Safe Solicitation Act,” HB 1200, the “Real Property Owners Protection Act” and HB 1203, a bill that prohibits camping on public property.
“Sleeping and laying in public places, you’re not going to be able to do that anymore,” he said. “There’s a law that has been passed that you can’t just set up encampments on public or private properties where it’s a public nuisance, it’s a problem.”
The “Real Property Owners Protection Act,” authored by Rep. Brent Powell, R-Brandon, is a bill that expedites the process of removing squatters. The “Safe Solicitation Act,” authored by Rep. Shanda Yates, I-Jackson, requires a permit for panhandling and allows people to be charged with a misdemeanor if they violate this law. The offense is punishable by a fine not to exceed $300 and an offender could face up to six months in jail. Wade said he’s currently working with his legal department to determine the best strategy for creating and issuing permits.
“We’re going to navigate these legal challenges, get some interpretations, not only from our legal department, but the Attorney General’s office to ensure that we are doing it legally and lawfully, because I understand that these are citizens,” he said. “I understand that they deserve to be treated with respect, and I understand that we are going to do this without violating their constitutional rights.”
Wade said the Jackson Police Department is steadily fielding reports of squatters in abandoned properties and the law change gives officers new power to remove them more quickly. The added challenge? Figuring out what to do with a person’s belongings.
“These people are carrying around what they own, but we are not a repository for all of their stuff,” he said. “So, when we make that arrest, we’ve got to have a strategic plan as to what we do with their stuff.”
Wade said there needs to be a deeper conversation around the issues that lead someone to becoming homeless.
“A lot of people that we’re running across that are homeless are also suffering from medical conditions, mental health issues, and they’re also suffering from drug addiction and substance abuse. We’ve got to have a strategic approach, but we also can’t log jam our jail down in Raymond,” Wade said.
He estimates that more than 800 people are currently incarcerated at the Raymond Detention Center, and any increase could strain the system as the laws continue to be enforced.
“I think there’s layers that we have to work through, there’s hurdles that we are going to overcome, but we’ve got to make sure that we do it and make sure that my team and JPD is consistent in how we enforce these laws,” Wade said.
Diners applauded Wade after he spoke, in between bites of fried chicken, salad, corn and 4th of July-themed packaged cakes. Wade offered to answer questions, but no one asked any.
Rev. Jill Buckley, executive director of Stewpot, said that the legislation is a good tool to address issues around homelessness and community needs. She doesn’t want to see people who are homeless be criminalized, but she also wants communities to be safe.
“I support people’s right to self determine, and we can’t impose our choices on other people, but there are some cases in which that impinges on community safety, and so to the extent that anyone who is camping or panhandling or squatting and is a danger to themselves and others, of course, I fully support that kind of law. I don’t support homelessness being criminalized as such,” Buckley said.
Many of the people Wade addressed while they ate Thursday said they have housing, don’t panhandle, and shouldn’t be directly impacted by the legislation. But Marcus Willis, 42, said it would make more sense if elected officials wanted to combat the negative impacts of homelessness that they help more people secure employment.
“There ain’t enough jobs,” said Willis, who was having lunch with his girlfriend Amber Ivy.
The two live in an apartment together nearby on Capitol Street, where Ivy landed after her mother, whom Ivy had been living with, suffered a stroke and lost the property. Similarly, Willis started coming to eat at Stewpot after his grandmother, whose house he used to visit for lunch, passed away.
Willis holds odd jobs – cutting grass, home and auto repair – so the income is inconsistent, and every opportunity for stable employment he said he’s found is outside of Jackson in the suburbs. The couple doesn’t have a car.
Making rent every month usually depends on their ability to find someone to help chip in, said Ivy, who is in recovery from substance abuse. She said she’s watched problems surrounding homelessness grow over the years in Jackson. Ivy grew up near Stewpot and has lived in various neighborhoods across the city – except for the times she moved out of state when things got too rough.
“There was just moments where I just had to leave,” Ivy said. “Sometimes if you hit a slump here, there’s almost no way for you to get out of it.”
This article first appeared on Mississippi Today and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.
The post 'You're not going to be able to do that anymore': Jackson police chief visits food kitchen to discuss new public sleeping, panhandling laws appeared first on mississippitoday.org
Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.
Political Bias Rating: Center-Right
This article primarily reports on new laws in Jackson, Mississippi, targeting public sleeping, panhandling, and squatting, focusing on statements by Police Chief Joseph Wade and community perspectives. The coverage presents the legislative measures—authored by Republican and independent lawmakers—with a tone that emphasizes law enforcement challenges and community safety, reflecting a conservative approach to homelessness as a public order issue. While it includes voices concerned about criminalization and the need for social support, the overall framing centers on law enforcement and property protection. The article maintains factual reporting without overt editorializing but leans slightly toward a center-right perspective by highlighting legal enforcement as a solution.
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