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How Medicaid expansion could have saved Tim’s leg — and changed his life

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How Medicaid expansion could have saved Tim's leg — and changed his life

Note: This article is part of Mississippi Today's ongoing Mississippi Care Crisis project. Read more about the project by clicking here.

Tim Floyd has never been one to sit still. 

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After being forced to leave community college to move home to Guntown to help his mom pay the bills, he landed a job driving a truck in his early 20s. But three or four years later, he was diagnosed with sleep apnea, a dangerous condition for professional drivers because it can lead to fatigue and slow reactions when driving. Just like that, his truck driving career was over.

The health insurance that job had provided him abruptly disappeared — and his has never been the same since.

“It made me no longer insurable to the truck, and that's what led me down the path of not being able to find a job with health insurance and not being able to afford (private) insurance with the jobs I had,” said Floyd, now 46 years old.

Since then, Floyd has been trapped in what is called the "health insurance gap": he doesn't qualify for Mississippi's strict and limited Medicaid program, and he doesn't have private health insurance from an employer. He can't afford a private plan himself. 

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Meanwhile, over the past five years, Floyd's serious health problems have mounted. He's been diagnosed with diabetes. He's lost part of his leg. He's battled cancer. He told Mississippi Today he's sure he has medical debt, but he tries not to think about it: the past few years have just been about surviving each day.

Floyd's conundrum is not unique in Mississippi. The state leads the nation in both rates of poverty and of uninsured people. Mississippi remains one of 12 states – and will likely soon be one of only 10 – not to accept federal dollars and provide health insurance to hundreds of thousands of , many of them working poor.

Studies, including one from the state economist, have shown expanding Medicaid would up to about 230,000 Mississippians making up to 138% of the federal poverty level, or about $30,000 in annual income for a family of three. Floyd would have been covered under expanded Medicaid during the years he worked as a cashier and other low wage jobs, but because Mississippi never expanded, he wasn't.

The study also showed the state would save anywhere from $186 million to $207 million from 2022 through 2027 and create thousands of jobs. 

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Medicaid expansion has also been associated with reductions in mortality in addition to declines in medical debt, which is highest in the South and in lower-income communities. 

But both Speaker of the House Philip Gunn and Gov. Tate Reeves remain unwaveringly opposed to expansion. 

“Extending Medicaid to people who can't afford health insurance would offer them and their families basic financial security to a healthy life, that includes preventative care. Mississippians shouldn't face financial ruin if they need health care or worry that a lack of preventative health care could cost them their lives,” said Roy Mitchell, executive director of the Mississippi Health Advocacy Program. 

After he lost the trucking job, Floyd then worked many other jobs – including multiple at one time – but never landed another that offered health insurance. 

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The combination of jobs wasn't enough to afford private insurance or pay out-of-pocket medical costs. So he remained uninsured and stopped going to the doctor. 

Six in 10 uninsured adults say they have postponed getting health care they needed due to cost, according to KFF. Uninsured adults are also more likely to report skipping recommended tests or treatment due to cost than adults with insurance. 

In 2012, that practice caught up to Floyd. He was working a construction job when a rock got stuck under his inside his boot and created a sore. He put some antibiotic ointment and a Bandaid on it and continued working. But six months later, the sore became infected and his foot swelled up. He used savings to go see a doctor, who referred him to a wound specialist. 

For the next five years, he battled that sore: he would treat it and stay off his feet for a month (which would sometimes cause him to lose whatever job he had at the time), the sore would heal, and he would go back to work. Then the whole cycle repeated again. 

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In 2017, a doctor suggested he have his blood sugar tested. So Floyd, again, dipped into his savings for a basic appointment and test. The results showed he was diabetic, and the sores were diabetic foot ulcers. The infection was now in his bones.   

There was only one option at that point: amputate his leg from the knee down. So again, just like that, his life changed. The charity program at North Mississippi Medical Center where he received his care covered the costs of the surgery, he said. Six months later, he was fitted for a prosthetic and began the process of rebuilding his strength and relearning how to do the things dear to him: basic things like walk, take care of the family's dog, play the drums. 

“It was hard. It was hard not only on me but on the people that cared about me,” he said. “Also, my emotional health wasn't all that great … It took me about another year (after getting the prosthetic) to be able to walk unassisted – no cane or walker or nothing. Then, just building –  going from being pretty active to being very sedentary to to get active again took me another year from that before I got my stamina back up to where I could work.”

Tim Floyd, left, listens as his father, Macky Floyd, plays the guitar at their home in Guntown, Miss., Friday, Nov. 4, 2022.

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The Tupelo hospital – a hub for health care and employment in north Mississippi – offers a financial assistance program for uninsured and underinsured like Floyd who need emergency or medically necessary care. The hospital and its subsidiaries spent over $190 million in fiscal year 2021 in charity care and uninsured discounts.

The hospital is situated in the district of Sen. Chad McMahan, a Republican who also lives in Floyd's same small hometown of Guntown. McMahan drew criticism from Republican counterparts in 2021 when he indicated he was willing to discuss Medicaid expansion “and look at what (it) might look like.”

Today, he still maintains he sympathizes with people who work but are uninsured. He says he's not for Medicaid expansion, per se, but does believe it should be discussed and that the health care system in Mississippi needs to be reformed.

“I think everything has to be on the table – whether or not we're going to have Medicaid enhancements or Medicaid expansion or if we're going to have a modernization of the way prices, menu prices, are put out from hospitals,” or how insurance companies operate, he said. 

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McMahan said he regularly speaks with administrators at the hospital that employs nearly 9,000 people. 

“For the hospital system I represent, they have annual salaries of half a a year and then an annual income revenue stream of 1 billion-plus. Last year, they gave away 19% in charity,” he said. “… It's unsustainable. In what other business can you give away 19% (and survive)?” 

Beyond the economics of Medicaid expansion and health care reform, McMahan, who grew up without health insurance as the son of a carpenter and a clerk, says he feels for Floyd and identifies with him.

“In the 9th grade I got hurt, and my parents didn't have insurance … I remember seeing the fear in my family's eyes and hearing discussions at the dinner table when my parents would be discussing what we were going to eliminate from the family budget that month to pay for the $20,000 hospital bill I had,” he said. 

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“I'm sympathetic to him (Floyd) because I was like that myself … If we're going to do any type of Medicaid overhaul, there has to be a work requirement. I'm not for anyone getting a public service unless they're in a position to contribute.”

Tim Floyd plays the djembe drum at a festival in Amory, Miss. in 2021.

Finally recovered from losing his leg, Floyd started submitting job applications again in 2020 – right as the U.S. began reporting its first COVID-19 cases and the country subsequently shut down. 

Floyd, still uninsured and ineligible for disability, discovered a knot on his neck. He went to the doctor and was diagnosed with an ear infection and prescribed antibiotics. Floyd said the doctor didn't mention any further testing. 

“You know, actually, most doctors that I've dealt with understand my situation. Because I am uninsured, they don't even bring that stuff (additional testing) up,” he said about. 

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Over the next year, the lump got bigger. He returned to the same doctor, who at that time recommended a biopsy. The biopsy, which the hospital's charity care program again covered, revealed he had stage II Hodgkin's lymphoma.

The oncologist told him if it had been diagnosed earlier, it would've been caught at stage I and required less rigorous treatment, he said.

He went through six weeks each of chemotherapy and radiation, which burned his vocal chords. Until now, his health conditions hadn't kept him from his musical talents: singing and playing the drums in a band called Proximity Rule. But for a while, he couldn't sing, and it was difficult to even speak.

Floyd, who has been in remission since May of 2021, is now on disability, which pays him about $800 a month. The cancer and amputated leg didn't qualify him for the government assistance – but the later addition of a severe carpal tunnel diagnosis did. 

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Looking back, he says, the logic of state leaders who have refused to expand Medicaid is baffling. 

“It would make a lot more sense to find people like me … and (give) them Medicaid for a short period of time to get back healthy so they can continue working and continue providing for their family ….,” he said. “Because if they don't have health insurance, they don't go to the doctor and get seen, eventually they're gonna be just like me, and we're on the hook for them for the rest of their life.”

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

Mississippi Today

Pro-Palestinian protest at University of Southern Mississippi ends without confrontation

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mississippitoday.org – Molly Minta – 2024-05-07 16:57:17

HATTIESBURG — A pro-Palestinian protest at the University of Southern Mississippi ended after an hour, with the roughly 50 students and faculty who silently held signs facing no counter-protesters or arrests — a sharp contrast to the demonstration five days earlier at the University of Mississippi. 

According to a social media post, the ad hoc group, called USM for Palestine, were calling on the university to divest if it is invested in Israeli companies, echoing demands made by students across the country in the wake of the Israel-Hamas War. A university spokesperson said information about USM's investments would not be available by press time. 

“All members of the University community conducted themselves peacefully and respectfully,” Nicole Ruhnke wrote in an email. 

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It marked the second pro-Palestine protest at a Mississippi university since students at Columbia University set up an encampment about two weeks ago with protests touching over 40 campuses across the country. On May 2, broke up a similar protest at the University of Mississippi after some 200 of mainly white, male counter-protesters heckled, chased and threw food-related items at pro-Palestinian students. 

of the Ole Miss protest went viral, and the university has said it is investigating the conduct of at least one student. The Phi Delta Theta fraternity expelled from membership a student who was filmed making monkey noises at a Black female student protester. 

At USM, there are significantly less Greek students, but the specter of what could happen seemed to haunt campus . About 20 minutes before the protest was slated to start, the university police chief, Rusty Keyes, was already patrolling Shoemaker Square, the campus free-speech zone.

Keyes pulled aside a legal observer from the to say the students would only be allowed to protest for an hour because they had not followed university policy.

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“Now, I'm not happy with them,” Keyes told the legal observer. “They have to go by the rules. I have the ability to (approve) time, manner and place, okay? … That's my authority, off the policy.”

“If we're going to do this … it's going to be right there so I can protect them,” he added, gesturing to a patch of grass next to a brick building to the side of the square. “There's a lot things they could've done to make it a lot easier on theirselves (sic). And the policy works with them. But they're doing everything in their power to work against it. If they would just work, they can have everything they want. But they gotta go by the policy. That's why policies and laws are in place. It's to protect everybody. And I'm going to make sure everybody is protected.” 

Rusty Keyes, University of Southern Mississippi's chief of police, issues instructions to pro-Palestine protesters at the University of Southern Mississippi in Hattiesburg, Miss., on Tuesday, May 7, 2024. Credit: Eric Shelton/Mississippi Today

Then Keyes asked how many people were going to show up, before gesturing at a photographer on of the fountain. 

“They called this photographer, they called that photographer,” he said, “and that shows right there — I mean, what's your intent, you know?” 

“Their intent is just to exercise their free speech,” the legal observer replied. 

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“I hope so,” Keyes said. “I hope so. I want to that for them. But they've got to go by my instructions for their safety, okay? And then this ends at 1 o'clock, okay? By 1 o'clock. And they gotta disperse.” 

When Mississippi Today tried to to Keyes, he said he wasn't commenting for the university and asked a reporter to delete her recording. 

A few feet away, Sirena Cantrell, the dean of students, stood with her arms crossed. Student groups aren't typically allowed to hold events during finals, she noted, so the protest wasn't fair. And she was concerned that what happened at Ole Miss could happen at USM, especially because the police were stretched thin preparing for graduation. Since the protest was silent, she hoped it would be pointless to counter-protest. 

“We had actually asked the group not to do this, cause of finals weeks,” she said.

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Cantrell added she had tried to talk with a student from USM for Palestine, but it wasn't productive, which was, she added, “unfortunate.” 

“I didn't really have a discussion with her,” Cantrell said. “I just told her the policy, and she said ‘okay,' and then I never heard from her again.” 

By 12 p.m., officers had stationed themselves at all four corners of the fountain. Police cars blocked off the sidewalks to prevent people from walking too close to the protesters. 

Students wearing keffiyehs began to trickle in, holding signs that said “Save Gaza,” “Nothing Justifies Genocide” and “Humanity Above .” After speaking to Keyes, they shuffled over to the grass. 

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The protest was so silent, chirping birds could be heard over the fountain. So could the laughter of a group of mostly male students who stood to the side. 

University of Southern Mississippi students gather at the university's Shoemaker Square during a pro-Palestine protest at the campus in Hattiesburg, Miss., on Tuesday, May 7, 2024. Credit: Eric Shelton/Mississippi Today

“Because if Israel sees their signs, they'll stop shooting at Palestine,” one of the students said to snickers. He wore a blue ball cap, a gray shirt and gave his name as Tim, then “Binky.” 

Rumors about the protest had been all over social media, “Binky” said, and he had been looking forward to it. But so far, he was disappointed. 

“I kind of wanted it to be wild,” he said. “I was excited to watch them look stupid.” 

“I think there's no sense in yelling at each other, though,” responded his friend, who wouldn't give his name. Cantrell, he added, had told them “we can't raise havoc, just like they (the protesters) couldn't.” 

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“The stuff at Ole Miss got taken too far,” another added. “It was funny but like, some of the shit was way too far.” 

The protest was only supposed to last an hour, someone else said, and they all started laughing again. 

“That's gonna stop what's going on over there,” he said. “An hour of sign holding.” 

The silent protest was an attempt to follow university policy and avoid replicating the confrontational atmosphere of Ole Miss' protest, said Willem Myers, a 22-year-old social work major who was acting as USM for Palestine's spokesperson. 

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A protester holds a pro-Palestine sign during a protest at the University of Southern Mississippi in Hattiesburg, Miss., on Tuesday, May 7, 2024. Credit: Eric Shelton/Mississippi Today

Though they hadn't anticipated the Keyes' restrictions, Myers noted the mood was calmer than at a protest he attended at Tulane University in New Orleans, where police broke up an encampment and arrested 14 people, including him. Myers had to get permission to leave the city, where he lives, to be on campus that morning for an exam. 

The goal was to support Palestinians, said Myers, who is Jewish. He disagrees with the idea that Israel “speaks for or is in the best interest of the Jewish people.”  

“What we're seeing overwhelmingly from people who are on the frontlines and who are in Rafah is that they are emboldened by and given hope by the actions of student protesters throughout the world right now,” he said. “The fact is that we don't exist in a vacuum, we're not an island here at USM or in Mississippi. We're part of the larger U.S. imperialist , and we are firmly standing against it … to have it on record that USM students do not stand with the ongoing genocide and violence against Palestinians.” 

At 1 p.m., the protest was over. Students clapped briefly, then started packing up. 

As police watched, a white student in a blue shirt walked up to them. He asked what “the rules” were and why he wasn't allowed to talk to the protesters, “because it's a public university.” 

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“If you want to communicate with them, wait till they leave,” Keyes responded. “We just want to keep this area safe.” 

Though the student, a 23-year-old finance major who declined to give his name, was friends with the group that was making jokes, he said he actually wanted to have an open dialogue with the protesters. He would've liked to ask what their “end goal” was. 

He said he already knew their answer would be a ceasefire, but he wasn't sure that was possible in the Middle East where, he said, “it's built into their culture not to like each other.” 

But it's like that here, too, he said. In America, political beliefs are becoming more polarized due to “Big Tech” and misinformation. Though he identifies as a conservative, is in a fraternity and plans to vote for Donald Trump, the student said he also opposes the military industrial complex — but where else, except for a protest like this, would he have an opportunity to actually talk with people on the other side? 

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“I guess I do,” he said, when asked if he agreed with the protesters. “I guess I do, in a way. I think I saw a big sign that said ‘‘ceasefire.' Yeah, I do agree with that. I agree with a ceasefire. Of course. Why would I want more people to die?” 

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

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Mississippi Today

State revenue is sluggish, but interest from federal COVID-19 money is buoying budget

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Mississippi is collecting enough money to fund the current year's budget passed by the in 2023 — largely due to interest earnings on federal money — but tax collections remain sluggish.

April's revenue, just released by the staff of the Legislative Budget Committee, was $6.87 million or 0.65% over the estimate. But actual tax collections were $1.3 million below the estimate.

The reason total revenue for April was above the estimate is the interest earnings the is garnering on its surplus money. For the month of April, interest earnings were $8.2 million above the estimate, thanks to the unprecedented amount of surplus money largely from federal COVID-19 spending and because of high interest rates.

Through April, the first 10 months of the fiscal year, interest earnings are $93.4 million above the estimate. Interest earnings are more than half of the total collections above the estimate of $185.8 million for the year.

For the fiscal year to date, revenue is .39% or $24.7 million above the previous year. Without interest earnings, the state would be collecting less revenue that it did the previous year.

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The sluggish collections for April was released just as the Legislature was finalizing a budget for the upcoming fiscal year, which begins July 1.

For the upcoming fiscal year, the budget, all state funds, will be $7.28 or $583.2 million more than was budgeted for the current fiscal year. That number excludes the use of surplus funds to pay for one-time construction projects throughout the state.

Kindergarten through 12th grade education will $246 million or 8% of the increased funds while universities will receive an additional $60.8 million or 7.5% more than they received for the current year. Community colleges will receive an additional 18% or $53 million.

The Legislature is in an unusual position of being able to make record expenditures even as revenue collections appear to be slowing, thanks, in large part to COVID-19 relief funds and other federal funds.

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But many legislative said during the just completed that they will continue to monitor collections that could impact budgeting in future years if the trend continues.

For the year, state income taxes are down $131.2 million or 6.6%. That, according to state Economist Corey Miller, is attributed at least in part to the $525 million income tax cut that currently is being phased in over a four-year period. Sales tax collections are up $71.7 million or 3.2%.

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

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Mississippi Today

Ex-Mississippi sheriff admits lying to the FBI

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mississippitoday.org – Jerry Mitchell and Ilyssa Daly – 2024-05-07 11:40:49

As sheriff, Terry Grassaree stoked fear into the citizens of Noxubee County by imitating his idol, wrestler “Stone Cold” Steve Austin.

On Tuesday, the 61-year-old former enforcement officer spoke in a soft voice to District Judge Daniel P. Jordan III as he pleaded guilty to lying to the FBI when he denied that he made a jailed woman take and share sexually explicit photos and of herself.

He faces up to five years in prison and a $250,000 fine when he is on Aug. 7.

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Assistant U.S. Attorney Kimberly Purdie told District Judge Daniel P. Jordan III that Grassaree lied to an FBI agent on July 13, 2020, about making a woman behind bars take and share nude photos and videos in exchange for favorable treatment, which included making her a jail trusty.

After she texted the photos from a contraband cell phone, he responded, “Butt is great” and “Body looks perfect.”

Standing next to his attorney, Abram Sellers of Jackson, Grassaree admitted all of what Purdie had said was true.

Grassaree was also charged with destroying evidence and wire fraud. If he had pleaded guilty to all of his charges, he could have faced up to 90 years in prison.

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But his story goes far beyond what the former sheriff pleaded guilty to on Tuesday.

The Mississippi Center for Investigative at Mississippi and The New York Times highlighted Grassaree in its series, “Unfettered Power: Mississippi Sheriffs,” which showed how sheriffs can rule like kings in rural counties. They answer to no one and typically face little press or prosecutorial scrutiny.

The investigation published April 11, 2023, revealed that the allegations of wrongdoing against Grassaree have been far more wide-ranging and serious than his federal charges suggest. The investigation included a review of nearly two decades of lawsuit depositions and a previously undisclosed by the Mississippi of Investigation.

At a minimum, the documents detail gross mismanagement at the Noxubee County jail in Macon that repeatedly put female inmates in harm's way. At worst, they tell the story of a sheriff who operated with impunity, even as he was accused of abusing the people in his custody, turning a blind eye to women who were raped and trying to cover it up when caught.

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Over nearly two decades, as allegations mounted and Noxubee County's insurance company paid to settle lawsuits against Grassaree, prosecutors brought no charges against him or others accused of abuses in the jail. A federal investigation dragged on for years and finally led to charges in fall 2022.

In a 2020 lawsuit, Elizabeth Layne Reed accused two deputies, Vance Phillips and Damon Clark, of coercing her into having sex. She said the men gave her a cellphone and other perks in exchange for sexual encounters inside and outside the jail. Deputies even put a sofa in her cell.

According to her lawsuit, Grassaree knew all about his deputies' “sexual contacts and shenanigans,” but the sheriff did nothing to “stop the coerced sexual relationships.” 

Grassaree has previously denied any knowledge of what his deputies were doing. “Are you a boss?” he asked. “Do your employees tell you everything they do?”

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Instead of intervening, the lawsuit alleged, the sheriff “sexted” her and demanded that she use the phone the deputies had given her to send him “a continuous stream of explicit videos, photographs and texts” while she was in jail. She also alleged in the lawsuit that Grassaree touched her in a “sexual manner.”

The lawsuit was settled for an undisclosed amount.

No date has been set for the sentencing of one of those deputies, Phillips, who pleaded guilty last year to bribery, which experts say could have been the perks the woman says she received. Prosecutors asked for his sentencing to be postponed “pending a resolution of another criminal matter,” an obvious reference to Grassaree's case.

The other deputy, Vance, wasn't charged. “I never coerced Reed into sex,” he wrote in his response to the lawsuit, but he never answered whether he had sex with her.

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Under Mississippi law, it is a for officers to have sex with those behind bars, and the felony carries up to five years in prison.

Nearly two decades ago, Grassaree faced allegations of rape inside the jail that he supervised and lawsuits claiming that he covered up the episodes. At least five people, one of his fellow deputies, accused him of beating others or choking them with a police baton.

In 2006, after Grassaree and his staff left jail cell keys hanging on a wall, male inmates opened the doors to the cell of two women inmates and raped them, according to statements the women gave to state investigators. One of the women said Grassaree pressured her to sign a false statement to cover up the crimes, according to the state police report.

About a year later, in a lawsuit, four people who had been arrested gave sworn statements accusing Grassaree of violence. Two of the people said he choked or beat them while they were in his custody. A third said he pinned her against a wall and threatened to let a male inmate rape her.

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All told, at least eight men — including four deputies and Grassaree himself — have been accused of sex abuse by women inmates who were being held in the Noxubee County jail while Grassaree was in charge.

Now, 18 years after a woman first said that he pressured her to lie about being raped, the former sheriff faces possible prison time.

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

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